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CAP Membership for the Academic Pathologist

Roseann I Wu, MD, MPH, FCAP

“I’m not a CAP member because CAP doesn’t do anything for academicians.”– Anonymous

I’m fairly certain my mouth dropped open in incredulity at this statement, while thinking that I had so many counterarguments, it would take me all evening to write up an email response. Instead, I simply wrote, “That’s just not true” and volunteered to author this article. Not only can I offer myself as an academic pathologist who has benefited personally and professionally from my membership in the College of American Pathologists (CAP), but I also have peer-reviewed literature to support my position. Here are a select few of the reasons I find my CAP membership valuable:

Networking

If I had to choose the single most important CAP benefit for the academic pathologist, I’d pick networking. Joining a professional organization like the CAP helps you stay in touch with pathologists from your training program, connect with others in your subspecialty, learn from leaders across pathology, share best practices, and solve problems when things get tough. Having a network of Board-certified pathologists is like having access to a think tank that can help brainstorm, provide resources, and serve as a source of inspiration. Particularly for junior pathologists, involvement in the CAP opens channels of communication and access to senior faculty at other institutions—those senior faculty members can provide valuable advice and perspective about all sorts of problems that occur in pathology departments. After all, they’ve experienced a lot during their tenures! Connections through the CAP mean that access to supportive mentors is just an email or phone call away.

Looking for a job or looking to hire? The CAP Annual Meeting and committee meetings are great places to meet potential hires and employers. I have received several tip offs to job openings from folks I met through the CAP, which allowed me to get the "inside scoop" on the positions. After all, pathology is a fairly small world, and connections are key to success. Even if you completed all your training at one institution and plan to stay as a faculty member for life, connections through the CAP can launch your career by providing professional opportunities (see next sections).

Publications

For most academic pathologists, publications are the currency for promotion. Membership and involvement in the CAP opens doors to research opportunities and collaborative projects, particularly in regard to practice guidelines. CAP committees and working groups often collaborate with other professional organizations to publish reviews and guidelines. For instance, the Lower Anogenital Squamous Terminology (LAST) project was co-sponsored by the CAP and the American Society for Colposcopy and Cervical Pathology (ASCCP), and the results were published in high-impact journals.1 The CAP, along with the International Association for the Study of Lung Cancer (IASLC) and the Association for Molecular Pathology (AMP), produced guidelines on molecular testing of lung cancer patients for EGFR and ALK tyrosine kinase inhibitors.2 Consensus statements, recommendations, standards, and guidelines have been published in areas including active surveillance in patients with prostate cancer, clinical grade genomic databases, and validating next-generation sequencing bioinformatics pipelines.3,4,5 The CAP members serving on these committees have made significant contributions to pathology and built their reputations as experts, thanks to these collaborative projects.

Another new-in-practice pathologist offered this anecdote:

“I joined the CAP right after I attended my first meeting as a resident. I had a poster at that meeting and Philip Cagle walked by, read the poster, and suggested I submit it to Archives in manuscript form. That was a big deal to me as a resident. Archives published the article, I joined the CAP, and I've been a member ever since.”

Membership in the CAP includes access to Archives of Pathology & Laboratory Medicine and CAP Today, which include excellent and up-to-date research articles as well as news and perspectives from leaders in pathology. Certainly, these publications also offer opportunities to publish your own work or to serve on their editorial boards—other great items for your CV. And if you’re considering authoring a textbook, pitch your idea to CAP Publications!

Professional Development

Even if shaping the future of the specialty is not your top priority, involvement in the CAP opens many other doors. Part of the promotion process in academic departments is developing a regional, national, and, ultimately, international reputation. Committee involvement is a great way to meet colleagues from around the country and is a fantastic way for new-in-practice pathologists to get to know renowned faculty, program directors, practice leaders, and department chairs. This also provides junior pathologists with leadership experience which allows us to rise in the ranks of our own institutions. Activity within national organizations reflects positively on you and your department and ensures that you have connections around the country to serve as references.

A study of the Duke pathology department’s structured annual faculty review program revealed that “[a]mong all national societies, the College of American Pathologists (CAP) provided the most opportunities for our young faculty to participate.”6 The study pointed out specific examples of how involvement in the CAP helped faculty in receiving recognition, thus supporting the promotion process. Networking in the CAP leads to invitations and opportunities to speak at other institutions, present courses at the Annual Meeting, collaborate on projects and publications, and gain national exposure in general. These types of activities are crucial for building a reputation and establishing that “storyline” for promotion. Educational opportunities such as the CAP’s Advanced Practical Pathology Program (AP3) in Breast Pathology, Laboratory Management, and Ultrasound-Guided FNA can also give you an edge when being considered for leadership positions or expanded responsibilities.

Evidence-Based Practice

The CAP Cancer Protocols align with the American Joint Committee on Cancer (AJCC) Cancer Staging Manual and represent some of the practical educational resources used on a day-to-day basis. While these “cancer checklists” are free for anyone to access, CAP membership and continued involvement and feedback by members ensure these remain the gold standard for cancer reporting. And if you don’t like something about the Cancer Protocols, CAP members are welcome to submit feedback or apply for the committee. In addition, the CAP’s Pathology and Laboratory Quality Center develops evidence-based guidelines through a rigorous and transparent process, and academic pathologists must stay current on these up-to-date practice guidelines.

Advocacy

Advocating for the specialty, including reimbursement issues, is not just critical for private practice pathologists. Many legislative issues affect all pathologists. Even if you don’t see an immediate change in your paycheck when CPT codes are revalued, these changes can ultimately hurt pathology departments and hospitals’ bottom lines, meaning fewer resources for everyone. As reimbursement declines, academic hospitals face faculty staffing issues. Fewer faculty on staff means less protected time for research and teaching. So while academics may think they’re immune to the effects of decreasing reimbursement, this trend ultimately affect the amount of time allotted for performing required academic duties.

The CAP Policy Meeting or grassroots PathNET are excellent ways to learn about the critical issues affecting pathologists and to make your voice heard. CAP’S PATHPAC is the only political action committee working exclusively for pathologist interests. Advocacy isn’t just about influencing policy, though. It also ties into how pathology services are valued by the rest of the health care field, as well as public perceptions about pathologists and the laboratory. The reality is that academic pathologists cannot hide in offices and expect that nothing will ever change or that legislation won’t affect them.

Education

Okay, academic pathologists don’t need any more CME credits, and there are plenty of subspecialty educational resources that may be more applicable to daily practice. Therefore, the great courses at the Annual Meeting, the Online Learning Portal, and discounted educational products may not be your main reason for joining the CAP. However, all new-in-practice pathologists subject to maintenance of certification need SAM credits that aren’t as easy to find, plus maintaining your CP certification isn’t so easy when you don’t practice CP anymore (and vice versa with AP). The CAP’s educational resources cover AP and CP broadly, which is one reason why the Annual Meeting is so great for residents and those wishing to stay up-to-date in a variety of areas. Plus, textbook discounts are offered at the Annual Meeting by CAP Publications and other exhibiting publishers.

Is your main area of interest education? Did you know the CAP has a Graduate Medical Education Committee? The committee actively publishes articles on hot topics in pathology education that may be helpful to program directors and faculty, such as recommendations on Entrustable Professional Activities.7 The CAP was also involved in Pathology Informatics Essentials for Residents (PIER), an instructional resource and informatics curriculum, developed in conjunction with the Association of Pathology Chairs (APC) and the Association for Pathology Informatics (API).

Fun

I’ve also had more fun, thanks to my CAP membership. CAP has the staff and resources to ensure that committee meetings and projects are productive and rewarding. It’s satisfying to develop programs and resources that you wouldn’t otherwise be able to do, sitting in your faculty office within your institution. It’s fun to use your creativity and individual skill set for the benefit of the profession and patient care. And it’s a pleasure to work with people that you admire and respect. The informal chats during breaks, meals, and receptions can be fulfilling and help relieve stress. Involvement in these organizations isn’t just about work; there’s also a component of getting to know other pathologists and their families. Friendships develop and can have a lasting positive impact on your personal life in addition to your career. Socializing at CAP events and feeling like you could travel across the country and recognize friendly faces everywhere… this is what keeps me coming back.

Conclusion

What are you waiting for? CAP membership is indispensable for the successful academic pathologist!

References

  1. Darragh TM, Colgan TJ, Thomas Cox J, Heller DS, Henry MR, Luff RD, McCalmont T, Nayar R, Palefsky JM, Stoler MH, Wilkinson EJ, Zaino RJ, Wilbur DC; Members of the LAST Project Work Groups. The Lower Anogenital Squamous Terminology Standardization project for HPV-associated lesions: Background and consensus recommendations from the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology. Int J Gynecol Pathol. 2013 Jan;32(1):76-115.
  2. Lindeman NI, Cagle PT, Beasley MB, Chitale DA, Dacic S, Giaccone G, Jenkins RB, Kwiatkowski DJ, Saldivar JS, Squire J, Thunnissen E, Ladanyi M. Molecular testing guideline for selection of lung cancer patients for EGFR and ALK tyrosine kinase inhibitors: Guideline from the College of American Pathologists, International Association for the Study of Lung Cancer, and Association for Molecular Pathology. Arch Pathol Lab Med. 2013 Jun;137(6):828-60.
  3. Amin MB, Lin DW, Gore JL, Srigley JR, Samaratunga H, Egevad L, Rubin M, Nacey J, Carter HB, Klotz L, Sandler H, Zietman AL, Holden S, Montironi R, Humphrey PA, Evans AJ, Epstein JI, Delahunt B, McKenney JK, Berney D, Wheeler TM, Chinnaiyan AM, True L, Knudsen B, Hammond ME. The critical role of the pathologist in determining eligibility for active surveillance as a management option in patients with prostate cancer: Consensus statement with recommendations supported by the College of American Pathologists, International Society of Urological Pathology, Association of Directors of Anatomic and Surgical Pathology, the New Zealand Society of Pathologists, and the Prostate Cancer Foundation. Arch Pathol Lab Med. 2014 Oct;138(10):1387-405.
  4. Yohe SL, Carter AB, Pfeifer JD, Crawford JM, Cushman-Vokoun A, Caughron S, Leonard DG. Standards for Clinical Grade Genomic Databases. Arch Pathol Lab Med. 2015 Nov;139(11):1400-12.
  5. Roy S, Coldren C, Karunamurthy A, Kip NS, Klee EW, Lincoln SE, Leon A, Pullambhatla M, Temple-Smolkin RL, Voelkerding KV, Wang C, Carter AB. Standards and guidelines for validating next-generation sequencing bioinformatics pipelines: A joint recommendation of the Association for Molecular Pathology and the College of American Pathologists. J Mol Diagn. 2018 Jan;20(1):4-27.
  6. Robboy SJ, McLendon R. Structured annual faculty review program accelerates professional development and promotion: Long-term experience of the Duke University Medical Center's Pathology Department. Acad Pathol. 2017 Mar 1;4:2374289516689471.
  7. McCloskey CB, Domen RE, Conran RM, Hoffman RD, Post MD, Brissette MD, Gratzinger DA, Raciti PM, Cohen DA, Roberts CA, Rojiani AM, Kong CS, Peterson JEG, Johnson K, Plath S, Powell SZ. Entrustable Professional Activities for pathology: Recommendations from the College of American Pathologists Graduate Medical Education Committee. Acad Pathol. 2017 Jun 27;4:2374289517714283.

Roseann I. Wu, MD, MPH, FCAP is a staff pathologist and assistant professor of Clinical Pathology & Laboratory Medicine at the Perelman School of Medicine/University of Pennsylvania Health System in Philadelphia. She has clinical and educational responsibilities in cytopathology, breast and pulmonary surgical pathology, and medical pathology. Her interests include fine-needle aspiration, organized pathology, and innovative ways to deliver pathology education.