What Does a Pathologist Do?
If you have ever seen a doctor about an illness, chances are you have benefited from the services of a pathologist. However, you probably never saw the pathologist. So, what is pathology, and what does a pathologist do?
Pathology is the study of the causes, nature, and effects of disease. You may be wondering: what is a pathology doctor called? A pathology doctor is called a pathologist. Both pathology and pathologist come from the Greek word pathos, meaning suffering. To answer the question:what’s a pathologist? A pathologist is a medical doctor with additional training in laboratory techniques used to study disease. Pathologists may work in a lab alongside scientists with special medical training. Pathologists study tissues and other materials taken from the body. They analyze these items to diagnose illness, monitor ongoing medical conditions, and to help guide treatment.
A pathologist is a vital part of any patient’s care team. And yet, the pathologist may be largely invisible to the patient. That’s because much of a pathologist’s work is conducted in the lab. There, a pathologist draws on medical knowledge and a detective’s passion for mystery to put together the picture of an illness.
WHAT IS PATHOLOGY?
A pathologist studies fluids, tissues, or organs taken from the body. Pathologists often work with a surgically removed sample of diseased tissue, called a biopsy. The pathological examination of an entire body is an autopsy.
Pathologists are often involved in the diagnosis of illness. A pathologist may examine a sample of tissue for a virus, bacteria, or other infectious agents. The vast majority of cancer diagnoses are made by, or in conjunction with, a pathologist.
Pathologists may also help guide the course of treatment. For example, a pathologist may analyze blood samples, helping to monitor and track the progression of a bloodborne illness.
Modern pathologists have more than microscopes at their disposal. They may use genetic studies and gene markers to diagnose a hereditary condition.
Much of a pathologist’s work culminates in the form of a pathology report. In such a report, the pathologist details the analysis of samples sent to the lab by a doctor or other professional, meticulously laying out their findings.
HOW TO BECOME A PATHOLOGIST?
Because pathologists often play a behind-the-scenes role, even medical students may find themselves wondering exactly what is pathology and how to go about becoming a pathologist. A pathologist education begins with a four-year undergraduate degree. The next step is four years of education at a quality medical school, such as the American University of the Caribbean School of Medicine (AUC).
There is no such thing as a pathology degree. Rather, the aspiring pathologist generally must undertake a residency. During residency, future pathologists study and practice pathology under the training of experts in the field.
Pathology is sometimes divided into anatomical pathology and clinical pathology. Anatomical pathology involves the analysis of body organs and tissues. Clinical pathology involves the analysis of body fluids, such as blood and urine.
A doctor may be able to complete a residency in either anatomical pathology or clinical pathology in three years. Combined anatomical and clinical residencies may take four years or more. The final step to becoming a pathologist is passing a board certification exam.
MEET A PATHOLOGIST
Constantine "Aki" Kanakis, MD, a 2020 graduate of the American University of the Caribbean School of Medicine (AUC), is a resident physician at Loyola University Medical Center Department of Pathology and Laboratory Medicine. We asked Dr. Kanakis to describe the role of a pathologist.
Q: Why did you decide to go into your specialty?
A: So many reasons. After seeing first-hand how patients go through the process of being managed and treated for a variety of illnesses, nothing I've found comes as close as pathology to the root of the medical philosophy. It helps that I worked for a decade as a medical laboratory scientist in clinical diagnostics. Those years cemented my interest in the field that treats all the patients in a hospital or community.
Nearly 70% of information in a patient's chart comes from laboratory-derived diagnostic data and virtually 99% of cancer diagnoses are signed out by pathologists. With as many subspecialties and fellowships as there are for all of clinical medicine, your career path is as broad as you like. And, when it comes to work-life balance, it can't be beat!
Pathology focuses on the most accurate and expedient final diagnosis of illness in order to make sure that every patient receives the best and most prompt care. And, while we work primarily with our patient-facing colleagues to coordinate a strong interdisciplinary approach to medicine, some of us see patients, too. For example, a pathologist trained in transfusion medicine sees patients who need apheresis therapy, or have transfusion-related complications, or even cellular therapy.
We are an integral part of intraoperative cancer spot diagnoses that determine long-term implications and treatment, invaluable prognostic and diagnostic information comes from our tireless research, and we're the ones to turn to when medicine becomes a mystery.
A long time ago pathologists were called the "doctor's doctor," but I like to think we're an inseparable part of practicing medicine. Who do you think makes and validates COVID tests out of thin air? We do way more than just autopsies. (Even though those are important for their medical and public health implications)
Q: Any advice to medical students considering the specialty?
A: This is an invisible specialty! Please find exposure to the field, do a rotation, meet your friendly neighborhood pathologists, and engage in something that could change your future. There are plenty of stereotypes about every specialty, and ours is often brushed aside (or kept in the basement). But, I assure you, we would love to work with anyone who has a passion for engaging patient care at this level. Look into #PathTwitter, visit websites like PathElective.com, read some of my writing on Lablogatory, do your own in-person elective, and learn more about pathology and laboratory medicine.
Q: What’s the most rewarding part of your job?
A: First, those of us in pathology and laboratory medicine pride ourselves on not managing 1 or 10 patients at a time, but a whole demographic of patients. You rarely practice pathology alone, and when you're part of a thriving department, you care for a whole region or community of patients together. You've got a front row seat to trends in cancer, infections, and any disease that needs attention. Lab data is public health data.
Second, pathology is full of fulfilling experiences. Every single microscopic slide, or laboratory test, is a living, breathing patient waiting to discuss the results of your interpretation with their PCP or specialist that has downstream effects on their care plans. If you're a surgical pathologist in a regional hospital, you might be paged to come in for a frozen section intraoperative consultation on a suspicious brain mass and rule out or diagnose cancer then and there. If you're a hematopathologist, you might be sent a critical consultation on a bizarre lymphoma by one of your heme/onc colleagues. Your call and your diagnosis can change the course of an entire treatment plan, and that's something to take very seriously and can be very rewarding.
SUBSPECIALTIES WITHIN PATHOLOGY
Pathology includes a myriad of subspecialties. In fact, it may seem as if nearly every specialty in medicine has a counterpart subspecialty within pathology. Dermatologists depend on dermatopathologists to diagnose skin disease; neurologists relying on the expertise of neuropathologists; and so on. Here are a few of the more popular subspecialties within pathology:
- Cytopathology, sometimes called cellular pathology, involves the study of changes in cells. Cytopathologists are instrumental in the diagnosis of cancer.
- Hematology is the study of bloodborne disorders and illnesses, such as anemia, leukemia, hemophilia.
- Forensic pathology is the study of the bodies that died suddenly, unexpectedly, or violently.
- Medical microbiology is the study of infectious organisms. Pathologists in this subspecialty may advise doctors and public health officials how to fight contagious illness.
- Immunology involves the study of the immune system as well as disorders caused by a malfunctioning immune system.
- Molecular genetic pathology involves analyzing a patient’s genes to diagnose chronic conditions.
- Toxicology is the study of poisons and poisoning.
YOUR CAREER AS A PATHOLOGIST
As a specialty, pathology tends to attract critical thinkers and problem solvers. Pathologists tend to be methodical, step-wise thinkers with an eye for recognizing patterns in evidence.
Many doctors spend most of the day seeing patients. Pathologists, on the other hand, generally spend most time in the lab. As a result, pathologists tend to enjoy more regular hours and better work/life balance than many other specialties.
Many pathologists work in hospital laboratories or in independent labs. Others work in academic institutions or private practice. A typical day for a pathologist might begin with taking in samples for analysis and planning experiments. The middle of the day might involve working with lab equipment to analyze samples and refine results. The afternoon might be spent communicating results to other members of the treatment team.
Several factors are driving the need for more pathologists. The population is getting larger. The population is also aging. Both these trends are increasing the demand for all medical services, including pathology. According to studies conducted by the College of American Pathologists, most pathologists find jobs soon out of residency, and most report high levels of satisfaction with their jobs.
Now you know the answer to the question “What is pathology?” Is a career as a medical mystery solver right for you? Your path to becoming a pathologist begins with four years of study at AUC. Apply for admission in AUC.