The Digital Pioneer
Sitting Down With… Rajendra Singh, Professor of Pathology and Dermatology, Director of Dermatopathology, and Associate Chair of Digital Pathology at Northwell Health, New York, USA
Olivia Gaskill | | Interview
You’re a pioneer in digital pathology – what led you to the field?
When I worked at the University of Pittsburgh Medical Center, we had residents, fellows, and visitors come from all over the world to train with us – and we had a lot of slides being digitized. I believe that, once you look at a digital slide, you realize it’s going to change the way pathology is practiced and taught. I came to the US because I didn’t have the resources to train myself, but digital pathology suddenly opened a lot of doors. Digital slides could be uploaded to the cloud so that anybody sitting in any country could log onto the platform and start teaching themselves pathology.
What inspired you to create PathPresenter?
I realized that I needed to make the resources we had at large academic institutions available to people anywhere in the world, but that was extremely difficult because the slides all came from different scanners that produced different file formats and therefore needed different viewers. To remedy this, we built a platform in which we could put the slides on the cloud, have the back-end software convert them into a single format, and then make them available on a single viewer. At first, it was just for our own use – so that we could use these digital slides for teaching – but, when other people saw the platform, they told us it was the sort of resource they had always needed. After that, institutions became interested and wanted to use the platform for their own internal teaching. That’s when PathPresenter became a company and we hired people to build these platforms for interested institutions.
Last year, you hosted the first online pathology review for residents on PathPresenter. How did it go?
When COVID-19 hit, the entire medical education system had to go online – the question was, “How can we do it in a way that’s easy to use and can bring together files from different scanners?” I reached out to a few people who are prominent on social media and, together, we built a conference in which we showed people how they can use these files for teaching – all for free. All the conference speakers volunteered and had the opportunity to pre-record their lectures if the timing didn’t suit them. We also built a Q&A session that included even the pre-recorded lectures – when an attendee entered a question on the platform, the speaker received an email and could go online to answer the question. These tools weren’t even heard of two years ago – and now we have an online community of renowned experts who are willing to put in the time to teach the entire world. More than 6,000 people registered for the conference (which is usually unheard of!) and we received a lot of good feedback that we’ll be using to improve the platform.
Tell me about the new initiatives coming up on PathPresenter…
We are creating a section called “high yield” with the bread-and-butter cases that every trainee should know. We have teamed up with various societies and institutions whose members are going to build these high-use cases in which experts will point out features on the digital slides that helped them make a diagnosis. Because they’re doing it on the cloud instead of on a multi-headed scope, it becomes an “infinite-headed scope!”
How did you end up on the editorial board of the WHO Classification of Tumours, 5th edition?
I was presenting at a conference in Chicago, talking about how PathPresenter can be used for data sharing in education. Ian Cree, the current pathology leader at WHO and the person in charge of the 5th edition, was sitting in the audience. Afterwards, he approached me and said they were moving the Blue Books to an online digital format, but wanted to make sure they were in line with how pathology is taught. Of course, there is no way you can teach pathology without having access to the slides. When he saw how PathPresenter worked, he realized it had the same mission as the WHO – to facilitate the spread of information around the world and democratize availability of resources, especially to low- and middle-income countries. Because of that, he asked me if I’d like to be on the editorial board – and, of course, I accepted.
Do you have any time management tips for lab medicine professionals?
It has to be a passion. It’s not about making money – do your job and money will come. If you have a passion, it becomes much easier because you’re not worried about how much time you’re putting in. Not everyone can put all of their time into building platforms like PathPresenter; I have been lucky enough to have institutions support me along the way. But there is no magic formula for time management – the more you want to do it, the more passionate you will be about your projects, and I believe then you will find the time to fit them around your day-to-day work. In the end, it is all about patient care – and if there is anything you can do to help our patients, the world will come together to help you achieve your goals.