In the Netherlands

Training program of Pathologist’s assistants

Dorit Rennspiess, Maastricht UMC+, Pathologie

Pathologists’ assistant

• USA since 1969

• Canada

• England

• The Netherlands 2009 (~87 Pathologist‘s assistants since 2009 trained)

• USA

- Master studie ( Degree: Master of Science in Pathology)

- 2 years- costs : 44.000 – 90.000 $

Pathologists’ assistant (Pathasser)

• Netherlands

- post Bachelor additional qualification- duration 1,5 years- dual training (university, Pathology)- costs ca. 6000 €

Pathologist's assistant (Pathasser)

General tasks of Pathologists‘ assistants

• responsible for the gross examination and dissection of anatomic pathology

specimens

• Optimizing and development of standard grossing protocols

• Teaching/ training pathologists assistants, pathology residents

• Processing of native material

• Collaboration on research projects

Training• Requirements

-bachelor degree in science (comparable to)

-min. 2y of working as a technician (in a pathology lab)

• Dual System : Theory: 1day/month, UniversityPractical experience: Under supervision by a pathologist (own lab)

• Subdivided into 3 modulesModule 1: non oncological specimens + written examModule 2: oncological specimens + written examModule 3: Project (Management project in Pathology) Written report + presentation

TrainingModule 1: non oncological speciments (6 month): Appendix, gallbladder, skin (inflammatory, melanoma and non melanoma skin cancer) , upper and lower GI tract, Gynecology, urogenital tract

Anatomy, Histology, clinic, grossing protocols

Module 2 :oncological speciments (6 month)All specimens of module 1

Histology, clinic, TNM- Classification, Carcinogenisis, grossing protocols

Example

Appendix- length, diameter- fat (Mesoappendix)- texture, intact- surface (serosa)

Lumen- feces - (stone) fecolith- mucus, pus-filled- tumor (carcinoid, adenocarcinoma,..)

Do we really need Pathologists’ assistants ?

Pro/Contra Pathologists’ assistant

78,2% The use of the pathologists’ assistants in my program helpsoptimize resident workload

82,3 % allows residents to spend more time on complex specimens

6,0% I would attempt to obtain training in a program that does not utilize pathologists’ assistants

Pro Pathologists’ assistantResident: - takes a lot of work off

- can spend more time on complex specimens- more time for microscopy- knows the whole process

Pathologist - grossing is faster- continuous parameter in grossing room- takes a lot of work off- somebody who knows both sides - very good description.- knows her limits

TA - faster, steady, explains - continuous, standardized daily routine

Legal position

- Training program- Grossing protocols- Supervision

Basic conditions

• Standardized grossing protocols

• Standardized Training program

• Under supervision by Pathologists

• Protocolling competence of a Pathologists’ assistant

• Pathologist is and stays always responsable !!

dorit.rennspiess@mumc.nl

Grazie per la vostra attenzione