What is it like to be a pathologist?
March 24, 2010 9:29 PM   Subscribe

I have the opportunity to get into a pathology residency programme in Singapore. Does anyone have any idea what pathology will be like as a medical specialty?

I am a recent medical graduate from a UK university who is currently based in Malaysia but looking to train in Singapore. Among the current specialties offered, it appears to be the one that appeals to me the most. A broad scientific scope, more opportunities to get into research and of course, a better work-life balance than most clinical specialties (no night calls!). I tend to work better by myself, which also compels me towards this field.

I have been spending a bit of time googling websites that provide some overview what "a life in the day of a pathologist" is like but I was hoping there are some Mefites who can provide some insight.
posted by ianK to Work & Money (5 answers total) 3 users marked this as a favorite
Instructions for experiencing life as a pathologist:

Step 1:
Get a hold of a microscope and a few dozen slides.

Step 2:
Spend all day looking at those slides under the microscope and describing what you see on a voice recorder.

Step 3:
There is no step 3.
posted by euphorb at 10:20 PM on March 24, 2010

Best answer: I worked in a Pathology department a few years back - as a techy/web designer, not a pathologist - but I might be able to shed a little light.

Pathologists are famously strange amongst medics. They make jokes about it. There are some who go into pathology for the love of pathology (science, etc.), but there are some who go into pathology because they don't have the bedside manner or the ability to deal with patients. As a techy-geek, I fitted right in (hey, social skills are over-rated, right?). There was one guy who I worked directly with who never succeeded in saying hello to me in the corridor. When we had a meeting, he'd be fine (if reserved), but it was as if he was incapable of recognising me outside of scheduled appointments. People assured me this was not personal, and that he did it to everyone, but it did freak me out a bit.

Whilst a lot of places are still using glass slides and there will of course be glass slides involved, the new slide scanners by people like Aperio are revolutionising aspects of pathology. I think that they're going to have the largest impact on teaching and collaborative working (no more multi-headed microscopes! being able to point accurately at regions of interest! being able to share cases without having to cut multiple slightly different slides!). An interest in tech/digital imaging will almost certainly be required in the future of pathology.

I know nothing about Singapore, but I know that in the UK the path from trainee to consultant can be fairly rapid for pathologists, which is another thing to take into account if progression drives you.
posted by handee at 2:28 AM on March 25, 2010

I know someone who was considering pathology as a specialty, until he did a rotation and found that after 10 minutes at the microscope he got so violently ill that he had to stop. He said it was similar to very bad motion sickness, and he was never able to work more than a few minutes at a time without feeling sick.
Something to consider.
posted by nprigoda at 2:55 AM on March 25, 2010

Best answer: In the United States, pathologists are sometimes called "The Doctor's Doctor" because most of their work tends to be interpreting test results that primary care (UK = general practitioner?) doctors have ordered for their patients. So most of a pathologist's customer contact is actually going to be with other physicians, not with patients. Wikipedia has a pretty good article about it, which you doubtless have already read.

(I am so tempted here to tell you to watch Crossing Jordan, because being a pathologist in real life is exactly like that. Must resist temptation....)

Going back into serious mode for a moment: Another thing you may wish to consider is that pathologists are the doctors who traditionally perform autopsies. Most of your work will overwhelmingly probably still be of a clinical/diagnostic nature, but you may occasionally be called upon to carve up cadavers. This leads to another unfortunate nickname for pathologists (at least those who are also medical examiners) i.e. -- "canoe makers".

As well, in developed countries, pathology (along with radiology) is in some areas seeing a decline in enrollment. Anecdotally, this is blamed on fear of litigation. Yes, it's true-- they are not training as many radiologist and pathologists because so many of them have been sued by patients for not correctly diagnosing their cancer, and recent graduates don't want to enter a specialty that is so potentially dangerous to their careers. Again, things may be different in Malaysia and Singapore.

Finally, some hospitals and clinics in the US and Europe are now using super-high resolution scanners to email their biopsy slides/xrays to places like Singapore or India. There they are read by Chinese and Indian pathologists/radiologists, who are almost universally as good or better than their counterparts in the developed world, but who work for a lot less money. Also these pathologists don't have the temerity to demand things like offices and parking spaces and health insurance. This is another factor that may lead to diminished opportunities for pathologists in Europe and North America. This is conjecture, since there is generally a shortage of qualified pathologists in developed countries, but may be food for thought for the future of the specialty. On the other hand, since you may be looking to practice in Singapore or Malaysia, you could actually be on the other side of this equation as a pathologist who picks up a lot of extra consultations from hospitals in Denmark and Canada! Such global employment was not possible until recent advances in technology and information bandwidth.

Well, just a few thoughts. Congratulations on your graduation-- the world needs more good doctors!
posted by seasparrow at 8:21 AM on March 25, 2010

Well I'm one so feel free to ask any questions and I'll try to answer (I could probably write tons and tons but I'd rather answer specific questions).
(US medical school --> US residency --> US Pathologist so there is likely to be some differences in specifics. It is a great field, and I genuinely love what I do.)

In any given hospital, any of the really cool cases brush up against pathology at some point. I always love zebra cases (you know... when you hear hoofbeats...) and pathology is the best opportunity to see them.

For the most part, pathology is the starting pistol for any really serious medicine. You can't get treated for your cancer, until we tell your doctor what kind of cancer you have.
posted by i_am_a_Jedi at 5:07 PM on March 25, 2010 [1 favorite]

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