Careers in Neuropathology

Neuropathology, a subspecialty of pathology and neuroscience, requires expertise in diseases of the nervous system. The central nervous system includes the brain, spinal cord, peripheral nerves, and muscles, all of which are subject to disease. The neuropathologist’s job to determine the cause of disease and to help direct the correct course of treatment.

Neuropathology draws from many closely related disciplines, including pathology, neurology, and neurosurgery. Neuropathologists study rare diseases, work with a wide range of patients and other specialists, and add to the growing body of knowledge regarding human anatomy and disease.

Overview of Neuropathology: What Is a Neuropathologist?

The term “neuropathology” has two roots: “neuro,” which means “relating to nerves or the nervous system,” and “pathy,” which denotes a disorder in a particular area of the body. Neuropathology, therefore, is the direct study of diseases in specific parts of the central nervous system.

Neurologists diagnose diseases in the nervous system, and neuropathologists work closely with the neurologist, conducting extensive lab tests. In addition, neuropathologists work with pathologists, who study neural disease as well. However, neuropathology is more specialized than either of those disciplines. All three specialties fight diseases of the central nervous system.

While neuropathologists may occasionally diagnose other areas of the body, especially as they relate to or are affected by diseases of the nervous system, their primary concentration is on the central nervous system. Often, a neuropathologist focuses on one single group of nerves, the spinal column, the brain, or other specific neurological areas.

Neuropathologist Job Duties: What Does a Clinical Neuropathologist Do?

To determine the cause of a disease of the nervous system, neuropathologists take a variety of approaches. Typically, they begin with a medical exam, during which they talk with the patient about their symptoms. Next, they may take tissue samples, examine them under a microscope, study blood samples, and perform other routine medical tests.

One of a neuropathologist’s primary responsibilities is to study tissue biopsies to determine the cause of disease. After the discovery of a problem in a patient’s nervous system – resulting from a patient report, examination, X-ray, or another test – a medical specialist requests a biopsy, which he or she gives to a neuropathologist for professional examination and opinion. Biopsies and tissue samples may be taken from tumors, nerves, the brain, the eye, muscles, organ surfaces, or the nerves of the skin.

Some neuropsychologists have a background in clinical psychology and psychiatry, which helps them determine how nervous system pathologies affect specific mental or emotional problems. This background also helps them determine the effects of medications on these types of disorders.

A forensic neuropathologist, an even more specific neurological subgroup, conducts autopsies. In this position, the primarily task is to seek evidence as to how neurological diseases affected the body and caused death. These neuropathologists, like others in the field, consult with other medical professionals to inform specific cases and to advance overall knowledge in the field. Many consult with surgeons to help guide surgical procedures.

An effective neuropathologist must possess many qualifications:

• Background: Understanding of nervous system function and a range of other medical issues
• Expertise: Deep knowledge of diseases affecting the nervous system
• Training: Lab training, including skill with microscopes and the ability to identify pathogens on the cellular level
• Attention to detail: Ability to perceive even minute changes in tissue samples
• Reliability: On time and dependable
• Logical thinking: Collecting samples, analyzing tissue, and recording information require excellent organization and disciplined thought processes
• Communication: Ability to communicate clearly and effectively with colleagues and patients
• Reading and writing: Ability to synthesize the work of others and communicate ideas via the written word; publishing in peer-reviewed journals as required
• Research skills: Expertise in gathering, understanding, and putting data to use
• Persistence: Willingness to persevere with a problem even if it defies explanation

During a typical work day, a neuropathologist must possess the knowledge and skill to address a wide range of pathologies. While these specialists don’t typically see patients on a daily basis, they work with other neuroscientists to identify and help cure diseases, which is a challenging and complex task. Some of the most common diseases addressed include:

• Degenerative disorders
• Cancer, especially of the brain
• Locomotor dysfunction
• Evaluate eye, muscle, and blood vessel constriction
• Pituitary and adrenal gland malfunction
• Spinal cord conditions
• Issues with the topographic layout of the brain and spinal cord
• Traumatic brain injuries
• Inflammatory reactions within the nervous system

Neuropathologist: Work Environment & Populations Served

Neuropathologists usually work in laboratory settings within hospitals, research institutions, or medical universities. They spend much of their time examining tissue and cellular samples to determine the nature of a neurological pathology, which requires a significant amount of labwork. The neuropathologist may have a small team of assistants, although in some cases, he or she may work alone or with neuroscience peers.

Neuropathologists specialize in various sub-areas. They may examine postmortem tissue from organ donors. Forensic neuropathologists find work at morgues or coroner’s offices, where they examine those who have died unexpectedly or from known or unknown neurological disorders. Others may specialize in examining tissues removed during surgical procedures.

Neuropathologists serve a variety of populations, though many concentrate in specific areas to deepen their expertise. Some, for instance, work with Alzheimer’s patients. As a poorly understood but widely prevalent disease, considerable opportunity exists to specialize in this field. Others may work with children, the elderly, or populations that exhibit particular symptoms or diseases.

Neuropathology Salary & Employment Outlook

According to the Bureau of Labor Statistics (BLS), neuropathologists (categorized by the BLS as medical scientists) earn an average salary of $110,670 as of May 2022.

Those working in medical and diagnostic laboratories take home an average salary of $102,280, while those working for scientific research and development companies earn a higher average salary at $121,210.

Neuropathology Jobs & Job Description

Neuropathologists typically are employed by hospitals or clinics, where they provide specialized assistance to neuroscientists, neurosurgeons, and others in related fields. They also may be hired by public health institutions, research facilities, governmental organizations, or nonprofit bodies. Their day-to-day research and duties focus on identification, cataloging, and diagnosing neurological diseases. Other responsibilities include:

• Preparing slides for examination
• Examining slides and taking notes
• Drawing conclusions from evidence, such as the progression of the disease
• Comparing findings with those of other tests, such as CT scans or MRIs
• Reporting findings to colleagues
• Recommending courses of treatment for patients
• Publishing their findings
• Providing consultation on potential treatment and cure

Clinical Neuropathology Degrees & Education

Neuropathologists are medical doctors. The would-be neuropathologist must earn a doctor of medicine degree after acquiring a bachelor’s degree in a related field – usually biology or pre-med – and then apply to medical school.

To gain acceptance into medical school, however, potential neuropathologists must satisfy a number of requirements. Firstly, they must have earned the required number of requisite credits in undergraduate school, usually consisting of a combination of chemistry, biology, and physics; anatomy and physiology; and, often, the soft sciences as well, such as psychology and sociology. After completing an undergraduate degree, the student must take and pass the Medical College Admission Test, or MCAT.

Once in the program, students receive intensive medical training in an academic setting. Neuropathologists focus on the nervous system, neurological disorders in particular. The second two years of medical school comprise clinical work overseen by practicing medical professionals. Students begin to interact with patients suffering neurological disorders and practicing the skills they will need throughout their careers.

After medical school is complete, neuropathologists must undergo at least three years of residency, gaining valuable work experience that will enable them to run their own practices or oversee other medical professionals in a hospital setting. A fellowship following residency can open more doors in the neuropathology field, specifically, and the medical field as a whole.

When they have successfully completed a residency program, potential neuropathologists may apply for a medical license. This requires successful passage of the U.S. Medical Licensing Examination (USMLE), a grueling multi-step test composed of several day-long testing sessions, some of which the students complete while still in medical school. Budding neuropathologists can find additional information about the specifics of the test by contacting USMLE directly, or consulting the faculty of the program in which they intend to enroll or are contemplating enrollment.

A medical license is required to practice any branch of medicine in any state or jurisdiction in the United States. To keep the license current, neuropathologists must complete continuing education requirements. The last step is to become board certified in pathology, which entails sitting the exam delivered by the American Board of Pathology. Afterwards, if neuropathologists maintain licensure, they may continue to practice for their entire career.

External Resources and Organizations for Neuropathology

• American Association of Neuropathologists
• The International Society of Neuropathology

2022 US Bureau of Labor Statistics job market trends and salary figures for medical scientists are based on national data, not school-specific information. Conditions in your area may vary. Data accessed July 2023.