In Pathology’s Best Interests

A recent article discussed the need to make pathology fun and innovative (1), especially through pathology interest groups and research opportunities – and this could not be more true. Students are more likely to choose pathology as a career if they have opportunities to take part in clinical or research experience in preclinical years, autopsy learning experiences, and involvement in pathology interest groups (2).

Seeing a need to improve pathology exposure, the Michigan State University (MSU) College of Human Medicine-College of Osteopathic Medicine Pathology Interest Group (@CPathIG) was established in 2020 – during the peak of the pandemic – with the aim of promoting pathology and creating a community in which students could explore the specialty. Thanks to a collaborative effort among medical students, alumni, and practicing pathologists across Michigan, the joy of pathology has taken root not only at MSU, but also around the world. The group embraces the fundamental values of pathology and seeks to increase visibility, encourage education, and ignite excitement for laboratory medicine beyond classroom walls using innovation and teamwork.

Meredith Herman, President
 

Starting medical school, it seemed like I was the only student interested in pathology. I loved pathophysiology, hematology, and histology courses and would often stay after class to talk about pathology with my professors – but I knew I needed more hands-on experience to better understand the discipline, so I became a post-sophomore pathology fellow at the University of Toledo. During the fellowship year, I saw the direct impact of pathology on patient care while assisting with FNAs, frozen sections, and tumor boards. It was an exciting time and I was eager to share the experience with other students at my home institution.

Pathology interest groups have a crucial role in raising pathology’s profile, especially at medical schools that lack pathology departments, university hospitals, or full-time pathology faculty. In these cases, students may not fully understand the scope of work or ever learn about pathology. With few applications to pathology and limited opportunities to interact with this specialty, we saw a need for change. Through enthusiasm, creativity, teamwork, networking, and social media savvy, we’ve established a strong presence at our home institution and on #PathTwitter to bring students into the realm of pathology. In a way, we’ve become pathology ambassadors to help connect students to this remarkable specialty.

It has brought me immense gratification to help students discover their passion and appreciation for pathology through the interest group. Even though we’re small, we’ve been able to connect students with clinical shadowing, professional development, research, and hands-on experiences that have solidified their decisions to pursue pathology. Many students have received prestigious awards, taken up post-sophomore fellowships, contributed to pathology research, and become leaders in the group. Students are excited about pathology – and it shows!

The response from the greater pathology community has also been overwhelmingly positive. We’ve been honored to host guest speakers, program directors, and residents from across the country virtually via Zoom. Grant funding from the Association of Pathology Chairs gave our events a welcome boost. Widespread support and commitment has made this group successful – and the momentum builds as more students become involved and find their niches in the pathology community.

Basma Al Masraf, Co-President
 

I initially joined the group to discover what pathologists do and learn about their community impact. Now that I have seen cases and learned how pathologists handle patient specimens and communicate diagnoses to clinicians, I admire the discipline’s impact on the professional team – and on the patient. My experience as a DO-PhD candidate, group member, and now CPathIG leader has matured my passion for pathology and laid the groundwork for my selection as a 2022 Society of ’67 Kinney scholar.

Despite the pandemic, CPathIG has excelled in recruiting students and sharing awareness of pathology careers. The group continues to increase its outreach and awareness through online and in-person initiatives that offer networking, direct pathology field exposure, and team bonding. We have connected our students to program directors, fellows, chief residents, and practicing pathologists throughout Michigan and the nation – and we are working toward expanding our horizons even further!

Pathology Day was a particularly successful event led by our faculty advisor and pathology professor, Paul Kowalski, and supported by additional pathologists at Spectrum Health. Students spent the first half of the day looking through a variety of “unknown” tissue specimens using a brightfield microscope and then going through vignettes, diagnoses, and high-yield pearls for each case. The second half of the day was spent looking at gross specimens and discussing the pertinent pathology to reach a final diagnosis as a group. Students also met laboratory faculty and staff, including medical technicians and technologists, microbiologists, and clinical chemists.

Following this hands-on event, we were approached by several interested students whose passion for pathology had arisen from direct exposure. Some attendees went on to match into pathology residency programs and others are working toward that goal.

CPathIG also recognizes the importance of research background and experience, which I value as a DO-PhD candidate. We aim to introduce and connect current medical students to ongoing research led by pathologists in their area. We welcomed alumnus Casey Schukow to become our group’s alumni education and research coordinator, given his strong research background. As a result, students have collaborated on projects, presented posters at conferences, and published articles (3). It’s our hope that this will allow students to not only strengthen their pathology background, but also build successful avenues of collaboration and scientific discovery that accompany the field of pathology.

Curtiss Johnson, Vice-President
 

CPathIG was the first group I became involved with as a first-year medical student and I haven’t looked back. From day one, I was drawn to CPathIG’s interesting events and positive vibes, and I look forward to the exciting experiences to come. Since attending events over the last year and interacting with pathologists, I have felt more confident in my abilities to discuss pathology concepts and the field in general with my classmates and colleagues; I believe this is the heart of what this group offers.

Being involved has further confirmed pathology as my specialty of choice – and events such as board review sessions and Q&As with pathology residents and practicing pathologists have broadened my perspective on the impact this field has on medicine. And I’ve met new classmates and mentors in pathology! Especially in a pandemic, having a group like this to interact with and learn from has been a great addition to my medical education. I wouldn’t trade it for anything.

Casey P. Schukow, Alumni Education and Research Coordinator
 

Being a part of @CPathig has changed my medical career trajectory – and that’s no exaggeration. To put this comment into perspective, my involvement with @CPathig began after connecting with its president, Meredith Herman, and faculty mentor Paul Kowalski several weeks after not matching into an advanced residency position in March 2022. Although not matching was an exceptionally difficult experience, it gave me the opportunity to step back and reflect on what I appreciated the most in both medicine and surgery. This reflection brought me to disease pathogenesis and diagnostics. As if an internal lightbulb had finally switched on, I realized pathology was meant for me.

When I think of @CPathig, I think of us as a team, which feels very natural after the many years of football I played before entering medical school. Whether in athletics or healthcare, effective communication, clarity of responsibilities, group commitment, and accountability are essential in establishing success in interprofessional teams (4). In pathology, teamwork is imperative in both undergraduate and graduate medical education (5) and in hospitals, where pathologists are a part of multidisciplinary teams (6).

As Alumni Education and Research Coordinator, I establish teaching-based opportunities, collaborate with other educators to set-up interactive learning sessions, help @CPathig group members develop outreach experiences in their communities, and help coordinate research projects. Through this team, which was founded in the absence of a pathology department here at MSU, I have found my passion and voice in pathology. I encourage other medical schools (regardless of their academic settings) to develop their own pathology student interest groups. Without the support of @CPathig, my transition into pathology after my difficult match week experience this past spring would not have been possible.

Paul Kowalski, Faculty Mentor
 

Several years ago, I mentioned to a pathologist colleague that I was planning on transitioning to an academic position, teaching medical students at a community-based medical school. The reply? “Good. The students need to see that pathologists actually exist.” Medical schools in the community struggle to retain (or even locate) education-oriented pathologists who can serve as mentors and role models. Presumably, this lessens medical students’ ability to interact with pathologist colleagues, understand the role that pathology plays in clinical care, and – of most concern – envision a potential future for themselves in pathology.

Having seen too many years of graduating classes in which not a single student matched in pathology, it became evident that we needed intentional attempts to reach and engage with potentially interested students. At a minimum, a pathology interest group can help establish a milieu in which a few basic processes are allowed to prosper: i) highlighting the role pathology plays in every stage of education, ii) creating enthusiasm and leadership among interested students as they explore pathology content and topics, and iii) establishing peer, residency director, and local pathologist contacts that can lead to lasting friendship and employment opportunities. For highly active student groups, one can watch the development of physicians in the making as they continually tackle institutional unknowns and apathy. And yes, our general student body does see that pathology exists – thanks to leaders born from the pathology interest group.