Pathology at the University of Louisville School of Medicine
The scientific basis for the practice of medicine is found in the medical specialty of Pathology. Giving up the stethoscope, reflex hammer and other tools used by clinicians, the pathologist uses tools in laboratory medicine to develop insight into patient problems. Pathologists typically practice in hospital and clinical laboratory settings and are consultants to clinicians in a multitude of different specialties. Most clinicians use the laboratory in one fashion or another including laboratory medicine dealing with evaluation of body fluids like blood and cerebrospinal fluid and as well as anatomic pathology dealing with gross and microscopic assessments of cells and tissues removed at biopsy, surgery and autopsy or through scrapings or aspirations.
The pathologist is involved not only with patient care but also clinical research and medical education for undergraduates, graduates, physicians and the public. The autopsy provides an unusual opportunity to recognize natural and unnatural human conditions and to evaluate treatment protocols for various diseases. Ultimate quality control for medicine is obtained from the autopsy. Unfortunately, the latter are dwindling. At the University of Louisville Hospital the autopsy rate approaches 40 percent, yet most are done at our affiliated Medical Examiners Office since UofL Hospital is a major trauma center. Health professionals, law enforcement personnel, coroners and society in general interact with clinical pathology in areas such as hematology, clinical chemistry, microbiology, transfusion medicine, flow cytometry, molecular pathology and immunopathology. Molecular techniques are used to understand, confirm and treat many diseases more frequently now and are routinely relied upon in medical research. Nobel Laureate pathologists, such as Carl Landsteiner, George Whipple, Howard Florey, Alexander Fleming, McFarland Burnett and Baruj Benacerraf have made major contributions to medicine.
Numerous opportunities are available for pathologists in community hospitals, private and public clinical laboratories, academic medical centers, industry and government. Seventy-five percent of pathologists practice in community hospitals but other settings include medical schools, independent laboratories, specialty hospitals and military and government agencies including the Center for Disease Control. The American Board of Pathology currently offers certification examinations in not only anatomic and clinical pathology, but in many subspecialties including blood banking/transfusion medicine, chemistry, cytopathology, forensic pathology, hematology, medical microbiology, molecular genetic pathology, neuropathology, pediatric pathology and dermatopathology. At the University of Louisville, in addition to an anatomic and clinical pathology combined program, subspecialty fellowship training in transfusion medicine, cytopathology, and forensic pathology is available. Satisfaction in the specialty of pathology is high, and contributions to the medical community and society are significant.