The European Society of Pathology (ESP) is growing from strength to strength. Whilst its membership continues to increase by more than 10 percent each year, its annual meeting – the European Congress of Pathology (ECP) – is now cited as the world’s largest pathology congress, exceeding 5700 delegates in 2024.
But how does the ESP manage to represent the needs of members from such a wide geographical area, from countries with such wildly varying economic climates? How is the society connecting with non-European pathologists? And what is it doing for non-pathologist laboratory professionals? We decided to put these questions and others to the people in charge.
It’s never easy to bring four people at the forefront of pathology leadership together at the same time – but somehow the planets (and schedules) aligned. We spoke with Chief Executive Officer Raed Al Dieri, President Peter Schirmacher, immediate past president Aleš Ryška, and special guest Fred Bosman, who served as President from 2007–2009, to learn more about the ESP’s strategies, priorities, and plans.
Meet the ESP’s leaders
What is the purpose of the ESP?
Raed Al Dieri: Like any other medical association, we focus on providing educational and scientific activities and events that serve our members – many of whom come from outside of Europe.
We look at how we can position pathology within broader networks – including partnerships with other societies, politics, industry, funding agencies, patients, and the public. We want to encourage our members out of silos and into multidisciplinary teams and environments. Only the ESP can do that on the European and international level.
The vision of the ESP is one of excellence in pathology, resulting in optimum patient care. If this is what our members see, then we believe that the ESP is really fulfilling its purpose.
Aleš Ryška: For me, the purpose of the ESP is to bring together practising pathologists who are interested in collaboration in science and education. Empowering these collaborations inspires our community to achieve more, to better serve the patients, to better understand the diseases, and to enjoy our profession every day.
Fred Bosman: When I was President, I used to describe the ESP as the house of pathology in Europe. It's a busy house with a family living there and many people coming and going. The family enjoys activities together, and it also represents the interests of everyone within the house wherever representation is needed.
Incidentally, my presidency coincided with the ESP establishing its headquarters in Brussels, Belgium, which gave further weight to the idea of a house of pathology in Europe.
How has the vision and mission of the ESP changed (or not changed) during your combined leadership?
AR: I think the mission and vision of the ESP has always been there – it has always been concerned with excellence in education, research, and diagnostic services. The only thing that has really changed is that now it is formalized and explicitly stated.
What characteristics are essential for the role of President?
Peter Schirmacher: Any officers elected to serve on our executive committee are always chosen on the basis of their strong track record of engagement with the ESP. All our leaders will have already demonstrated their commitment to the society by serving on our various committees and working groups over the years and being actively involved in the work.
FB: My route into the presidency is quite a funny story. Whilst attending the 2006 international congress in Brazil, I was approached by a former president, Antonio Cardesa, who asked me if I would consider putting myself forward for the role. I told him, “I have absolutely no interest whatsoever. I don’t think the society is heading in the right direction. I think the scope is too limited, the primary purpose seems to be the organization of a biannual conference [as it was then], and the overarching goals are poorly defined. I don’t think I’m the right person to take over the presidency.”
He smiled and said, “But that is exactly the reason we want you as president.”
Now, if you look at the presidents we have had in the last 15 years, they all had a great sense of purpose, which is essential for a society like the ESP. Our current president, I think, is a great example of that.
We also need somebody that can translate that sense of purpose into action to achieve the goals, and I think Raed Al Dieri is a great example of a CEO who is exceptionally capable of translating vision into reality.
PS: I think the turning point was when the ESP decided to change the constitution to introduce the CEO role to effect growth and impact of the society. It was agreed that we needed an excellent CEO with the potential to build up the administration in order to fulfil the different tasks. This is not feasible for our presidents alone, who are still in full clinical or administrative service. By employing a CEO, we now have a growing and fully functional administration, which is a major achievement.
RAD: In my experience, I would say the two key attributes for the president of an organization like the ESP are vision and dedication.
Leadership skills, experience in the field, and familiarity with the administration are essential, of course. But you also need someone with a clear vision for the society over the next two or three years.
AR: Picking up on the theme of dedication, it is crucial that the president is willing to sacrifice part of their time and energy for the society. It really is extra work and, therefore, we always look for people who are willing to commit to that. We need to be wary of people nominating themselves for the honor and the title, and be convinced of their dedication to the role.
What role does the ESP play at a global level? And how does it interact with other societies?
PS: The only aspects of the ESP that are limited by geography are our administrative office and our annual conference, which must always be located on European soil. Our other activities – and our membership – are very much international.
What’s more, our associated societies program facilitates memorandums of understanding with many pathology societies outside Europe. These allow bilateral support of activities and issues. In fact, one of our partner societies,located in the Far East, sent around 80 delegates to our last European Congress of Pathology (ECP) meeting, which, when you consider the effort and travelling expenses involved, really reflects their motivation to be involved.
The needs of education, quality assurance, interaction with policy makers, and so on, do not stop at the European borders. We see the ESP very much as a global society.
How does the ESP attract – and retain – new members?
PS: Membership is certainly on the rise. This year it increased by around 20 percent, which is considerable. Access to the ECP meeting is certainly an attraction, and we also offer many other educational events, such as the ESP Academy, which is available exclusively to members.
The accessibility of ESP membership is also a factor in attracting and retaining members. Medical students and pathology residents can join free of charge, with proof of their course or placement. Even our senior memberships for board certified professionals cost only €50 per year – and that falls to €40 per year for the extended memberships. In my opinion that cost is so low that it is accessible even to professionals in low income countries.
I already mentioned that membership is available to anyone in pathology, regardless of geography. That creates a global community that is another attractive feature. We have members in Brazil, Kenya, and Japan, for example, and we like to keep very close contact with the national societies in order to promote this sense of community.
We hope that the national societies realize that we are acting with, not against, their interests, and make it attractive for their members to become ESP members.
RAD: What’s more, the price of membership has remained the same for the last 10 years.
During this time, we have seen at least two generations of trainees becoming attending pathologists. So, really, we have been investing in the future of pathologists, independent of their location, their income, or their individual specialties.
This is very important, and we certainly don’t plan on any membership fee increases, at least for the next two years.
What incentives do you offer to attract members in low- and middle-income countries?
PS: The need for good quality educational and training programs is especially high in those countries, which strengthens the attractiveness of ESP membership.
We also offer a large number of bursaries for the ECP meetings. These go to junior members who submit an abstract and, especially in lower income countries, they open the possibility of attending the conference.
The ESP also offers stipends like the Giordano Fellowship, which is specially dedicated for those countries with lower incomes. It enables our members to acquire specialist knowledge at dedicated centers and help to build up structures in their home institutions and countries. For example, with the Giordano Fellowship, the trainee can stay for up to three months at the host institution, and the ESP pays the expenses for the stay.
AR: Maybe a good illustration that we really are attracting people from low- and middle-income countries is the fact that, in the last couple of years, Romania has been among the top ten countries represented at the ECP meeting. Romania is definitely not a high-income country.
PS: Turkey is always well represented at ECP meetings, despite the income of pathologists being relatively low there. And Portugal is also consistently well represented at our meetings.
What have been the major achievements of the ESP recently?
RAD: The growth in popularity of the ECP meetings has been phenomenal. The last three meetings – held, respectively, in Basel, Dublin, and Florence – have all broken records for participation. This year we achieved nearly 6000 delegates, making ECP the largest pathology congress in the world.
I attribute this success largely to ESP’s hard work in attracting more colleagues from Asia, North America, and Africa – which has been a key strategy for us since 2019 – as well as the quality of the scientific program put together by our various working groups and committees.
Another major achievement is our publication of a number of guidelines addressing the challenges in the field of translational science. The ESP has worked hard over the last 12 to 24 months to highlight the importance of the role of pathologists in clinical settings – both internally and externally, as well as with industry. We have strongly advocated for the involvement of the pathologist in the whole clinical trial process – from conception, to design and protocol development, through to reporting of results. We are now beginning to see a shift in mentality of industry when setting up clinical trials.
PS: A key achievement, in my opinion, is the move early this year to new, more spacious and better equipped offices, close to the European Parliament in Brussels. This has allowed us to significantly increase our administrative staffing, to the point where we are now able to have our own in-house congress and event management.
This expansion was absolutely instrumental in not only the success of our annual congress, but also in our other educational activities, which exceeded 200 CME credits for the first time this year. It has also allowed us to fulfill our 2019 strategy plan – in spite of the pandemic – except for a few specific research aspects. What’s more, we have now completed work on our new “ESP Strategy 2030.”
And, perhaps most importantly, feedback from our meetings tells us that our members are supportive of our developments and happy that we are moving in the right direction.
What would you say are the biggest challenges in clinical pathology at the moment?
AR: I think that worldwide we are facing a growing discrepancy between the number of pathologists and the amount of work. This is something which has to be addressed somehow. Of course, you can increase the efficacy or productivity of a pathologist – if we are well trained we work faster and more accurately – but this is unlikely to be enough.
So next we must look at new areas of pathology that might help increase productivity – like computational and digital pathology. Whilst there are extremely high expectations regarding these technologies, we have to be realistic regarding what is really validated and applicable in everyday routine practice versus what is still in the research phase.
This is an area in which the ESP decided to play a key role – to not only partner with industry but also provide guidance on the clinical reality of computational pathology. We aim to be instrumental in pushing for standards and driving the field forwards.
The same is true for molecular pathology. A couple of years ago, the ESP published a very important and impactful paper about the role of pathologists in the molecular testing of cancer. It clearly defined how – and why – pathologists must be involved in this diagnostic process. This arose from examples of molecular testing being carried out by other specialties with substandard – and sometimes disastrous – results. So this is another area in which ESP, I believe, plays a crucial role.
Brain drain is also a very concerning challenge. Pathologists are being lost from economically weaker countries to countries which can offer better income and better payment for the service. We see pathologists from Romania, Hungary, Poland, Slovakia, and Czech Republic disappearing to Germany, Switzerland, UK, and Ireland. This is something that we cannot ignore. The ESP will need to help its members to nourish more trainees to maintain the quality of service, irrespective of which country they live in.
How do those challenges inform the ESP’s priorities over the next few years?
PS: Pathology is a cross-sectional discipline, closely interacting with 25 or so different clinical disciplines. The challenge for ESP is to make our voice heard across all of those disciplines and fully represent our members in all the clinical societies we interact with. Whether this is in training future medics or creating clinical guidelines and recommendations, we have to be present in order to assure that our interests are seen.
As a technical discipline, pathology relies on good communication with the suppliers of its consumables and instrumentation. One of our priorities will be to continue to influence the industry to explore diagnostic needs before starting any clinical trials and to involve pathology expertise from the offset.
Further, as a clinical theoretical discipline, if we fail to invest in diagnostic research then we have no future as a discipline. Therefore, the ESP also needs to work to strengthen the impact of research, and make it sustainable. We will prioritize supporting research infrastructures, biobanks, diagnostic aspects of clinical trials, and comparative pathology. These efforts will also address the infrastructures for digital and computational pathology being in place – including the bioinformatics behind it all. These are all aspects which the ESP needs to be driving and facilitating.
We must also prioritize working with policy makers to ensure the regulatory burdens on labs ensure quality without being obstructive. This is an area where our success is critical to the future of pathology.
How might the organization of the ESP evolve in the future?
RAD: It is crucial that the ESP continues to grow its membership in all categories. To that end, we are planning a campaign strategy with two important strands. Firstly, we will target recruitment from Latin America, North America, Asia, and other regions in the world.
Secondly, we will support memberships for non-pathologists and expand our educational and scientific programs to serve their interests. As of next year, for instance, we will have a dedicated scientific track for technicians.
This is extremely important when you consider that, in a typical pathology department, in addition to pathologists many more medical scientists, technicians, bioinformaticians, molecular biologists, and others, are employed. All of these will be invited to become ESP members and to have a voice and a vote in the organization. This will allow for much better representation of the discipline as a whole.
In terms of expanding our outreach activities, we plan to look beyond collaborative agreements with other pathology societies, and reach out to other clinical medical associations. Together we will look to forge joint ventures such as educational programs and clinical guidelines not only for pathologists but also for oncologists and other healthcare professionals in oncology, for example.
This will also help to improve the visibility of pathology in the field of healthcare.
Fred, as you're not currently involved in the leadership, what does the ESP mean to you as a European pathologist?
FB: I can’t imagine pathology in Europe without the ESP.
The ESP has achieved so much – scientifically, educationally, and community-wise. Look at the number of people the ESP attracts, and how happy they are. The success of the ECP meetings enhances that. Nowadays, if you ask a North American pathologist who has attended ECP to name their preferred pathology meeting, in all likelihood the answer will be, “We prefer ECP because the atmosphere suggests we are on an adventure together.”
The structure of ECP meetings certainly enhances that atmosphere. Lunches, coffee breaks, and so on, are integrated into the scientific activities of the congress. The informal get-together after the opening session and the congress party at the end of the meeting have also been instrumental in bringing together a large group of people into what feels like a family.
I’m in the old league now, but I still feel very much like a happy member of this family – that’s what it means to me.
About the ESP
Its mission is to promote high quality pathology diagnosis for all patients, provide up-to-date education across Europe, and support cutting-edge research to understand disease and translate science into clinical practice.
It has over 5000 members in 90 different countries.
The European Congress of Pathology, ESP’s annual meeting, is the world’s largest pathology conference, attracting more than 5000 delegates.
The society formed in 1963 and has had 26 presidents to date.
Students and trainees are entitled to free membership.
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