The School of Life

How can pathologists provide the best possible diagnostics in countries with limited resources? The answer to that question is often sought in the development of low-cost equipment and techniques that can offer alternatives to the bulky, expensive options found in many high-tech laboratories. But there are other ways to improve pathology services under difficult conditions. I believe that education is the key. The more our young pathologists know, and the more varied their experiences, the better service they can provide. And what’s more, they innovate – translating that knowledge and experience into new ideas.

My colleagues and I asked one another: how can we help young pathologists learn? And the answer that came to us was simple: give them a school. Easier said than done, of course – but once we had the vision, we only needed motivation and hard work to find the resources we needed. Thanks to a few key people in the British chapter of the International Academy of Pathology (IAP), our vision is now a reality.

School’s in session

The inspiration to have the British chapter of the IAP sponsor a set of seminars in Bosnia came from Mike Franey, a great friend of mine and a great friend to Bosnia as well. Although he himself is from the UK, Mike has established close relations with the people from northwestern Bosnia – a region devastated during the war from 1992 to 1995. He has always been enormously supportive of my countrymen, delivering all sorts of humanitarian aid to that region through Acorn Aid – an organization he set up himself.

In 2005, Mike met Bryan Warren, who shared his passion for cars and driving – and who also happened to be an outstanding gastrointestinal pathologist from Oxford. He connected me with Bryan in 2006, during the centennial IAP meeting in Montreal. Before the meeting was over, we had made plans to set up the Bosnian-British School of Pathology under the auspices of the British Division of the International Academy of Pathology (BDIAP). The inaugural school was held in Sarajevo in the summer of 2007, and it was a great success! Ever since, we have organized a course every year that covers all aspects of diagnostic pathology. We call it the Bryan Warren School of Pathology (BWSP), and we’re very careful to keep it noncommercial; sponsorship comes from the BDIAP and my hospital, the Clinical Center of the University of Sarajevo. The local organizing committee members are all volunteers, and we try to keep the registration fee very low – currently €50 per participant, just enough to cover our costs. Why? It’s very important to us to keep this kind of education accessible to all young pathologists in Bosnia and its neighboring countries, so that they face no unnecessary barriers to advancing their knowledge and skills.

I believe there are no other projects like ours in the region, but we’d like to change that! Last year, we started a collaboration with the Turkish Division of the IAP, who initiated a cytopathology course in Bosnia. The inaugural session was held in Sarajevo in June of 2016. Our initial goal was to improve cytopathology service in Bosnia – and our plans are growing ever more detailed. Now, we’re planning a series of more in-depth courses in upcoming years to examine various aspects of diagnostic cytopathology. For instance, our next course will have an intensive focus on the cytopathology of the lung and thyroid. We’re also currently working with the MD Anderson Cancer Center to plan an advanced surgical pathology course that would be held in Sarajevo in 2018. We may be a small country, but we have big plans for pathology education!

Beyond the basics

The BWSP is more than just a collection of practical courses in diagnostic pathology. I’ve found that it’s also a great platform for participants and lecturers to establish professional relationships. Thanks to the people involved with the school, several of my colleagues and I have had a chance to visit their workplaces in UK and learn from them. We’ve studied breast pathlogy at Guy’s and St Thomas’ hospitals and Nottingham City Hospital, lung pathology at the Royal Marsden, gynecopathology at John Radcliffe Hospital, and hematopathology and molecular pathology at the University Hospital of Wales. This detailed on-location training, funded by the BDIAP, has substantially improved the diagnostic skills of all of us fortunate enough to take part, and has undoubtedly increased the overall quality of our pathology service.

In fact, the BDIAP has been very generous in a number of ways. Not only have they provided us with training, but they also support our pathologists biannually so that they can attend the Congress of the International Academy of Pathology (IAP). And in 2012, the BDIAP established a special award called the Nermin Duraković Bursary, in honor of the eponymous translator who supported our collaboration so tirelessly in its early stages. The bursary provides a reduced registration fee and covers travel expenses for any young Bosnian pathologist intending to present at the symposium. Last year, it allowed three pathology trainees to attend the joint IAP and European Society of Pathology meeting in Cologne, Germany. One day, those trainees may come back and teach at the BWSP!

Growing and changing

After each course, we distribute a questionnaire to the participants so that they can tell us what they liked – and how we can improve. Wherever possible, we try to act on those suggestions. The good news is that not only do we have more students every year, but many of them are repeat attendees who keep coming back to continue learning. It seems that the BWSP has become a recognizable annual event with a reputation for quality education and organization – and seeing our numbers increase year on year is the best recognition and reward any of us could possibly have.

We’ve been asked how long we plan to keep running the school. The answer is: as long as there is a need to improve pathology practice in Bosnia and neighboring countries. Pathologists here work with few resources and limited budgets, which leaves young people who want to study abroad with little to no hope of doing so. For those early-career pathologists, the BWSP is a window to the developed world, and an excellent opportunity for them to receive a high-quality education in modern diagnostics. It may even serve as a springboard to training in other countries or to visiting congresses they had not previously dreamed they might attend!

Last year marked the 10th anniversary of the BWSP. To celebrate the occasion, we conducted a special course in conjunction with the third national pathology congress of Bosnia and Herzegovina. But even a decade after its inception, there are still things we’d like to develop further for the BWSP. For instance, we’d like to improve the practical aspects of the course by using digital slide images, multiheaded scope slide evaluation, and similar tools. We also want to attract more people from countries on the cutting edge of pathology technology – so far, we’ve had participants from Austria, Slovenia, Great Britain, Germany and the Netherlands, but we’d like to see much more of that.

Please consider this an invitation to all you pathologists out there who are interested in teaching – the Bryan Warren School of Pathology welcomes you!