Pathologists' assistant

General Overview

PA’s work under the direct supervision of a board certified anatomical pathologist, who ultimately renders a diagnosis based on the PA’s detailed gross description and/or tissue submission. Requirements to become a pathologists’ assistant include graduation from a National Accrediting Agency for Clinical Laboratory Sciences (NAACLS) accredited education program and/or successfully passing the American Society for Clinical Pathology (ASCP) certification exam. With ongoing changes in health care, a growing elderly population, and a decreasing number of pathology residents, the PA is in high demand due to their high level of training and contribution to the overall efficiency of the pathology laboratory.

In addition to the major responsibilities outlined above, a pathologists’ assistant may also perform following tasks (for a complete list, refer to Article III, Section B of the AAPA Bylaws):

While many PA’s are employed in hospitals, they may also gain employment in private pathology laboratories/groups, medical examiner's offices, morgues, government or reference laboratories, or universities, and may be self-employed and provide contract work. According to a study published in Autonomic Pathology, PAs perform gross examinations on 56.5% of the total number of specimens submitted industry-wide, with a majority being biopsies.(needs citation)

History of Profession

The idea of physician extenders was conceived in 1966 by Dr. Eugene Stead at Duke University, where the first physician assistant program was established. Three years later, also at Duke, Chairman of Pathology Dr. Thomas Kinney implemented the first pathologists’ assistant program. To date, nine accredited programs have been established across the United States and Canada.

Education

Each program is NAACLS accredited and collectively graduates approximately 118 students a year. As of 2010, just over 1,400 pathologists’ assistants are in practice. The programs vary in details, but are generally two-year programs both at the bachelor and masters levels, and include didactic and clinical exposure. The didactic year commonly includes an education in clinical anatomy, neuroscience, physiology, histology, pathology, pathologists’ assistant (clinical correlation)- specific courses, medical terminology, and inter-professional classes. Students then are placed in a clinical setting in affiliated hospitals and medical examiner's offices to learn prosection and autopsy techniques hands-on.

Universities granting pathology assistant degrees include:

1. Drexel University Master of Science in Pathologists’ Assistant Studies
2. Duke University Master of Health Science
3. Indiana University Master of Science
4. Quinnipiac University Master of Health Science
5. Rosalind Franklin University of Medicine and Science Master of Science in Pathologists' Assistant Studies
6. University of Maryland, Baltimore Master of Science in Pathology
7. University of Western Ontario Master of Science in Pathology
8. Wayne State University Bachelor of Science in Pathologists' Assistant (transitioning to masters program in the near future)
9. West Virginia University- Master of Health Science

Education and Certification

Pathologists' assistants have been employed in pathology labs for over 40 years. Formal training programs slowly appeared (there were four nationwide in the late 1990s). The programs became NAACLS accredited beginning in the late 1990s, and then programs slowly continued their transitions from bachelor's to master's programs as their number increased. Prior to ASCP certification, which came about in 2005, the AAPA had a fellowship status that program trained pathologists' assistants or on-the-job trained (OJT) pathologists' assistants (who could do specific coursework and 3 years of active employment) could join only based on passing a rigorous exam that parallels the current ASCP certification exam. The OJT route was eliminated at the end of 2007. The professional association uniting PAs is the American Association of Pathologists' Assistants. Part of their duties as an association is to provide continuing medical education credits (CME) in order to keep members current on advances and procedures in the field that must be completed every 3 years in order to maintain ASCP certification.