FAQ - Pathology

[WildWing]

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We are working on a consistent set of FAQs for all specialties as part of a revamp of the Specialty Selector.

If you are a practicing Pathologist, please share your expertise by answering these questions.

Thank you in advance for considering this opportunity to give back to the SDN community!

• What is unique or special about this specialty?
• What other specialties did you consider and why did you pick this one?
• What challenges will this specialty face in the next 10 years?
• What are common practice settings for this specialty?
• How challenging or easy is it to match in this specialty?
• What excites you most about your specialty in the next 5, 10, 15 years from now?
• Does your specialty currently use or do you foresee the incorporation of technology such as Artificial Intelligence?
• What are some typical traits to be successful in this specialty? (For example, organization skills, work independently)
• What does a typical workday consist of in your specialty?
• What is the career progression for your specialty?
• How has your work impacted your life dynamics? What is your work-life balance?
• How does healthcare policy impact your specialty?

 

[Mace1370]

• What is unique or special about this specialty?
  Pathology is a very visual field requiring pattern recognition, correlation with the clinical history and presentation, and a deep understanding pathophysiology. Much of the work can be done independently. You interact a lot with other physicians, who may have questions about your reports. You also interact a lot with other pathologists (for example, sharing a difficult case). There is little patient interaction. You will spend a lot of time looking through a microscope. Slides are beautiful and full of color. I have spoken to pathologists with over 30 years of experience who say they still encounter novel findings, so there is always more to see and learn.
  
  Finding the correct diagnosis for a case can be an exciting puzzle. Most tumors have unique morphologic clues that allow for precise classification, but may require correlation with ancillary testing such as immunostains or molecular tests. Many inflammatory conditions require close correlation with the clinical history, since the body often can only react to insult/injury in a limited number of ways. This results in every organ having a reaction pattern that can correlation to a differential diagnosis. Taking your reaction pattern differential and combining it with the clinical differential (essentially a Venn diagram) is often challenging and rewarding when done well.
• What other specialties did you consider and why did you pick this one?
  I considered radiology, dermatology, anesthesiology, as well as medicine with a fellowship in allergy or GI.
• What challenges will this specialty face in the next 10 years?
  Reimbursement cuts are an ever present threat. Pathology advocacy has an uphill battle to keep insurance companies and government agencies from slashing funding.
• What are common practice settings for this specialty?
  Most pathologists are either an employee for a large corporate lab, work in private practice, or work in an academic setting.
• How challenging or easy is it to match in this specialty?
  It is easy to match into pathology. The very top tier programs have some competition, but beyond that you will easily match. Most fellowships are also easy to match. Exceptions to this are dermatopathology, which is competitive. The top tier programs for subspecialty fellowships are also competitive.
• What excites you most about your specialty in the next 5, 10, 15 years from now?
  I think advances in AI technology could increase the accuracy of our diagnoses. Molecular pathology is another huge area of development that is constantly changing how we classify tumors.
• Does your specialty currently use or do you foresee the incorporation of technology such as Artificial Intelligence?
  Absolutely. I am hopeful it will increase productivity as well as accuracy.
• What are some typical traits to be successful in this specialty? (For example, organization skills, work independently)
  Working independently, attention to detail, and strong communication are vital to success.
• What does a typical workday consist of in your specialty?
  An anatomic pathologist usually has a 40 hour work week, but jobs exist with more or less hours per week. Each day you are assigned new cases and so I start my days going through those. I prioritize new cases and rush/stat cases because I may need to order additional testing (such as immunostains) and many labs have a cut off time for when you need to get your orders in for same day delivery. I usually look at the slides for a case blind to the clinical history so I can get an unbiased impression. I look at the history after I formulate my diagnosis (or differential diagnosis). If these match up and I do not need additional testing, then I enter the diagnosis into the LIS (software that interfaces with the patient chart) and sign the report out. Rinse and repeat until all my cases are either complete or have orders placed. Immunostains are usually delivered later in the day and once I get those I review and sign those cases out. I work at an academic setting and so I usually have a resident sitting with me as I review cases and spend some time teaching them. There are department meetings I have to attend throughout the week as well as other responsibilities related to my administrative position, such as approving instrument validations or troubleshooting laboratory problems.
• What is the career progression for your specialty?
  Most complete a fellowship after residency. Pathologists may find one job and work there for their entire career, or job hop as appropriate. Most spend the majority of their time signing out cases for the first 10+ years of their career. You can transition into more administrative positions as desired.
• How has your work impacted your life dynamics? What is your work-life balance?
  Pathology has one of the best work-life balances out there. I can go into work when I want and leave when I want. I generally do not work more than 40 hours per week. I have two weeks of call per year and generally am rarely bothered while on call. My work stays at work and doesn't follow me home.
• How does healthcare policy impact your specialty?
  It greatly impacts my specialty. More access to care means more patients and more biopsies/resections. Reimbursement cuts translates to having less pay or more work for the same amount of pay. This is probably true of most specialties in medicine.

 

[mike-sheree]

Wild wing, you will not get a better summary on a board than the excellent and exhaustive one Mace just gave you.