There are a number of career paths in Laboratory Medicine and several clinical practice models for the discipline. This article summarizes the state of current training at the medical student and residency/post-graduate levels, emphasizing practice in the U.S., and the challenges of education in the discipline to meet the needs of diverse career paths. Data regarding effectiveness of current pedagogical approaches are discussed along with a brief review of evolving didactic methodologies. The recently published curriculum in Laboratory Medicine (Clinical Pathology) by the Academy of Clinical Laboratory Physicians and Scientists is reviewed, including its major emphases and the importance of competency assessment. Finally, the future of Laboratory Medicine and Pathology and the need to train for that future is expanded upon.