A Global Citizen
Sitting Down With Malak Abedalthagafi, Assistant Research Professor of Genomics and Neuropathology at King Abdulaziz City for Science and Technology, Medical Director of Molecular Diagnostics at King Faisal Specialist Hospital, Saudi Arabia, and part-time faculty member at Harvard Medical School, Boston, USA
What inspired your journey into pathology?
When I was very young, I was diagnosed with a rare genetic disease that required frequent trips for treatment. I lived in London for a year, then went back and forth between Makkah and Riyadh for follow-up treatment. Those visits to a specialist in Saudi Arabia, as a young girl in the late 1980s, gave me my first glimpse of the possibility of becoming a physician-scientist. That specialist, Nadia Sakati, became my first role model. I later learned that she had established one of the first genetics departments in Saudi Arabia.
Initially, I intended to concentrate on studying genetic diseases in children – but as I studied, I moved toward molecular pathology and then became more focused on surgical oncology, molecular genetics, and neuropathology. Now, my goal is to improve personalized medicine in the clinical management of cancer patients.
I am extremely pleased that I made the decision to become one of only a few board-certified molecular neuropathologists in the world. To reach that goal, I was fortunate to have a mentor who spoke candidly about – and helped me to overcome – the obstacles women still face in science and medical careers. I also obtained an MBA degree, which serves me well in directing research and clinical labs. My background is somewhat unique, but it has helped me to carve out an equally unique niche. I find it very rewarding to not only diagnose cases in the classical way, but also guide oncologists toward new targeted therapy approaches that save lives.
You’ve been educated around the world – was it hard to settle back in Saudi Arabia?
It’s true that my career path was quite a journey, but by that time in my life, I was used to it. I attended medical school at King Abdulaziz University in Jeddah and then, thanks to the King Abdullah Scholarship Program, had the privilege of studying at world-renowned American universities. Although I was driven to seek out the best education I could find, eventually, the cultural differences – notably the misconceptions I kept hearing about the Middle East – had me eager to return home. I was thrilled to become part of the Saudi Human Genome Program in 2014. Now, I wear many hats – as a genomics researcher, clinician, and educator.
What are the most important issues in pathology today?
The quick transition to molecular diagnostics is a key issue right now. To stay relevant, pathologists must continue to specialize and take a personalized approach to their work. I hope the next generation of pathologists will standardize integrated reports and play an active part in molecular tumor boards.
As I’ve hinted, discrimination is also a big problem in the medical community, from both patients and other health care providers. At its worst, people refuse to believe I could have received an adequate education at home. As a Saudi woman, it’s common for people to assume I can’t speak English or understand basic concepts. Working in world-class institutions, I was shocked to hear some of the misconceptions people had and the questions they asked. There is a prejudice that non-western doctors don’t have the same quality of education and experience – in fact, even when I trained alongside western colleagues, they questioned my abilities!
Pathologists and medical professionals worldwide can benefit from a larger worldview and a more inclusive mindset. I was fortunate enough to be surrounded by collaborative mentors who taught me to overcome discrimination. If we are all more conscious of our attitudes and preconceptions, we will come together more effectively.
How are new technologies changing the face of modern pathology?
My research involves the genomes of tumors – particularly brain. My clinical genetic specialization involves diagnosing disease using the latest genetic technologies, especially in the field of cancer. Today, novel technologies are having a major effect on our field. Artificial intelligence (AI) and next generation sequencing are popular examples, but I urge my colleagues not to get too excited without considering the potential downsides. For instance, doctors who create AI platforms may run into conflicts of interest, as advanced AI could threaten laboratory jobs. In general, my position on new technologies is positive, but cautious.
What’s your advice for younger pathologists?
Mentorship has benefited me immensely, and I encourage all younger pathologists to find role models in their specialty. I recommend mentoring networks, so people can surround themselves with others who are driven to succeed. Multiple mentors are ideal; each will keep you on track in a different way. I also recommend sitting back from time to time to assess how you want to learn and grow in your career.
