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Assistant Professor and Director of Autopsy and After Death Services, Department of Laboratory Medicine and Pathology, University of Washington, USA, Co-founder and Past President of the Society of Black Pathology

Biggest challenge in pathology? Pathology's biggest challenge is the same beast everyone is wrestling with. I look around, and people everywhere are tired – within pathology and laboratory medicine, other medical specialties, and nearly every system and workplace in America and likely across the globe. I believe this exhaustion is a consequence of the pandemic, which directly and indirectly took a lasting toll on us. Many of us survived but never returned to full functionality. 

COVID-19 exposed and exacerbated every system's weaknesses, leaving us all relatively understaffed and overworked. Many lost someone directly or indirectly due to the virus. Many are battling the lingering effects of a SARS-CoV-2 infection. Many have felt the effects of the Great Resignation. It was a global, traumatic event that I believe we did not fully respect as such. At a minimum, it was mentally and emotionally taxing, and I believe that many, if not most, have not appropriately grieved and processed the past few years and everything that came with it. This universal challenge is felt deeply within pathology as caseloads and new diagnostics increase.

Exciting developments and trends? I recently attended a fascinating seminar on 3D pathology. For those unfamiliar with the subject, this technology transforms our standard practice as anatomic pathologists from a two-dimensional to a three-dimensional analysis of tissue specimens, allowing for a far more comprehensive evaluation of potential pathologies. Additionally, unlike standard histological specimens, this process is non-destructive, meaning the tissue is not exhausted and is available for further use should the need arise. This technology bypasses the histology lab, allowing for improved workflow. It can provide more accurate diagnoses and decrease turnaround times when used with AI.

Controversial opinion? Specializing in forensic pathology makes you one of the most marketable physicians in medicine! You can practice in a Medical Examiner’s/Coroners’ Office, academia, or a hybrid. You can easily supplement your work by teaching, doing per diem work, becoming an expert witness, and taking on consult cases. You can take a break from having a regular 9 to 5 and go into locum tenens or work for yourself. You can write textbooks, nonfiction, and fiction (i.e. crime novels). You can have your own television show or become the expert on the news for highly publicized deaths. 

Additionally, you can volunteer with a multitude of projects: serving on mortality review panels research collaboratives investigating deaths; helping exonerate wrongfully convicted people through the Innocence Project; advocating for the deceased through initiatives like cold case task forces and Colin Kaepernick’s Know Your Rights Camp’s Autopsy Initiative; helping after disasters with DMORT (Disaster Mortality Operational Response Teams). Very few in medicine can speak as an expert on death across its entire spectrum, making you a unique and valued voice on various panels, speaking engagements, and collaborative projects. This specialty is one of the most flexible - there are so many options for career paths within the field!