PATHOLOGY: A Career in Medicine

1. PATHOLOGY: A Career in Medicine • Pathology is the study of the nature of disease - its causes, development and consequences • Career Opportunities: • Diagnostician • Teacher • Scientific Researcher

2. The Pathologist in Patient Care • Identifies diseases in cells, tissues & fluids of the body • Analyzes gross and microscopic structural changes in tissues caused by disease • Examines cells to aid in disease detection • Provides and interprets laboratory information to help solve diagnostic problems and monitor effects of therapy

3. Anatomic Pathology: Surgical Pathology • Analysis of Biopsies and Surgical Specimens • Surgically Removed Tissue • Frozen Section/ • Gross and Microscopic Evaluation • Diagnosis and Prognostic Information

4. A Case Study in Lung Cancer • Patient: • 46 year-old man • Heavy smoker • Complains of: • Weakness • Chronic cough • Chest pain • Physical and Lab Findings: Elevated Blood Pressure Elevated Serum Calcium

5. A Case Study in Lung Cancer • CT imaging reveals mass • in right lung • Patient taken to surgery • Mass biopsied and sent for frozen section • Microscopic evaluation yields: • - Precise diagnosis • - Extent of disease • - Information needed to determine course of action

6. Anatomic Pathology: Cytopathology A Case Study in Thyroid Cancer Patient with thyroid mass receives a tracer dose of radioactive iodine, which reveals a “cold” nodule Pathologist performs fine- needle aspiration (FNA) Surgeon and oncologist determine course of action based on pathologist’s FNA diagnosis Mass removed during surgery

7. Anatomic Pathology: Autopsy • Autopsy provides insight into disease processes and the influence of therapy on disease: • Reveals cause of death • May detect previously undiagnosed genetic disorders – information that may benefit living family members • Provides feedback to physicians involved in patient care: 1. Accuracy of diagnoses 2.Effectiveness of treatment

8. Clinical Pathology • Clinical pathology specialty laboratories include: • Hematology • Microbiology • Immunology • Clinical Chemistry • Toxicology • Transfusion Medicine • Pathologists serve as consultants to other physicians by: •  recommending appropriate tests •  interpreting test results

9. Molecular Pathology • DNA sequencing to identify • infectious agents • Molecular identification of chromosomal rearrangements • Genetic alterations • Prenatal screening for hemoglobin disorders and metabolic diseases • Genetic susceptibility to cancer

10. The Pathologist as a Consultant • Interprets laboratory results • Advises physicians on appropriate diagnostic tests • Contributes to medical and surgical patient management decisions • Serves on hospital committees (e.g. quality assurance, blood utilization, infection control) • Updates physicians about laboratory medicine in Continuing Medical Education programs

11. The Pathologist as a Teacher • Provides instruction to medical students, pathology residents, graduate students • Provides instruction to students in allied health science training programs • Provides instruction in local, regional or national continuing medical education programs

12. The Pathologist in Research • Investigates the causes and mechanisms of diseases by: • Tracing new diseases to their origins • Improving diagnostic approaches to diseases • Identifying the genetic basis for patient response to treatments • Identifying new pathogenic bacteria and other infectious agents • Identifying genes involved in specific cancers

13. Pathology Training for Medical Students • General and Systemic Pathology courses • Elective opportunities for senior students • One-year fellowships in pathology, usually following the second year of medical school

14. Graduate Medical Education in Pathology • Residency Programs: • Anatomic and Clinical Pathology • Anatomic Pathology • Clinical Pathology • Fellowships: • Blood banking/transfusion medicine • Chemical pathology • Cytopathology • Dermatopathology • Forensic pathology • Hematology • Medical microbiology • Molecular genetic pathology • Neuropathology • Pediatric pathology

15. Pathology Practice Options • Community Hospitals • Private/Group Practice • Clinics • Health Care Facilities • Independent Laboratories • Medical Schools • Military • Federal Government Agencies (NIH, FDA) • State Government • Pharmaceutical/Biotech Companies

16. Sources of Information Sources of Information Intersociety Council for Pathology Information (ICPI) www.pathologytraining.org American Society for Clinical Pathology ( ASCP) www.ascp.org American Society for Investigative Pathology (ASIP) www.asip.org Association of Pathology Chairs (APC) www.apcprods.org College of American Pathologists (CAP) www.cap.org United States and Canadian Academy of Pathology (USCAP) www.uscap.org

17. Directory of Pathology Training Programs Undergraduate Study in Pathology Listing of Residency Training Programs, Fellowships, and Post-Sophomore Fellowships. Print-on-Demand available for the full Directory or Residencies-only or Fellowships-only versions. Order online atwww.pathologytraining.org. The Directory is also available online and is fully searchable by institution, region/state, and specialization. www.pathologytraining.org

18. Biomedical Physician Scientist Careers Published by the American Society for Investigative Pathology with support from ICPI • What is a Physician Scientist in Pathology and Laboratory Medicine? • Why Choose Academic Pathology and Laboratory Medicine? • Is a Physician Scientist Career for Me? Choosing a Training Path • Choosing a Program • Choosing a Supervisor • Searching for Your First Job • Launching your Physician Scientist Career • Tenure, Promotions and the First Ten Years • The Institutional Challenge to Train and Maintain Physician Scientists

19. Journey To Success: Career Pathways for Biomedical Scientists in Pathology and Laboratory Medicine Published by the American Society for Investigative Pathology, with support from ICPI • What is a Biomedical Scientist in Pathology and Laboratory Medicine? • Why Pursue Pathology as a Career in Biomedical Science? • Is a Biomedical Career in Pathology for Me? • Education • Non-Traditional Careers • Searching For Your First Job

20. Intersociety Council for Pathology Information (ICPI) Intersociety Council for Pathology Information (ICPI) 9650 Rockville Pike Bethesda, MD 20814-3993 (USA) Phone: 301-634-7200 Fax: 301-634-7990 Email: ICPI@asip.org www.pathologytraining.org