The pathologist—no longer the mysterious doctor behind the microscope. Pathologists are increasingly becoming more visible through patient-pathologist consultations, high profile research collaborations and social media. We wanted to further highlight the importance of pathology and the pathologist in a series titled Spotlight. The purpose of this Spotlight series is to highlight pathologists in various specialties to learn more about how they arrived at the title of Pathologist.
We decided to kick off this series with a veterinary pathologist, and the first doctor we thought of was Dr. Nicola Parry (@TuftsVetPath). She is currently Clinical Associate Professor, Head of Pathology, and Director of Residency Training in Anatomic Pathology at the Cummings School of Veterinary Medicine at Tufts University. She is also a Diplomate of the American College of Veterinary Pathologists (ACVP). This national organization, amongst many other things, governs the board certifying examination that certifies veterinary pathologists.
Where did you go to veterinary school?
I’m English, and I went to the University of Liverpool’s vet school, in my hometown! I graduated back in 1997.
Where did you complete your residency?
I came over to the US to do my residency in Anatomic Pathology at the University of Pennsylvania’s School of Veterinary Medicine.
In undergrad, what did you see as your career path?
Becoming a veterinarian was something I always wanted to do, even as a child! So it was no surprise to anyone in my family or friends’ circle when I did just that!
When did you decide you wanted to become a pathologist?
When I started vet school, I was like most veterinary students -- focused on a career in general practice. But as the courses ticked by and we got into our pathology courses, this field really drew me in. I’ve always been a bit of a science geek, and I loved how pathology kind of pulled together so much—it’s a real bridge between the basic sciences and clinical specialties. It fascinated me to see how critical pathology was to patient care. Over the course of the first 3 years, I was fortunate enough to get student grants to allow me to work on research projects in the pathology department. And I really enjoyed seeing how pathology research operated. I quickly realized that I’d probably be pursuing a career in pathology at some point when I was a vet.
What are some interesting research projects you’ve worked on?
I work across a range of diseases (and species!). Since about 2005, a lot of my collaborative research has focused on the general area of One Health. I enjoy contributing to this area because it’s so important to keep furthering our knowledge and understanding of how the health of animals and humans (and the environment) are so interconnected. A lot of the studies I’ve worked on have focused on infectious organisms that cause zoonotic disease (such as E. coli and Clostridium difficile), and on animal models of human disease—specifically related to how infections with certain organisms (like Helicobacter pylori) can cause inflammation-driven cancer.
I was interested in this general area of research and was fortunate to have opportunities to work with infectious disease researchers at Tufts back when I worked here the first time—this is my second time working at the school. I was here on faculty between 2005 and 2009. These collaborations introduced me to more collaborations in the Division of Comparative Medicine at MIT, and this was what led to me joining them in 2009 when they were looking for a new Chief of Pathology. Most of my research involvement there was in this infectious disease area.
How can veterinary school education be improved to bring pathology into the limelight as a great career option?
Many veterinary schools are still teaching pathology like they did in the 1970s – it’s very prescriptive and didactic, and taught like a basic science. Inevitably, some of this is necessary, especially in the early years. But I think there’s a lot we can do to improve our teaching of pathology, especially by doing more to highlight its relevance to clinical medicine and surgery. It’s not enough for students to simply ‘know pathology’—they have to ‘know why they need to know pathology’. Currently, the emphasis is often more on the former than on the latter, and most students just see their pathology rotation as a few weeks of dirty work and awful smells.
What qualities do you believe make an excellent pathologist?
It helps to be a bit nerdy, because all the basic science stuff is the backbone of pathology. You definitely need good communication skills (especially to translate the nerdy stuff into something meaningful that other vets can use as they manage their cases). You also need to be collaborative (it’s simply not true that pathologists just hide away behind a locked door all day—we have other vets to help and lives to save!). It definitely pays to be humble, too—if you’re someone who likes to pretend you know it all, you’ll quickly lose the trust of other vets who are looking for your help. And you also need to be okay with your opinions being questioned by vets as well as by other pathologists. There's an old joke that if you ask 10 pathologists a question, you'll get at least 11 different answers!
What are your thoughts on digital pathology? Is it the way of the future? I think it truly is the way of the future in veterinary pathology, and there is a lot of excitement right now in our field, about its applications in research as well as in the diagnostic setting. It’s already gained a lot of traction here in our field. Many corporate veterinary diagnostic labs have now moved away from having their pathologists use microscopes, and instead, they use digital pathology platforms.
What challenges will the adoption of digital pathology face in clinical practice?
This kind of thing will be very difficult in the veterinary world because the infrastructure of veterinary clinics is a world apart from that of human clinics. Among other things, the lack of any kind of large-scale health insurance involvement in our profession means there’s a lack of funding for this kind of platform. It also means that not all lesions make it to pathology—cost prevents many owners choosing to have biopsies evaluated. Many clinics are small operations owned by one or two vets, and that kind of expense (with relatively low yield, in return) would never rise to the top of their wish list. It might have a chance in the corporate world—for example, there’s one corporate chain that runs veterinary hospitals and also diagnostic laboratories. I could see how they might consider something like this to connect their veterinarians in clinics with their pathologists.
What do you find really rewarding about your career? I like a lot of things about my career, but especially how varied my work is. I don’t just work alone at a microscope every day—I’m communicating with other veterinarians to help them manage their patients’ care, training residents, teaching students, working with researchers, writing scientific papers, doing volunteer committee work…..There’s never a day when I can say I’m bored!
How do you network with fellow paths/vet paths? Meetings play a big role in this, whether at the local, state, or national level. And committee work, too—I’ve been involved on various committees within ACVP since about 2005, and have made so many friends, colleagues, and collaborators that way. And all people whom I likely never would have met outside of the committees.
What's the next laboratory test that needs to be invented? There are probably many I could list that I’d like to wave a magic wand and have them magically appear. But one that springs to mind would be a simple, accurate test for feline infectious peritonitis (FIP). This is a viral disease in cats, caused by a mutated strain of feline coronavirus. Sadly, it’s a relatively common and mostly fatal disease in cats, and we really haven’t made many advances in diagnosing and treating this disease since I graduated more than two decades ago. It’s still really challenging to diagnose because there’s no single test that does it accurately, and diagnosis usually involves a complicated algorithm based on clinical and pathology findings, and typically only allows us to “strongly suspect” a diagnosis of FIP during life.
We’d like to extend a sincere thank you to Dr. Parry for her participation in this series. Stay tuned as we’ll be spotlighting pathologists of various backgrounds in the weeks to come.
Built on the vision of better patient outcomes, Instapath was founded in 2017 by engineers and scientists to enable patients to immediately know their cancer diagnosis. Our team made it our mission to develop fast and easy digital pathology technology so diagnosis can be made in minutes instead of days. To learn more about Instapath and our technology, visit https://instapathbio.com or contact us at info@instapathbio.com.