Pathologists in small, low-income, politically unstable countries like Bosnia–Herzegovina, in Eastern Europe, might not always have equitable access to subspecialty training and upskilling compared with their colleagues in wealthier countries. Conference attendance, professional memberships, and short courses all require financial investment that might be routed elsewhere.
That is where philanthropic, cross-country educational partnerships are proving invaluable. The Bosnian Turkish Cytopathology School and the Bryan Warren School of Pathology are two such ventures that are helping to redress the skills balance.
A key founding member of both these initiatives is Semir Vranić, Associate Professor of Pathology at the College of Medicine, Qatar University, and a corresponding member of the Academy of Sciences and Arts of Bosnia and Herzegovina. We connected with Vranić to find out how the schools operate and why they make a difference.
What is the current situation with cytopathology services in Bosnia–Herzegovina?
The whole country suffered terribly during the Bosnian War in the early 1990s. Since then, pathology services in general, and cytopathology in particular, have made significant progress, but there are still challenges to address.
Not only is there a shortage of pathologists, but cytopathology is not included as a distinct specialty of pathology training in Bosnia–Herzegovina. The consequence is a shortage of well-trained cytopathologists, as well as cytotechnologists.
This situation is exacerbated by the brain-drain effect, whereby newly qualified professionals seek work in other countries that offer higher wages and better subspecialty training. Bosnian graduates who are proficient in German, for example, can easily find places on residency programs in Germany and Austria.
Another important issue is that the diagnostic infrastructure for cytopathology is not evenly distributed across the country. The major academic centers are largely well equipped with modern technologies and laboratory professionals who have been trained abroad. Smaller centers, however, are struggling with limited resources due to underfunding.
Initiatives such as the Bosnian Turkish Cytopathology School aim to bridge this gap and bring pathology services up to the standards of those in neighbouring countries.
When and why was the Bosnian Turkish Cytopathology School established, and what are its aims?
It was established in 2016 after a chance meeting with renowned Turkish pathologist, Sitki Tuzlali, who was, at that time, Secretary of the Turkish Division of the International Academy of Pathology. Aware of his many international connections – and recognizing that cytopathology training and infrastructure is more advanced in Turkey – I talked with him about the opportunities to provide cytopathology training in Bosnia. He came up with the concept of the Bosnian Turkish Cytopathology School.
The aim is to provide high-quality, accessible education and training to pathologists in Bosnia–Herzegovina and neighbouring countries.
Who is invited, and how do you keep it affordable/accessible?
The target audience is early-career professionals looking to upskill in cytopathology. From its initial beginnings as an in-person training event, the school has expanded to include online delegates, which has allowed it to become a more international event. The teaching is all in English to reinforce the international reach.
Importantly, the school is a philanthropic, not-for-profit initiative. The instructors give their services for free, which allows us to invite delegates for only a nominal fee.
How would you summarize the initiative’s achievements so far?
The events are very well attended – particularly in Bosnia–Herzegovina, where almost all the institutions send delegates – showing that the school’s reach is meeting expectations.
The school recently delivered its tenth training event, and each one helps to grow a network of motivated and well-trained early-career cytopathologists who value the culture of continuous education.
Anecdotally, there has been a marked improvement in cytopathology services and practices – at least in Bosnia–Herzegovina – which speaks to the main goal of the school.
You’re also involved in organizing the Bryan Warren School of Pathology in Bosnia–Herzegovina. What’s the background to that meeting, and how is it helping to upskill Bosnian pathologists?
I am very proud of this school, which has been running for almost 20 years. It’s named after the late Professor Bryan Warren, of Oxford University, who died in 2012. He helped me establish the school as a collaboration between the British Division of the International Academy of Pathology, the Association of Basic Medical Sciences of the Federation of Bosnia and Herzegovina, and the Department of Pathology at the University of Sarajevo.
I was introduced to Bryan Warren in 2005 by Mike Franey, founder of Acorn Aid, which provided humanitarian aid from the UK to northwestern Bosnia. I had approached Mike about putting out an appeal for support for pathology services in Bosnia–Herzegovina, and Bryan responded.
Bryan and I met in 2006 in Montreal during the IAP meeting. He was a strong advocate for pathology education globally – and particularly in transitional countries. We discussed the situation in Bosnia–Herzegovina and agreed to establish the school, initially named the Bosnian British School of Pathology. The first event was held in summer 2007.
The Bryan Warren School covers pathology as a whole, and aims to enhance specialty expertise in areas such as gastrointestinal, genitourinary, reproductive, breast, and all other specialties and subspecialties in pathology. The seventeenth school, held as a hybrid event in Sarajevo in June 2025, focused on lung and mediastinum pathology and attracted around 150 delegates.
Just as for the cytopathology school, the lecturers are volunteers, and the training is offered for minimal cost.
Why are inter-country partnerships important in keeping pathology subspecialties thriving?
These sorts of partnerships are absolutely essential for small countries with limited resources, for whom being left in isolation would be a disaster. They serve as a sort of lifeline for continuous education and professional growth.
Global knowledge exchange is so important for bringing exposure to best practices, research opportunities, and the latest diagnostic skills and standards. I also believe that schools like the Bryan Warren School of Pathology and Bosnian Turkish Cytopathology School help to build trust, reduce educational inequality, and foster a culture of mutual advances that benefits both educators and trainees.
I should mention that, given the hybrid nature of our events, we also welcome involvement from colleagues around the world – particularly those who share our passion for advancing pathology education and training in the Bosnia–Herzegovina region and beyond.
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