A salute to military and VA pathologists
Donald S. Karcher, MD
July 2025—Whether we’re in academic or private practice, hospital labs or independent labs, as pathologists we share a broad set of common responsibilities and challenges. But a select group of us has an additional set of considerations for how to practice because of who and where they serve. In this month’s column, I’d like to shine a light on military pathologists and pathologists who serve our veterans in the Veterans Affairs health system—all of whom are supporting the defense of our country.
As you may know, I began my career as a pathologist in the military. I did my AP-CP residency at Brooke Army Medical Center in San Antonio, Tex., and was assigned to Walter Reed Army Medical Center in Washington, DC, right after residency, where I served as the chief of hematopathology. Having been given that kind of responsibility so early in my career was something that could happen only in the military.
I left the Army in 1981, and to this day people still thank me for my service. Being in the military for eight years was an incredible experience and gave me the opportunity to be part of a wonderful, close-knit community. It also gave me a keen appreciation for how, in many ways, practice is different for military pathologists. They do the same things we all do: serve as laboratory directors, sign out cases, and provide a wide array of other services. But they often have to do them under challenging conditions or in unusual locations that can make the job much more difficult.
Military pathologists sometimes have to put themselves in harm’s way. Wherever there is a military conflict, there are usually pathologists practicing as best they can under sometimes very demanding conditions. Compact mobile clinical lab units are deployed to advanced parts of a war zone, even out in the battlefield, and pathologists and other laboratorians provide critical services for injured or ill troops in some of these advanced locations. In these cases, as you might imagine, pathologists focus less on the routine work and more on dire necessities, such as transfusion services and triage care. There’s so much to be recognized here: the expertise and bravery of pathologists willing to serve in these dangerous places, and the fact that sophisticated laboratory services can be provided to soldiers even in the most extreme locations.
Even when they’re not in a war zone, pathologists in the military can sometimes get unusual postings. When I finished my residency I had orders to go to Landstuhl Regional Medical Center in Germany before a last-minute change sent me to Walter Reed. There are postings all over the world, such as in Germany, Korea, and Japan. Many postings are for larger medical centers and hospital facilities, but there are smaller ones as well. In the Navy, pathologists can also serve on board one of two hospital ships, the USNS Comfort and USNS Mercy. The scope of the work provided by these pathologists is quite impressive, as they oversee more than 400 clinical laboratories of varying complexity around the world.
My career as a military pathologist was not unusual: Great responsibility is often given to pathologists very early in their service careers. It’s a terrific pathway to future leadership. For me, the years I served in the Army prepared me for achievements that might never have happened with a more traditional career path. If you’re considering a future in pathology, I encourage you to think about whether military service could be the right choice for you.
Of course, when all military service members come home, they are eligible to receive care through the VA system. I recently had an opportunity to meet with some VA leaders and it reminded me of the important work pathologists do for this patient population. The VA has 170 medical centers and more than 1,000 outpatient facilities in its system, with a total of 1,135 hospital-based and other clinical laboratories. The CAP has the privilege of supplying proficiency testing materials for all of them. And the more than 575 pathologists who work in these hospitals and laboratories are responsible for providing great pathology and laboratory medicine services for our veterans.
All of these pathologists are doing important work for the defense of our country, and I hope you join me in honoring them. In true military tradition, I stand at attention and salute the men and women who serve our country, our soldiers, and our veterans as pathologists. Thank you for your service.
Dr. Karcher welcomes communication from CAP members. Write to him at president@cap.org.