International medical graduates representation in pathology academic workforce, departmental leadership and society leadership.

Compared with the overall physician workforce, pathologist workforce in the United States has significant representation of international medical graduates (IMGs). IMG representation in the academic pathology workforce, as well as in departmental and pathology societal leadership, has not been documented. In this cross-sectional study, we surveyed a sample of 20 North American academic pathology departmental publicly available websites. Each faculty was recorded according to the location of their medical school training as either US or Canadian medical graduateor IMG (country of medical school graduation any other than US or Canada). Past and present presidents of four major North American pathology societies [American Society for Clinical Pathology (ASCP), Association for Academic Pathology (AAPath), College of American Pathologists (CAP), United States and Canadian Academy of Pathology (USCAP)] were also recorded. A total of 1455 pathologists were retrieved in our search: 924 (63.5 %) were USCMGs and 531 (36.5 %) IMGs. Likewise, 65 % of pathology chairs were USCMGs and 35 % IMGs. These data mirror the 2022 Association of American Medical Colleges distribution in the pathology workforce (65.6 % USCMGs and 34.4 % IMGs). In contrast, historic data from 1993 to 2024 show that only 8 (8 %) past or current presidents of the major US pathology societies were IMGs (USCAP = 6, ASCP = 1, AAPath = 1, CAP = none). While the academic pathology community has proportional representation of physicians based on location of their medical school training, there is historical underrepresentation of IMGs in societal leadership. Unveiling the causes of this disparity and identifying any potential obstacles for faculty engagement is paramount.