Happy 1st Annual Pathologists’ Assistant Day

Since today is the 1^st Annual Pathologists’ Assistant Day, I wanted to ensure that everyone knew what was being celebrated! If you’re still confused as to what exactly a Pathologists’ Assistant is, I’ve answered a few frequently asked questions below.

What is pathology?

Pathology simply means the study of disease.  Pathology focuses on the four components of disease: the cause, the mechanisms of development, the structural alterations of cells, and the clinical manifestations (why you go see a doctor).  Pathology can be further subdivided into anatomical pathology and clinical pathology. Anatomical pathology regards the diagnosis of disease based on the gross, microscopic, chemical, immunologic, and molecular examination of organs, tissues, and whole bodies. Clinical pathology focuses on the use of laboratory analysis of body fluids to diagnose disease.

What is a Pathologists’ Assistant?

A Pathologists’ Assistant is a trained healthcare professional who works under a pathologist.  Just like a Physician’s Assistant assists the physicians with their services; Pathologists’ Assistants work in a similar way by assisting Pathologists with their services.  The majority of the PA's work encompasses the anatomical pathology subdivision; they are responsible for the gross examination of organs, tissues, and bodies. They prepare tissue for pathologic testing and examination under the microscope.

What is the difference between a Pathologist and a Pathologists’ Assistant?

A Pathologist is a physician who has completed medical school and residency. Pathologists make diagnoses based upon the gross examination and tissue prepared by the PA.  PAs do not go to medical school and complete crucial steps necessary for the pathologist to make diagnoses, but cannot sign out reports or make diagnoses.

How often do PAs use microscopes?

As I mentioned earlier, the PA's duties focus mostly on the gross examination of specimens, examination with the naked eye. The microscopic examination is left to the Pathologists.  For schooling and board purposes, PAs are required to have an understanding of histology and should be able to identify normal versus abnormal tissue under the microscope.

What kind of jobs can you have as a Pathologists’ Assistant?

As a PA you can work in academic and community hospitals, medical examiners offices/morgues, private laboratories, etc.

What kind of work do PAs do in hospitals?

Anatomical pathology can be further divided into surgical pathology and autopsy pathology.  Most people are familiar with autopsy pathology, but not as familiar with surgical pathology.  Every time something gets removed during surgery, the specimen is sent to the surgical pathology laboratory.  These specimens range from GI biopsies and gallbladders to leg amputations and lungs (and everything in between).  It’s the PA’s job to examine the tissue or organ and write a detailed description for the pathologist.  Then the PA will submit certain tissues for further testing and examination (frozen section analysis, flow cytometry, immunohistochemistry, etc.).  The Pathologist will then be able to make a diagnosis based on the gross description, microscopic evaluation, and any further testing.

What kind of training is needed to become a Pathologists’ Assistant?

The majority of the accredited Pathologists’ Assistant programs are two-year programs culminating in a Master's Degree in Health Science.  Currently there are 9 NAACLS (National Accrediting Agency for Clinical Laboratory Sciences) accredited Pathologists’ Assistant programs: Drexel University, Duke University, Indiana University, Quinnipiac University, Rosalind Franklin University, University of Maryland, University of Western Ontario, Wayne State University, and West Virginia University.  Typically the programs consist of one didactic year followed by a year of clinical training. After graduating from a PA program, Pathologists’ Assistants can choose to take the American Society for Clinical Pathology’s (ASCP) Board certification exam to become ASCP certified.

What do you like most about being a Pathologists’ Assistant?

I love that each day at work is completely different; you never know what you’re going to see at your grossing station or autopsy table. You’re constantly challenged and sometimes have to get creative with how you’re going to process complex specimens.

I want to wish a very happy Pathologists’ Assistant Day to all the current and future PAs; keep doing amazing work!

St. Francis Hospital

My six-week autopsy rotation has come and gone and I’ve started my new rotation at St. Francis Hospital.  St. Francis is a community-based hospital in Charleston, WV. It’s a smaller hospital and the Pathology Department is comprised of one pathologist, three histotechnologists, and one transcriptionist.  Since it’s a smaller hospital and there is a lighter specimen load, the PA students get to do all of the grossing. 

A typical workday at St. Francis starts by reviewing the slides, under the microscope, from the previous day with the pathologist.  I really value this time because it allows me to get immediate feedback on the sections I submitted and find out if anything was missing from my dictations. Once the pathologist has signed out the cases, I head to the gross room and start grossing the specimens for the day.  St. Francis seems to get a lot of head and neck specimens (tonsils, thyroid, parotid gland, etc.) as well as skins, GI biopsies, and occasionally colons. Occasionally, the pathologist does get called for frozen sections, so I’ve been able to get more practice cutting frozen sections as well.

I really enjoy the fact that this rotation allows you to work independently and make your own judgment calls.  I'm starting to feel confident that I know what sections to take and the pertinent information to include in the dictations.  It feels good not to be asking nearly as many questions!

So many tonsils!