Trends in the diversity of board-certified pathologists in the United States.

Medicine has historically excluded several marginalized groups, including but not limited to women and people of color. A lack of diversity is an injustice to those excluded from the field and adversely affects the patients we serve. We obtained de-identified demographic data from the American Board of Pathology to examine the diversity of the 39,124 US pathologists certified from its founding through 2024. We focus on pathologists certified since 2006, when continuing certification was introduced and data are most complete. Female representation has steadily increased, with 53% of pathologists certified since 2006 identifying as female compared to 27% of pathologists certified earlier. Nonbinary individuals represent 0.04% of active pathologists. Among active pathologists certified in 2006 or later, 89% identify as White or Asian, and 92% identify as non-Hispanic/Latino/Spanish origin. We observed much lower female representation in clinical pathology only (39%) compared to anatomic only (52%) and anatomic and clinical (54%). Representation varies across subspecialties, with the lowest female representation in clinical informatics (25%). This work demonstrates a substantial improvement in female representation among recently certified pathologists, but the overall proportion of women with active certification remains under 50%, and women are underrepresented even among recently certified pathologists in some subspecialties. Several racial and ethnic groups (American Indian or Alaska Native, Black or African American, and Hispanic/Latino) remain severely underrepresented. This work highlights the continued need to recruit and retain a diverse workforce and ensure that all pathologists have equitable access to the full range of career trajectories in our field.