The role: From blood samples to throat swabs and even coronavirus tests, when a physician sends samples to a lab for testing it is a pathologist who provides a diagnosis.
“Anything that is taken off a patient goes to a lab, and the medical people that look after the lab are the pathologists,” says Raymond Maung, a staff pathologist at Interior Health Authority and chair of the Workload and Human Resources Committee at the Canadian Association of Pathologists.
He explains that pathologists have historically been divided into four distinct categories; anatomy pathologists, who diagnose anything taken out of the human body, or the entire human body itself, such as autopsies, biopsies and skin legions; hematopathologists, who investigate and diagnose blood disorders; chemical pathologists, who investigate other bodily fluids such as plasma and urine; and molecular microbiologists, who study viruses and infections.
Dr. Maung adds that there are also general pathologists, who have more limited expertise in a wider array of fields, and are typically employed by smaller hospitals and laboratories with fewer specialty staff. There is also a newly emerging field in pathology known as molecular pathology, which utilizes DNA sequencing to diagnose and treat ailments.
Pathologists in Canada are primarily employed by hospitals, Dr. Maung explains, though a small minority also work in private laboratories. Depending on their specialty, they typically spend between half and all of their time looking down a microscope analyzing samples, with the rest dedicated to oversight, maintenance and administrative duties.
“The other thing that’s very big in medicine now is quality assurance," he adds. “It’s become a big part of our work; about 10 per cent of our time is spent doing quality assurance.”
Salary: According to PayScale.com, the average annual salary of a Canadian pathologist is about $245,000, with compensation starting at $78,000 a year and reaching as high as $370,000 annually.
Education: Working in Canada as a pathologist often requires more than a decade of postsecondary education. After high school, pathologists need to complete an undergraduate degree, and then enroll in and complete medical school.
“After that you apply for a subspecialty to become a pathologist. You can apply as a general pathologist or you can apply for one of the subspecialties; this is another five years,” Dr. Maung says. “If I like lung pathology, for example, I have to do another fellowship for one or two years to become subspecialized in lung pathology as well.”
As a result, he says, most pathologists complete their education in their early or mid-30s.
Job prospects: According to a study published in the U.S. National Library of Medicine, Canada’s pathologist work force increased by more than 20 per cent during the decade between 2007 and 2017. According to Dr. Maung, however, the need for pathologists in Canada will only increase as more enter retirement.
“In my recent study of B.C. and Ontario, which have the highest number of pathologists, pathologists that are 65 and over is about 25 per cent [of the work force]," he says. “There are a lot of us retiring, so there a lot of job prospects coming.”
Challenges: One of the biggest challenges pathologists face is an inconsistent workload that often requires overtime without additional compensation.
“The sample needs to be tested on the day it arrives," Dr. Maung says. “We know there’s a patient waiting at the other end, so we need to finish it on our own time, and the overtime is done without anybody really noticing it.”
Why they do it: While pathologists often work behind the scenes, the field can be just as rewarding as patient-facing medical positions, only without the added challenges of meeting with patients face-to-face. Furthermore, as a lab-based profession, the hours are much more consistent than is typical for medical professionals.
“We come to a lab and there’s no patient waiting, just slides, so we can be flexible in terms of how we do the job,” Dr. Maung explains.
Misconceptions: Most Canadians only know about the field based on what they see on TV, but media portrayals of pathologists often focus on one specific part of the job.
“If I say I’m a pathologist, most people think I’m just doing autopsies, which is a minor portion of our work, but it’s the one you see on TV shows like on CSI or medical and forensic dramas,” Dr. Maung says. “We are doing a lot of tests that are essential for treatment, but most people don’t see that; I don’t even think most physician[s] even know what pathologists even do, because they don’t see us at work.”
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