How to Choose a Medical Specialty by Anita D. Taylor

Author:Anita D. Taylor
Language: eng
Format: epub
Publisher: Publish Green

"THE PATHOLOGIST, I AM CONVINCED, IS THE UNKNOWN man of medicine."1 Often called "the doctor's doctor," the pathologist acts as consultant to clinicians; therefore the only channels by which his or her services reach the patient are controlled by other doctors.

Some medical students characterize the pathologist as being a "recluse—insecure, uncomfortable, ill at ease with others, and inept in interpersonal communication." Others see the pathologist as "simply trying to beat the hassles of everyday medical practice."2 All seem to agree, however, that the pathologist prefers the science of medicine over patient care and this specialty offers the physician the opportunity to serve as the link between basic science and clinical medicine.

Pathology is the branch of medicine concerned with the cause, manifestation, diagnosis, and outcome of disease. The pathologist provides the morphologic and laboratory analysis to assist in patient care. Although many pathologists have traditionally practiced both anatomic and clinical pathology, increasingly the trend is to limit one's practice to one or the other area of investigation. An anatomic pathologist's work, often done in a hospital setting, is related to the effects of disease on the human body, for example, the examination of tissues removed from surgical patients and the performance of autopsies. A clinical pathologist specializes in laboratory medicine which includes chemistry, hematology, microbiology, and immunology. The pathologist selects testing methods and equipment, supervises the technical staff, maintains quality control, and confers with clinicians regarding the significance of the tests.

Residency Information. A combined anatomic and clinical pathology residency, preparing physicians for the general practice of pathology requires four years; a single area - anatomic or clinical - requires three years. There is training in medical informatics and management as part of the residency, anticipating that many pathologists may someday direct large laboratories.

Board Certification. Following completion of a residency training program and successful passage of a written examination, one may be certified in anatomic or clinical pathology or both.

Special qualification certificates can be attained in more than 20 subspecialties including the following: blood banking/transfusion medicine, chemical pathology, cytopathology, dermatopathology, forensic pathology, hematolopathology, medical microbiology, molecular diagnostics, neuropathology, and pediatric pathology.

Supply and Projections. A shortage is predicted because growth in this field has been slow.

Economic Status and Types of Practice. An influx of foreign medical graduates in pathology in the 1970s brought increased competition and a drop in income. Many pathologists' expenses are paid for by their hospital employers, third-party payment is received for services rendered, and technicians are employed to help provide services.

The dominant mode of practice has been in a hospital-based setting. However, pathologists also can join a private group practice that may run the hospital laboratory under an exclusive contract and be compensated on the basis of laboratory revenue, per-test fees, or a negotiated salary. Pathologists report that there is increasing competition from large commercial laboratories that do not use the services of pathologists and charge less to perform automated clinical tests.

Other work settings for pathologists include state and local law enforcement agencies, public health departments, medical research centers in the private and public sectors, and academic institutions.

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