Vet Clinical Pathology Day-to-Day

[micro555]

Hey There,

I'm just starting as a new vet student this fall. I know its a long time before I graduate, but I think I'm interested in Vet Clinical pathology. What I'm wondering is, what is the day-to-day like? I'd be interested in any more info about it, like:

• Do you collect tissue / samples from patients, or are they sent to you?
  
• Do you stain slides to look at them? Does the laboratory stain slides for you?
  
• Do you see slides from all species? Do you have a lot of primate slides, or do primate centers tend to have their own clinical pathologists?
  
• What is working in industry like compared to academia? That being said, how would one go about shadowing someone in industry?
• What is the task that you spend the highest proportion of your day doing? Writing up results, reading slides...
• How do you split your time with research?

---

Members don't see this ad.

 

[WhtsThFrequency]

Are you talking industry or academia?

I'm anatomic, but I can answer a few of these from an academia perspective.

All tissue/sample collection is done by the referring vet or the service by which the patient was admitted.
All staining and processing is done by the lab, and then you receive the slides
It depends a lot where you work. If you're at a teaching hospital, it is cats, dogs, horses, cattle, some small ruminants maybe, etc. Most primate centers have dedicated labs.
Do you mean industry like diagnostic companies (e.g. Antech, IDEXX) or pharmaceutical-type stuff?
In academia, diagnostics and writing mostly.
That depends completely on your appointment, and how much you are designated to spend time on. Most clinical track positions are only about 10-20% research.

@JaynaAli is a clinical pathology resident and may be able to help here as well.

 

[micro555]

Do you mean industry like diagnostic companies (e.g. Antech, IDEXX) or pharmaceutical-type stuff?
That depends completely on your appointment, and how much you are designated to spend time on. Most clinical track positions are only about 10-20% research.

Thanks for the response! I guess I would be interested in learning more about what the vet path's role in either diagnostic companies or pharmaceutical research is. I hadn't really thought about the distinction between the two roles.

I guess a related question - what are the pluses and minuses to doing a PhD with the path specialty? Are there many academic positions which focus more on research than clinics?

 

[JaynaAli]

• 99% of the time slides are sent to us. We sometimes get a petri dish of bone marrow and make those slides ourselves, but that is rare and typically limited to academia. In other countries, the pathologist is more involved in sample collection, I believe. One of my co-residents is Brazilian and theydid a residency in Brazil first (not fitting the standards for ACVP boards) and routinely went to draw the blood, take aspirates, etc. That isn't how it is in the US.
  
• The lab stains them. I know how to do it, but it isn't a good use of my time to do that. Sometimes I request they do special stains.
  
• I am at a school with a huge wildlife clin path caseload. I see easily ten times more exotics than most residents I've talked to. Primates aren't the most frequent but I have seen some. A capuchin this week. I've also had blood from a duck, red shouldered hawk, american alligator, bat, sun conure, cockatoo, gopher tortoise, and an axlotl. Plus we've had cytology from three bats, all in one week.
  
• At diagnostic companies you are expected to be high volume output for reading cytology cases. 50+ cases per day, all day, every day. It's great for some (and likely what I'll do for at least a little while), but others hate it. CP's in labs like Antech or Idexx don't usually have a lot of extra time to take on shadows because there is so much pressure to produce. They can't waste time teaching you. Pharma research with clinical pathology is more about CBC and chemisty data. For example, you may get a ream of paper containing labs from all the mice/rabbits/dogs/primates in a toxicologic safety study and be expected to identify trending changes, determine a cause and if they are test article related (caused by the drug being tested), and write a layman level report for the researcher. There are lots of meetings with the research groups. You may get 100 bone marrow slides to read for a study. I managed to get an externship at a research company my senior year of vet school, but it took 'knowing someone who knew someone' and my advisor personally contacting the pathologist I was with and recommending me for it since most pharma externships are intended for residents. I found it to be terribly monotonous and boring, but that's just me. I like cytology too much. Your best bet to shadow a clinical pathologist is to talk to the ones at your school. They are there because they like teaching for the most part and they'll likely have time to explain things to you.
  
• What you do depends on where you work. It also depends on your experience level and how fast you can formulate the report if you're doing diagnostics. I'd say I currently spent 2/3 of my time looking at glass and 1/3 typing, but I'm just starting out. Where you work will determine your case load and the complexity of cases. I look at a lot of organ aspirates such as liver/spleen MCT met checks done by oncology, but I know a CP at Antech who has read almost 4,000 cases since March and she's had two liver/spleen combos. I lot of CPs I know use Dragon software and dictate while they look at slides to be more efficient. The pharma CP's day is completely different.
  
• Regarding PhD, I'll let WTF chime in since she's doing a PhD now. It will make you more a attractive candidate for the jobs in academia. For clin path, there are some programs that are combined, but these are the minority. If you aren't planning on academia, I have been told there isn't too much of a benefit. I'm not sure how that plays into pharma jobs, though. For jobs at commerial labs, the PhD isn't necessary. You don't have to have a PhD to be hired at a school, but they prefer it. The two CPs in my program don't have PhDs, but they are looking to hire one and will only accept someone with a PhD.

By the way, most clinical pathology residencies are preferring it if applicants have done rotating internships in clinical practice. So keep that in mind if you do pursue clin path. Grades aren't the end of the world in path, but do as good as you can. References and dedication to the field are very important, though.

If you have questions about specific opportunities or residency programs in the future, send me a PM.

 

[WhtsThFrequency]

By the way, most clinical pathology residencies are preferring it if applicants have done rotating internships in clinical practice. So keep that in mind if you do pursue clin path. Grades aren't the end of the world in path, but do as good as you can. References and dedication to the field are very important, though.

If you have questions about specific opportunities or residency programs in the future, send me a PM.

Huh, that's interesting! Anatomic tends not to care one way of the other; most come straight out of vet school. Then again I suppose our quirk is that we tend to put more emphasis on research experience in our applicants than clin path, and most of our residencies *are* combined residency/PhD as opposed to CP (you lucky bastards).

I can expound more on the PhD aspects here in a bit.

 

[WhtsThFrequency]

By the way, anatomic pathology is way cooler. Jayna's just a grease monkey poser.

 

[JaynaAli]

Huh, that's interesting! Anatomic tends not to care one way of the other; most come straight out of vet school. Then again I suppose our quirk is that we tend to put more emphasis on research experience in our applicants than clin path, and most of our residencies *are* combined residency/PhD as opposed to CP (you lucky bastards).

They are technically not required most places (anywhere?) yet, just 'strongly preferred.' If not internship then several years practice experience. I applied straight out of school (and like to think I at least had a decent chance) despite CP advisors telling me I should plan to do an internship. I applied 6 places. Below average grades, but worked as a lab tech, 500+ hours shadowing cytology, student poster at ACVP, whole nine yards. I applied to six programs and the only feedback I got from any of them was 'you're great and we liked you but we chose the person who had done an internship.' Applied after an internship and had interview offers everywhere I applied. I know a couple that got accepted recently without practice experience, but I do think it was beneficial having done it.

 

[Lupin21]

Huh, that's interesting! Anatomic tends not to care one way of the other; most come straight out of vet school. Then again I suppose our quirk is that we tend to put more emphasis on research experience in our applicants than clin path, and most of our residencies *are* combined residency/PhD as opposed to CP (you lucky bastards).

I can expound more on the PhD aspects here in a bit.

I have been writing my first grant. I do no like it. At all. haha

 

[WhtsThFrequency]

I have been writing my first grant. I do no like it. At all. haha

Oh eff that. I never want to have to do that IRL. I wrote a practice K grant and that was bad enough.

 

[Lupin21]

Oh eff that. I never want to have to do that IRL. I wrote a practice K grant and that was bad enough.

Definitely has made me feel like the most incompetent person in the world, and generally I am a pretty good writer. No so for this.

 

[micro555]

• I am at a school with a huge wildlife clin path caseload. I see easily ten times more exotics than most residents I've talked to. Primates aren't the most frequent but I have seen some. A capuchin this week. I've also had blood from a duck, red shouldered hawk, american alligator, bat, sun conure, cockatoo, gopher tortoise, and an axlotl. Plus we've had cytology from three bats, all in one week.

Thanks for this answer! I'm at a university with a large aquatic center - I wonder if a lot of researchers want fish pathology done as well? I suppose there is an overlap with lab animal vets vs. clin path? I've seen a lot of people do both specialties.

• At diagnostic companies you are expected to be high volume output for reading cytology cases. 50+ cases per day, all day, every day. It's great for some (and likely what I'll do for at least a little while), but others hate it. CP's in labs like Antech or Idexx don't usually have a lot of extra time to take on shadows because there is so much pressure to produce. They can't waste time teaching you. Pharma research with clinical pathology is more about CBC and chemisty data. For example, you may get a ream of paper containing labs from all the mice/rabbits/dogs/primates in a toxicologic safety study and be expected to identify trending changes, determine a cause and if they are test article related (caused by the drug being tested), and write a layman level report for the researcher. There are lots of meetings with the research groups. You may get 100 bone marrow slides to read for a study. I managed to get an externship at a research company my senior year of vet school, but it took 'knowing someone who knew someone' and my advisor personally contacting the pathologist I was with and recommending me for it since most pharma externships are intended for residents. I found it to be terribly monotonous and boring, but that's just me. I like cytology too much. Your best bet to shadow a clinical pathologist is to talk to the ones at your school. They are there because they like teaching for the most part and they'll likely have time to explain things to you.

I wonder how you'd even know if a particular Pharma company employs a veterinarian? I would assume most do if they are doing any kind of drug trial in animals.

By the way, most clinical pathology residencies are preferring it if applicants have done rotating internships in clinical practice. So keep that in mind if you do pursue clin path. Grades aren't the end of the world in path, but do as good as you can. References and dedication to the field are very important, though.

I wonder what the best way to "show dedication to the field" is? I've seen this sentence in a lot of the application descriptions for applying for a residency position. I would expect like joining path club, trying to shadow, etc etc. I'm in a research lab now, but I don't know that it is that connected to any kind of diagnostics that clin path would be doing, since it is more basic research at this point...

 

[JaynaAli]

Most of clin path isn't exotics. I don't know enough about research to really answer your questions about those needs. I know zebrafish are common research animals so I assume anatomics look at them, but I don't know of much in clin path for fish. I'm sure there are places that do, but that is a very specific niche within the specialty. I don't know details of lab animal but I haven't ever met anyone double boarded. My understanding is lab animal is taking care of the animals themselves. Clin path in a research setting is more often interpreting data for researchers and is extremely hands off in regards to live animals.

You can find a few clinical pathologists in industry through the ASCVP, ACVP, and STP websites. Networking at conferences is important. I told my advisors I wanted to go to a pharma group for a couple weeks and they helped me set it up with people they knew. It's a small world in pathology. You will likely not get anywhere by cold calling companies...you'll need connections.

You "show dedication to the field" by being as active as possible in it. Join path club (do more than just join, be an officer, organize events), shadow, do well in path courses (a CP I know says the first thing she looks at on a residency app is whether you got a good grade in clin path), go to ACVP conference, present at ACVP conference, do externships your senior year, visit programs with residencies, get an article published, etc etc etc.

Edit: I think a lot of people apply to clin path because they don't want to see patients. While I can see the appeal, you have to really love it to chain yourself to a chair and microscope all day every day for the rest of your life. For every exciting case, there are 5 boring ones. Industry path is a whole other beast, but you have to do a standard residency to get boarded before jumping into path. Some residencies have a bit of a focus on industry, but boards don't so it's a small focus.

 

[KCgophervet]

There are people who are double boarded in anatomic pathology and lab animal - some residency programs I know of actually count for both (University of Washington in Seattle for instance).

 

[micro555]

So, who does the rabies testing? Clin path or anatomic? Zoonotic diseases are cool.

 

[WhtsThFrequency]

Since it is the brain that needs to be submitted, anatomic (although we usually just remove it and the state lab does the actual testing). We're the ones who do necropsies and such.

 

[WhtsThFrequency]

Most of clin path isn't exotics. I don't know enough about research to really answer your questions about those needs. I know zebrafish are common research animals so I assume anatomics look at them, but I don't know of much in clin path for fish. I'm sure there are places that do, but that is a very specific niche within the specialty. I don't know details of lab animal but I haven't ever met anyone double boarded. My understanding is lab animal is taking care of the animals themselves. Clin path in a research setting is more often interpreting data for researchers and is extremely hands off in regards to live animals.

You can find a few clinical pathologists in industry through the ASCVP, ACVP, and STP websites. Networking at conferences is important. I told my advisors I wanted to go to a pharma group for a couple weeks and they helped me set it up with people they knew. It's a small world in pathology. You will likely not get anywhere by cold calling companies...you'll need connections.

You "show dedication to the field" by being as active as possible in it. Join path club (do more than just join, be an officer, organize events), shadow, do well in path courses (a CP I know says the first thing she looks at on a residency app is whether you got a good grade in clin path), go to ACVP conference, present at ACVP conference, do externships your senior year, visit programs with residencies, get an article published, etc etc etc.

Edit: I think a lot of people apply to clin path because they don't want to see patients. While I can see the appeal, you have to really love it to chain yourself to a chair and microscope all day every day for the rest of your life. For every exciting case, there are 5 boring ones. Industry path is a whole other beast, but you have to do a standard residency to get boarded before jumping into path. Some residencies have a bit of a focus on industry, but boards don't so it's a small focus.

Definitely, definitely, DEFINITELY. Networking is super important. I'm always happy to provide contacts if I can and if you want to PM me and tell me your location - I may know people in the area.

Also echo the dedication to the field. My grades were so-so, but I had significant and varied summer externships, electives, research experience, and good connections with other pathologists who wrote me excellent LORs - that's honestly what got me my residency position.

 

[Andeve33]

Hey There,

I'm just starting as a new vet student this fall. I know its a long time before I graduate, but I think I'm interested in Vet Clinical pathology. What I'm wondering is, what is the day-to-day like? I'd be interested in any more info about it, like:

• Do you collect tissue / samples from patients, or are they sent to you?
  
• Do you stain slides to look at them? Does the laboratory stain slides for you?
  
• Do you see slides from all species? Do you have a lot of primate slides, or do primate centers tend to have their own clinical pathologists?
  
• What is working in industry like compared to academia? That being said, how would one go about shadowing someone in industry?
• What is the task that you spend the highest proportion of your day doing? Writing up results, reading slides...
• How do you split your time with research?

I think it will be interesting, good luck and share with us late about experiences

 

[Teepster87]

By the way, anatomic pathology is way cooler. Jayna's just a grease monkey poser.

I was actually expecting your first post in this thread to have something to do with leaving oil on a microscope

 

[WhtsThFrequency]

I was actually expecting your first post in this thread to have something to do with leaving oil on a microscope

All. The. Time.

 

[PrincessButterCup]

I'm curious what it's like to read histology or clin path slides. Do you become so familiar with everything that you can identify what you need to know right away, or do you typically have to spend a lot of time on each slide?

I've shadowed and worked on the necropsy floor, and I've gotten to watch the residents walk through slides a couple of times with the 4th years. I don't know what that part of the job actually looks like though, or how difficult it is to go through each case.

 

[JaynaAli]

I'm curious what it's like to read histology or clin path slides. Do you become so familiar with everything that you can identify what you need to know right away, or do you typically have to spend a lot of time on each slide?

It depends on the sample, really. You definitely get familiar with things but there are details or tougher cases that can take time to read. It gets faster with practice, for sure, though.

For me, I can usually identify what I'm looking at and reach some answer pretty quickly, but for cytology (in academia) you describe EVERYTHING on the slides. That mast cell tumor it took you literally 2 seconds to diagnose? Make sure you look at the entire slide to find the eosinophilic inflammation, reactive fibroplasia, and collagenolysis that typically accompanies mast cell neoplasia. On a liver aspirate you can quickly find vacuolar changes within the hepatocytes, but don't miss the mild atypia to the hepatocytes, or the mild lymphocytic inflammation, biliary epithelium, mesothelial cells, cholestasis, and various pigments like lipofuscin, bile, and copper. We look at every slide you submit and describe everything. Most of that is because that is how we will have to do on our board exams, but part of it is to be complete and give you all the information possible. In commercial labs, there is more of a time crunch to produce, produce, produce so the descriptions tend to be less detailed and just hit the high points. Most practitioners don't care about anything but the bottom line diagnosis and are happy enough with that but you can really learn a lot about your sample by getting a good description and comments.

 

[WhtsThFrequency]

I'm curious what it's like to read histology or clin path slides. Do you become so familiar with everything that you can identify what you need to know right away, or do you typically have to spend a lot of time on each slide?

I've shadowed and worked on the necropsy floor, and I've gotten to watch the residents walk through slides a couple of times with the 4th years. I don't know what that part of the job actually looks like though, or how difficult it is to go through each case.

I would say that 80% of the time I have it diagnosed and morphed in under 30 seconds, less if I already have a good idea of what it was from the necropsy or biopsy submission. The other 20% are the ones you show around to multiple people because your just aren't sure, and it takes a lot longer. It's borne purely out of the insanity of repetition and volume of residency - we see SO MUCH. Histology takes a bit longer than cyto because we have all of the architecture to deal with as well as the cells themselves - but then again, those cyto wizards are crazy cool and I still don''t know how they can pull as much info from smears and such as they do. I *almost* went clin path, but ended up knowing I would miss necropsy too much.

Of course, like Jayna said, we describe everything for completeness. That is usually what takes so long. Although annoying, it's a good thing, because often as I go through a slide I might notice other smaller things that, while they may not have actually contributed to death or sickness, are still important.

That being said, I still love the fact that I can write "hemorrhage" instead of "extravasated erythrocytes", or just plain "necrosis" as compared to "necrosis composed of copious eosinophilic proteinacous fluid admixed with karyorrhectic debis" because I passed boards and I don't have to deal with that BS anymore

 

[PrincessButterCup]

Thanks for the info WTF and Jayna.

 

[deleted676737]

Thanks for the info WTF and Jayna.

As someone who is gradually becoming more interested in path as a possible career choice, I echo this. Thanks for all of the super helpful posts, you two! I really appreciate it!

 

[PrincessButterCup]

As someone who is gradually becoming more interested in path as a possible career choice, I echo this. Thanks for all of the super helpful posts, you two! I really appreciate it!

You too? WTF is a rockstar of sdn and she's converting us all without realizing it. (Jayna is a rockstar too! But was she also converted by WTF? )

I found this site when I was curious about pathology a few years ago. I read some threads in pre-vet that WTF had commented in and that's why I started shadowing necropsy. This is why the internet is a dangerous place.

 

[JaynaAli]

But was she also converted by WTF? )

Negative. Luck with accepting a job and a couple awesome mentors. One mentor has told people that she 'gave me the kool aid early.' I found SDN when I finally decided to commit to path second year.

Even if you don't end up making a career out of path, you'll learn a lot so it's a win win being interested in it during school.


Sent from my iPhone using SDN mobile app

 

[PrincessButterCup]

Negative. Luck with accepting a job and a couple awesome mentors. One mentor has told people that she 'gave me the kool aid early.' I found SDN when I finally decided to commit to path second year.

Even if you don't end up making a career out of path, you'll learn a lot so it's a win win being interested in it during school.


Sent from my iPhone using SDN mobile app

I love microbiology a lot so I'm not sure where I'll end up. If vet school doesn't work out then I'll probably pursue micro in some capacity. The toxicologist at my IS school wanted to do path before she started school, and then she fell in love when tox. So who knows?

What job did you have that brought you to clin path?

 

[JaynaAli]

What job did you have that brought you to clin path?

A prevet advisor I had is married to a clinical pathologist. Prevet advisor knew I was looking for a veterinary job during undergrad to gain experience and convinced their spouse to hire me for their lab as a student worker. I didn't know what clin path even was then, but they trained me and I quickly realized how much I liked it.


Sent from my iPhone using SDN mobile app

 

[WhtsThFrequency]

@dyachei is better termed a rockstar than me. She can actually adult. Plus she's bionic.

 

[dyachei]

@dyachei is better termed a rockstar than me. She can actually adult. Plus she's bionic.

not a rockstar in the least. And not bionic enough

 

[LetItSnow]

Since it is the brain that needs to be submitted, anatomic (although we usually just remove it and the state lab does the actual testing). We're the ones who do necropsies and such.

Is it more common for states to have separate labs? In MN, the UMN VetDiagLab is where all of that is done.....

 

[WhtsThFrequency]

Is it more common for states to have separate labs? In MN, the UMN VetDiagLab is where all of that is done.....

It depends on the state. The state dx lab was literally across the street where I did residency. Here? State lab is an hour away. I believe (could be wrong) IFA testing needs to be done by a state govt sanctioned lab as opposed to a vet school. Getting the accreditation you need for rabies IFA isn't something schools hone in on.

 

[Trilt]

For NC the state lab is separate but quite literally down the street from the vet school. My understanding is that they work together fairly regularly.