Oncologists and pathologists are physicians who are linked by cancer. Oncologists treat the disease while pathologists make the diagnosis. In some ways -- such as education and licensing -- the two specialties are very similar, but there are also differences between them. Pathologists rarely have direct patient contact, while oncologists spend a great deal of time with patients. Both specialists may be involved in a patient's care.
Oncologists specialize in treating people with cancer. They may be medical, surgical or radiation oncologists, each of whom uses different techniques: chemotherapy, surgery and radiation. Oncologists may also specialize within the discipline, treating only women -- gynecologic oncology -- treating only children, or treating cancers of the blood such as leukemia. This last specialty is known as hematology-oncology. Oncologists educate patients about their cancer, review possible types of treatments, and treat the cancer with different techniques. In addition, the oncologist manages pain, side effects and other symptoms, and if necessary, provides end-of-life care.
Pathologists specialize in the diagnosis of medical conditions and diseases. Performing autopsies, which is a relatively small part of a pathologist's job, may be the most familiar pathology task for most people. In addition, pathologists examine specimens of blood, tissue and body fluids, using a microscope and other laboratory techniques, to identify organisms causing an infection or cells that indicate cancer. Pathologists work closely with other medical specialties but see patients infrequently. They may also supervise blood banks and transfusion processes or microbiology labs that identify infectious disease.
All physicians must complete college, medical school and residency. All states require that physicians be licensed, and although certification is not required for medical practice, many physicians choose to become certified. Continuing education in a specialty is required to maintain certification. Oncologists and pathologists begin their medical careers in other specialties. Medical oncologists are first trained in internal medicine; surgery oncologists in general surgery; radiation oncologists are trained as radiologists; and pathologists are trained in general pathology. After residency, each moves into a particular specialty by completing an extended period of training called a fellowship. Pathologists, for example, may complete fellowships in microbiology, forensics or anatomic pathology.
Pathologists spend their days in the lab and oncologists spend their days seeing patients. Oncologists, who spend their time with patients who have cancer and must often deal with patients' deaths, are more susceptible to burnout, according to an October 2012 article in the "Journal of the American Medical Association." Internal medicine subspecialties, surgical subspecialties and radiation oncologists all had higher burnout rates than pathologists. Salary is another area of difference. Oncologists earn starting salaries of $222,000 to $300,000, according to the 2011-2012 Profiles Database salary survey. Starting salaries for most pathologists in 2010 were above $150,000, according to the American Society for Clinical Pathology, and could be as high as $200,000.
Patient contact may be the defining issue in choosing between oncology and pathology. Pathologists' direct patient contact is much more limited than that of an oncologist. However, patient contact has its down side, as not all patients with cancer survive. Pathology, on the other hand, has an element of detective work, which may be attractive to some people. In most other respects, these careers are similar in terms of work hours, the length of education and other requirements.