Have You Heard?

Long gone are the days of learning medicine solely by didactic lecture, seated in crowded halls, pen in hand, notebook on desk. The educational revolution has brought forth practical experiences, simulated autopsies, virtual grand rounds, and a host of innovative educational tools. But it’s not just formal education that has seen a sea change; nontraditional learning has also fed into revolution. And among the fastest-growing informal training tools are podcasts – audio recordings that can be listened to anytime, anywhere, on any subject. From true crime tales to hobby how-tos, there is a podcast for every interest – and pathology is no exception. We spoke to a panel of pathology podcasters to find out what inspired them to take on the challenge of hosting a modern-day radio show – and why they think the medium is so popular.

The Panelists

• Lori Ryan (ScopeMD)
• Dennis Strenk (People of Pathology)
• Natalie Banet (Deeper Levels)
• Jordan Taylor and Nicole Croom (Dead Men Do Tell Tales)
• Xiaoyin (Sara) Jiang, Christina Arnold, Michael Arnold, and Kamran Mirza (PathPod)
• LokMan Sung (Detroit’s Daily Docket)

Who are the people behind the podcasts?
Lori Ryan (ScopeMD): I am an AP/CP trained pathologist with a master’s degree in epidemiology. I am privileged to serve multiple patient populations as a pathologist; most of my workday is spent signing out lung pathology and cytopathology cases. I am director of the immunohistochemistry laboratory and also serve as Chair of Pathology at Abbott Northwestern Hospital in Minneapolis.

Dennis Strenk (People of Pathology): I’m a pathologists’ assistant (PA) and was previously a histotechnologist. I started in the laboratory in 1997 – by accident. At the time, I had a degree in biology and wanted to go into microbiology. I ended up getting a job as a lab assistant in the histology department of a local hospital and found that I loved it. The more I learned, the more I enjoyed it – and I just kept going from there.

Natalie Banet (Deeper Levels): I’m an academic pathologist and I practice in Rhode Island. I specialize in gynecopathology and cytopathology. I have wanted to be a physician for as long as I can remember. In my journey through medical school, pathology – specifically, histology – was one of my favorite subjects, and I ended up in this career after realizing that not only is it the best fit for my style of learning, it also facilitates my love of teaching.

Jordan Taylor (Dead Men Do Tell Tales): My grandfather was a pathologist and, at the time, local pathologists covered forensics cases, so I grew up hearing some very interesting stories. You can’t escape pop culture, either; I watched all the TV shows, including Crossing Jordan, which was about a forensic pathologist named Jordan in Boston, two hours from where I grew up – and I went, “That’s me!” I loved the idea that there were doctors who could put “bad guys” away. I tried to keep an open mind throughout my education, but I pretty much always knew I wanted to be a forensic pathologist.

Nicole Croom (Dead Men Do Tell Tales): I also got interested in forensic pathology in high school. Unlike Jordan, I didn’t have any firsthand stories, and although I really liked crime TV shows growing up, I never focused on the person doing the autopsy. It wasn’t until high school, when I started asking myself what I wanted to do with my life, that I thought more deeply about it. In my senior year, I shadowed a deputy coroner and met Bennet Omalu, who was chief medical examiner at the time. He said I could come in anytime I was free, so during college breaks, I worked with him. He was a fantastic mentor. When I applied to medical school, I wrote my personal statement about wanting to be a forensic pathologist – and they still let me in! Like Jordan, I tried to keep an open mind, but nothing drew me the way forensic pathology had.

Xiaoyin (Sara) Jiang (PathPod): I am at Duke Health and do cytopathology and head/neck/endocrine pathology. I love pathology because I get to solve puzzles every day, harness my love of science, and educate and network with amazing colleagues around the world.

Christina Arnold (PathPod): I am from the University of Colorado and I practice gastrointestinal pathology. I love pathology because it is visual, interesting, lets me think outside the box, and the field is full of wonderful educators.

Michael Arnold (PathPod): I am a pediatric pathologist and Medical Director of Anatomic Pathology at Children’s Hospital Colorado. I am a visual person, so I love that anatomic pathology is a very visual field. Pediatric pathology is a relatively general subspecialty, so every day is a different learning opportunity.

Kamran Mirza (PathPod): I am a hematopathologist at Loyola Medicine in the Chicagoland area and serve as Vice Chair of Education in the Department of Pathology and Laboratory Medicine. I was always intrigued by the behind-the-scenes, but extremely powerful, role of pathology and instantly fell in love with the field.

LokMan Sung (Detroit’s Daily Docket): I am an Assistant Medical Examiner at the Wayne County Medical Examiner’s Office and a Clinical Associate Professor of Pathology at the University of Michigan Department of Pathology. My decision to pursue medicine evolved during my undergraduate education at Alma College. Before beginning college, I had every intention of studying chemical engineering. I had been to engineering camps and was pretty interested in the field. In my senior year of high school, I had been accepted into two Schools of Engineering and was all set to start down that path. However, for reasons that I can’t really explain even today, I changed gears and headed off to a small liberal arts college. Through my years in college, my interest in medicine grew, ultimately leading me to medical school.

I distinctly remember when I decided to jump headfirst into forensic pathology. I attended Wayne State University School of Medicine, where a major portion of my second year was pathology. Admittedly, portions of it were pretty dry – but, for me, the lecture we received on forensic pathology was entirely different. Leigh Hlavaty was able to make the subject incredibly fascinating. From that point on, I was all in. I have the pleasure of working with Leigh Hlavaty now and she and I have had discussions about how a single person or event can alter the trajectory of one’s life.

What inspired you to start podcasting – and how did you begin?
LR: The podcasts I listen to focus on the insights and experiences of women leaders, the majority of whom are entrepreneurs and CEOs. Though I have learned a lot from these podcasts, I really wanted to listen to a podcast focusing on women in healthcare. In late 2017, I began exploring the idea of creating a podcast for women in medicine as a way to give back to the medical community. My goal was to create a podcast that explored the scope of challenges and opportunities for women in medicine. Across 2018 and 2019, I researched podcast editing and recording equipment and created a list of potential episodes. ScopeMD launched in March 2020.

DS: I’ve been a fan of podcasts for a few years now, but it seemed there weren’t any about those of us in the lab – at least, not in the interview format I enjoy most. My friend Alyse, a fellow PA, said I could interview her for practice because she was writing a book. That became the first episode. I researched hosting sites and recording software and picked whatever seemed easiest to use. Then I bought a good microphone and just went from there.

NB: I listen to podcasts all the time! I had been mulling over starting my own for a while, but I was finally prompted to get going when COVID-19 hit hard here in the Northeast. I had a more flexible schedule and I was eager to talk to others about the shared experience of the pandemic. The technical aspects were slightly overwhelming, but I am lucky to be married to a technically proficient partner who helped me pick the most user-friendly recording and editing software options. My first show was with one of my closest friends, who agreed to be my test subject.

JT: Nicole and I talked about how true crime podcasts weren’t particularly well-explained and jokingly said we should have our own podcast and cover the real science. One day we just went, “We should do it!” Nicole sent me a bunch of options for podcast names and cover art and, once we settled on what we wanted, we rented equipment from the university and got started. It was fun (but terrifying)!

XJ: It really began because the podcasts I most like to listen to are quiz show-type podcasts, and I’ve always thought pathology would make a wonderful quiz show. I’m so lucky to have already known the perfect co-hosts!

CA: I have always wanted to be a game show host. This was my chance!

MA: When Sara Jiang proposed the idea of PathPod, I knew it was going to be fun and interesting.  I didn’t know anything about podcasting, so I was excited to try and figure it out.

KM: This amazing PathPod team, led by Sara Jiang and her brilliant idea, had me sold from day one.

LS: There are several reasons we started the podcast, but one of the most compelling is education. Our office is focused on education. We have long-standing relationships with Wayne State University and local pathology residency programs, where we have a one-month rotation for residents and medical students. The rotation is entirely immersive; rotators are afforded the opportunity to perform autopsies, not just watch them. In addition, the staff give lectures on many different forensic pathology topics. In the past, our knowledge-sharing was more local; now, with the evolving world of podcasts, we have an incredible ability to reach far beyond our borders.

What was the pathology podcasting landscape like when you began – and what is it like now?
LR: In 2017, I was not aware of any pathology podcasts. Now, multiple pathology podcasts are available. In my opinion, the exponential increase is due to technological advances that have made it easier to record, edit, and distribute podcasts, as well as work-related changes during the COVID-19 pandemic. I am particularly excited about podcasts by pathology organizations, such as IASLC’s Lung Cancer Considered podcast. Podcasting is a great way to get new information out quickly to a large audience.

DS: At the time, there really weren’t any pathology podcasts. But, as I came to find out, a few others had the same idea that I had at almost exactly the same time!

NB: I can honestly say I didn’t see any other pathology podcasts when I began, but I now know that they were out there. There is such a diverse set of perspectives and interests – I think it’s all lovely.

JT: We still feel like we’re pretty new to pathology – and to podcasting. True crime podcasts are possibly some of the most popular and people who enjoy them want more information about the science, so we hit a good niche. There are a lot more medical-adjacent podcasts now than there were when we began – and certainly more pathology podcasts.

XJ: I think the podcasting medium is getting more and more popular not only with individuals, but also with organizations and journals working in this sphere. We are all looking for ways to learn more efficiently and I think podcasts really maximize our ability to learn on the go.

LS: There is huge interest in “true crime” and many of the podcasts were, and still are, focused on that. In comparison, pure pathology podcasts are not that common. For pathology, I think podcasting is still in its early infancy. Podcasts that have a sharp focus on pure pathology have narrower audiences. An issue we all face is broadening to reach a wider listenership.

What lies ahead for pathology podcasting? 

LR: I anticipate that all medical journals and organizations will either have a podcast or consider having one – and I anticipate that future pathology podcasts will be niche-driven. Examples include podcasts for pathology trainees, monthly journal podcasts with episodes focused on article highlights, subspecialty-specific podcasts, and podcasts offering CME.

DS: I think video will be incorporated more. I could see live broadcasts from various conferences as they happen. That’s not something I’m ready for just yet, though.

NB: I think it would be great if some of the flagship journals and educational organizations had podcasts and offered them as supplements to major publications and updates. Imagine how much an author or a committee would have to say about their work, the process of bringing the information to the page, and the advice they could share for those interested in pursuing similar projects!

JT: I hope things get more focused. We have a couple of big-picture podcasts, but I think pathology needs a more intellectual approach – but that, in turn, makes it hard to find an audience beyond pathologists themselves. We got lucky; forensics is one of the few pathology subspecialties that captures the attention of a wider audience.

I also hope things will become more interactive. I’ve had to learn how to describe something that’s visual using only words, because so much of pathology is visual. Maybe we could upload virtual slides or other media for people to refer to while listening. That said, I feel like images and video – although useful – go beyond the scope of a podcast. It’s not really a podcast anymore.

NC: We don’t always correlate what we’re doing in our episodes with our social media. Perhaps we could post more on social media in weeks when we don’t release an episode – but it’s hard to balance residency life with not just the podcast, but also its many social media platforms.

LS: I have a very positive outlook for pathology podcasting. With a broad stroke of the brush, pathologists are a reclusive bunch. We can do a better job reaching out to the community at large. This is easier with a large, established listener base, but one arena that we can explore in the future is live shows with audience participation and call-ins.

What are the strengths of podcasts in comparison to other informal educational tools?
LR: Podcasts are portable and are relatively easy and inexpensive to produce. I listen to podcasts while commuting and exercising. Because I spend most of my day in front of a computer screen, I prefer podcasts because they don’t require additional screen time.

DS: To me, one of the strengths of podcasts in general is that you can listen while doing other things – commuting, exercising, and so on. That’s true of pathology podcasts, too. Other formats have their place, but podcasts allow you to listen wherever you are.

NB: Podcasts are so easy to access – both in the “click and listen” sense and in the didactic sense. They expose the basic truths of situations and allow for nuance in tone and meaning that is missing from the written word. I came to love some of my favorite journalists because I heard them talking about their work and now, when I read their words, I have a deeper appreciation for their meaning. I think podcasts give folks the space to offer their opinions without limitations.

JT: The great thing about podcasts is that you can listen while you’re doing something else. I love multitasking, but if I want to watch a video or read Twitter, I have to look at the screen. With podcasts, I can learn while cooking, driving, or working out. There are only so many hours in a day!

NC: I also like the auditory component. My preferred learning methods are interactive, so I enjoy multitasking while listening – and a dynamic speaker grips your attention and keeps you focused. Social media is interactive and often image-based, but limited by character count – and it’s easy to get distracted. A well-done podcast is gripping and educational at the same time.

XJ: I think the strength of podcasting is that it allows us to have more in-depth conversations and for people to tell their stories in their own voices.

CA: Podcasting allows us to connect the way we used to pre-COVID-19. We are having conversations, engaging, sharing ideas, and laughing.

MA: I think podcasting provides a platform where you can hear people talk through a topic in a conversational style. It keeps things interesting for the listener, and I’ve loved hearing people give their candid thoughts about everything from how they got into medicine to what they are doing now.

KM: The ubiquity of podcasts is a powerful element – in contrast to other, less prevalent methods of disseminating information.

LS: People consume media in all forms; each has its benefits and drawbacks. I don’t tweet or read blogs much, but I have spent countless hours watching YouTube videos. All three of these forms of media require visual focus. Podcasts can be listened to anywhere. They are perfect for people with any type of commute. If you download them to your media device, you can be offline and still enjoy them.

How do you find the experience of podcasting – an audio-only medium – in a discipline as visual as pathology?
LR: Podcasts have very few distractions, allowing the audience to really focus on the conversation. I find that my guests are more candid because there is no video component. Our conversations are like going out for coffee – and the audience gets to listen in on the conversation.

I think all pathology and laboratory medicine topics are amenable to the audio-only format, which lets the conversation focus on interesting and challenging issues – what terminology should we use? Is this entity clinically important? What’s the role of ancillary testing? How do new technologies impact our work? If additional resources are needed, podcast show notes are a perfect place to put links to references and photographs.

DS: It can be difficult at times. I include links in the notes for each episode so that listeners can learn more about the topics that might be more visual. Twitter is useful for that, too.

NB: My podcast, when it focuses on pathology, does so from the human perspective – the stories behind ideas and people’s journeys into the field. I don’t think that pictures of actual diagnostic entities can be replaced by podcasts, but they supplement one another well.

JT: I was always taught that you don’t completely understand something until you can explain it to a child. Podcasting has been good practice, especially because, as forensic pathologists, we’re going to have to testify someday – and that often involves explaining complicated things without visual aids. We’ll be explaining complicated scientific concepts to laypeople for the rest of our careers, so this is a great start.

NC: The advantage we have as a forensic pathology podcast is that a lot of our findings are going to be gross findings, which are easier to describe. People know what organs and bodies look like, whereas they may not be familiar with cells and tissues. Fortunately, much of our training has involved learning to communicate our findings using words instead of pictures. A pathology report is a verbal description of what we see on the slide.

In a residency interview, I was asked, “How would you describe orange to a blind person?” They wanted to gauge my ability to communicate – so it’s clearly an important skill.

CA: We actually record over Zoom, but we only broadcast the audio recording. I think that’s the best of both worlds. Recording over Zoom allows us to see and react to each other’s facial expressions and body language, which are lost on an audio recording. But listeners want a medium they can consume while doing other activities, so audio-only is a good fit.

MA: I think pathologists are naturally skilled at talking about our visual field. Our work products are pathology reports, books, and manuscripts, so it has been easy to have discussions about many topics without a visual component. It feels like the casual conversations that happen in small groups at national meetings.

LS: I don’t think podcasting detracts from highly visual subjects – in fact, they may even carry benefits. For example, some people have visual deficits that make audio input a major source of information acquisition. Also, certain learners gain the most by listening. Pathology is a visually driven discipline, but that doesn’t mean you can’t convey a message through audio. I’m certain any podcaster’s goal is to deliver a narrative that is sufficiently descriptive for the listener to use their imagination to construct an image that fits the audio. They can then take that foundation and search other sources of (perhaps visual) information.

What was your proudest, funniest, or most unexpected moment as a pathology podcaster?
LR: I have had the opportunity to interview amazing people in healthcare. I can honestly say that I am proud of every single episode of ScopeMD. It has been humbling to have listeners ask me to produce an episode focusing on a challenge or opportunity impacting their careers. Interestingly, the most challenging episode for which to find a guest was the “history of women in medicine” episode. The most unexpected moment was when one of my children burst into the room during an interview, sat on my lap, and learned about immunotherapy. My guest was completely unfazed.

DS: There are so many. I’m certainly proud of the fact that I set out to create a podcast and, 40-plus episodes later, I’m still here. I research my guests in advance, but they still often say something unexpected that turns out to be the most interesting part of the interview. The funniest was probably the crossover episode with Natalie Banet at Deeper Levels when we talked about our theme songs.

NB: I was recording an early episode with a physician from Spain and she took her laptop out on the balcony to let me hear folks clapping for healthcare workers. I had a lump in my throat for the rest of the episode. Throughout the pandemic, I have really appreciated my podcasts as a way of filling in the gaps that human-to-human connection has left in everyday life.

JT: I think the proudest is just the fact that we have over 300 listeners. I don’t have that many friends and family who will listen to me drone on for up to an hour! In terms of humor, I love how well we can riff off of each other. I wouldn’t describe myself as a funny person, but when you’re with a friend, it’s easy. I know what makes Nicole laugh.

NC: We’ve gotten to interact with some really cool people – and podcasters with relatively popular shows have asked to do crossover episodes with us. They have thousands of listeners. “Sure!” we say. “Yes, please!”

XJ: My proudest moment is definitely the fact that this got off the ground (thanks to the amazing team working on it) and that people are listening to it and sharing it. I am amazed that something like this came together so quickly. It’s one of the silver linings of the pandemic.

LS: One of my proudest moments happened very early on. In fact, it was before we even went live with our podcast. It dealt with finding a name for our podcast and its announcer. We very much wanted to get the whole office involved in this project, so we had a contest. Leigh Hlavaty, Omar Rayes, Milad Webb, and I came up with three names each and then had the whole office vote on them. It was a tough choice because we have some great entries, like “Forensics in the D,” “Motor City Forensics,” and “The Y-Incision.”  We also put out a casting call for everyone who wanted to stretch their vocal cords and be the voice to introduce the episode. When we did it, I was worried that we wouldn’t get any people, but I was wrong. I can’t remember how many auditioned, but there were a lot. Then we had a pizza party for the whole office to vote on the name and announcers. It was a fun time, and I was really proud that the whole office took such an interest in the project.

If you could do an episode on any subject you wanted, what would you choose?
LR: I would really like to host a roundtable of women who are CEOs of healthcare systems. I would like to know more about their leadership journeys and their insights regarding future challenges and opportunities in healthcare.

DS: I’m interested to learn about pathology in other countries. I know my job as a PA doesn’t exist in most other countries. I’m curious about other differences.

NB: I would do a show about all of my esoteric interests – like science fiction, mystery novels, or a show in which I could ask my favorite political journalists what they really think about their subjects.

JT: I would probably choose a crossover with My Favorite Murder where they ask forensics questions based on cases they’ve talked about. There are many times I’ve gone, “I would love to be the person who could answer those questions” – and it would be special because they got us into podcasting.

NC: If I could do an episode on any subject I wanted, I’d like to tackle emerging infectious diseases. A crossover episode with This Podcast Will Kill You would be interesting. I’ve also seen a book about how fashion has killed people over the years – for instance, with carcinogenic dyes – and I think that would be a fascinating topic for an episode.

CA: I would love to hear a “Beyond the Scope” segment with Vinay Kumar, one of the authors of Robbins.

MA: I’ve always been interested in astronomy and physics. I’d love to interview Neil deGrasse Tyson.

KM: I would love to interview Michelle Obama. Not sure how that would fit under our PathPod umbrella, but I would make it happen!

LS: Expanding on the auditory experience of a podcast, I would like to go much more in-depth on the sounds of an autopsy room. The actual performance of an autopsy holds little mystery for a pathologist, but it is something that others rarely experience accurately. I would like to present classic sounds, such as the X-ray machine, bone saws, and the shutter of a camera, and then have discussions on each of those sounds to expand on where they fit into an autopsy. As with the other four senses, hearing can produce a very visceral reaction.

Do you have any advice for readers who would like to begin listening to podcasts?
LR: With so many podcasts to choose from on almost every topic imaginable, I would suggest that they reach out to their friends and colleagues for recommendations.

DS: It can be overwhelming, because you can find a podcast about nearly any subject. I’d say to pick a few favorites and then branch out from there.

NB: I would say that, no matter how niche you think your interest is, there is likely a podcast about it. Anything you want to feel a sense of community about, you can find in podcasting. It’s a really nice way to learn from very smart people – and it sure passes the time during chores and exercising!

JT: Start with a subject you really like. Don’t try to sit down and listen to it, because humans are very distractible. Do something else, like go for a walk or cook – anything that will keep you physically occupied – while listening. If I try to sit quietly and listen to a podcast, I’m going to pick up my phone and start looking at Instagram.

NC: I agree with going for a walk or doing dishes; those are things that work for me when listening to podcasts. I also recommend checking the charts to see what podcasts are highly rated. Popular podcasts are popular for a reason! It’s a good sign that the creators are dynamic enough to get other people engaged. If you can find a topic that you love presented by informative or engaging speakers, you know it will be good.

XJ: There are so many podcasts out there, and they’re great to listen to when unloading the dishwasher, putting away laundry, or exercising!

MA: I agree. There are so many good podcasts – download a bunch and try them out!

LS: Education and entertainment are not mutually exclusive. If someone is interested and seeking out knowledge, a podcast can be an excellent introduction to a topic. They can be valuable sources of information. That said, it is the listener’s responsibility to do additional research and not take a podcast as a definitive reference – but that is true of written text as well. There are always levels of integrity to the materials we use as references.

Do you have any advice for readers who might like to start a podcast of their own?
LR: I would encourage anyone interested in podcasting to consider how much time and money they would like to commit. This will help determine how often episodes can realistically be released and whether they want to work with an editing and production vendor. I took Pat Flynn’s Power-Up Podcasting course, which I found extremely helpful.

DS: The hardest part is just to start. You don’t need fancy equipment. Basically, all you need is a good microphone and a way to record. There are many options for hosting sites and they’re fairly inexpensive. If you have a good idea, just give it a try!

NB: Just go for it! Don’t wait for the perfect time or assume that you will ever feel all the way “ready.” You will learn so much along the way. And it’s so much fun!

JT: Just do it! We had a good brainstorming session and, once we got started, it was a blast. If you’re not sure you want to invest in it, start by renting equipment. One of our biggest hurdles was looking at equipment, because it seems so overwhelming at first. I’ve also read that you should set yourself a minimum length of time to do it – that stops you from doing it once or twice and then giving up because you hate the sound of your own voice.

XJ: If we can do it, you can too. All it takes is ideas, some time, and a good headset!

MA: There are lots of ways to make it happen, and capturing audio is much easier now that most people have access to Zoom for recording. The first episodes will take a lot more time to figure out than later ones.

KM: Be targeted and know your audience!

LS: Equipment is no longer a barrier if you wish to start a podcast. If you have a recording device and broadband access, you can start podcasting. Beyond that, you need to go back to basic interrogatives: who, what, when, where, and why. Take some time and really think about why you want to start a podcast, who your audience is, and what your topics of discussion are. What is the message you want to send? Do you have a twist that sets you apart from other podcasts?

One of the largest hurdles to overcome is capital investment – and the greatest investment is time. A significant amount of time and effort goes into the preproduction, production, and post-production of a podcast. I cannot emphasize this point enough. I encourage anyone who wants to start a podcast to do so – but you must be able to dedicate the time to create a high-quality product.