Hematological pathology is a specialty within laboratory medicine that integrates clinical consultation and diagnosis with quality laboratory management and practice. We provide consultations to hematology, oncology, internal medicine, anesthesiology, critical care, surgery, and organ/tissue transplant specialists. These consultations involve the diagnosis and investigation of hematological disorders, coagulation disorders (bleeding and thrombosis), transfusion medicine and blood product utilization, histocompatibility/immunology and molecular pathology. In other words, we don’t just look at glass slides under the microscope. We enjoy having a rich variety of clinical encounters with other clinicians and specialists. The resulting breadth and depth of hematopathology practice is the most attractive and exciting aspect of our daily work.

There are not enough of us, so we all have a lot to do. The silver lining is that there are positions available across the country for graduating residents.

Our alumni have worked/are working in Victoria, Vancouver, Edmonton, Toronto, Kingston, Ottawa and Halifax. Some have pursued additional fellowship training in the U.S. before beginning their staff positions. Instead of having traditional contact with patients in the hospital or outpatient clinics, we encounter them through bone marrow biopsies, under the microscope during blood film and bone marrow reporting, and during discussions at coagulation and transfusion medicine rounds. Since we do not see or admit patients in the traditional sense, we do not have to worry about problems like a lack of clinic or operating room time or space, or the lack of hospital beds to admit patients.

Options are academic practice or community-based hospital practice or private laboratory practice. There are a number of hematopathologists in Edmonton who work part-time and most have families and children. Some spend part of their time doing clinical/translational research. Others work with Canadian Blood Services to oversee the blood collection, processing and testing of donors. Some hematopathologists confine their practice to one or more areas of hematopathology or have a specialty interest in a specific area. Examples of affiliated subspecialties include coagulation, flow cytometry, molecular pathology, histocompatibility/immunology and transfusion medicine. Lymphoma pathology, pathology informatics and medical education are other subspecialty areas where hematopathologists are active.

The payment structure varies considerably, as does the range of income depending on the province. Some hematopathologists are on salary, paid by a hospital or health region. In some provinces (not Alberta), there is a fee schedule similar to the schedule of medical benefits used in clinical practice but involving lab testing procedures. Hematopathologists in private practice in these provinces may bill “fee for service” and their income will depend on the volume and complexity of lab testing performed. Some work under a contract for services under which they are paid by a hospital, health authority or government agency for providing a range of laboratory consulting services.