In 1966, Dr. Eugene Stead at Duke University Medical Center pioneered the concept of physician extenders when he established the nation's first physician assistant program. This allied health profession differed significantly from all other allied health professions because rather than being another support profession working independently on tasks not considered to be the practice of medicine, these individuals were trained to perform tasks previously performed exclusively by physicians. Dr. Thomas Kinney, Chairman of Pathology at Duke University Medical Center, saw a need for similar professionals in anatomic pathology so he initiated the nation's first pathologists' assistant program in 1969. These professionals were trained to perform tasks, under a pathologist's supervision, in autopsy and surgical pathology that had previously been performed by pathologists. Since that time, other programs have been established and the profession has grown in number and stature. The training programs have grown from certificate programs to bachelor's degree programs and currently, all but one of the programs are graduate level offering Master’s degrees.
At its inception, the physician assistant profession was mentored and structured by the American Medical Association and accreditation of training programs and certification of individuals were established. Because of the small number of pathologists' assistants, high degree of specialization, and uneven initial acceptance of the profession by national pathology organizations, no guiding physician or pathology organization would establish criteria for training programs and credentials for individuals. This task was assumed by the national professional organization of pathologists' assistants, The American Association of Pathologists' Assistants (AAPA), which was founded and incorporated as a not-for-profit organization under the statutes of Ohio in 1972. The objectives of the organization, then and now, are to:
The AAPA held its first meeting in Atlanta in 1975. The first goals set by the organization were guidelines for training programs, a mechanism for approval of training programs, and the development of an examination for fellow status of membership in the AAPA. Graduates from AAPA approved programs or persons with a bachelor's degree and three years of AAPA approved on-the-job-training were eligible to sit for the examination. The major long-term goal of the AAPA was to achieve professional recognition for pathologists' assistants through establishing both independent accreditation of training programs and national certification of individual practitioners. The program approval and membership examination of the AAPA has served as de facto accreditation and certification by many employers for over 25 years.
In 1995, the Accrediting Agency for Clinical Laboratory Sciences (NAACLS), following negotiations with the AAPA, agreed to accredit training programs. Over the following two years, all of the former AAPA approved programs became accredited. Subsequently, all of the initially accredited programs have been through several rounds of evaluation by NAACLS. All programs have been re-accredited.
In 2000, the National Commission for the Certification of Pathologists' Assistants was formed and held its first meeting in Toronto in conjunction with the annual AAPA meeting. The Commission was comprised of representatives from most major stakeholders in the practice of pathology. The Commission was charged with assuring the development and implementation of a national certification process for Pathologists' Assistants. The Commission partnered with the American Society of Clinical Pathology and the first national certification was held in Boston in September 2005 in conjunction with the annual AAPA meeting. Certification is now available only to graduates of NAACLS accredited Pathologists’ Assistant Programs, no longer to on-the-job-trained individuals and the board of certification examination is offered through the ASCP as Computer Adaptive Testing at multiple Pearson Professional Centers throughout the United States.