Pathology is the study of disease and how it affects the body. A pathologist is a medical professional, often a doctor, who examines and analyzes tissues to identify changes and unusual features. Their findings underpin every aspect of medical care.

The term pathology comes from ancient Greek and translates to the study of suffering. Doctors and scientists working in pathology are experts in illness and disease and use their expertise to support every aspect of healthcare.

There are different routes to becoming a pathologist, but they involve years of studying and training. Pathologists may practice in all areas of pathology, but they will typically specialize in a certain field or discipline within this subject, such as neuropathology, hematopathology, or dermatopathology.

In this article, we will discuss what pathologists do, how to become one, and the types of specialties that exist.

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Pathology is a general term to describe the study of diseases and injuries that may occur in the human body. By obtaining samples of bodily cells, fluids, and tissues and then analyzing them, an expert can identify any abnormalities or distinct changes. This enables them to better understand the cause of the issue, how it is progressing, and how the condition is affecting the body’s typical functions and processes.

Pathologists are typically either doctors with specialist laboratory training or scientists with specialist clinical training. They work closely with other healthcare professionals and contribute toward the diagnosis, prognosis, and treatment of diseases. They are responsible for performing laboratory tests to show the presence, cause, and severity of diseases and to monitor the progress of the condition and effects of treatment.

While most pathologists receive training in both the clinical and anatomical realm of pathology, some receive additional training, giving them expertise in a certain subspecialty of their choosing.

The route to pathology will usually commence after the successful completion of a related degree and training. A person will then complete a residency, where they study and practice pathology under the training of experts in the field. The field of pathology encompasses both anatomic and clinical aspects, with anatomic focusing on the effect of disease on the human body and clinical involving laboratory work and supervising testing procedures.

A person may choose to specialize in one of these disciplines or take a longer residency and practice both. The final step to becoming a pathologist is passing a board certification exam.

The path to becoming a pathologist may follow a similar trajectory as follows:

  1. An individual will first go to college and receive an undergraduate education in a medical-related subject. They may already be considering which subspecialties are of interest, as this may help them choose a suitable medical school.
  2. Next, a person will take the Medical College Admissions Test (MCAT). Most students take this during their junior year so that they can get their results by the time they apply to medical school. Most medical schools share their minimum MCAT requirement along with the average incoming student MCAT scores to inform prospective students about ideal scores.
  3. After medical school, an individual must complete a pathology residency, which typically lasts 4 years. This is when prospective pathologists participate in rotations at hospitals to learn different skill sets such as microbiology, immunology, and more. Pathologists choosing a subspecialty will complete one or two additional years of fellowship training in that specific field.
  4. Prospective pathologists must then obtain a Doctor of Medicine license after completing a medical doctorate and residency.
  5. All pathologists must then receive certification. In the United States, the American Board of Pathology certifies eligible doctors. In order to obtain this, an individual must have a medical degree from an accredited school, completed their pathology residency, have a medical license, and passed a certification test. A person may also become a member of the College of American Pathologists or the American Society for Clinical Pathology.
  6. Lastly, a pathologist may want to have a subspecialty. While this is optional, any individual interested in having a subspecialty must complete a fellowship where they receive additional training in their area of interest. A person will complete this fellowship at a hospital, and it typically lasts around 2 years.

Some pathologists have a subspecialty within a certain discipline of pathology. This typically requires additional training and an assessment of knowledge. While training standards and organizations may differ between countries, they largely cover similar duties. Some subspecialties and their corresponding responsibilities include:

Blood banking or transfusion

A pathologist specializing in this area is responsible for the monitoring, processing, and compatibility of blood products. This involves ensuring sufficient blood is available and overseeing the safety, testing, and preparations for blood and blood components.

Clinical pathology

Clinical pathologists, sometimes known as chemical pathologists, are experts in biochemistry and how changes in bodily pathways relate to disease diagnosis and progression. These individuals monitor substances in bodily fluids, such as blood and urine, to assess changes in an individual’s body chemistry.

Clinical informatics

A pathologist who specializes in clinical informatics aims to improve patient and society health outcomes, patient care, and doctor-patient relationships. They do this by evaluating data, health trends, and communication systems and collaborating with other healthcare professionals. These individuals use the information they collect to try to improve and polish medical processes that will allow for better patient outcomes.

Cytopathology

Cytopathologists analyze cell samples from bodily fluids to check for cellular abnormalities and use that information to study and diagnose conditions. They use techniques that enable them to observe cells, such as staining methods or using a microscope.

Dermatopathology

Dermatopathologists specialize in interpreting skin biopsies to help diagnose a variety of skin conditions. This may involve studying a skin sample under a microscope to evaluate the tissue’s structure, detect any agents causing the condition, and assess for abnormalities.

Forensic pathology

A forensic pathologist will study tissue in an individual after a sudden, unexpected, or violent death. They sometimes will work as a medical examiner or coroner by performing autopsies for law enforcement. It is their responsibility to help determine the cause, manner, and mechanism of death.

Hematology

A pathologist who specializes in hematology studies conditions specific to blood cells, blood clotting pathways, bone marrow, and lymph nodes. These individuals use blood samples to diagnose conditions such as anemia, leukemia, lymphomas, and more.

Medical microbiology

A medical microbiologist studies infectious organisms and antibiotic susceptibilities. They support and oversee the prevention, diagnosis, and treatment of conditions that result from microorganisms.

Molecular genetic pathology

A molecular genetic pathologist studies genetic markers. These individuals assist with the monitoring, diagnosis, and prognosis of diseases relating to genetic disorders, infectious diseases, and human development. They also help determine the risk of genetic disorders.

Neuropathology

Neuropathologists are individuals who study conditions that affect the nervous system. They will frequently act as consultants to neurologists and neurosurgeons and will analyze samples postmortem to study dementia, assess trauma, and evaluate genetic conditions.

Pediatric pathology

A pathologist who specializes in pediatric pathology investigates diseases that occur in children up to 18 years of age. These individuals may also specialize in perinatal pathology, which involves the study of disorders of the placenta, problems affecting development, and causes of pregnancy loss.

Pathologists are medical professionals who help study the cause and progression of a disease or injury. They are typically experts in a certain subspecialty and frequently help other physicians with the diagnosis, prognosis, and treatment of conditions. Becoming a pathologist involves many years of education and training under experts.