Pathology: Fellowship Application

Fellowship Requirements

  • Fellows must have completed their basic training, either AP or AP/CP, with at least two years of AP training in an accredited program in the US or Canada or have completed a general pathology residency training program in their country of residence (for International Breast Pathology Fellowship.)
  • All fellows must be eligible to obtain a New York State license or limited permit.

About This Application

  • This application has 24 sections with a total of 92 questions.
  • Estimated Time to Complete: 1 hour.
  • This application does not allow you to save and continue at a later time. If this is of concern to you, please see information in the sidebar on this page about free, third- party software that can perform this function.
  • You will have the opportunity to preview your application before submitting. Use this opportunity to make your text as readable as possible, ie, fix line breaks, etc.

What You Will Need

  • Curriculum Vitae
  • Personal Statement (of no more than 750 words)
  • Names of 3 References
  • Citations from your published journal articles, abstracts, poster presentations, and chapters
  • Telephone number of your current residency program if you are still in training
  • USMLE Scores

You will need to “cut and paste” from these documents into our application. Text that exceeds stated limits will be truncated. We advise that you convert your CV and personal statement to ASCII text format before cutting and pasting. This will help insure that we receive your application in the most readable format. Do not “hit” refresh while completing this form. Your data will be lost.

If you have questions, email

Applying To

If "yes", please specify which program (s).

General Information

Contact Information

Ex. 999-999-9999
Ex. 999-999-9999
Ex. 999-999-9999

Current Address

Permanent Address

Work & Visa Information

USMLE Test Scores

Please provide your test scores below.

Degrees & License

Board Eligibility

Current/Most Recent Pathology Training Program

(Primary Hospital)
Actual or Expected End Date

Additional Pathology Training Program

(Primary Hospital)
Actual or Expected End Date

Medical School

Graduate School

Undergraduate School

European candidates, please indicate a N/A in this field.

Additional Education Information

Employment Information

Research Experiences

List in chronological order with start and end dates.

Honors & Awards

Include dates of awards and honors.


Example of Required Format:
Smith RJ, Jones GK, Calloway AL. Therapeutic implications of the new biology. N Engl J Med. 2004 Aug 5;351(6):575-84.

Abstracts/Poster Presentations, Etc.

Other Activities & Interests

Language Skills

Personal Statement

Letters of Recommendation

(last name, first name)

Please Answer the Following Questions

This refers to actions/investigations in connection with your practice of medicine or participation in a health profession's training program. This includes any such actions or investigations currently pending and any previous or currently pending charges to professional licensure or registration, (e.g., state or district; Drug Enforcement Administration).
This includes any criminal misdemeanor convictions.
This includes any relinquishment of license, registration or certification that occurred during an investigation or under threat of official or institutional proceedings.
This includes any circumstances in which your participation in a multi-year program or position was ended prior to the end of the complete program or position.