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The ACGME defines neuropathology as the subspecialty of pathology dealing with the tissue-based diagnosis of diseases of the central and peripheral nervous systems, skeletal muscle, and eye.
Neuropathology is a highly specialized field with a unique set of characteristics that plays a significant role in a wide range of clinical settings—from neuromuscular and ophthalmic cases to neurodegenerative diseases and forensics. Because it relies so heavily on molecular analysis for tumor cases, and intensive brain examination for medical and forensic autopsies, most general surgical pathologists are not comfortable working with neuro cases. Neuropathologists also get the opportunity to work on neuroscience topics, which is a rapidly evolving part of biomedical research.
Frequently Asked Questions
While there are no significant employment challenges, the predominance of academic settings for neuropathology positions can limit opportunities for those seeking jobs in other areas—it can be rare to find a community position that requires a specialization in neuropathology. Additionally, due to the relatively low case volume, neuropathologists often need to combine their practice with another specialty, research, or autopsy work.
The neuropathology fellowship is two years.
Yes, although it varies from practice to practice. For instance, at some institutions, on-call time may involve activities like coverage of operating rooms for frozen sections, intraoperative consultations, and/or other practice-specific scenarios.
The neuropathologists’ case volume can vary depending on the institution, with most having low to medium case volumes but others (ie, at larger academic centers) seeing a higher number of consultation cases from outside. Ancillary tests are definitely run, and the majority of brain tumors are sent for some type of molecular testing—such as NGS, copy number analysis, or methylation profiling—particularly in busy neurosurgery practices where they may see as many as 10–20+ tumors a week.
Neuropathologists interact with a variety of other specialties. A few of the more common include neurologists, rheumatologists, neonatologists, ophthalmologists, neurosurgeons, neuro-oncologists, neuro-radiologists, neuropsychologists, and clinical trials staff.
Neuropathology tends to pair well with molecular pathology, forensic pathology, and pediatric pathology. However, one may find it can also pair well with autopsy, as well as general surgical pathology or another high-volume subspecialty.
Neuropathologists typically do not interact with patients.
Other Resources:
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Neuropathology Committee
Participating in a council or committee is a great way to be a part of the CAP community.
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Subspecialty Spotlight Series
Hosted by the CAP Residents Forum, this unique event offers medical students and pathology residents the opportunity to hear from experts representing a range of subspecialties.
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