Life Balance

We spoke with Kamran Mirza about the joy of work, his online elective platform, and the surprising power of social media in education.

Could you describe a typical day, and how you manage being involved in so many different projects?
 

If I’m on clinical service, I will orient my day around the clinical schedule, looking at all the cases, triaging them, and coordinating the different ancillary studies. Alongside that I’ll be working with my fellows, residents, and trainees at the microscope and delivering their patient-centric education. 

The rest of the day might be a mixture of meetings on operational administration, educational programs, or mentorship for individuals seeking information on pathology, laboratory medicine, or medical education. In between, it will be back to the lab to make sure everything is working on the clinical service front. And I might work on lectures, conferences, and talks. So, it’s a mixed bag and every day is a little bit different – which I really love.

That’s the key – that I really love what I do. It’s what keeps me going, if the long list of tasks feels overwhelming.

Going back to the beginning – what was it that led you into pathology?
 

I wish I could tell you I had an epiphany. But I enjoyed all the disciplines in medical school. I went through different rotations thinking, “That’s it, I’ll be a psychiatrist… I’ll be an obstetrician… I’ll be a cardiologist…”

Ultimately, I saw that every subspeciality of medicine is represented in pathology. Spending time doing research showed me that, behind the scenes, the diagnostic aspect of medicine is crucial to starting the journey of healing. And I think that’s often overlooked – patients and other health care providers don’t always understand the role of the pathologist or laboratory medicine professional. When I realized what an august and awesome responsibility a pathologist has. And that was it. And I predicted that I would be intellectually challenged every day, which has happened thus far. But what really solidified it for me was when I saw what a difference I could make by giving a correct diagnosis – both to patients and their loved ones. 

I had an innate curiosity about diagnosis of cancer or benign tissue, and about the beauty of the human body on a molecular level. Unraveling how all those pathways interact to create either diseased or normal tissue fascinates me. And so I think there’s no turning back now. I know pathologists aren’t regarded as patient-facing, but there are subspecialities where they can be. I’m happy that I can make a difference to patients’ lives on a day-to-day basis, even though they don’t know it. 

Do you come from a long line of physicians?
 

My parents were both doctors. They both tried to convince me not to become a physician – not to feel culturally pressured to go into medicine. I remember wanting to be an architect as well. In fact, I applied to both an art school and a medical school. I loved a lot of things about art and architecture – but I didn’t love math so much.

So, medicine was familiar to me. That said, I don’t know of anyone around me who was a pathologist, so in that sense I’m definitely an outlier.

Have you kept up your interest in art?
 

I did paint and draw all the way through college. I never took any art classes, but I’ve always appreciated art. I do think pathology lends itself well to people who are visually inclined. I have found a lot of artistic people who end up doing medicine are drawn to pathology because those visual patterns kind of intrigue them.

What changes have you seen since you entered the field?
 

In the eight years that I’ve been in practice, I’ve seen some developments – people are now looking at artificial intelligence and at different molecular techniques, and so on. And sometimes I now look at cases on a computer screen because of whole slide imaging – that certainly wasn’t around when I was a medical student. That said, in most centers, we’re still using microscopes.

However, the core approaches of diagnosing lesions of the body remain the same: we need a clinical history, we obviously need good tissue, and we need ancillary techniques that we can use on top of H&E slides. They will likely stay the same a while longer.

You are one of the most popular pathologists on social media. How did that happen, and did you anticipate that it would become so important in your career?
 

I’m an immigrant to the United States; my family is in Pakistan. Initially, I only used social media to stay connected with my relatives. Then, in 2013, I did a fellowship in medical education research at the University of Chicago, and my course directors all spoke about the importance of harnessing the power of social media in our practice. 

I immediately joined X (formerly Twitter), but I was unsure what to do or how it would actually help. Time passed and, in 2017, I was recognized as one of the rising stars by the American Society for Clinical Pathology. As part of that we were required to do some pathology advocacy on social media. I could see that, since I started on X, there had been a huge increase in the number of pathologists on the platform. Jared Gardner, Sara Jiang, all these social media superstars had established themselves, and I reached out and collaborated with them. They are very close friends now.

It took off once I saw that I had the ability to extend my educational outreach and provide access to education resources. I try to harness my social media following to educate people about pathology. And this is broad: it could be about mentoring, making new connections, collaborating with The Pathologist, or creating the PathElective website.

I think that all of these things kind of organically grew from that foundation in 2017, when I really started using social media more actively. So, yes, the short answer to your question is that I had not even imagined that social media would be such a big part of my professional existence, but I’m very grateful that it is.

Could you tell us more about the PathElective project?
 

When the pandemic hit, the pathology elective rotations in most institutions shut down, because they relied on in-person teaching. I recognized this as a huge problem, and decided to bring a sort of social media and web-based pathology elective to the students.

Initially, I was thinking of doing this just for my institution, but then I partnered with one of my medical students, Cullen Lilly, now a pathology resident at UCLA. We developed a free modular website, which has anatomic and clinical pathology content. It’s an honor system program where you work through the content and then take a post-course assessment. There are videos from over 50 faculty members, who all volunteered their time.

Recently, PathElective became an official online publication of the Association of Pathology Chairs. It has had almost 1.5 million views and 200,000 users worldwide and remains completely free. We’re very proud of it. People use it as part of their early medical school education, as well as for formal education within departments. We are so excited that it took on the energy that it did.

You are involved in many projects – but you’re also a family man. How do you manage to achieve a good work–life balance?
 

Because I love what I do, I think of it more as “life balance.” I have a life at work and a life at home and I don’t mind mixing them up a bit. For example, today I will leave a bit early to pick up the kids from school. Similarly, on weekends I will be with my family, but I might complete a work task. I’m fortunate to be able to do both things at the same time as I have an incredibly supportive partner. My wife is fantastic and understands these are my passions. She’s there for me and vice versa. We are both physicians and we have three kids, so it’s always a balancing act. 

To borrow an analogy from my good friend, Sara Jiang, it’s like having six kitchen burners on at once. If all are on full throttle, you’re going to run out of gas. So you need to know when to temper some to go full throttle on others. We need to keep adjusting the flow on the home burner, or the family burner, or the work one, depending on which needs to be a bit stronger.

But I always circle back to the fact that I really enjoy what I do, and because of that I don’t think I’ve ever truly burned out. Whereas things like negative attitudes or situations that I can’t really fix can drain my energy, other things like my family, my lectures, my courses, and social media all give me energy. So, thus far, I feel like I’m doing ok.

Who inspires you?
 

Along with my social media mentors, I’m also inspired by my hematology colleagues (and by what we can achieve together as a team) – and by all those colleagues who stay in touch with newer technologies to keep moving the needle forward for health care and for patients, research-wise. I’m an avid follower of hematopoietic research, both on the genetic level and in terms of clinical outcomes. And I’m also inspired by my family. It sounds cliche, but my wife’s role as a pulmonary and critical care physician was quite difficult during the COVID-19 years. The work she did was very inspiring. And then my kids inspired me too.

In general, if you are a positive spirited person who is putting out their best side into the world, it is very inspiring to me.

What advice would you give to someone starting out on their pathology career?
 

Firstly, I would say that it’s an incredible field and you have chosen wisely! Obviously, your first responsibility is to your patients, so you will need an excellent knowledge base to do a great job in diagnoses. But there is also an indirect responsibility to advocate for pathology and laboratory medicine in the spirit of best patient care.

I think it’s our responsibility to be flexible in incorporating more and more technology and accelerated techniques. My advice would be: don’t be scared of change, but embrace and, in fact, leverage it to become the best physician possible. Changes are coming in multiple ways, including, perhaps, pathologists sitting with their patients in clinics. I think that embracing change, unlearning what you think you knew about pathology and relearning it over time, is the best way to grow. I wish you the best of luck in your pathology journey.