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Career Path and Fellowship Opportunities
Clinical informatics is a subspecialty that collaborates with other healthcare and information technology professionals to promote safe, efficient, effective, timely, patient-centered and equitable patient care. Pathologists who specialize in clinical informatics (also known as pathology informaticists or pathology informaticians) serve as medical directors for laboratory information systems and/or the laboratory components of electronic health records (EHRs). In addition, they lead, oversee, and support technological advances in all areas of the laboratory for improvements in patient care. Residents who are interested in pursuing clinical informatics as a specialty need to have a strong desire to improve patient care through the integration of people, information, and technology. With the tsunami of artificial intelligence and machine learning, pathology departments are more eager than ever to hire pathologists with clinical informatics expertise.
While pathologists generally comprise 1% of the overall physician population in the United States, they currently make up over 7% of the board-certified clinical informaticists. This speaks to the importance of clinical informatics to the pathology specialty. Pathologists who are board-certified in clinical informatics often serve their institutions by leading innovation in the use of pathology and laboratory data and related resources.
Are you interested in pursuing clinical informatics?
Clinical Informatics Fellowship Training
Clinical Informatics is a two-year fellowship co-sponsored by the American Board of Pathology (ABP) and the American Board of Preventive Medicine (ABPM). The fellowship prepares trainees for leadership in diverse informatics disciplines, including health information systems management, clinical data analytics, machine learning/AI applications in medicine, and process improvement in patient care. Because of its unique nature, clinical informatics is a subspecialty that’s open to physicians who have completed ACGME-accredited training in any of the 24 current primary specialties (eg, surgery, family medicine, and others).
Clinical informatics is an ACGME-accredited fellowship, and its fellowship programs can be housed within any medical specialty. Some programs are housed within pathology, and those that are housed in non-pathology departments frequently have pathologists on faculty, often serving as fellowship program directors. Regardless of the setting, all trainees are required to take the same board exam on the same topics. This ensures they all meet a consistent standard of knowledge in clinical informatics, which benefits both their careers and the healthcare system through their leadership.
Just like any other specialty, each clinical informatics fellowship has its own unique culture, as well as its own strengths and weaknesses with regard to the experiences that it provides to fellows. All candidates are advised to research the list of available fellowships and to apply to those that will provide the experiences and culture that they feel will be best for their overall training and future career goals. The College of American Pathologists (CAP) has listed programs below which are known to be housed in a pathology department, have a pathologist as program director, or otherwise have a strong pathology and laboratory medicine informatics component. If you know of programs which should be added to this list, please contact the CAP Informatics Committee.
There are currently two pathways for trainees to become certified in clinical informatics. A candidate may sit for board certification after successful completion of a two-year ACGME-accredited clinical informatics fellowship. For any physician planning to take two fellowships, this second pathway can take the form of an integrated training experience in which clinical informatics and another fellowship program are taken together. This typically shortens the training duration by one year by taking advantage of clinical informatics’ natural compatibility with other specialties for research and the individualized curriculum components of both fellowships. Such integrated training must be pre-approved by the respective medical boards for each fellowship in order for the fellow to sit for both board examinations.
The second pathway is the practice pathway. This allows candidates to sit for board certification after demonstrating specified contributions and working in the field without undertaking an ACGME-accredited clinical informatics fellowship. At a minimum, candidates must have either been practicing in clinical informatics for at least 25% of a full-time equivalent (FTE) for a minimum of three years, or have completed a master’s or PhD in biomedical informatics that meets certain criteria specified by the ABPM. This pathway will expire in 2025.
Frequently Asked Questions
Pathology informaticists often serve as medical directors for laboratory information systems (LIS), other systems relevant to laboratory operation, or the laboratory components of the organization’s electronic health record (EHR). The relationship with technical teams mirrors the relationship of a laboratory section medical director with the supervisor and medical technologists in that section. The pathology informaticist may establish and review laboratory IT procedures, review and accept testing results for new systems and communication interfaces, review monitoring results for appropriate operation, and help consult on IT problems. Pathology informaticists are frequently involved in organization-level quality improvement projects, system implementations and evaluations, clinical decision support changes, and test improvements that involve the laboratory or pathology. In a broader sense, pathology informaticists seek to implement, effectively maintain, and improve laboratory operations and quality through information technology and usability that enhance the diagnostic capabilities of all physicians and the value of laboratory reports and test results. Pathologists with clinical informatics training and certification can and do have positions in organizational and informatics leadership.
There is actually a shortage of informatics specialists and at the same time a growing demand for their services. While many pathology programs support only one pathology informaticist, the opportunities are constantly growing and are expected to increase as the use of AI in medicine rises. Most clinical informaticists provide patient care through another specialty in conjunction with their informatics practice; this has the dual added benefit of embedding informaticists in clinical workflows and also providing revenue-generating services for the organization.
Informatics interacts with all specialties across the health care system, including surgical, inpatient, ambulatory, acute care, and more. It collaborates with professionals from various fields to optimize the use of technology and data in patient care, from developing improvements in EHR systems to enhancing communication and information exchange between different departments. Because pathology data are used by all specialties, pathology informaticists have the potential to take advantage of all these relationships and work with all specialties.
Pathology informaticists also frequently get involved in the development of national and international standards, the creation or enhancement of technologies to improve patient care, and the development of systems to make patient care safe, inclusive, and equitable. In these environments, interaction with other medical specialties is not only frequent but critical to ensure the best possible outcomes.
Yes. The American Medical Informatics Association (AMIA), the Association for Pathology Informatics (API), the Association for Molecular Pathology (AMP) Informatics Subdivision, and Digital Pathology Association (DPA).
It’s unusual for pathology informaticists to interact directly with patients. However, the practice of clinical informatics can improve systems that impact thousands of patients at one time. Informaticists have an important role acting as advocates for both patients and physicians with respect to information system design, report design, and compliance with important data regulations such as security and privacy.
- What aspects of informatics are performed by physician informaticists at the institution (eg, analytics, software design, information system builds, AI, etc)?
- How much access are fellows granted to actively participate in the informatics operations?
- What is the background of prospective mentors at the organization? How much and what kind of laboratory and pathology experience do they have?
- What skills are emphasized in the program, and will they be broadly useful for your intended career path?
- What is the overall quality of interaction with prospective mentors?
- Is the informatics service generalized to the entire hospital, nested within pathology, or nested in another subspecialty?
A list of clinical informatics programs which are either housed within a pathology department, have a program director who is a pathologist, or have a strong pathology informatics component are listed below.
- University of Illinois College of Medicine at Chicago Program
- McGaw Medical Center of Northwestern University Program
- Massachusetts General Hospital/Brigham and Women's Hospital Program
- Mayo Clinic College of Medicine and Science (Rochester) Program
- Methodist Hospital (Houston) Program
- Baylor College of Medicine Program
- University of Texas Health Science Center San Antonio Joe and Teresa Lozano Long School of Medicine Program
- ACGME website: The most current list of ACGME-accredited clinical informatics fellowship programs is on the ACGME website. For a full list of CI programs, type “clinical informatics” in the search bar and choose each department that displays to pull all the programs within each specialty. Unfortunately, this site does not offer a single page or search to get all the programs, but it is the most up-to-date because all active accredited programs are registered with the ACGME.
- American Medical Informatics Association (AMIA) Clinical Informatics Fellowship List: AMIA houses the Clinical Informatics fellowship match, so they also have a single search where you can find appropriate programs. Pick “CI Fellowship” from the Program Type drop-down list.
Look for a mentor during your informatics rotation. If you don’t have easy access to informatics mentors at your residency program, try to find an away rotation with a strong informatics presence. Look for posters and abstracts from past informatics conferences to see different areas of research, and align this with what is of interest to you. Reach out to fellowship program directors to ask about their programs. Look for pathologists serving on the various CAP committees which include and are under the Council on Informatics and Pathology Innovation (CIPI). CIPI is the CAP’s newest council and is charged with overseeing strategy on current and emerging medical information science, data science, and computational technologies that could impact the practice of pathology. Within CIPI, there is also an Informatics Committee. Pathology residents are eligible to serve on CAP Committees. Residents interested in clinical informatics should apply to become Junior Members of CIPI or one of its committees. It’s an excellent way to network and to find out everything that’s going on within the pathology informatics space.
Under CIPI’s umbrella, there are the following committees:
Being on call is typically reserved for direct patient care activities, which most pathology informaticists perform in addition to their clinical informatics duties, but unexpected situations with information systems, cyberattacks, go-lives of large systems, and other events will often require pathology informaticists to work additional hours. When deploying new systems which create enhancements for the organization, pathology informaticists have the advantage of being embedded in these amazing improvements, and this can be extremely satisfying professionally.