The Pathologist Assistant

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LADoc00

Gen X, the last great generation
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Creating a separate thread because I sense a derail coming in the other one...

PAs only recently received national certification under the ASCP. There are VERY VERY few supposedly accred. training programs, in fact there are only 8 in the US and none in the Western states....yet curiously Pathology continues on here in California without them (LMAO).

LADOC's PA FAQ:
What is a PA degree and how did this nonsense all begin?
The acred. PA degree was actually an invention at Duke University in the late 60s.

Originally floated as a graduate level program, it was popular due to a little thing called Vietnam, which granted draft exemptions to people pursuing graduate school. This Class II-S exemption resulted in the single greatest year over year percentage increase in medical school applications in history.

Although getting into med school had been tough in the 50s, this was real competition. As a result, there was a real market and profit margin to made on those looking for something medically related who were MD school rejects (realize this was before most DO schools and the foreign options).

An added benefit of being a PA was that unlike a RN, after your training it was unlikely you could wind up in Danang or China Beach when your Class II-S expired.

PA training is, essentially, a glorified 2 year mini pathology residency with a focus on grossing and autopsy (because you know, autopsy is in demand and generates mad bank...:laugh:) as well as having a histotech component (okay...).

What do cert. PAs make?
Currently due to the fact that there are exactly 8 schools and it is a graduate level program (because well of course you need a broad liberal arts undergrad at Princeton to cut and stuff meat...rofl'copter) they make salaries equivalent to an entry level chemical engineer, roughly $80,000 or 40/hr. Often they qualify for OT pay at 1.5x and can have compensation exceeding 80/hr if properly scamming the system.

Do I need a certified PA in my lab?
Depends, if you suck at teaching someone how to gross or are incompetent at it yourself, then absolutely yes. Likewise if you somehow are ******ed enough to be in a situation where you are performing 4 hour ritualistic medical autopsies for little to no pay, then it might be a good option as you can push the employee cost off onto the hospital.

In terms of JACHO and CAP lab certification, an ASCP or otherwise certified PA is not mandated. Let me repeat that: both the 2 big pathology lab organizations which certify do NOT have PA cert mandates. If they did have mandates, it would be highly unlikely they rest the sole ability to certify within the ASCP's hands.

What is our professional organizations' stance on PA cert mandates?
Pathology societies are nearly unanimously against this. In fact the CSP and the CAP worked together to block legislation even defining what PA cert is, let alone actually mandating it. Likewise, the CMA and AMA are against further encroachment of non-MD/DO physician extenders into the practice of medicine and are actively lobbying PA cert down. The Amer Assoc of PAs has all of 8 schools to draw donated funds from. GI Joe action figure collectors represent a larger lobbying presence in Washington atm.
 
I thought that the CAP inspection checklists (and the inspection teams) implied that only a pathologist could do real dissections--in fact, I've wondered if even gallbladders or appendices could be processed by a non-certified PA, never mind a placenta or colon resection.
 
I thought that the CAP inspection checklists (and the inspection teams) implied that only a pathologist could do real dissections--in fact, I've wondered if even gallbladders or appendices could be processed by a non-certified PA, never mind a placenta or colon resection.

Nope, "gross examination" is part of the CAP definition of "gross and microscopic diagnosis" and is meant to imply a pathologist has "some role" in supervising and taking part in the gross process. The elaboration of the process of "dissection" is not checklisted afaik nor would be in our best interest to be so. If the gross exam entails examining the specimens in vitro as they are received from the OR, then the criteria is fully satisfied.

Actually getting into the legalese of the CAP checklists is an interesting issue, they are far more complex and lengthy then the JCAHO ones, which why I strongly perfer JCAHO.

[aside: Just a basic definition of a Pathologist is interesting as it can vary from state and state and is often completely independent of ABP board certification and residency training.]

REGARDLESS, there is no certified PA language present in the online checklists I have reviewed and certainly not in JCAHO, so if the criteria isnt fulfilled by an unlicensed PA it cant be fulfilled by a certified one, debunking your comment. When the very concept of a "certified and licensed Pathologist assistant" is being defeated in the legislature, it is unlikely it will make its way into any future checklists.

Folks, welcome to smoke and mirrors.
 
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So is there any Pathologist Assistant programs in Canada that you know of?
My girlfriend is getting her forensic science degree and was actually looking forward to being a Pathologist Assistant.

From what I am reading here it seems like it is being shot down? no?
 
I am a cytotechnologist currently in medical school--the goal is to become a pathologist. I know a few fellow cytotech's who have went on, or are going on to become pathologist assistant's. They get to do autopsies themselves, as well as gross. I do not know if they can screen slides. I am not sure of the legislation on that currently. What is weird however, is that I regularly get job openings from my Cytotech instructors, and recently I got a job for a "cytotechnologist" yet they offered a "great salary" and on the job training to become a pathologist assistant. This just seemed amazing, and if I wasn't already in medical school I would be jumpin on it! lol! So I don't know how good these "programs" are. I mean yes, it is definitley great to get your masters and all, but at the same time....if there is OTJT for cytotechs then IDK what this all entails?
Also, I have heard around path labs the term "path's ass" for pathologist's assistants....which they claim is because they do all their work for not too much money...IDK...I would say just go all the way and become a pathologist. As a cytotech, I felt that is was a ripoff to screen all the slides, dot them and make a diagnosis...while the pathologist does similar work for WAYWAY more money...so just don't sell yourself short. 🙂
 
which they claim is because they do all their work for not too much money...

That's a little delusional. Grossing is not "all the work." Grossing is work which while important does not require as much skill and training as signing out cases, or as much responsibility as running labs and supervising others, which PAs do not do. That's basically akin to saying the scrub nurse in the OR does all of the surgeon's work.

And as for "not too much money" that is also pretty delusional. PA is a relatively high paying profession, especially given what the average day entails. Some are given lab management type of responsibilities, but if they do they often get paid even more for that, similar to any type of manager.
 
I kinda saw them as a pathology substitute for physicians assistant which is also a masters degree. The PAs here are wonderful. Very knowledgable about what they do. They work long hours sometimes though. But to be honest I haven't figured out why the program here has so many PAs (10, now I think) and only 5 residents per class because we cost much less than a PA. I'll get back to you all when I figure that one out.
 
... But to be honest I haven't figured out why the program here has so many PAs (10, now I think) and only 5 residents per class because we cost much less than a PA. I'll get back to you all when I figure that one out.

Do you get plenty of preview time? Plenty of scope time with an attending? Reading time? Or do you spend your days grossing biopsies, gallbladders, appendices, placentas, assorted ditzels, and engaging in all other manner of minimally-cerebral activities?

Maybe it's better not to try and figure that one out...
 
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