Impact of the hidden curriculum and unprofessionalism on medical student specialty choice.

The hidden curriculum in medical education refers to implicit lessons not formally taught, including specialty hierarchies, stereotypes, and misconceptions. Pathology, in particular, is often subject to derogatory comments and the perception that communication skills and patient care are wasted in this specialty. This study explored pathology residents' experiences with the hidden curriculum and its impact on medical student education. A survey was administered to pathology trainees to assess demographic trends and specialties associated with positive or negative perceptions of pathology and included free-text responses. Most respondents reported encountering negative remarks about pathology, spanning all levels of training and practice. Reactions to a declared interest in pathology were typically neutral or discouraging. Certain specialties were consistently identified as sources of both positive and negative perceptions. Free-text responses revealed recurring themes: negative views of pathology included concerns about job market instability, low prestige and compensation, potential replacement by artificial intelligence, and stereotypes of pathologists as socially withdrawn. Positive views highlighted work-life balance and intellectual rigor. Many respondents noted that expressing interest in pathology led to being belittled or receiving less educational attention. These findings underscore harmful aspects of the hidden curriculum and unprofessional behavior within medical education. In an era of multidisciplinary care, it is concerning that physicians would disparage other specialties and compromise medical student education in response to a student's planned career choice. Strategies are needed to bring attention to and to break this vicious cycle.