How did you find your way into clinical microbiology?
I was a late comer to clinical microbiology, selecting it only towards the end of my third year of pathology residency. Based on my interest in the gross and microscopic morphology of various pathologic states, I had originally planned on becoming an anatomic pathologist. However, I realized that I was better suited to the clinical pathology workflow, where I could have a wide variety of responsibilities and activities.
Having different things to do every day – and even every hour of the day – appealed to me. I was worried that I would become restless if I sat at a microscope all day long. I also found infections fascinating!
Finally, I realized that I was more interested in the pathology of infectious diseases than malignancies, and was very excited about the opportunity to combine my anatomic and clinical pathology training to diagnose infections from both traditional microbiology and histopathology specimens.
Could you please share your career highlights?
One was being hired – right out of fellowship – to direct the Clinical Parasitology Laboratory at Mayo Clinic, leading the team that discovered two new tick-borne pathogens in the United States. I also had the opportunity to serve as Vice Chair of Education for the department, Division Chair of Clinical Microbiology Division (my current role), and Interim Chair of the Department of Laboratory Medicine and Pathology.
In this last role, I was responsible for over 170 physicians and PhD scientist laboratory directors, and over 3000 staff. Though I wasn’t interested in the permanent position, I was honored to lead our department during a dynamic and exciting 16-month period.
Perhaps my biggest career highlight to date, however, is being elected to the Board of Governors for the College of American Pathologists.
What key leadership lessons did you learn as interim departmental chair?
There were so many! There are plenty of books on how to be a good leader, so I won’t repeat the wisdom held within. Instead, I’ll focus on three practical points I learned during the 16 months I was in this role.
First, it’s important to take control of your calendar – as much as possible at least – to ensure that there is time for the important things you want to accomplish. Otherwise, it’s easy to end up in 10 hours of back-to-back meetings that are focused on other people’s priorities.
Second, remember that all eyes are on you as the leader, and that people who were colleagues – or even previous mentors – will now look to you for approval. It took me a while to get used to this change in how people saw me.
Finally, it’s important to reflect on your performance regularly so that you can improve. Take some time to talk through challenging issues with a trusted advisor if you can. Good leadership is a skill that can be learned through effort, reflection, and practice.
What achievement brings you the most pride?
My accomplishments in education and mentorship give me the most pride. I had the honor of being inducted into the pathology educator hall of fame by being selected as Educator of the Year in clinical pathology six times in my first nine years at Mayo Clinic. I also received the highest-level award for educational excellence offered by Mayo Clinic.
Though I am proud of my achievements in clinical care, research, and leadership, I feel that my legacy will be the students, residents, and fellows that I have had the privilege of teaching.
Teaching and mentorship allow me to have a much bigger impact than I could accomplish alone. I am just one person, but I have the ability to make a positive impact on thousands of others by inspiring them to excel in their chosen fields.
What do you like most about your job?
I love the ability to contribute in so many different ways, from the teaching and mentorship I just mentioned, to creating innovative new tests and signing out cases in ID pathology, a subspecialty of anatomic pathology.
I am lucky enough to work with diverse teams of health care professionals, providing individualized consultation for patients and physicians around the world. Although I probably say “yes” to too many things, I am constantly stimulated by my work and the people I get to work with.
How does your role as Editor of the Journal of Clinical Microbiology enhance your knowledge and experience?
As Editor, I get to evaluate the newest literature in the field and ensure that promising articles get a full and careful review. It helps me keep up-to-date in the field, and it’s allowed me to work with talented microbiologists around the world.
Does your work ever take you outside the US?
I love to travel, and my favorite type of travel is work related, as I get to learn while exploring new places and meeting new people. For example, I served in a consultative role for the American Society of Microbiology to help Indonesian microbiologists create a standardized national curriculum. As a guest in their country, I was given tours of different laboratories, traveled off the beaten path, and even got to try a little karaoke! Importantly, I was able to help my colleagues create a modern curriculum for their residents.
Other highlights include my trips to Kampala, Uganda, where I taught medical parasitology as part of the East African Clinical Tropical Medicine Course offered in collaboration with the Infectious Diseases Institute, Makerere University, the Mayo Clinic, and the University of Minnesota.
What have you learned about communicating with different audiences during your career?
I’ve had the opportunity to teach multiple different learners – from members of the general public to highly trained medical specialists. It’s always important to consider your audience and what is important to them. It’s also important to continuously assess their comprehension.
I recently gave a lecture on the histopathology of infectious diseases to a small but very diverse group of learners, including pathology residents, infectious diseases fellows, and PhD microbiologists. It was soon apparent that most of the audience had little to no training in histopathology, but that various aspects of the infectious diseases I was covering were still of interest.
With that realization, I changed my teaching style to be more Socratic and focused on asking questions that were relevant to each of my different learners. Once the pathology residents had identified the microorganism present, for example, I then asked questions about clinical presentation, treatment, and laboratory diagnosis. This allowed me to engage everyone and keep the discussions interactive.
What innovations in molecular diagnostics are you excited about?
I am most excited about the increasing availability of nonbiased (so-called “shotgun”) metagenomic next-generation sequencing that can detect any type of pathogen – bacterial, viral, fungal, and parasitic – in any sample type. Right now its availability is limited, but that will change quickly in the coming years.
What advice would you give to pathology residents in choosing their subspecialty?
First, look at how the attending pathologists spend their time and reflect on whether it would be a good fit for you. Remember that what you are doing as a resident will not be the same as an attending. For example, I really enjoyed grossing but realized that I was unlikely to spend much time doing this as an attending if I stayed in academic medicine.
Second, pick the area of pathology that truly excites you the most – even if it is not what your mentors had in mind for you. I had been told by several of my respected mentors that I would be wasting my career in microbiology. Fortunately, I had come to my own conclusions and had other supportive mentors to guide me on my way.
Finally, don’t worry if few residents specialize in the area you are drawn to. As long as there are job opportunities, it doesn’t matter if you are the only one in your group to specialize in that field. Being a rarity might even make you more highly sought after!
Few pathologists move into microbiology, for example, but pathologist-trained microbiologists can do things that other microbiologists can’t easily do, such as sign out surgical pathology cases and cover other areas of the clinical laboratory. This may make you a more attractive job applicant.
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