By: J. Buttivant
10 Questions for Dr. Bayardo Perez-Ordonez
What is your position?
Medical Director of Surgical Pathology and staff pathologist.
What do you do here?
In addition to my responsibilities as medical director of Surgical Pathology, I am a Head and neck pathologist and also do some soft tissue pathology.
Why did you get into lab medicine?
I didn’t know about laboratory medicine until I started my Anatomic Pathology residency in 1990. Since Med School, I wanted to do cancer pathology.
How did you get started at UHN?
I‘d completed fellowships in Oncologic Surgical Pathology and Head and Neck pathology; so it didn’t take long for me to accept Dr. Asa’s offer to be part of this Department. UNH’s Head and Neck surgical service is one of the largest in North America, so that was an easy decision.
How long have you worked here?
Since the spring of 2002.
What is the favourite part of your job?
Hands down, the favorite part of my job is its diagnostic component. Reviewing pathology slides (hopefully soon, digital slides) and issuing reports with diagnoses and pathologic findings for use in the patients’ staging (important for prognosis) and clinical management.
What is the most challenging part of your job?
That’s an easy answer too: the medical directorship of a surgical pathology service as complex and large as UHN’s. This involves coordinating a team composed of MLAs, Pathology assistants, MLTs, administrative personnel, and pathologists. Often there are no easy answers, issues range from some very trivial to those suggesting important gaps. UHN surgical pathology service is always a work in progress.
What value would you say you add to patient care?
A patient with a transplant may have either rejection or a viral infection, or both. A patient with a breast mass may have a benign lesion or aggressive breast carcinoma which is ER/PR/Her2Neu negative, a potential liver graft may have too much fat to be use in a recipient. Our pathologists’ diagnoses are a fundamental piece of information in the proper management of patients.
How would you say you support the LMP mission to advance lab medicine in its three foundational pillars: research, education and clinical service?
Everyday we review/discuss our cases with pathology residents to educate the pathologists of tomorrow. Clinical service, my reports confirm if a patient’s lesion in the lateral tongue is a recurrent carcinoma or just granulation tissue, or an enlarged lymph node is reactive or a metastatic carcinoma. The members of the head and neck group research many aspects of the pathogenesis of squamous cell carcinoma of the head and neck and those of salivary gland tumors.
In LMP, we often talk about serving as “global leaders” – what do you do to serve as a “global leader”?
I try to engage in all the activities of the Laboratory Medicine Program with our partner hospitals.
10 Questions for Dr. Anna Porwit
What is your position?
My clinical position is Staff Haematopathologist, my administrative position Medical Director of Flow Cytometry and my academic position is Professor of the University of Toronto
What do you do here?
I am a specialist in haematological disease diagnosis, including malignancies such as leukemia and lymphoma. I analyze and report blood, bone marrow and lymph node samples. My position is 50% for clinical work and 50% for teaching, research and administrative duties.
Why did you get into lab medicine?
I started my medical career as clinical haematologist/oncologist and got interested in diagnostics so I did a second residency in pathology in order to work as a haematopathologist.
How did you get started at UHN?
I heard from colleagues that this is a good workplace with possibilities for further development so I applied when there was a position in haematopathology
How long have you worked here?
I am new at UHN since I started in March 2011. I have previously been responsible for haematopathological diagnostics at the Karolinska University Hospital and professor at the Karolinska Institute in Stockholm, Sweden. I worked in Sweden for 25 years except for a postdoc in London, UK.
What is the favourite part of your job?
We are now developing and validating new methodology in the flow cytometry lab (10-color flow) so this part of my work is really interesting. I also like to solve difficult diagnostic cases.
What is the most challenging part of your job?
To maintain and find enough time for all my research and development interests and simultaneously meet the demands of a heavy clinical workload.
What value would you say you add to patient care?
Correct diagnosis provided in a timely fashion is extremely important in haematology since it allows our clinical colleagues to give patients appropriate treatment. In the developing era of personalized medicine, haematopathologists combine various methods such as morphology, flow cytometry, immunopathology, molecular diagnostics, and cytogenetics in providing integrated diagnostic and prognostic information.
How would you say you support the LMP mission to advance lab medicine in its three foundational pillars: research, education and clinical service?
My research is focused on the pathobiology of myelodysplastic syndromes with the goal of applying flow cytometry to diagnosis and follow up of MDS patients. In education I take part in teaching haematopathology giving lectures and case presentations for haematopathology program. In clinical service I aim on putting our flow cytometry lab at the highest possible level so we can add valuable information to the diagnostic process.
In LMP, we often talk about serving as “global leaders” – what do you do to serve as a “global leader”?
I was a member of Pathology Committee and co-author of the 2008 WHO Classification of Haematopoietic Malignancies. I am the Chairperson of the European Bone Marrow Working Group (EBMWG) Coordinating Committee and a member of Executive Committee of the European Association for Haematopathology (EAHP). I also work on standardization of diagnostic methods in haematopathology (both morphology and flow cytometry) within Work Package 10 (Diagnostics) of European Leukemia Net (www.leukemia-net.org) and on standardization of the immunohistochemical diagnostics of bone marrow biopsies within ICSH. I often lecture at international symposia and courses organized by European Leukaemia Net, European Haematology Association and European Society of Clinical Cell Analysis
The Pathology Report 
Medical pathology is a very important aspect of health and many people do not realize that.