Becoming a pathologist

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Published: 27 Nov 2013
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Dr Gordan Vujanic – University of Cardiff, UK

Dr Gordan Vujanic explains the field of pathology and how one gets involved in the field.

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The Royal College of Pathologists of Great Britain, they have a motto that pathology is science behind cure and that’s probably the best short definition of what pathology is about. So pathology is the science or medical discipline which is dealing with diagnosis of diseases, it’s not only tumours, obviously, but diseases. So, for example, very often pathology is associated with post-mortems, that’s what the majority of people think pathologists do which is, of course, true but it’s only part of our job, depending in which environment you work. Sometimes it’s only 10% of your job and the rest is all so-called surgical pathology where you make a diagnosis of tumours, of other diseases which cannot be diagnosed by any other means. So, for example, if somebody has got some gastrointestinal problems they’ll take a biopsy of the bowel and give it to a pathologist and the pathologist will say, ‘OK, on the basis of this analysis this patient has got this disease,’ and again then clinicians will treat the disease but they cannot treat something until the pathologist tells them what to do.

So basically pathology is dealing with the diagnosis of different conditions, including tumours, in living patients first of all and probably most importantly, but also in patients who die and the cause of death is not obvious to clinicians, pathologists do post-mortems in order to establish the cause of death and try to explain why somebody who, according to the clinicians who treated them, was not supposed to die, did die eventually. And that’s the purpose of doing a post-mortem, to establish the cause of death because then clinicians can learn what went wrong with a patient, why he or she died and obviously it’s equally important for the family to know why their relative has died and so on. So pathology is about diagnosis in living and in dead persons, children included.

Now there are a lot of TV programmes about forensic pathology in particular. If you go to any station of mine every day some crime scene investigators and some forensic pathologists doing post-mortems and so on. So I think people now have more idea what pathology is about although it’s not always the right idea because, as I said earlier, the majority of people would associate pathology with post-mortems which is only part of that and many people… very few people know that, for example, the treatment of tumours in adults and in children is 100% based on pathological diagnosis. Why people decide to be pathologists, it depends on their exposure as medical students, as you go through your medical studies and if you are exposed to pathology, obviously, because you have that subject as part of your exams and so on. Some people, like myself, became fascinated with that and that’s how I decided that I was going to be a pathologist when I was a medical student. I had no doubt once I understood what pathology was about, I said to myself that this is what I want to do. But people come to pathology through different routes and I hope they don’t regret it.