3 Questions With Alison Krywanczyk, MD, FASCP

As an undergraduate, Alison Krywanczyk, MD, FASCP, thought she would become a family medicine doctor, based on her experiences working in a local practice. That changed when she applied on a whim for an internship at the local medical examiner’s office, and realized on day one that the field of pathology was something special. Dr. Krywanczyk notes there are more similarities between family medicine and forensic pathology than one might think. “We get to be generalists, making diagnoses in every organ system....and we also work with the whole context of a person’s life, assessing socioeconomic factors, mental health and addiction, family and community structures.”  

Here, Dr. Krywanczyk shares her thoughts on how pathology fulfills her, advice to others thinking about pursuing the field, and more.  

What aspects of pathology do you find most intriguing and fulfilling? How do these align with your personal and professional interests?  

For me, the most fulfilling part of my job is providing people with answers. Sometimes it’s determining the cause and manner of death; sometimes it’s figuring out someone’s identity; and sometimes it’s being able to tell a family member their loved one didn’t suffer. The other part of our field that piques my curiosity is the huge amount of data generated by pathology laboratories and autopsy reports. We have a treasure trove of information, which we can use to identify public health trends and ways to improve patient care.  

Pathology can involve challenging cases and emotionally charged situations. How do you handle the emotional aspects of your work?  

I’m not sure there’s a one-size-fits-all answer for this! I will say that although everyone involved in medicine faces these kinds of situations, it always surprises me when people think pathologists are sheltered from the emotional fallout. As a forensic pathologist, I talk to grieving families every single day. Some days, I need to limit my phone calls or family meetings so I can be my best for each one — no one wants to feel rushed in these situations. That said, I think we all find our niche specialty based on the kind of grief we cope with best. For me, even though the patient is dead, I know I’m doing the best I can for their family to salvage whatever we can from the situation. I would have a much harder time diagnosing patients with breast cancer every day, yet other people can manage that well.  It’s important none of us consider ourselves immune from the emotional impact — that’s the way medicine has historically wanted providers to be, and it’s a fast track to burnout! 

What advice would you give to someone considering a career in pathology? 

I would tell them they’re on the right track! And to keep exploring — pathology is such a diverse field, and if you’ve only been exposed to one aspect it’s just the tip of the iceberg. And don’t let other people dissuade you. I had several people tell me in medical school that it was a waste for me to go into pathology because I had ‘good people skills’, which is shocking because as pathologists we have to be excellent communicators. There are a lot of incorrect stereotypes out there about pathology which I think frighten students away without them ever giving it a chance. Don't believe what you hear — come and see for yourself!