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Pathology

What is Pathology?

If you are curious about the causes and nature of diseases, then you may consider a career as a pathologist. So what is pathology? Simply defined, pathology is the study of disease, and it requires an extensive and detailed knowledge of medicine. Pathology links science and medicine, and it underpins every aspect of patient care, from diagnostic testing and treatment to using new technologies and preventing disease. 

You may be wondering what is a pathology doctor called? A pathology doctor is called a pathologist, which is a doctor specially trained in the diagnosis, prognosis, and treatment of disorders of body tissues and fluids. That may sound like a broad area to cover, and it is. If you are considering a career as a pathologist, ask yourself these questions:

  • Are you fascinated by how diseases work?
  • Are you interested in helping patients with a wide variety of illnesses?
  • Do you like working in the laboratory?
  • Are you curious enough to learn about numerous aspects of medicine?
  • Do you like working with cutting-edge technology?
  • Do you want to study a dynamic and constantly evolving science?
  • Do you want a field that offers professional challenges and specialized options?
  • Do you want an intellectually stimulating and rewarding career?
  • Do you want a career in one of the most in-demand fields of medicine?

If your answer to these questions is “yes,” then pathology may be the specialty for you.

Wondering where you stand as a medical school candidate?

What Does a Pathologist Do?

A pathologist uses a variety of means—including microscopic examination and laboratory tests—to diagnose and monitor diseases. Pathologists can see the history as well as the probable trajectory of a disease. If a cell or other structure is altered in a certain way, the patient will have certain symptoms, now or in the future. 

A pathologist may study such health issues as anemia, cancer, or tuberculosis, or the doctor may be called upon to determine the cause of a patient’s death. Sometimes considered a “doctor’s doctor,” a pathologist is often a second line of clinical care and may help a patient’s primary physician make or confirm a diagnosis. Pathologists use a wide variety of examinations, procedures, and tests. These may include:

  • Autopsies
  • Biopsies
  • Blood investigations and blood sugar tests
  • Fine needle aspirations
  • Pap smears

Pathologists have long been involved in research to advance medicine and devise new treatments to fight diseases, infections, and viruses. They have played key roles in the development of vaccines and the treatment of inherited conditions, as well as in the advances of blood transfusion and other processes. Pathologists are also active in academic circles and participate in conferences and publications dedicated to advancing medical knowledge and therapeutic options.

Pathology is divided into two broad categories: anatomic and clinical. Anatomic pathologists study diseases through the chemical, gross, immunologic, microscopic, and molecular examination of organs, tissues, and whole bodies. This includes seeing patients in person as well as examining samples. Subspecialties in anatomic pathology include:

  • Breast pathology
  • Cytopathology
  • Dermatopathology
  • Forensic pathology
  • Gastrointestinal pathology
  • Genitourinary pathology
  • Gynecologic pathology
  • Hematopathology
  • Neuropathology
  • Pediatric pathology
  • Pulmonary pathology

Clinical pathologists study diseases through the laboratory analysis of bodily fluids and tissues. They may analyze hundreds of samples per day, looking for indicators of such maladies as heart disease, liver malfunction, or tumors. Clinical pathologists may also work directly with patients suffering from metabolic disorders. What is pathology in a clinical setting? Clinical pathology includes:

  • Blood banking and transfusion medicine
  • Clinical chemistry (including toxicology)
  • Hematology
  • Microbiology (including immunology)
     

HOW TO BECOME A DOCTOR OF PATHOLOGY

To become a pathologist, you must first become a physician by graduating from an accredited medical school*—such as Ross University School of Medicine (RUSM). The steps to a medical degree at RUSM, which is located on the Caribbean island of Barbados, are the same as at United States-based schools: two years of medical science classes and two years of hands-on clinical training. For RUSM students, the medical sciences curriculum is completed at the Barbados campus; the clinical training can be completed at affiliated teaching hospitals in the United States.

During clinical training, all RUSM students complete core rotations in internal medicine, surgery, pediatrics, family medicine, obstetrics/ gynecology, and psychiatry. It is up to each student, then, to select elective rotations to fulfill their clinical requirements. Students can round out their education of remaining clinical requirements in any of 40 specialty elective areas (including pathology).

During the fourth and final year of medical school, students prepare for the next step in their medical education: residency. At RUSM, the Office of Career Advisement (OCA) helps students determine which residency specialty—such as pathology—suits them best. The OCA then helps students negotiate the National Resident Matching Program® (NRMP®)—a placement system which medical students who want to obtain licensure in the United States use to “match” with a medical residency. Residencies are required to become a licensed physician, and they last from three to eight years. Individual anatomic or clinical pathology residencies are usually three years, while an extra year is added for a combined anatomic and clinical pathology residency.

In 2021, RUSM had a first-time residency attainment rate of 92 percent for 2020-2021 graduates, a match percentage rate comparable with the overall match rate (93 percent) for medical schools in the United States. In recent years, RUSM MD’s have matched with pathology residencies at such hospitals as Case Western Reserve University/ University Hospitals Cleveland Medical Center in Ohio; Henry Ford Hospital in Michigan; North Shore University Hospital/ Long Island Jewish Medical Center in New York; and Penrose Hospital in Colorado.

After the successful completion of pathology training, a doctor is eligible to become certified by The American Board of Pathology. Many board-certified pathologists are members of the College of American Pathologists or the American Society for Clinical Pathology. Doctors who want to subspecialize in a specific area of pathology must take additional training.

MEET A PATHOLOGIST

Emma Henrie

Emma Henrie, MD, a 2017 RUSM graduate, is an Anatomic & Clinical Pathology PGY-4 at University of Texas Medical Branch. We asked Dr. Henrie to describe the role of a pathologist.

Q: Why did you decide to go into your specialty?

A: I’ve wanted to be a forensic pathologist ever since dissecting my first frog in seventh grade science. Once I got to medical school, I became even more fascinated with the human body, but I found myself gravitating toward processes that make everything stop, like disease, drugs, and injuries. Residency has been a similar story. Though I enjoy making tissue and laboratory diagnoses in the living, I am drawn to the morgue and its stories. I will be completing a fellowship in forensic pathology at the Georgia Bureau of Investigation in 2022.

Q: Any advice to medical students considering the specialty?

A: Take at least one pathology elective. If you have a choice between all the different services pathology has to offer but you can only choose one, take forensic pathology. You will learn several important things: 

  • How to fill out a death certificate.
  • See how common diseases (i.e. pneumonia, cirrhosis) appear with your own eyes.
  • Perform the ultimate physical examination.
  • Experience crime scene investigation and how law enforcement works with medicine in real time.
  • Attend court and witness how important confidence and competence can be in the judicial system. 

I stress forensic pathology because even if you decide to take a different path in medicine, many of the things you learn during the rotation will affect your practice for the entirety of your career. Regardless of which specialty you ultimately choose, you will utilize pathology and/or the laboratory at some point. Without this branch, medicine as we know it would cease to exist.

During third year clerkships, find ways to meet pathologists. Surgery clerkship is often the most helpful in this regard—any time there's a "frozen," ask to go with it to pathology. If a patient has surgery for cancer or some other type of lesion, follow the case to pathology a day or two after surgery. You'll want letters of recommendation from the pathologists. As a whole, the specialty wants to see students who are truly interested in the field.

Additionally, communication is extremely important as a pathologist. Even though we don't often give patients the news directly, we are often behind the scenes talking with the physician who will deliver the news. You can demonstrate your communication skills in your application by having a well-written and interesting personal statement. 

Don’t stress about learning as much "pathology" as you can before residency. Knowing your clinical skills comes into play more often than you might expect, and medical school will be the last opportunity you have to practice interviewing and physical exam skills (pathology does not have an intern or transitional year). Pathology programs know that no medical school prepares anyone for pathology residency, and pathology faculty know that it's pretty near ground zero for learning histology well enough to make a diagnosis. Electives during fourth year should be interesting to you. Don't stress about doing a ton of audition rotations. 

Q: What’s the most rewarding part of your job?

A: The most rewarding part of my job is the closure it provides my patients and their families. Speaking specifically to my intended specialty, I look forward to providing answers to difficult questions so that families can begin to heal after their loved one has passed. However, even in the broader view of making diagnoses based on tissue, knowing the patient has been worried about this new "mass"—and knowing that whatever answer I provide them will help them plan the next steps—gives me great personal satisfaction. Another major perk of this field is the flexibility of my days which provides a healthy work-life balance.

If you want to become a doctor, and a career in pathology appeals to you, learn more about the RUSM MD Program and investigate the Office of Career Advisement. When you’re ready, take the next step on your path to a specialization in pathology: apply for admission to Ross University School of Medicine.

A Career in Pathology

Many are curious to know what does a pathologist do and what’s a pathologist’s normal routine like? Pathologists may work in a clinic, hospital, or medical office, and some have their own private practice. Others work in university medical schools or research facilities, in independent diagnostic laboratories, or as coroners or medical examiners. 

A pathologist’s time is spent caring for outpatients, doing laboratory work, performing procedures and tests, discussing cases with other doctors and visiting hospital wards. Meetings and administration tasks absorb a lot of time, and hours are also spent consulting with other specialists, doing research, studying, and teaching. Most pathologists work a typical 40-hour week, and some are also on-call—available for consultation at night or on days off.

Because pathologists diagnose and study a wide spectrum of illnesses and conditions, they can have a great impact on the individual lives of patients as well as overall community health.

Demand for Pathologists

The demand for pathologists is as certain as the occurrence of disease and death among the world’s population. In other words, pathologists will always be needed. And that demand grows as the world population ages—diseases disproportionately affect older people. Pathologists too—like doctors in all medical fields—are an aging population, and as those doctors retire, the United States will see an increasing shortage of pathology specialists. 

In July 2020, an Association of American Medical Colleges report showed that one third of U.S. physicians are age 60 or older, and well over half—57 percent—are over 50 years old. A 2018 study by the College of American Pathologists revealed a healthy overall job outlook for pathologists, as many new pathology positions were being created alongside those required to replace retiring pathologists.

Now that you have the answer to the questions: what is pathology and what does a pathologist do? You can take the next step on your path to becoming a pathologist: apply for admission to Ross University School of Medicine.

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In 2020, 91% of RUSM students passed the initial step of the United States Medical Licensing Examination® (USMLE®) on the first attempt. And in 2021-2022, results show yet another strong year for RUSM with a 96% first-time residency attainment rate* thus far. Located on the island of Barbados and with a network of more than 15,000 alumni, RUSM is one of the largest providers of doctors for the U.S. healthcare system. RUSM graduates practice in all 50 states and in Puerto Rico.

*First time residency attainment rate is the percent of students attaining a 2022-23 residency position out of all graduates or expected graduates in 2021-22 who were active applicants in the 2022 NRMP match or who attained a residency position outside the NRMP match.