Pathology: Fellowship Application

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 [email protected].

Applying To

Area of concentration for surgical subspecialty
Have you previously applied to a Fellowship Program at Memorial Sloan Kettering?

Please specify which program(s).

Area of concentration for surgical subspecialty

General Information

What sex were you assigned at birth?
Place of Birth

Contact Information

Current Address


Permanent Address


Work & Visa Information

Are you authorized to work in the United States of America?
Do you require a visa?

USMLE Test Scores

Please provide your test scores below.

Degrees & License

Select Degree(s)

Board Eligibility

Board Status
In what area(s) are you, or will you be board eligible?

Current/Most Recent Pathology Training Program

(Primary Hospital)
Did you successfully complete this training program?
Actual or Expected End Date

Additional Pathology Training Program

(Primary Hospital)
Did you successfully complete this training program?
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

Please Answer the Following Questions

1. Have you ever had any disciplinary/remedial action or investigation taken against you by any state/regulatory agency, administrative body/professional organization.
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).
2. Have you ever been involved as a witness or named as a party in any medical malpractice actions?
3. Do you have pending against you any medical malpractice actions or are you currently a witness or scheduled to be a witness in any medical malpractice actions?
4. Have you ever been convicted of committing an act constituting a crime, including driving under the influence (DUI), or driving while intoxicated (DWI)?
This includes any criminal misdemeanor convictions.
5. Have you ever voluntarily or involuntarily relinquished your license, registration or certification to practice medicine?
This includes any relinquishment of license, registration or certification that occurred during an investigation or under threat of official or institutional proceedings.
6. Have you ever voluntarily or involuntarily left, been separated from, or resigned from a training program or medical staff position?
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.
7. Have you ever voluntarily or involuntarily agreed to a limitation or reduction of your clinical privileges at another hospital, health care facility or in relation to a health professions training program?
8. Have you ever voluntarily or involuntarily left or resigned, been terminated from or been disciplined at, a job or training position because of inadequate performance, unprofessional conduct or any disruptive or violent behavior?
9. Are you currently in the practice of engaging in the unlawful use of drugs or the abuse of alcohol?
10. Has your use of prescription drugs, alcohol or other substances ever impaired or limited, or is it currently impairing or limiting, your ability to practice medicine with reasonable skill and safety?
11. Do you have any physical or mental condition that prevents you from practicing medicine with reasonable skill and safety?