A busy pathologist needs help, the hospital budget doesn't allow for more pathologists and a medical technician doesn't have the necessary skills. That's why pathologists' assistants are becoming so popular.

"With the changing health care system, every doctor wants to have an assistant," says Dr. James G. Lewis, head of Duke University's pathologists' assistant program. "Pathologists are no different."

Pathology is the study of disease. Pathologists' assistants help with and perform biopsies (examining tissue for diseases) and autopsies (determining the cause of death) under a pathologist's supervision.

"As a country, we don't graduate many of them and there's a big demand for them," Lewis says. "There are only three or four nationally accredited training programs in the country." Those programs combined graduate only a handful of pathologists' assistants every year.

"In every single graduating class I've ever had, each student has had several offers to choose from."

That's not too shabby when you consider that salaries in the U.S. range from $50,000 to $60,000 for graduating students. Throw in a comprehensive benefits package and you might be thinking your ship has come in.

But before you rush off for that application, hold your proverbial horses. "I get about 40 applications a year," Lewis says. "There are a bunch who are completely unqualified for the program, so they're eliminated almost right away. Generally, I get about two qualified people for every slot I have to fill. Sometimes it's more."

Lloyd Kennedy, a pathologists' assistant in Canada, says while the situation in the U.S. is great, it isn't too bad north of the border. "There is a demand for PAs here. The salaries are much better in the States than they are here, but the demand is here," says Kennedy.

"Right now, there's a surplus of pathologists in Canada. That makes it hard to get a good job and have good training programs."

But Kennedy adds he thinks that in the next few years, a lot of pathologists will be retiring, leaving a serious need for both pathologists and their more affordable assistants in Canada. When that happens, Kennedy says, university-level training programs will appear.

Kennedy, who took science as an undergraduate and pre-med as a post-grad program, says he's one of a handful of Canadians certified through the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS). Most of its members are American, and all of its members meet certain criteria: namely, a B.Sc., pathology courses at the master's level, on-the-job experience and a written exam.

"In Canada, you get some pathologists' assistants who have PhDs, others who have B.Sc. degrees, and still others with a foreign medical degree," Kennedy explains. "It's just more informal here."

The American program is more structured. "This is not a field to be entered into lightly," Lewis says. "You need to go to college and you need to prepare yourself properly."

His students never suffer from a lack of academic or on-the-job experience. "My typical student is usually not coming to me right out of school. Most have a master's in a basic science. They graduate thinking that they'll be scientists, but end up as research technicians. I get a cadre of people like that, and for the most part, they've come to the right place."

But far too often, Lewis says he sees wannabe pathologists' assistants taking undergraduate courses like anatomy and cell biology, thinking they'll make a good impression on a director like Lewis.

"Why would I want students to take what I'm going to teach them?" he asks rhetorically, with a hint of bewilderment in his voice.

His advice: "Get a good, solid, basic science background. Know the basics and make sure you know if pathology and dealing with a removed colon is something you want to spend your life doing. People have to like the work. The big paycheck will wear off real quick if you don't like performing autopsies."

Lewis says the potential for pathologists' assistants is virtually limitless. "I don't see mechanization taking this job away," he explains. "It will be way, way into the next century before pathologists' assistants are replaced by technological advances because this job involves looking, understanding and describing. No computer can do that."

Net Sites

Duke University
An outline of the pathologists' assistants program
http://pathology.mc.duke.edu/paprogram/history.htm

American Association of Pathologists' Assistants
All the latest information on issues affecting pathologists' assistants
http://www.pathologistsassistants.org

American Society of Clinical Pathologists
Promoting public health and safety
http://www.ascp.org/