The AAMC team (as part of our Specialty Perspectives series) recently sat down with Dr. Mirza to discuss his work. Learn more about Dr. Mirza’s path to pathology below.
Can you describe your work as a pathologist?
My work as a pathologist is to find the ground truth about what ails a patient. There's a biological narrative that the tissues, blood, or specimen tells us. Our job is to put on our physician hats, interpret what these materials are telling us, and make a diagnosis so that the patient can start their journey towards healing.
Part of the lifelong learning in medicine is the understanding of pathology. Even if you're not a pathologist, you're focusing on the pathophysiology of disease and talking about pathologies, such as interpreting lab values. Teaching that is part of what a pathologist does. My role as an educator is to think about a couple of things: the next generation of pathologists, the pathways to pathology practice, shaping the future of what the pathology field looks like, and keeping in mind the innovations and technological advances that are happening around us.
What attracted you to a career in pathology?
I found pathology to be a cross section of an understanding of the sciences and human impact. For most of medical school, I wasn't familiar with pathology as a field. I knew our pathologists as teachers, but I didn't really understand the physician role of pathology. I've always been drawn towards complex processes and unraveling the mysteries of what makes people sick. When I discovered that there's a specialty that actually gets to that answer, it became very attractive to me.
For me, one of the biggest concerns was that for the majority of our subspecialties within pathology, we aren't seeing patients directly and I’d always imagined myself seeing patients in the clinic. But once I understood the monumental impact that pathologists have on patients’ lives, even without ‘seeing them’ in a conventional sense, I was convinced that this is what I wanted to do.
Can you describe a typical work week?
If I'm on service – essentially a clinical service in an academic center - I'm typically working everyday with my hematopathology fellows and residents to review patient tissue biopsies, blood smears, and flow cytometry studies. My day starts relatively early and involves going over cases with the trainees and issuing those reports, making phone calls, and relaying updates to patient-facing physicians or patients themselves, especially if there's an emergency. Since I have an administrative role and I'm the assistant chair for education, my day also involves meetings and making sure that the continuum of education in my department is running smoothly. When I'm off service, it’s mostly administrative time, mentoring trainees, and thinking about the next educational initiative or global pathology endeavor.
What previous experiences have helped you the most in your current role?
First, I was very fortunate that I have strong clinical training. It not only taught me the necessary medical knowledge but also taught me discipline, resilience, and gave me other tools that I needed to be successful. Secondly, I was fortunate that my career path had a PhD in it, which allowed me to have agency to ask bold questions and to not shy away from uncertainty. And lastly, my fellowship in medical education has allowed me to create educational platforms, like the free pathology elective platform that we created called PathElective.com. All these experiences really reinforced the elements that I need to be successful in my role.
How would you describe someone that would excel as a pathologist?
The most important thing is to keep the patient front and center, remembering that we are physicians first and everything else second. Doing this successfully requires someone that is equal parts a rigorous thinker and a compassionate human being. Also, pathologists often get stereotyped as being antisocial, but pathology is far from that. In fact, what I think would make someone an excellent pathologist is to be a good communicator. We are communicating life-altering diagnoses to patients and the last thing patients need is to receive a negative diagnosis from a poor communicator. So ultimately, I would say a person pursuing pathology should be a compassionate physician, a rigorous thinker, and an excellent communicator.
What parts of your job do you find most challenging? What parts do you find most rewarding?
Making decisions in ambiguity is hard. Sometimes, we don’t know the entire picture of what’s happening to a patient. Grappling with the unknown as we make a diagnosis in a silo is, from a diagnostic perspective, the most challenging bit. Secondarily, within healthcare systems, or even broadly speaking, people don’t understand the value that pathologists bring. That can be challenging as well because people don’t really understand our role.
The most rewarding part is how we impact human life. On one hand, it’s incredibly rewarding to be able to say, “there’s no evidence of leukemia” or “this is just a benign process.” On the other hand, pathology is interesting because we take care of patients for the entire continuum of human life. From the first beta HCG test that tells a person that they’re pregnant to the autopsy after a patient dies, those tests and everything in between are pathology. It’s super rewarding to be the backbone to healthcare in that way.
Can you share a case that you found especially rewarding?
It may seem like a simple thing, but I think the most rewarding part of my job is to be able to get the right diagnosis. What stands out to me are the rare times that patients have been mistakenly or incorrectly diagnosed, and they’re sent to specialized centers for treatment, where we’re able to catch the fact that they don’t have a malignancy, but a reactive condition. For example, if a patient has a high burden of white blood cells in their blood and are wondering if this could be leukemia and then we complete our studies and say “no, this is likely just an infection.” These are the kinds of moments where we can alter the course of what we think a patient’s life would be like, just because we rendered the right diagnosis.
Is there any advice you’d share with premeds?
Follow your curiosity. Medicine is vast and, often, the place you will find fulfilment will lie at the intersection of several disciplines. I remember as a medical student I wanted to be an OBGYN and neonatologist, because I wanted to take care of women and babies in the peripartum period and now I do that, but in a different way. You will find many of these intersections in medicine are represented in in pathology.
To learn more about Dr. Mirza and his work, visit his Linktr.ee.