Pathology Grand Rounds, Nov. 9, 2023 - Chen Liu, MD, PhD

November 10, 2023

Information

Chen Liu, MD, PhD, Anthony N. Brady of Pathology and Chair of Pathology, delivers the first State of the Department of Pathology address.

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00:00Good afternoon everyone.
00:02Thanks for coming.
00:04So I will take this grand round
00:07opportunity to give the first
00:09State of the department report
00:15for CME purpose. I have nothing to
00:17disclose for this presentation.
00:21First of all, I think it is a good idea,
00:26you know to have the chair to
00:28report it to the the faculty,
00:30staff and the trainees about the
00:32department on an annual basis.
00:34So I think that this will
00:35be the beginning of that.
00:37So from now on so every year so,
00:41so the chair will present at this
00:44state of the department because the
00:46purpose of that is really just to
00:48guide people to know the current
00:50state of the department and the to
00:53really celebrate the achievement
00:54that we have done in our missions,
00:57particularly research,
00:58patient care,
00:59education and also community services.
01:02And also we needed to be have
01:04an open discussion about the
01:06challenges we face ahead of time.
01:08And that way we have a plan and
01:10to continue to build you know to
01:13to to to build up on our success.
01:16So this is the the,
01:19the first one I think for people
01:21who are new to our department and I
01:23think it is always very nice to think
01:26about the history of the department.
01:28So our department is actually one of
01:31the first department in the school
01:33and it was established in 1867.
01:35So they the building which what we
01:38predominantly host is a the Brady
01:41Memorial Laboratory building which
01:43is still stands probably look at the
01:46picture is still very familiar to you
01:49instead of this nice cars but right
01:52now it's all lined with food trucks,
01:54right because that's I'm pretty sure
01:56you'll see it, you have enjoyed it.
01:58So I think and then the other
02:00iconic building for our school,
02:01it will be the medical school building,
02:03this is across the Cedar St.
02:06and which I actually build
02:07about 20 years later.
02:08So it's just kind of see you know
02:11where you know we came from and then
02:13you know see where we are right now.
02:15So this is a basically our
02:17department pathology of 2023.
02:19So we have total members,
02:21about 461 people in our department.
02:25So we break down by you know 3-4 categories.
02:29I will say primary faculty.
02:31We have 127 primary faculty members
02:34and then we have 223 staff members
02:37and then we have 91 trainees.
02:39You see this is the trainees we
02:41break down by clinical fellows.
02:43We have 11 pathology residents.
02:45We have 30 post of the fellows
02:48you know including the research
02:50on all different kind of post.
02:52Doctor fellows with 50 and
02:56we have graduate student,
02:58this is the mainly the graduate
03:00student in our PBS program we have 20.
03:03So for support what do we do?
03:06So the department total revenue
03:08is by the 80 to $1,000,000 a year.
03:11So you can break down into 3 categories
03:14and one is mainly is the clinical
03:17revenue is about $61 million and
03:19our research grant is $17 million,
03:22both direct and indirect and
03:24also some others,
03:26including teaching endowment incomes,
03:28that's around $4 million.
03:30So this kind of,
03:31I will say,
03:31called the wider sign of the
03:33department and that's what
03:34people to think, you know,
03:36to have an idea what we are, what we are.
03:39So this is our current leadership team.
03:43I think we're very pleased to welcome
03:45you know Vice Chair last year Doctor
03:48Sanya Desek and Vice Chair and
03:50Director for Anatomic Pathology.
03:52She joined us last year and she's
03:55you know we're really pleased.
03:57And also Doctor Angelique Levi
03:59also took additional obligation to
04:02be the Vice Chair for operation
04:05and as you know we are pathology
04:08is also joining into the schools,
04:10you know IPO business management.
04:13And so we have Donna Eisenberg to
04:17be the the Senior Director for
04:21the IPO Business office.
04:23So she's what pathology is one of her
04:26four departments and it's all that
04:28same time And you know we last year
04:31we also welcomed our Director for
04:34Finance and Administration Diamers
04:36Battaglia to join us and from Rutgers.
04:40So this is the leadership team.
04:41You know certainly we're all here
04:43to serve you and if you you have
04:46any question concerns certainly we
04:48are all reachable and be accessible
04:50to to you all.
04:54So always nice to welcome new
04:57members of to the department.
04:59So first I start first you know welcome
05:01our new faculty members in physical 23.
05:04So we have a total of 12 new faculty members
05:07joined us last year and to start with,
05:09you know a Doctor Colin Cartagena
05:12who is assistant professor,
05:14She's a breast pathologist and a doctor
05:17colleague who is both broad breast
05:20pathologist and also molecular pathologist.
05:23Doctor Kumar is join us as as Assistant
05:26Assistant Professor and she's doing the
05:28hematopathology and the geopathology.
05:30Doctor Stephanie Liberal who is
05:33the research track is a tenure
05:35track and she's joined us as well.
05:38Doctor Yan Liu Assistant Professor also
05:41Tanya Track research Faculty and Dr.
05:44Wenyu Lu who is a GI pathologist and Dr.
05:49Mando Bram is who is also Tanya Track
05:52Assistant professor on research track
05:54and Doctor Sumi Thomas is assistant
05:57professor who is a general surgical
06:00pathologist and and a cytopathologist.
06:02Doctor Ming Fu Yu and also general
06:05surgical pathologist and the doctor
06:07San Hu Yu also join us and she is
06:11a cytopathologist and also some
06:14ENT pathologist.
06:15And now we have our two physician
06:18scientists who has been with us
06:20and right now they are on the,
06:22you know,
06:23research rotation is a doctor PO
06:26Hong Chen who is an instructor
06:29in hematopathologist and working
06:31with the Sam Taz lab.
06:34And the doctor Harrison Menzel who was our
06:38GI fellow and also physician scientist.
06:41You know, he, you know, he's under,
06:43he's our instructor right now.
06:46So and also I was always nice to celebrate,
06:50you know, the faculty's promotion.
06:52So for last fiscal year Doctor
06:56Kleinsten about promote you know
06:58receive you know Anthony Anthony
07:01Brady professorship and a doctor
07:04Kruger also you know appointed as
07:08Anthony Brady professor and Joe's
07:11doctor miss strategy is now for
07:14professor of pathology Andrew Barry
07:17who is a social professor right now
07:20and doctor TT Pallotti was just
07:23promoted to for professor with tenure.
07:26I think also we have a number of
07:28other faculty members who are in the
07:30process of the promotion but it's
07:32not a finish cross the finishing
07:34line yet because sometimes this
07:36prophet size takes time.
07:38So we'll celebrate their promotion
07:41later and also we welcome about 2222
07:46new staff members to our department
07:48because the lease is quite long.
07:50So I want to read everyone's name,
07:52but I just showed it here.
07:53You can see you,
07:54I'm pretty sure you know many of them.
07:56So they are essential to support
07:58our mission to both administratively
08:00from business office and the
08:02clinical technologies and all that.
08:04Well, 23 of them.
08:05All right,
08:06welcome all you know to our department.
08:10So this is a kind of the,
08:13I want to just remind all of us,
08:16So what is what we do here?
08:18So what is our vision,
08:20what our mission and what we value?
08:22So our vision is to be a leading
08:25destination Center for the highest
08:27clinical service and a place to train
08:30future academic pathology leaders
08:32and a powerhouse for original
08:36scientific research and a hub for
08:39interdisciplinary collaboration.
08:40This is our region,
08:41this is where we wanted to be and so
08:44our mission is always is we follow
08:46the transition as I mentioned we
08:47have over that 150 years history.
08:50So we always you know deliver the world,
08:54world world renowned clinical service,
08:58innovative and creative research and
09:01train next generation of pathologists
09:04and and and also scientists.
09:07So this is our value.
09:08We value the high quality of work,
09:10patient care and we value impact the
09:14research innovation and particularly
09:16we also emphasize we value
09:19teamwork and we embrace diversity,
09:22inclusion and equity and we
09:25you know value professionalism,
09:27accountability and responsibility.
09:29So we value trust and the transparency
09:33and we value empathy and respect.
09:36So this is a has coming to be I think
09:40is the foundation to remind all of us
09:42you know we hope you know we all know,
09:44you know really know what it
09:47what we're here for.
09:51So last year. So for that you know we
09:53follow it will achieve our mission.
09:55So we came together and actually came
09:59design or put together this road map about
10:042027 I was this is our strategic plan.
10:06So this is a strategic plan,
10:08has about 8 strategic theme,
10:11a strategic of priorities.
10:13So, so today, I kind of under each
10:16strategic strategic priority and the
10:19plan and we have specific action plans.
10:23So today, so I'm just going through some
10:25of the action plans to see where we are.
10:28So what are our success and
10:30what are the misses,
10:31what are the things that ongoing And
10:34then to walk through you know to just
10:37basically inform you about the progress.
10:39But I as you can see we have 460
10:43employees and I will say I really
10:46appreciate everybody's effort to
10:48make the department where we are.
10:49I think we are strong department and
10:52but as The thing is as I go along,
10:54it is impossible for me to
10:57acknowledge every individual's by
10:59name naming their contribution.
11:01But I definitely think everybody
11:04contribute significantly to our success.
11:07So I I apologize upon you know you
11:10know the ones that you are not
11:12mentioned sometimes it's just time
11:13to issue I have to put everything and
11:16there's this 50 minutes and it will
11:18complete it and there's some other
11:20time is that you know I just want to
11:23make sure people well you know know
11:25that we value all your contribution.
11:27So this is the the strategy you
11:29know priority wise.
11:30So basically we want to be a destination
11:33for patient care by delivering the
11:35highest quality and efficient clinical care.
11:38So the action plan is, you know it's
11:41here if you can read the fine you don't,
11:44I do not mean you probably read it,
11:46but I'm going to just go through
11:48some of the key points.
11:49For example,
11:51emphasize such special care expert diagnostic
11:57expert diagnosis and integrate anatomic
12:00pathology with molecular pathology and
12:03integrate our practice throughout the system.
12:06Your health system and the establishing
12:09digital pathology you know throughout
12:11the health system is one of the you
12:14know the the goals was and you know
12:17expand the vigorous QAQC and the
12:19patient safety program and setting
12:22up the division molecular pathology
12:24and you start this liquid testing
12:27program to for cancer diagnosis.
12:29So now we just walk a few highlights what
12:32we have done so far first of all in the
12:36patient care and arena you know under
12:38this you know first strategic priority.
12:41So we established the center of
12:44Excellence for Women's Health Pathology.
12:47So we doctor Natalia Booza has
12:50been appointed as a director and
12:52basically is to consolidate the G1
12:55pathology as well as various pathology
12:57together and the system wide.
12:59So I think that Doctor Booza has really
13:01building up this consensus conference,
13:03you know within very short period
13:05of time she has set up the system
13:07wide GM and consensus conference.
13:09I think this was a remarkable and to
13:11say how we could do you know to promote
13:13high quality patient care and also and
13:16we we build up a new program and Doctor
13:20Mina Shi is the inaugural director,
13:23we called it the consultation services.
13:25So the consultation services really
13:27encompasses you know encompasses
13:29the two parts,
13:31one is for pathology clinical consultation.
13:34So this is a mean that means you
13:37directly counsel you to clinicians
13:39and the writing patient charge
13:41chart and you know writing a note
13:43and put that in patient charge.
13:45So this is a really almost
13:47near direct patient services.
13:49The other is experts of consultation
13:52is providing pathology interpretation
13:54and we wanted to receive,
13:57you know we have been receiving some
13:58of the difficult cases throughout
14:00the country and I think that this
14:03will kind of want to expand this
14:05consultation service even more.
14:06And then you know Doctor you know
14:09really under doctor Sonia Desik that
14:11she has been doing a tremendous work
14:13and they're trying to integrate our
14:15surgical pathology and the molecular
14:17pathology because I we believe this is very,
14:20very important for us how to really
14:22bring the most update and the molecular
14:26knowledge to our surgical pathology practice.
14:29And also and about Sonia,
14:31Sonia DESI has been working you
14:34know making multiple effort in
14:36you know create a standardization
14:38and and the quality of pathology
14:40practice across why an HHS system.
14:42And I think more is it,
14:45this is an ongoing thing it you know
14:47later on I will show you why with you
14:50know that the task is a tremendous
14:52you know well this was a really
14:55ongoing project and then the other I
14:58mentioned is the digital implementation
15:00Digital pathology is a strategic
15:01report is a so critical for us.
15:03I think this is a transformative
15:07initiative for for us.
15:09Yeah.
15:10So right now we really started this
15:13implemented this digital pathology for
15:15clinical practice and so we have two high
15:18support scanner and you can see in under
15:21the directorship of Doctor Perry Cherry.
15:24So we have really created multiple
15:28different user scenarios. For example,
15:31we we scan all the console cases,
15:33so we're testing how we can
15:35scanning some of the controls.
15:37Right now the IH e-mail e-mail,
15:39his chemical stain controls and for
15:41all the sign out of cases and now we
15:45can make sure we scan all the slides.
15:47This way we will never lose a record
15:49and also you know the connection
15:51between the molecular tumor profiling
15:53lab and the surgical pathology,
15:56it was like a constant battle over the years.
15:58But now I think that we scan all these
16:01guys really facilitate that process.
16:03So right now we we scan about
16:06more than 130,000 slides,
16:07but I think this is absolutely not enough.
16:11This is a really I call
16:13the baby step to start.
16:15But the good thing is, is,
16:16is allow us to learn to,
16:18you know the workflow allow allow us
16:21to really appreciate how this thing
16:23works and then give us you know future
16:26direction on how we can spill it out.
16:29And then we also have three robot
16:32remote microscope and it's really
16:35the wire here on this campus,
16:37one at SRC and a wide bridge bar.
16:40So those are the remote microscope
16:42that are really useful for you
16:45know consultation as well as
16:47a frozen section coverage.
16:50And also they as I mentioned
16:52we took the first baby step.
16:54There are significant challenges and
16:56also potential opportunities and I think
17:00the challenge is it's really it need
17:03multi $1,000,000 investment upfront
17:04investment that's is a significant cost.
17:07But at the you know The thing is
17:11you know but this is something we
17:13have to do and this is thing with
17:15definitely the same value but the
17:17opportunities abound that too because
17:19we can see if we have sort of a
17:22more robust the digital pathology,
17:24a lot of the things it
17:26can really be achieved.
17:28So those are the as I said the
17:30challenges that are there,
17:31the opportunities are absolutely there.
17:34So at the same time we also
17:36have a you know digital scanner,
17:38smaller scale and relatively low
17:41throughput and right now this is
17:43an entirely supported department
17:45educational and research activity.
17:47So this so far we have 60 user already
17:50and in conjunction with the digital
17:53pathology and also the department
17:55of set up a new software system,
17:57it's called a test presenter.
17:59I think many, many of you have been using it.
18:02I think it's really you know really
18:05helpful and for a lot of the
18:07academic work we do particularly
18:09related to presentation.
18:11And then also in the process you
18:13know Peter Gerschwitz group has
18:15looking at all the softwares and to
18:17see how we can really achieve the
18:19identification basically transfer the
18:21slides from between the the patient
18:23or endless scanning and the tool the
18:26EO University server and for research
18:29and that many purposes those are
18:31the ongoing project and it's really exciting.
18:34So because we started that,
18:36so the as you bubbly all heard
18:38there is a line in the project.
18:41So alignment is going on between
18:43the Yale School medicine and the
18:45Yale New Human Health System.
18:46So really just last week and that the
18:49health system they call the enterprise
18:53strategic session basically it's attended
18:55by the leadership from the medical
18:58school and also the health system and
19:00for that from all the service lines
19:03and to present the strategic priority
19:05priority and to the top leadership.
19:09So it was really useful session.
19:10I think that we you know what we have done.
19:13So this is the slide I presented to the
19:16leadership basically from pathology
19:18perspective I will two priority I told
19:21the the leadership of the one is fully,
19:24fully you know full
19:27implementation of pathology,
19:29the digital pathology.
19:30The other is to building a destination
19:33program by enhanced consultation services.
19:36Those are the our two high priorities.
19:38So you can see you know the you know
19:40the more to come about this strategic
19:43session by the you know in the end
19:47of my presentation and then you know
19:49we when we go to through increase our
19:52efficiency we must the thinking about
19:55it the all the operational issue.
19:58So this is a for example,
20:00is 1 the Histology life,
20:02even our histochemistry life.
20:03They are essential for our practice.
20:05So under the Histology lab right
20:08now is under the directorship of
20:10Joe Mastragi and Sandy Di Russo
20:13under the highway really making
20:16tremendous improvement for example,
20:18you know to really enhance our
20:20ability to for the Histology
20:23and also you know his chemistry.
20:25And then of course the challenges here,
20:27the bigger challenge here is,
20:29is a space which I will come back later.
20:32It's always a problem with us.
20:35So you mean again here you mean his
20:39chemistry operation here as well.
20:40And we have to say we have much
20:43more effective,
20:44you know new you mean history
20:46histochemistry lab right now and
20:48we have more validated testing.
20:50And one good news soon is we are in the
20:56process to open immunohistochemistry
20:58lab for Saturday.
20:59So in other words we would like to
21:01have a full immunohistochemistry
21:03lab operation on Saturday.
21:05So I think that this is a really
21:06come to the vision at the some point
21:08and then when we have a system wide
21:10integration we needed to create
21:13almost 24/7 Histology in in
21:15the immunohistochemistry life.
21:17That's is really the our eventual goal.
21:20So I think we are making some small
21:23step right now is to for the immunochemistry.
21:25So this is I hope it will really
21:28improve the the turn around time
21:33and also they under the
21:35directorship of Doctor Gibson.
21:37So we really enhance the patient
21:39quality and the safety program.
21:41So this is a so Doctor Gibson has
21:45really building all this like MMM
21:48conference case if ISQ and also designed
21:51multiple different electronic and
21:53IT tools and for event management.
21:56That's why I as you can see this
21:59is area we must do well this is
22:02a patient's life on the line.
22:03So we have to do everything possible
22:05to improve continue to improve the
22:07quality and the patient safety.
22:11At the same time when we try building
22:14our own department process we also
22:18participate the system wise quality matrix.
22:21So this is just giving you one example at
22:24a system level that means that all the 5-6
22:27hospitals across the system now develop
22:30this common safety reporting system.
22:33So this is one of the reporting
22:36system is looking, looking at is
22:38full of the pathology floaters or
22:41we call the contaminants, right.
22:44So those are the,
22:45you know fortunately since we started now
22:48for the the floaters has made any patient
22:52you know direct impact on patient care.
22:54So that's good thing otherwise you we
22:57all know it is unavoidable to have
23:00sometimes floaters or contaminants
23:02of getting into our slides.
23:04So that's why we're so vigilant to be you
23:07know to look at it the pre analytical
23:10process and also post analytical
23:12process particular for pathology sign
23:15up and all of those things it will
23:17it will never too much to do.
23:19So I I think we need to do much
23:22more in this area as well.
23:24And then you know along this line you
23:26know to really continue promote a you
23:28know a patient our practice this is
23:31a pathology informatics team under
23:34Peter Gershwin and as you know this
23:37is always our you know really pride
23:39to have this very robust and a very
23:43expert pathology informatics team player.
23:47So I think as you was here Peter has
23:49listed a number of the initiative
23:51they have been doing.
23:52I just emphasize a few things particularly
23:55it's related host wide imaging analysis
23:57is related to digital pathology.
24:00The other thing is you know it's
24:02creating tracking the specimen
24:04that's another area where you know
24:07his group has done a lot and also
24:09trying to exciting area or in
24:12conjunction with digital pathology
24:14would be to introduce creative AI in
24:17the pathology practice particularly
24:19thinking about the incorporate,
24:22yes thinking about incorporating
24:23large language model and the in
24:25the pathological practice.
24:27I think that's really open opportunity
24:29for almost all of us to think about
24:31it to be creative to think something
24:33how we can promote efficiency.
24:35So this is a great and the moving you
24:39know in a few years down the road we
24:42are thinking about the introduced ipic
24:45beaker system into anatomic pathology.
24:49So this is it will involve everybody but
24:52a certainly the you know informatic team
24:56will play a a very essential role for this.
25:01So here at the same time we I can you know
25:05with all our clinical operation I really
25:07wanted to have a shout out to all our
25:10the contribution from our staff members.
25:13So at least the here some of the main,
25:15you know, key staff members who have
25:18a number of our you know who has done
25:20tremendous work in number of our areas and
25:22I just don't really give them a shout out,
25:25appreciate that their
25:26contribution to our department.
25:28So I'm not going to read everybody's name,
25:30but the lecture is recorded I think.
25:33I hope people will appreciate that their
25:36contribution plus as I mentioned many
25:39more who are not mentioned in here.
25:42The 2nd strategic priority or strategic
25:46goal is we wanted to be a global leaders
25:50in high impact research by promoting
25:53thematic and innovative research.
25:55So those are the action plan,
25:57all the the bottom lines we need
26:00to really do high impact research.
26:03So here is a summary, put them all together.
26:07This is really our overall strategy
26:10for our research.
26:11So we want we are helping people with cancer,
26:14inflammatory disease and also
26:16population health.
26:17So to do that we build
26:20the translation platform.
26:21Here we have bio banking and
26:23reference live is 1 platform.
26:25As you know we are playing really
26:28pivotal role for institutional banking
26:30and we have YH centre and we build
26:33a centre for FP genome and the bio
26:36markers and we are in the process trying
26:38to build a therapeutic pathology and
26:40then the end needs of the transport.
26:42You know basically that the
26:44trans translational platform is
26:45the fundamental science.
26:47Our department faculty are
26:48working on cancer biology.
26:50It has always been our strength.
26:53We have most of our faculty members
26:56somehow working on projects related
26:58to cancer and then we have IP genome,
27:01genomic science and we have
27:03faculty members immunology,
27:05inflammation,
27:06vascular biology particular our recent
27:09to recruit the new faculty members.
27:11We want that they have more focus
27:14in this area particularly related
27:17to inflammatory disease as we know
27:19inflammatory disease certainly including
27:21all the infectious disease as well.
27:24And then we have a strong data science
27:27team and particular mentioning the
27:29Steve Kleinstein and Joel Krueger.
27:32So I think we have really tremendous
27:35you know basic science basis to for
27:38us to do the translation research
27:41we've been achieving a lot.
27:43So here is a list that provided
27:44by you know our Vice Chair,
27:46David Stern and as what are the really
27:48the highlights are from our basic science
27:51and basic and translation science division.
27:54So our faculty continue to do really
27:56well in funding and particular for
27:58the junior faculty we have,
28:00they all gather all kind of different
28:02external funding.
28:03That's really,
28:04really a great news to hear.
28:08And then then the others,
28:09Our PhD program is under famous
28:12Caracatis and it continue to do well.
28:15And I think our residents,
28:16you know,
28:17our graduate students continue to do a
28:20remarkable work.
28:21And also here later on I will show
28:24more about more about it that we
28:26have a research affairs office.
28:28It's really provide really amazing
28:30support for all of us And recently
28:34just last month and we have a very
28:37successful YH Symposium on Aging Research
28:40under the director Doctor Deep Dixit.
28:44As we have almost 160 people attending
28:48the event, it was really remarkable.
28:50And also our faculty play a very
28:54important role in Cancer Center,
28:55namely like Pallotti,
28:57a new one and also Yan and Stern.
29:03So major research funding
29:04from basic science faculty.
29:05Again, it's impossible for me to
29:08mention all the papers we publish.
29:10I think there are a lot of we publish close
29:13to 300 papers a year from our department,
29:16All right.
29:17You know somewhere around
29:18somewhere around 3:00 to 350,
29:20that's on average.
29:21So I just highlighted a few.
29:23We published like a really impactful
29:26journals and I again I'm going to go into
29:29reading each one because of Time Writer.
29:32I just leave it here for people
29:34later on to really I can see
29:36the remarkable achievement from
29:38basic science faculty and also
29:40some of the honors at the doctor.
29:43Katie Pelosi was recently honored
29:45by the Lung Cancer Research
29:47Foundation in New York City.
29:49It was a remarkable event.
29:51I was there along with all
29:53the Cancer Center leadership.
29:54It's really we're so proud of,
29:57you know Katie's achievement.
29:58And also Katie has been appointed a Co
30:02director for Yale Spa in lung cancer.
30:04This is a really great honor to
30:07have that and then we have a ward
30:11with you know 1961 cancer reserved
30:15award given to Kurt Shopper and
30:18as a doctor Manju Prasad received
30:21a Yale Cancer Center Water for
30:24excellence in clinical care.
30:25This is A and also we it's really
30:29our honor and you know we're so
30:33all of deserved reward is the live
30:36achievement award to doctor geometry.
30:38So this is really right and well
30:41what winter is awarded school to a
30:44student Stephen Lee and also another
30:47one is the Qingyang has received this
30:50probably investigate investigative
30:52pathology this is one of the highest
30:56honor is receiving the American
30:58Society for Investigative Pathology
31:00the outstanding investigator award.
31:03So this is you know I'm sure we
31:05have more award and you're already
31:07some you know we will receive the
31:10notification from you and then we
31:12put you know we have them in our
31:14communication office and to be in
31:16our pathology newsletter later on
31:18I'm going to say that you mention
31:21that point again.
31:22So some of the high impact of
31:24translation of research you
31:26really think what do we do we'll
31:28bring potential clinical impact.
31:30I just highlighted this 21 is a
31:33diagnostic you know from David Rim's
31:36life so he's designing this Multiplex
31:38per tool on trouble two really new
31:41test potentially will make impact for
31:43you know for cancer therapy response.
31:46So the other is really Dimitri's bridal.
31:49So this is a we all wish
31:51this huge success it's a drug called
31:55the INZ 7 O one it was really invented
31:59in Demetrius life and there's
32:01although that you can see how long
32:03does it take for drug goes from
32:05phase one phase two eventual phase
32:07three and the the good news is now
32:10his drug is entering phase three.
32:13So I wish him a well I think this would
32:15be a tremendous impact on you know his
32:18research is is making in the field
32:23and the same time that I here is also
32:26acknowledge our our clinical faculty they
32:29have producing many important clinical
32:31or translation or research findings.
32:33So we have whole these you know our
32:35clinical faculty I want to be able
32:38to get everybody's name into it.
32:39So you can clearly see those
32:42are really population in the,
32:44I will say the the,
32:45the landmark journals in in
32:48academic pathology for example
32:50American Journal Pathology,
32:52American Journal Surgical Pathology,
32:54Modern Pathology and Human Pathology.
32:56Those are really remarkable papers
32:58and published by our faculty.
33:03The next strategic goal is to be a leader
33:06in medical student undergraduate education,
33:10residence training and also
33:12officiated scientific training.
33:14So this is a kind of a progress
33:17before our residency program,
33:19you know over the past year,
33:20but at least at first I'll
33:22go through the picture.
33:23It was a soccer event.
33:24It was very nice, it was nice day
33:26and also very energetic residents.
33:28It's so nice to see people
33:30are actually happy, right.
33:32But I think this is our program has been
33:34tremendously improving under the new
33:37leadership of Doctor Andrew Barbera.
33:40They're they have done a lot of
33:43work particularly making in terms
33:46of resident evaluation and resident
33:49interaction with the faculty resident,
33:52the interaction with the program.
33:54And I think it is anonymous
33:56feedback tool to create it is very,
33:58very instrumental and for us to continue
34:01to hear every voice from every resident.
34:04So this is a really doing really
34:07well and also in terms of the
34:10right resident our the composition
34:12of residency body you can clearly
34:15see and we continue to grow up
34:18to to create you know more robust
34:22diversity group of residents.
34:24And also that resident have achieved
34:27a lot you know like a sum of number
34:30of meeting abstract and as well
34:33awards for their attendance.
34:35And we have our residents are involved
34:37in more than 30 publications last year.
34:40This is a reflection you know the,
34:43you know their contribution to our
34:45research mission and the other
34:47thing is the
34:50AACMGME survey. I have to say we
34:53have a long road to go because
34:55I would like to see the survey
34:57is all fine you know guys really
34:59to be the best in the country.
35:00But I as you know this will take
35:02some time but we're improving.
35:04So I think at least the last year
35:07that they they what I call the very
35:10positive experience for our program.
35:12So if we are in inch up more than 10%,
35:15we're not a study,
35:17we're not going to downward.
35:18So in other words this is as I
35:20said we still have a long way to
35:22go and I think what are we is clear
35:24we want it to be the destination
35:27program for residents training.
35:30So medical student training there's is
35:33always very important for all of us.
35:35I think Rob Homer now is as a director.
35:39So he's actually organizing all
35:41our faculties who are engaged in
35:44medical student teaching.
35:45So we just want to see what's of opportunity
35:48out there and continue enhance the program.
35:51So I'm glad to now to know is that
35:54doctor Joanna Gibson was selected
35:56as a one of the 12 coaches in the
36:00medical school to mentor medical students.
36:03This is a really really important
36:06and a remarkable job and also Harry
36:09Sanchez was selected as the associated
36:12course director for for anatomy course.
36:14So this is the thing we didn't think
36:17about before but I I always feel I
36:20mean pathology is the probably should
36:22be at the probably one of the vice
36:25anatomy teachers because that's the
36:27name we have the anatomic pathology.
36:29I think this is really good and
36:32Harry now is represent us and to
36:35teach medical students anatomy.
36:37So Rob is really building the the,
36:41the curriculum of engaging all
36:44the stakeholders trying to really
36:47enhance the pathology electives.
36:49As as you know this is we are
36:52competing with medical student time.
36:54So the medical student seems that
36:57have so many different priorities.
36:58So this is the one of the area we
37:00need to have to hire the attention
37:02of the medical students because we
37:04wanted them to learn pathology.
37:06It is important for patient care
37:08and it is also important for the
37:11future science otherwise.
37:13And then one area I think we haven't
37:16done well since at least since I got
37:19out here every year we did not see
37:21any medical student is doing thesis
37:24research with within department pathology.
37:26So I have to say as a chair when
37:28team presented that I feel a little
37:31bit embarrassed each time when they
37:33present and say no medical student
37:34has done thesis in pathology.
37:36So this is Rob and I have been
37:38talking with a lot about this.
37:40We wanted to see what we can do to contain.
37:43We have great science here.
37:44You can clearly see the the tabs
37:46and the breadth of our science both
37:49basic science translational as well
37:50as well clinical.
37:52I think this is just the need us
37:54to do
37:55a little bit of more work in this
37:57area and then we also have a
37:59very unique course that we teach
38:01you and you know Yale undergrad.
38:03In other words it's the Yale college
38:05students called the peso biology lecture.
38:08This is a course.
38:09You know it's right now it's under
38:11the course director is John Morrow.
38:12You know we have a few you know
38:14other faculty you know Cass
38:16Feinberg my goon Patrick Cherry
38:17and the Sanchez that teaches car.
38:19It's been it's reflect very well.
38:21This is again it's not ordinarily
38:24medical schools department you really
38:27don't teach the the college student
38:28but this is the one area I think
38:30it's it's been doing very well.
38:32So we want to continue this and thanks
38:35all the faculty who are leading this course.
38:39So the other thing is building the structure
38:41to support the educational activity.
38:44So this is the office of education.
38:46We said we started the last year,
38:48so we appointed Marie Lee as a manager.
38:50This is I think everybody should appreciate
38:54a lot of the difference is making for
38:56our department in terms of you know,
38:57educational activity.
38:58It's really a big shout out for
39:01Marie Lee has been building this
39:03office of supporting the residency
39:05program along with the Ivy and to
39:08support the fellowship program.
39:10And also the vision is that this
39:12we consolidate all the educational
39:15activity under this one office,
39:17provide all the needed support
39:19including the training grant
39:20and the undergraduate program.
39:22And more importantly it's the
39:24yield pathology courses.
39:25So now we have this name under the umbrella
39:27we call the yield pathology courses.
39:30So that's including everything we
39:32want to teach potentially every
39:34symbolism that we wanted to gain.
39:36And so this will be under
39:38your pathology courses.
39:39So The thing is we have down for
39:42two years is that the surgical
39:44pathology CME courses and it was held
39:48in the Yale Club in New York City.
39:51So this is the we had one
39:54last you know last week,
39:56so in 2022 we had this inaugural CME course.
40:00At that time we have 47 attendees.
40:03Most of the people that time it was internal.
40:06People you know yeah or you know
40:08like our resident fellows and
40:09also our own faculty along with
40:11the people in the tri-state area,
40:13Connecticut and New York and the
40:15New Jersey already and the summer
40:17are really alumni but this year
40:19we have a 70 attendees it was a
40:21really good turn out the turn out
40:23and as a matter of fact we now have
40:25people from all over the country.
40:27So namely the really the far
40:29away and not far away,
40:30including people from Canada,
40:32Puerto Rico and California.
40:34So I think this is a remark where
40:36you can see our, you know, influence,
40:38you know the impact of this,
40:40this CME is we can feel it right now.
40:44So this is the,
40:45the fire faculty gave with the CME cars,
40:48you know see
40:50Doctor Bouza, Humphrey Hui, Dr.
40:54Kunsan and also Doctor Dana Rong.
40:57So I also bring your attention
40:58This is the first time I guess for
41:01our CME is really using technology
41:03you see the use of the digital
41:05scanner slides and also with have
41:07the interactive communication with
41:08the audience to provide diagnosis.
41:10I think that was a remarkable,
41:12I think it will hopefully we'll continue
41:15to grow this conference and this is
41:17you know to really you know spread
41:20our not spread the knowledge right
41:23because it is our tagline with the
41:25yield pathology is a place to create
41:28a knowledge and to share knowledge.
41:29So this is a certainly one of the things
41:32we needed to do more to promote and then
41:36the other part is very important to do.
41:39You know we wanted to be to set to have
41:42a nationally recognized reference line
41:44by growing outreach program as you know
41:47and also entrepreneurial preneurship.
41:50So the current status you see that
41:51our volume is growing you know in
41:53general in surgical you know pathology.
41:55So largely it's a really reflection of the
41:59GI certain you know GI surgical pathology.
42:02We've lost them for a few
42:03years and now it's a fully,
42:05nearly fully coming back to us.
42:06So those are the the breakdowns of
42:09our case volume and then we also this
42:12is under Angelique Levi's leadership,
42:15our Vice Chair for operation.
42:17And so we really wanted to enhance
42:21some specific more you know reference
42:24service line for example molar
42:26pregnancy high sensitive her tool
42:29testing ophthalmology Podiatry and
42:30so those are the high you know the
42:34the the outreach teammates are doing
42:36a really remarkable job of trying
42:38to marketing this also reference
42:40testing is so important for all of
42:43us it's as I mentioned it can serve
42:45as a translational platform for us
42:48to translate the latest technology
42:50into clinical practice.
42:51So one right now with the success
42:54it will be molar preximation molar
42:56pregnancy testing under doctor
42:58Pei Hui and and also the hurt new
43:02testing under David Ray.
43:04So recently we're also starting
43:06this reference newly that that
43:09established we call the diagnostic
43:10you know at the once the diagnostic
43:13test we're called the ADT lab.
43:15So this is really lighted by Curtis
43:17Shopper and the Curtis shopper has
43:19been the leader in this area to really
43:22design or operationalize certain
43:26really innovative testing for human
43:29tissue for to guide clinical therapy
43:33And he has you know been definitely
43:36recognized leader in this field.
43:37So now we kind of work have the system
43:40set up within the our reference lab and
43:43we want to promote that and grow it.
43:45So for this one you know there will
43:47be a lot of opportunity for everyone
43:50particular for our basic scientists
43:52to be part of this and to see how
43:54to translate their findings into
43:57potential clinical application.
43:59And and that this is the really
44:02consultation service as I mentioned earlier.
44:04So we wanted to do and right now
44:07the weeds
44:08we already have some international
44:09clients in the under the
44:11leadership with Doctor Moko,
44:14Dr. Hilbert Moko has been really
44:17leading those international
44:18consultation on renal pathology.
44:20So we continue to grow that but now
44:23with the availability of digital
44:25pathology we think of we can
44:27actually enhance our global presence.
44:32We cannot you know over emphasize how
44:36exciting we are with really the COVID
44:40pandemic's crisis actually it was this
44:43opportunity to really appreciate the value
44:46for us to building the community service
44:48and the community outsourage program.
44:50So we have this event is we mutual faith
44:53at this event become a mobile life And
44:56so the team has been using this mobile
45:00life delivering some you know point
45:02of care testing and also participated
45:05in numerous of community activity.
45:08This is you know here on top you can
45:10see this inflatable long distance,
45:12this is in conjunction with Cancer Center,
45:14the long spa program And then
45:16we there are so many different
45:18opportunities down the road.
45:20I think we can only see this
45:23is continue to grow.
45:24So this is you know we welcome
45:27everybody bring their ideas to
45:28to to this and also work with us
45:32together to build you know additional
45:35testing capacity down the road.
45:40The others you know strategic goal
45:43is really grow department resources
45:45assets in the infrastructure building.
45:47So this is really we needed
45:51to do a lot of amazing things.
45:53We must also have resources to do so.
45:55So this is a really we wanted to
45:58really enhance our funded rising
46:00capacity and also building more strong
46:04bioinformatics infrastructure and our our,
46:07the the department also setting
46:09up the core of shared research
46:12equipment for our research faculty.
46:14And so last year,
46:15I would say gladly to say,
46:18we set up one Zender Harper
46:22Professorship with a $3,000,000
46:24donation from the Zender Harper family.
46:26And we also got an anonymous donor for
46:29supporting the Brim Discovery Center,
46:31which is the Brim bank.
46:32That's a $3.5 million.
46:33I think we wanted to grow continue to
46:36see how you know what we can do and to,
46:40you know,
46:41grow additional resources for the department.
46:44And for that I think this is really
46:47important.
46:47I think I cannot say any other investment
46:50that we see that more exciting or
46:54direct ROI return on investment on
46:56this office of Research Affairs.
46:59So this is a really we are
47:01so glad to recruited Dr.
47:03Gina Della Potter Potter to be the UNR
47:06Director for our Research Affairs office.
47:09So her presence and her office
47:10has done a tremendous work and a
47:13tremendous support to our faculty
47:15particularly you know you can see that
47:17the the skill they have been doing.
47:19So our grand proposal has been really
47:23you know significant increase the
47:25quality of the grand as a dramatic increase.
47:28And also they are right now helping
47:31the team science which is one of the
47:34key initiative for us is to building
47:37this team science and the group
47:39program project and also large brand.
47:41So this office has really affected
47:43everybody in the department.
47:45I think we all supposed to,
47:46you know,
47:47we all should appreciate their effort.
47:49So under this office also we're
47:51supporting IRP and IRP summation
47:54and also graphic design.
47:56I have to,
47:57as you know say some of the figures I have
48:00is actually supported by Hannah Wong,
48:02you know in the office,
48:03you know to design the vision statement.
48:05I won't be able to draw that myself,
48:07right.
48:07So this is kind of clear they
48:09see and if you need help this is
48:12a place just talk to them.
48:13They are wonderful.
48:15I think this is one of the
48:17the support we provided.
48:19This is really,
48:21really,
48:21really,
48:21really valuable and I hope and we
48:25can see more and more value coming
48:27from this office down the road.
48:31And the another priority,
48:33strategic priority is how to set
48:37cultivating on us nurturing environment
48:40for professional development.
48:41All right.
48:42So this is a,
48:43this is a,
48:44it's never been able to stop because
48:46we wanted to really create a good
48:49environment for both our faculty
48:51and staff and for their career
48:53development and promoted their career
48:55and created a good environment.
48:57And this is also at least
48:59that they our culture,
49:00climate issue, our diversity,
49:02you know we call it the Dice
49:05program underneath that.
49:07And so I will have a few points to make here.
49:10For example last year, March 20,
49:13actually this year March 2023 and we had,
49:17we did at the department of Department of
49:20wide survey and we I'm very glad you know
49:23to know this nearly 90% of response rate.
49:26So this is probably the highest
49:28responsible rate of survey.
49:29So give us a lot of feedbacks and we
49:34clearly see quite a number of issues
49:37especially on our staffing staff side.
49:40You know the from the the group,
49:42you know who's a part of
49:44the department of missions.
49:46With that we had a number of you know
49:49sessions and go over what are we,
49:52you know what's the challenges,
49:54what are the opportunities.
49:56And certainly as I mentioned this
49:58is our ongoing and ongoing project
50:01because we never called this is enough,
50:04it's it's never been enough.
50:05We needed to do more.
50:07So though with that with this survey we
50:10came up with the seven you know action
50:13plans as we some are implemented already,
50:16some are in the process at the next year.
50:18I think this is certainly one of the
50:21high priorities for the department to
50:24really cultivating this organizational
50:26culture and the climate at the same time.
50:29Along with this line we decide and
50:32I we decided to really have some
50:34perform a matrix we need to monitor.
50:37So one is it's not always the the most
50:40important thing it but it's very useful
50:42for us to monitor and staff turnover rate.
50:45So this is because that give you an
50:49indication of what's going on and also
50:51you need to understand the FIC department.
50:53So we pull it right now we continue to pull
50:56previous data because it was incomplete,
51:00but at least I can face for say the
51:02for physical 22 and the physical
51:0423 we have this two years data,
51:06it's very accurate for physical 22
51:09for example just kind of your we
51:12have a total 22 termination and
51:16two is involuntary you know and the
51:2020 is a voluntary resignation.
51:22So our turnover rate for our
51:24stiffener is the 13% of physical 22.
51:27So I think a lot this year,
51:29I mean fiscal 23 there's A and
51:32and June 30th this year we're kind
51:36of almost ahead 7% terminal rate.
51:39So I hope that this trend will continue.
51:41We want to have a long terminal rate,
51:43but at the same time we have 73 hour
51:48faculty and the staff have more than
51:5120 years service in the department.
51:52You can clearly see we have
51:54a lot of faculty member,
51:56they're really loyal to the department.
51:58This is really great.
51:59I mean they only tell you fundamentally our
52:02department is really a good department.
52:04So this is a kind of a that we
52:06have to you know set at the records
52:08and also for on the faculty side,
52:11our faculty I go back there just for
52:15reference and nationally losses at
52:17least we checked for physical 22 or 23
52:20nationally the turn on rate is around 20%.
52:23It's a pretty high in this area.
52:24So now this is for us so faculty you
52:28know attrition rate is really little low.
52:30So it's this,
52:31we pull out physical 1920 this pre
52:34pre pandemic and during pandemic
52:37and 2122 and now post pandemic 20
52:41to three you can see we're hovering
52:43between between 3 to 6%.
52:44It's quite amazing and nationally
52:46according to AMC data is about a
52:4910 to 15% of Clin particularly in
52:51the clinical area for the clinical
52:53department that's will be the attrition rate.
52:55So I think that as I said this is
52:58just one of the indicate things
52:59that we want to monitor.
53:01So this way for us to have some more
53:04performance matrix KPI for us to
53:07know how we can improve ourselves
53:10and the next thing is really create
53:13a partnership and the internally
53:14and the national level.
53:16So without saying that that's a
53:18very important that is the line
53:19in the project between the health
53:21system and the medical school.
53:23So this is a slide Doctor Bran Smith,
53:25the Chair of Line Medicine and I myself
53:28presented this to the leadership group
53:30you know as I mentioned the last week.
53:33So basically you can clearly see
53:35that they wanted to have optimize
53:37A standardized consolidate the
53:38laboratory service across the system,
53:40that's the key.
53:41And then the other is expansion
53:43service location.
53:44And also the bullet point is 3
53:47digital pathology is so important,
53:50we are building it is we are continue
53:53to to you know to grow it to scale up.
53:57Why we have to do this you can clearly
54:00see this is the current landscape the
54:03laboratory pathology service within
54:05the houses state you can see you know
54:07you know why why and the HH Rich Park
54:10Greenwich and Lawrence Memorial see
54:12those are the live employees you know
54:15400 highest number here So right now
54:17is a basically we still have this
54:19live medicine pathology to tools
54:21department run the laboratory service.
54:24What I'm trying to show you here
54:26is that you can, you know,
54:27look at the record and then see
54:29how you will see it because I can
54:32see the challenges as well as
54:35opportunities coming with it.
54:36So it is for our department is
54:38really important for us how to play
54:41more proactive role and you know,
54:43really eventually achieve an integrated
54:46laboratory pathology service,
54:49service life for the health system.
54:52This is a last point for the strategy plan
54:56is the enhanced administrative and business
54:58part and the financial sustainability.
55:01So I think this is also an area affected
55:03everyone because they you're really
55:05behind the scene and around all the
55:07business and administrative part,
55:09but they are doing really tremendous work.
55:11So give you one example is this
55:14the pathology post award under
55:16the Peter Sardonic's leadership.
55:18So just a few highlights here and
55:21we as you know this particular our
55:24research faculty knew it was some,
55:26there were some issues and
55:28really challenging.
55:29You know about 18 months ago or two
55:32years ago we had a lot of challenges
55:35now with the IPO and the post award team
55:38implemented by you know Donna and Ron, Peter.
55:42So we're really moving really
55:44tangible progress.
55:46We all it's not to say we're
55:49100% you know the top program,
55:51but I think we're close to
55:53yearly achieve that.
55:54I think we are making a tremendous,
55:55tremendous progress in that area.
56:00Communication. So is under your
56:01Renee and the Terrace office.
56:03This is important.
56:05We started the Pathology monthly newsletter.
56:08I emphasize this again,
56:09this is your newsletter.
56:11In other words that you have any
56:13news for the item you please send
56:15director to Terry or Renee or send
56:17it to me or your supervisor whoever.
56:19We wanted to say good things,
56:22interesting things,
56:22we wanted them to be communicated
56:24within our department.
56:26So far we have issue about around
56:28the 16 letters, monthly letters.
56:30So I think we should continue use
56:33this as a basic platform for us to
56:36kind of know how things are going.
56:38Remember we have a close now
56:41marching to about 500 people in the
56:43department with a diverse group,
56:45different location.
56:46So I think it's always important
56:48for us to have a a base,
56:50you know some more communication.
56:52So this is a key, so key misses.
56:54So something we have done,
56:56we try to do,
56:57we haven't been able to push it you
56:59know to get it why the translational
57:01line to try to set it up last year
57:04because reason we haven't been
57:05able to do that because we have
57:06to wait out the funds flow model.
57:08As you know we have internal
57:09funds flow model coming up.
57:10We don't know what will be the
57:12impact on us to recruitment.
57:14The vice chair for the for dice,
57:17the Wellness program really needed
57:19to be there but we we haven't been
57:22able to you know to get there yet.
57:25And the other is is really it's
57:27a very important topic.
57:29I think everybody knows the
57:30value of that is how to promote a
57:33collaboration between our clinical
57:35faculty and the basic science faculty.
57:37I think we have a lot to do in that area.
57:40The other is ethnic clinic,
57:41we've tried to build this brand
57:44new service line number of you know
57:49obstacles you know we have tried to overcome.
57:52But again,
57:52we're not OK,
57:53why I'm not going to give up on
57:55this one because it is so critical
57:58for our cytopathology service
57:59and also for pathology practice.
58:01I called because this will be
58:04direct patient contact service.
58:05So we continue to push for
58:07it to build this clinic.
58:08Again, the last thing space or
58:10facilities that's really a lot of time.
58:13It's out of our control.
58:14But we try, OK, we try.
58:16But a good news is I think that
58:18hopefully we have the dotted line sign.
58:20We potentially have 5 office you
58:22know office you know faculty
58:24offices available very soon.
58:26You know new offices that we
58:27got from the health system.
58:29So I'm with So those are the kind
58:31of archaic that consider the key
58:33means is we need to do more lot of
58:36challenges are had you know because
58:38time it matter I think of many of
58:40those I probably already mentioned
58:42I thought during my presentation
58:44so I'm now going to read that
58:46I think this is we all know the
58:48challenges that it's out there.
58:50So this is the last slide.
58:51I just want to say that the key
58:54take away point I hope this is
58:56very I jammed everything together
58:58because a lot of information.
59:00I hope and you gather the impressions
59:02that our department is really strong
59:04they have a very strong foundation
59:06absolutely amazing history and
59:08we can continue to build on that
59:11success and our faculty staff and
59:13training is a really engaging.
59:15I don't make my eyes really an
59:18honor and privilege.
59:19Privilege for me to do this job
59:21is really we have this, you know,
59:24faculty, staff and trainee.
59:25They're engaging.
59:25They're very dedicated to what they do.
59:28And also I hope I showed you
59:31our strategic plan is effective.
59:33We are actually achieving some successes
59:36and we have continue to push for that.
59:38Remember that this is just
59:40the road map to wall to 2027.
59:43So we face challenges,
59:45but we will succeed, right.
59:47I think that we're all together.
59:49We can succeed.
59:50The most important piece point
59:51sometimes I think this is the kind
59:54of foundation for most everything.
59:55If we can work together
59:57and work collaboratively,
59:58we will fulfil our mission and a
01:00:01cultivate exemplary organizational
01:00:02culture And this climate because
01:00:04we wanted to be here all together.
01:00:06This will be a dream place to work,
01:00:09to learn and to do to do discovery.
01:00:12So with that I will stop there.
01:00:14I think I will put, you know,
01:00:15over about two minutes.
01:00:16Thank you very much for your attention.
01:00:18If you have any suggestions,
01:00:20comments, please send it to me,
01:00:23either e-mail me or there is
01:00:25anonymous side to the chair.
01:00:28So whatever the comment you may you
01:00:30may not comfortable to say in front of me,
01:00:32you just put send me this with
01:00:34the the anonymous chair side.
01:00:36Thank you very much and really looking
01:00:38forward to continuing working with you.
01:00:39Thank you.