Introduction
Pathology is the study of disease. Pathology is important because in order to treat a disease we need to identify, confirm the disease and understand how the disease works. Pathology is the bridge between science and medicine.
If you’ve ever been to hospital and had to get a blood test, that is a pathology service. Chances are you never met the person that processed your blood test, you only met the person that collected your blood and the person that gave you your test result. That’s because most of the work of pathologists happens in the background. Although hidden, pathology services are vital to all hospitals, clinics and public health efforts. Pathology supports the work of doctors and other healthcare workers who work in the wards as clinicians.
What is a Pathologist?
A pathologist is a medical doctor that does most of his work in a laboratory, working with body tissues and fluids to diagnose disease. Pathologists diagnose diseases such as infections, cancers, leukemia and other blood disorders.
A pathologist can work in numerous areas, or sub-specialties, such as anatomical pathology (deals with biopsies and tissue diagnoses such as cancer), hematology (deals with blood diseases such as leukemia, thalassemia and bleeding disorders), microbiology (deals with infectious diseases caused by microorganisms including virus and bacteria), chemical pathology (deals with lab chemistry, toxicology), forensic pathology (determining cause of death eg. by autopsy).
A Day in the Life of a Pathologist
Pathologists work closely with doctors from various specialties; they help surgeons with cancer diagnoses, they help pediatricians with monitoring leukemia treatment, they help radiologists to do biopsies and they help every doctor whose patient needs a blood transfusion. Much of the work of a pathologist is in collaboration with medical laboratory scientists, who are the backbone in the daily operation of laboratories. Unlike other doctors, pathologists are not assigned to a hospital ward to care for patients, but you may find them in every place in the hospital; from the special care nursery to the emergency department and from the operating theatre to the mortuary. Pathologists are the invisible hand that guides treatment.
The work days of a pathologist are a mix of examining microscope slides, reading and interpreting laboratory results, writing patient reports, attending case discussions and meetings with other doctors for patients that they co-manage, teaching resident doctors and junior staff, doing research work, and of course attending to patients. They might attend to patients at the laboratory and blood bank, patients in the wards and even patients in the operating theatre. Most work days are from 8 a.m to 4 p.m with more ‘regular’ hours compared to other doctors in terms of shift work or being on call. Despite the kind of hours worked, the days for a pathologist are anything but routine.
Why Pathology Is Vital in Papua New Guinea
Papua New Guinea has a low doctor to patient ratio with estimates of around 1 doctor to every 20,000 people. That number is much lower for pathologists. At the moment there are less than 100 pathologists in Papua New Guinea, which is for the entire country of 12 million people. With 1 pathologist graduating every 2 or 3 years, the need for more pathologists is urgent. One area that would benefit greatly from having more pathologists, is cancer diagnoses from examining body tissue samples, which is in the field of histopathology. Currently, bottlenecks due to shortage of pathologists required to read and report on potential cancer specimens, can result in months of waiting for the patient. Pathology is a high need, high impact specialty in medicine that is extremely under-served in Papua New Guinea.
Who Would Enjoy Working as a Pathologist?
What kind of person would enjoy being a pathologist? To be a pathologist is to have a keen eye for detail and pattern recognition, guided by scientific curiosity and problem solving. You will need to work logically and methodically, both independently and collaborating with specialists from various fields, often times remotely. A willingness or enjoyment of using and troubleshooting machines is a bonus; microscopes, laboratory analyzers, computers, telepathology equipment – all these are vital components in the work of a pathologist. Overall it is the ability to do procedural work and yet think outside of the box when called to; you are a combination of scientist, medical doctor and problem solver.
Career Opportunities and Training Pathway
How does one become a pathologist in Papua New Guinea? First you have to go to medical school for 5 years and graduate with an MBBS degree like other doctors. Next you have to complete 2 years of medical residency training as a Resident Medical Officer (RMO). After residency you need to work as a Medical Officer (MO) for at least 2 years in a major clinical discipline such as internal medicine, pediatrics or emergency medicine. This is called doing service registry. This part of your journey gives you valuable clinical context that will serve you well as a pathologist in training. After service registry you can apply for specialty training in pathology, which is essentially post graduate training to obtain a master’s degree in medicine-pathology and become a Specialist Medical Officer (SMO) in Pathology. Specialty training takes 4 to 6 years.
A pathologist has many career options and can find jobs in both the public and private sector working in hospitals, laboratories or even universities and NGOs doing teaching and research. Pathology is a diverse and growing specialty with emerging fields such as telepathology and artificial intelligence for diagnoses. It is an exciting time to join the field with a myriad of developments and opportunities on the horizon coupled with a pressing need for qualified people to serve a rapidly growing population.
The Privilege of Being a Pathologist in Papua New Guinea
With so few doctors in Papua New Guinea and even fewer pathologists, choosing pathology as a career is a privileged calling — a challenging path with unique and satisfying rewards: your work hours are more regular compared to other specialties; you get to travel often; you collaborate with visiting doctors and experts from other countries; you get to teach and train junior doctors, staff, and medical students; you still get patient interaction even if you don’t spend most of your time with patients; you are part of a small team doing focused work to solve pressing problems. You are at the forefront of a developing field, actively helping shape its future, and contributing to the big-picture impact across the entire healthcare system.
The core of medicine is treating and preventing disease. As a pathologist, you will understand disease processes from the level of the cell to how tissues, organs and body systems interact. You will understand diseases from fetal development to the changes that occur after death. Your knowledge will be vast, spanning patient signs and symptoms to physical examination, to collecting appropriate diagnostic samples for investigation, to interpreting test results, and understanding the principles, inner workings, and limitations of the machines that perform diagnostic tests, to laboratory workflows and to healthcare systems.
It is a privilege to have the opportunity to learn, teach and serve in the specialty. To be a pathologist is to embark on an extremely rewarding career where you have the chance to quite literally be a doctor who is one in a million.
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