Clinical pathologists sit in their office and work on presentations, research, teaching, or trying to figure out how to streamline lab functions and save money. Occasionally, a lab issue will come up (like mislabeled specimens, quality control issues, machine breaking, bizarre results, etc) that they have to deal with.
What they are paid to do is to supervise the lab. I.E. make sure everything functions smoothly and efficiently. They supervise protocols and determine which tests are appropriate. There are thousands of tests out there, and the lab directors have to decide whether it is cost effective to provide a test, how often to provide it, and how to report the results.
Like ANA for example - there are different ways to run the test - some are automated, some not. Which provides the best results? There are also many esoteric tests which are rarely ordered, thus if it is not worth the expense and expertise to provide that test, the lab will contract with another facility (like Mayo or ARUP, big places) who will run it - this happens a lot with certain molecular tests and rare disease assays.
Most academic CP people spend a lot of time on research. Some of the labs, particularly chemistry and micro labs, are run by PhDs (not MD/PhDs).
Immunopath is a fairly specific field and generally limited to researchers who also do some signout in their time. Immunopath issues include reading protein electrophereses, certain immunology tests like anti-GBM or difficult ANAs. Because a lot of CP is automated or done by techs who are experts in a specific test, the pathologist doesn't do a lot of the work. They are, however, responsible for it all.
In terms of day to day CP residency - at first you spend time learning about all the assays, tests, methods, etc. Eventually you work your way up to solving problems on your own and helping develop methods and procedures.
Anemic job market? Don't know. Don't think so, but if your only training is in clinical path there will not be a lot of job opportunities outside of specialized areas. Clearly, if you are an expert in microbiology and CP only trained you could find a job if you were good enough. But many average community jobs don't have jobs specifically for CP folks. You cross cover. This is why community jobs generally prefer people trained in both AP and CP.
What other questions do you have?
