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Neuropathologists are pathologists who specialize in diseases of the brain and spinal cord (the central nervous system), and make definitive diagnoses of brain tumors. A pathologist studies the cause or nature of the diseases and identifies the changes diseases create in our body. Therefore, the neuropathologist microscopically examines brain tissue, biopsy materials and fluids.

Usually, neurologists will perform various tests on a patient, such as an MRI or a CAT scan and once a tumor is detected, they perform a biopsy. Then, they will send the biopsy tissue, fluid, and cellular samples to neuropathologists in laboratories to be studied and interpreted. Neuropathologists use electron microscopes in pathology labs to determine the nature and type of tumor in a patient's brain or other type of neurological problem. For example, in Alzheimer's disease, the neuropathologist will examine the brain tissue for evidence of the plaques and tangles related to the disease. At the same time, the neuropathologist will also look for any changes of any other neurological disorders, which will conclusively establish a neurological diagnosis.

A biopsy is the most accurate way of diagnosing a brain tumor. After tests, the neuropathologist gives the tumor a name and grade, usually malignant or benign. There are hundreds of types of tumors thus, the exact name and grade of the tumor dictate treatment, and also give important information about prognosis.

When neuropathologists analyze tumor tissue under a microscope, they ask themselves two main questions: first, what type of brain cell did the tumor arise from? Second, do the tumor cells show signs of rapid growth? The answer to the first question gives the tumor a name, for example, astrocytoma. The second question involves assigning the tumor a grade, such as grade 3. The neuropathologist combines these two pieces of information, such as "grade 3 astrocytoma". Once a tumor has been given a name and a grade, neurologists can give advice about treatment choices, prognosis, and provide useful health-care information to brain tumor patients and their families.

Even if the neuropathologist gives the neurosurgeon a benign diagnosis, this does not mean the patient is safe, as the tumor may still be deadly because of its location. The distinction between benign and malignant is not always clear. An appropriate pathology report reflects the nature of a brain tumor to the best of our current knowledge.
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  Interests and Skills  
What does it take to become a neuropathologist? They have the intellectual ability required to successfully complete the required academic and laboratory training and to pursue a course of lifelong learning and the stamina required to work long hours. They have excellent communication skills and can get along with people well and instill confidence. They will need a mechanical mind and be able to diagnose tumors looking through the lens of microscopes.

Neuropathologists should enjoy finding solutions to problems and directing the work of others. They must also be proficient in neuropathological medicine -- they must have and apply this knowledge to diagnose tumors and illnesses of the nervous system. Also, ethics is a strong point for these types of people because they have to do what is right for their patients with their best interests in mind.

  Typical Tasks  
  • Study brain tumors and other tissues and fluids
  • Diagnose and classify tumors as malignant or benign
  • Study the results of pathological analyses of patient's cerebro-spinal fluid to determine nature and extent of a disorder
  • Identify the presence of pathological blood conditions or parasites
  • Advise neurologists and neurosurgeons of the results
  • Write reports on study results
  • Neuropathologists' working conditions depend on where they work. Most put in long days, spending many hours behind the microscope performing pathological tests on tissues and fluids of the nervous system. Some also work evenings and weekends on shift rotations. Neuropathologists may spend a considerable amount of time doing paperwork about their findings.

  Workplaces, Employers and Industries  
  • Neuropathologists work in laboratories, hospitals, public or private clinics, and universities or research facilities. The majority work in hospital and other research laboratories, studying brain tumors. Neuropathologists working in academic settings are required to teach classes as well as offer lab training to medical students, residents and others.

  Long Term Career Potential  
Neuropathologists can learn new skills, add more patients, or change jobs. With further training, they may work as neurologists or neurosurgeons, directors of research, hospital administrators, medical school administrators, and teachers in medical schools. They may manage clinics or do research for pharmaceutical companies. They may also write and publish in scientific and medical journals or take jobs in medical public relations.

  Educational Paths  
Becoming a neuropathologist requires a long educational road, so be prepared for a lifelong learning experience. Most neuropathologists start with a Bachelor of Science degree, however some Bachelor of Arts graduates may be accepted into medical school programs. While in high school, take math and science classes. Also, not all medical schools require a bachelor's degree and with good marks, some students can get accepted after two years of undergraduate studies. Check with the school for their requirements before applying.

The next step is medical school, which usually takes four years. Graduation from an approved medical school will result in the title Medical Doctor (MD). A one- to two-year internship and three years of specialized laboratory training are required after graduation from medical school.

Finally, before entering medical school, it is a good idea to volunteer in a hospital, nursing home or community center. This will give you valuable experience in dealing with people who need help and what it is like to work as a doctor.

Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2014-15 Edition, http://www.bls.gov/ooh/
Bureau of Labor Statistics, U.S. Department of Labor, Occupational Employment Statistics, 2002, http://www.bls.gov/oes/2002/oes_nat.htm

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