Evaluating the Impact of Formal Dermatopathology Fellowship Training on Practice Patterns and Characteristics Among Dermatologists Submitting Claims for Medicare Pathology Examinations in 2017.

Objective: Dermatopathology training is incorporated into dermatology residency programs, yet some individuals choose to pursue additional fellowship training in dermatopathology. We sought to characterize the impact of dermatopathology training on practice patterns of dermatologists performing pathology exams in the Medicare population.

Methods: We conducted a cross-sectional review of the 2017 Medicare Public Use File to identify all residency-trained dermatologists performing microscopic pathology exams in 2017. Formal dermatopathology fellowship training was identified through the American Board of Medical Specialties website.

Results: There were 2,150 dermatologists performing pathology examinations in 2017; of these, 592 (27.5%) had formal dermatopathology fellowship training. Fellowship training was associated with a higher mean annual pathology exam volume. Those without fellowship training were more likely to practice in the West, in non-academic settings, and in non-metropolitan counties.

Limitations: Residency-trained pathologists are not included in the sample. Additionally, some dermatopathology labs may submit claims as an entire organization, rather than at the level of each physician.

Conclusion: Fellowship-trained dermatopathologists perform pathology exams at a higher rate than their non-fellowship-trained colleagues and are concentrated in academic practice settings. The findings support the important role of fellowship-trained dermatopathologists in evaluating a wide array of skin pathologies.