ANATOMICAL PATHOLOGY PROFILE

ANATOMICAL PATHOLOGY PROFILE Anatomical pathology is the branch of medicine concerned with the study of the morphologic aspects of disease. Anatomical pathologists specialize in examining tissues removed by needle aspiration, surgical procedures or autopsy. They are responsible for diagnosing diseased tissue and investigating the mechanisms and development of disease. This may include the structural and physical changes that occur. Anatomical pathology includes subspecialties that deal specifically with organ systems. These include: gynecological pathology; dermatopathology; gastrointestinal pathology; cardiovascular pathology; respiratory pathology; musculoskeletal pathology; renal pathology, genito-urinary pathology; endocrine pathology; ophthalmic pathology; E.N.T. pathology; and neuropathology. It also involves specific laboratory methods such as cytopathology, immunopathology and electron microscopy, or certain types of clinical cases including pediatric pathology and forensic pathology. Upon completion of medical school, to become certified in this specialty requires an additional 5 years of approved residency training. This training includes: 1 year of basic clinical training; 3 years of approved residency training in anatomical pathology (including training in surgical

pathology and autopsy pathology); a minimum of 3 months' training in cytopathology; and training in forensic pathology and pediatric pathology. A further year of approved residency is also required. For further training requirements go to: http://www.royalcollege.ca/portal/page/portal/rc/credentials/start/routes/traditional_route Canadian Association of Pathologists: www.cap-acp.org

Number of physicians and physicians/100,000 population in Anatomical Pathology in Canada, 2015 Province/Territory Physicians Phys/100k pop'n Newfoundland/Labrador 18 3.4 Prince Edward Island 4 2.7 Nova Scotia 40 4.2 New Brunswick 22 2.9 Quebec 213 2.6 Ontario 403 2.9 Manitoba 46 3.6 Saskatchewan 22 1.9 Alberta 128 3.1 British Columbia 134 2.9 Territories 0 0.0 CANADA 1030 2.9 Source: 2015 CMA Masterfile

Physicians/100,000 population in Anatomical Pathology Canada, 1995 to 2015 3.2 3.0 2.8 2.6 2.4 2.2 2.0 1.8 1.6 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013 2015 Source: CMA Masterfile

1200 Anatomical Pathologists by gender and year in Canada, 1995 to 2015 1000 800 600 400 200 0 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013 2015 Total Males Females Source: CMA Masterfile

Anatomical Pathologists by age and gender in Canada, 2015 Gender Age Group 34 and under 4% 65 and over 15% 35-44 18% Male 58% Female 42% 55-64 32% 45-54 31% Source: 2015 CMA Masterfile

Anatomical Pathologists by age and gender in Canada, 2015 65 and over 48 95 55-64 117 197 45-54 140 166 35-44 85 91 34 and Under 21 18 Female Male Source: 2015 CMA Masterfile

Main work setting of Anatomical Pathologists in Canada, 2014 Academic Health Sciences Centre 42% Community Hospital 31% Non-AHSC Teaching Hospital 8% Research Unit 8% Private Office/Clinic 3% Admin/Corp office 2% Nursing home/ long term care facility/ seniors residence 2% Source: 2014 National Physician Survey. CFPC, CMA, Royal College

Practice organization for Anatomical Pathologists in Canada, 2014 2% 2% 6% 4% Solo Practice Group Practice Interprofessional Practice 86% Hospital-based Practice NR Source: 2014 National Physician Survey. CFPC, CMA, Royal College

Hours worked per week (excluding on-call) by Anatomical Pathologists in Canada, 2014 Activity Hours worked per week Direct patient care without teaching component 22.9 Direct patient care with teaching component 5.1 Teaching without patient care 2.1 Indirect patient care 7.2 Health facility committees 1.2 Administration 3.8 Research 1.7 Managing practice 1.9 Continued professional development 3.2 Other 1.5 TOTAL HOURS PER WEEK 50.5 Source: 2014 National Physician Survey. CFPC, CMA, Royal College

On-call duty hours spent per month by Anatomical Pathologists in Canada, 2014 1% 1% 10% 4% 84% Up to 120 hrs/month More than 120, up to 180 hrs/month More than 180, up to 240 hrs/month More than 240 hrs/month No response Time spent on call spent in direct patient care = 13 hrs./month Source: 2014 National Physician Survey. CFPC, CMA, Royal College

Remuneration for Anatomical Pathologists in Canada Primary payment method in 2013 2% 17% 15% 20% 46% 90% + fee-for-service 90% + salary 90% + other* Blended NR * Other includes capitation, sessional, contract and other methods National Physician Survey, 2013, CFPC, CMA, Royal College

Satisfaction in Anatomical Pathologists in Canada, 2013 Balance of personal & professional commitments 5% 8% 16% 32% 29% 9% Current professional life 5% 4% 11% 15% 47% 18% NR Very dissatisfied Dissatisfied Neutral Satisfied Very satisfied Source: 2013 National Physician Survey. CFPC, CMA, Royal College

Anatomical Pathologists who are Royal College, CFPC or CMQ certified in Canada, 2014 99% 15% 13% Royal College CFPC CMQ Outside Canada Note: Subset of those who reported a certification. Physicians could indicate more than one certification body. Source: 2014 National Physician Survey. CFPC, CMA, Royal College

Number of Anatomical Pathologists who retired during the THREE year period of 2012 to 2014 Males Females 18 16 21 20 2 2 1 2 < 35 35-44 45-54 55-64 65 + Total Age Group Source: CMA Masterfile year over year comparisons Note: Retired is based on giving up licence and is therefore excludes those who have retired from clinical practice but are still licensed; it includes physicians who have temporarily given up their licence but may return to practice at a later date.

Total and Ministry funded postgraduate MD trainees in 2014/15 Anatomical pathology Faculty of Medicine Ministry funded Total Faculty of Medicine Ministry funded Memorial U N&L 12 12 McMaster U 14 14 Dalhousie U 8 8 UWO 9 13 U Laval 16 16 NOSM 0 0 U Sherbrooke 11 11 U Manitoba 11 11 U Montréal 22 22 U Sask 0 0 McGill U 19 21 U Alberta 21 21 U Ottawa 19 19 U Calgary 17 21 Queens U 13 13 UBC 13 17 Total U Toronto 29 59 Canada 234 278 * Includes Forensic pathology Source: 2014/15 Annual Census of Post-MD Trainees, CAPER

First year and exiting postgraduate-md trainees in 2014/15 Anatomical Pathology 44 44 22 19 23 Female 22 20 16 IMG 23 14 Male 22 21 GCMS 0 First year Exits from postgrad 0 First year Postgrad exits IMG International Medical Graduates GCMS Graduates of Canadian Medical Schools Source: 2014/15 Annual Census of Post-MD Trainees, CAPER

Postgraduate-MD trainees in 2014/15 Anatomical Pathology Total of 42 first year Anatomical Pathology trainees representing 18% of all Anatomical Pathology trainees. Total of 234 Anatomical Pathology trainees representing 2% of all Ministry funded trainees. Total of 14 visa trainees in Anatomical Pathology. Total of 37 Anatomical Pathology trainees completed postgraduate training in 2014. Source: 2014/15 Annual Census of Post-MD Trainees, CAPER

Location of 2013 Postgraduate-MD exits in 2015 Anatomical Pathology 18 17 9 1 1 5 2 6 4 5 0 Of the 41 exits in 2013, 36 (88%) were known to be practising in Canada Source: 2014/15 Annual Census of Post-MD Trainees, CAPER

Stress associated with finding employment at end of residency FM resident 7% 43% 42% 8% Other spec res 6% 20% 50% 25% NR/NA Not stressful Somewhat stressful Very stressful Source: 2012 National Physician Survey of residents. CFPC, CMA, Royal College

Links to the organizations supplying information for this document National Physician Survey http://www.nationalphysiciansurvey.ca Canadian Medical Association http://www.cma.ca/pdc Association of Faculties of Medicine of Canada http://www.caper.ca/ Royal College of Physicians and Surgeons of Canada http://www.royalcollege.ca/portal/page/portal/rc/credentials/start/routes/traditional_route College of Family Physicians of Canada http://www.cfpc.ca Canadian Institute for Health Information http://www.cihi.ca