S01E4: The power of pathology in medical school

Hosted by RCPA Vice President, A/Prof Trishe Leong, Micro Waves is a Pathologist Cut spin-off exploring the fascinating careers in pathology.

In the fourth episode, we chat with Harry Gaffney, a final year medical student who discovered the power of pathology both as a way to enhance his learning, but also as a rewarding and compelling career path. 

Transcript

00:00:00:00 - 00:00:13:03

[Harry Gaffney]

It's the world that I belong in. I instantly fell in love. I became so excited and passionate about the disease process. And more so, learning about the why behind diseases as well. It's just, oh, it's just incredible.

00:00:18:02 - 00:00:24:07

[A/Prof Trishe Leong]

I’m Associate Professor Trish Long. I'm an anatomical pathologist and I'm the vice president of the Royal College of Pathologists of Australasia.

00:00:28:15 - 00:00:33:13

[Voiceover]

Find your path to pathology with the US EPA Microwaves Podcast.

00:00:39:04 - 00:01:03:08

[A/Prof Trishe Leong]

Welcome to everyone. Hi and welcome to the RCPA Micro waves Podcast. If you don't already know, I'm Associate Professor Trish Leong, anatomical pathologist, and I'm the Vice President of the Royal College of Pathologists. And a warning to our listeners today I've started intermittent fasting, so if I trail off, it just means that I have zero blood sugar. However, our guest today has more has plenty to say.

00:01:03:09 - 00:01:26:03

[A/Prof Trishe Leong]

I'm sure he'll be out to fill in any awkward silences on my part as I pass out. Today, I'm delighted to speak with Harry Gaffney. Harry is a final year medical student at Flinders University in Adelaide, my old stomping ground. He's a rural medicine advocate. He's had a placement with the Royal Flying Doctor Service and he spent a year working rurally in 2021.

00:01:27:00 - 00:02:00:01

[A/Prof Trishe Leong]

He's also completed an undergraduate degree majoring in microbiology and immunology and has a strong passion for pathology with a particular interest in anatomical hematology and microbiology. Harry, that's everything. That's nearly everything. You've got a narrow focus Harry recently received an RCP, a medical student grant to attend Pathology Update, and he joined us virtually earlier this year. He's also currently undertaking research and pathology at the Flinders Medical Centre whilst currently studying to sit the upcoming exams.

00:02:00:08 - 00:02:03:08

[A/Prof Trishe Leong]

Welcome Harry. It's fantastic to have you on the podcast today.

00:02:04:01 - 00:02:15:03

[Harry Gaffney]

Hi Trishe, it's really exciting to be here. I personally think that intermittent fasting is just a fancy way of saying skipping breakfast, but I'm also an intermittent faster as well. So, you know, no breakfast this morning.

00:02:15:03 - 00:02:40:04

[A/Prof Trishe Leong]

Well, in fact in that case I was a long-term foster all through my uni, which must have been why I was so I was so much less. That's, that's what, that's what that's the story will go is anyway on less about me. More about you. Harry so many medical students that's actually interested in pathology. Look, I'm delighted to hear that these rare they still exist and we're hoping to create more of them.

00:02:40:14 - 00:02:46:04

[A/Prof Trishe Leong]

Can you tell me and our listeners what is it that excites you about pathology?

00:02:47:15 - 00:03:07:08

[Harry Gaffney]

Looked at just to answer that question, I guess I'm going to have to take our listeners, viewers through a bit of a journey. So it started in my undergraduate degree and basically progressed onwards from there. So during my undergraduate degree, I studied microbiology and molecular biology and some immunology as well. They were my majors. And you know what?

00:03:07:12 - 00:03:35:04

[Harry Gaffney]

Out of every single topic I did, they were by far my favourite and you know, I love learning about the micro cosmos and especially the behaviours of those, you know, tiny little organisms that we can't see with our naked eye and how they, you know, cause disease. And, you know, and throughout undergraduate, I always find myself trying to find avenues to bring up microbiology with my peers just into any casual conversation and just so I could try and get other people excited about it.

00:03:35:11 - 00:03:56:14

[Harry Gaffney]

Because honestly, I think that you need to get excited about it. It is so cool. And I think that people are excited about it because you can't see it without a microscope anyway. I just think it's impossible. The impossibly incredible the amount of activity that's constantly happening at a micro and molecular level that causes us to exist.

00:03:57:05 - 00:04:17:04

[Harry Gaffney]

And, you know, I just feel so passionate about it and you know, after doing a pathology rotation, it's only been reaffirmed that I know it's the world that I belong in. And, you know, after undergraduate I got into a postgraduate medical course at Flinders University and I was introduced to pathology a little bit further and I instantly fell in love.

00:04:18:03 - 00:04:51:03

[Harry Gaffney]

I became so excited and passionate about the disease process and more so learning about the why behind diseases as well. It's just, oh, it's just incredible. And you know, there's a world that we can't see and there are morphological changes happening to us all the time at a cellular level. And I think we all need to learn more about or at least get a little bit interested and so from the course that I'm still in at the moment, you know, I love the huge positive impact to health outcomes that the research in pathology can have as well.

00:04:51:12 - 00:05:35:08

[Harry Gaffney]

The incredible work done in advancing targeted breast cancer therapy, for example, or discovering the pathogenesis and that causative organism and HPV of cervical cancer and developing a vaccine for it. That's just it makes such an impact and even the up and coming near magic, it's pure magic of pharmacogenetics and the potential future of personalized medicine. Going to your GP and them having a specific profile for yourself to have medications that have an increased efficacy for just you, that is insane, you know, and pathology has so many interesting fields and it has so much potential to be utilized for the future as well.

00:05:35:08 - 00:05:43:07

[Harry Gaffney]

And look, I just urge all medical students and junior doctors to just try and get some exposure like I have and you won't regret it.

00:05:45:03 - 00:06:06:06

[A/Prof Trishe Leong]

That's a fantastic story, Harry. It's great to hear how excited and passionate you are about pathology. And that's well, that's why I'm interviewing you. And you're not interviewing me because unfortunately, if I had my story in my medical years, I would say I was drawn to pathology because it was a nine to five job that was not on call.

00:06:06:09 - 00:06:29:05

[A/Prof Trishe Leong]

And it sounded like a good lifestyle, but also said so. That's very interesting, which might inspire our listeners quite as much, but it's still very relevant. Anyway, back to you. You know, so obviously, you know, you've got a real pathology focus, but yes, you're still you're still in med school there's still there's still you know, there is more to medicine than pathology.

00:06:29:05 - 00:06:32:13

[A/Prof Trishe Leong]

But how is that pathology focus helped you with the rest of your learning?

00:06:33:06 - 00:06:54:06

[Harry Gaffney]

Well, first, and foremost, there only have six weeks left of medical school. So I'm nearly there. If we had if we had this episode six weeks later, we wouldn't have we wouldn't have had that part of the question. Look, in in regard to helping with my learning pathology has been absolutely invaluable. And I can recite a lot of things as a result of just looking into pathology.

00:06:54:06 - 00:07:22:06

[Harry Gaffney]

And I'll explain why and for me to really learn medicine. And I think that this is echoed by a lot of other medical students as well and students overall in any course, I have to learn the why and the path of physiology behind a disease that I'm learning at the time. So for me, that framework of understanding starts at a cellular level, at the micro level, and then I zoom out into the macro and the measure thereafter to learn about the individual pathogenesis.

00:07:22:06 - 00:07:49:06

[Harry Gaffney]

And then the holistic sides of things, the public health sides of things too. So for me to learn about the differences, you know, I've got an example for me to learn the differences between papillary follicular medullary or anaplastic thyroid cancers. I needed to drill down into the histology and cytology to understand those morphological changes that occur and you know, and this helped me ultimately understand the disease progression much better.

00:07:49:10 - 00:08:22:04

[Harry Gaffney]

And, you know, the same goes for mesothelioma as well. Now that I have a solid understanding of the cellular morphological changes and immunohistochemical process behind diagnosing mesothelioma, I will never forget the clinical aspects of disease, including, by the way, all other respiratory differential diagnosis as well. So, you know, I have casual conversations with people all the time and I always bring up the pathophysiological changes on a cellular level about these diseases and they go how do you remember that?

00:08:22:08 - 00:08:44:10

[Harry Gaffney]

Because I'm interested in it and because I understand the why behind it on a molecular level. So ultimately pathology, you know, I'm sure you know this but just to our audience, pathology underpins every aspect of medicine. And to me, it's the very framework I build to understanding medicine as a whole. And it’s provided to be an invaluable resource.

00:08:44:10 - 00:08:54:02

[Harry Gaffney]

And as a result, I'm able to learn things better and I'm able to understand them better and I'm able to enjoy learning medicine which is fantastic for my quality of life.

00:08:55:08 - 00:09:23:14

[A/Prof Trishe Leong]

Now, as I always say, pathology is the basis of disease. I absolutely cannot argue with that. So you are very I've got to say, Harry, you are a very dynamic individual. I feel like after this podcast, I'm going to have to lie down in a dark room for 15 minutes every day. Recompose. You know, I don't have all the energy talking to you, but having said that, you know, you're obviously a guy who likes talking to people.

00:09:23:14 - 00:09:41:14

[A/Prof Trishe Leong]

You're probably a guy who, you know, likes, likes interaction. How do you think that's going to work? In the pathology lab? You know, they always say we're introverts. We don't like to talk to people, you know? Yes, I will be I'll be will be lying in a dark room. And then my preference is to keep my door closed.

00:09:41:14 - 00:09:57:03

[A/Prof Trishe Leong]

But I do like to think, you know, I can hold a conversation. So, you know, till tell me a bit about what the medical students think about what's the image of pathologists these days, one of the stereotypes. What do you think about it? Having actually interacted with some of us in the wild.

00:09:58:15 - 00:10:31:01

[Harry Gaffney]

Before I answer that question, I think your desire to go and lay down at the doctor and as your low blood glucose levels is anything to do with me but yeah, look, I think this narrative unfortunately persists based on the conversations that their colleagues and superiors have. And that's really why I'm here. To change that narrative. I personally think that most pathologists are drawn to pathology for its focus on demystifying human ailments and gaining a deeper understanding of the pathophysiology, as I've spoken about, of disease at a cellular level.

00:10:31:13 - 00:10:58:09

[Harry Gaffney]

And I think that allure really predominates over the fact that it's a non-patient facing role I know I've spoken a lot and I think I could just summarize it with an analogy and think about your favourite musical artist or author. Mine is Brandon Sanderson. He's a fantasy writer and is with a wonderful writer. And I think that, you know, think about all the time that they spend locked away to write their songs or write their books and those things that you love so much.

00:10:58:10 - 00:11:13:05

[Harry Gaffney]

And they do it because it's what they love doing, not because they don't like interacting with people. I think we need to stop. Thank you. Pathologists this is saying that they're doctors who are passionate about improving patients’ lives by uncovering the mysteries of disease.

00:11:15:03 - 00:11:37:03

[A/Prof Trishe Leong]

Yeah, no, I think I think you hit the nail on the head there, Harry. Everything's, you know, everything's a balance. If you're if you're a complete introvert, the fact is, you know, you're not going to be successful in pathology because of the amount of communication that we have to do. So, you know, while well, you know, my preference might be never to talk to anyone ever again.

00:11:38:11 - 00:12:02:15

[A/Prof Trishe Leong]

On the inside. On the inside, you know, on a on a day-to-day basis. I'm talking to my colleagues. You know, I'm doing consults and I'm running meetings. That's and that's all to advance patient care. But at the same time, it's just as you say, looking down the microscope and being able to provide a diagnosis for the patient gives me a real sense of satisfaction.

00:12:03:00 - 00:12:20:04

[A/Prof Trishe Leong]

There's a you know, there's a there's a perfect completion to it. And I'm not as good at the words as you are, but there is there's something very satisfying about being able to actually see and know what the diagnosis is. You're not guessing it's there. It's there right in front of you.

00:12:20:10 - 00:12:22:04

[Harry Gaffney]

Absolutely. Absolutely.

00:12:23:01 - 00:12:32:13

[A/Prof Trishe Leong]

So unlike some medical students, you've actually spent a bit of time in a pathology lab. So can you tell our listeners a bit about what that's like from your perspective?

00:12:33:03 - 00:12:53:09

[Harry Gaffney]

Oh, my goodness. Yes, I can. And I could speak for hours about this in my time in the lab. One thing that really stands out and my time in the lab and the office and looking at slides and cut ups and grossing things, one thing that I see, and this is a recurring theme in the talk is just how welcoming our pathology colleagues are while I'm there.

00:12:54:02 - 00:13:12:02

[Harry Gaffney]

You know, I always have the most interesting discussions with them about recent advancements in medical research and how it can improve patients lives. It always ends up turning into that. How can we improve the lives of our patients and our health outcomes? I look, I've never had more satisfying conversations than with the pathology team that these people are.

00:13:12:02 - 00:13:38:04

[Harry Gaffney]

They're witty, intelligent, thoughtful, they're empathetic. And, you know, just because they're not walking around the wards doesn't mean they're not incredible people as well. And you know, I always get pulled aside to look at these fantastic slides with cribriform cells and intercellular bridges. And, you know, I'm learning new words every day and what they mean and what they mean for the patients, because that's what it all comes down to, even with pathologists.

00:13:38:12 - 00:13:47:05

[Harry Gaffney]

And, you know, I'm having the time of my life I've got Robyn's basic pathology textbook in front of me. And I'm just look, I'm just loving it.

00:13:47:05 - 00:14:12:01

[A/Prof Trishe Leong]

I'm loving it you are a pathology nerd Harry, I have no other word for you OK, look, if we haven't already convinced all of your medical all of your medical student colleagues to now to now take it or at least consider pathology as career option. This is your this is your chance. Wrap it up for us, Harry. What would you what is your last words for other medical students about pathology?

00:14:12:08 - 00:14:34:08

[Harry Gaffney]

All right, everyone. I'm sure you've picked this up, but in short, I'm going to say it's all about exposure, exposure, exposure, exposure, exposure, exposure. I could say that at Infinite Home. Now, my medical school is a four-year postgraduate. It's got two years of preclinical and two years of clinical years. And we only have a little bit of pathology teaching in our preclinical years.

00:14:34:08 - 00:14:57:00

[Harry Gaffney]

We have a look at a few histology slides and that's about it. And this does two things. One, it makes us cram and dump pathology just for exams and due to lack of pathology exposure in clinical years, because you know, there aren't many mutations available, it just builds the narrative of the pathology isn't especially important or has clinical value.

00:14:57:07 - 00:15:26:03

[Harry Gaffney]

And you know, to this I say to all medical students and even junior doctors try and get a rotation in pathology if you can. They are available for medical students. I know that for a fact because I am in one right now. As for junior doctors and I'm not too sure about that, but, you know, learn about pathology value at face, not just a face value, not just of what you've experienced so far, but go and have rotation interact with pathologists, interact with the slides, interact with the grossing in the dissection.

00:15:26:14 - 00:15:49:06

[Harry Gaffney]

And, you know, if there's no pathology rotations to offer while you're on your surgery, rotations, follow the biopsy or tissue specimen or your frozen up to the pathology lab. Watch how they grow it, how they treat it, and if they stain it and how they interpret and report the specimen as well. A frozen specimen is really, really good for this because there's a 20-minute turnaround for it.

00:15:49:06 - 00:16:28:14

[Harry Gaffney]

So it's not that much time. And you get to see the entire process from start to finish. Go back and report what the pathologist has said to the surgeons, see how it navigates their treatment options live in surgery. You know, I'm currently working with several surgeons at the moment to introduce this process in in our medical school. And, you know, I think it's going to show really great success in introducing the world of pathology to our medical students and and show just the influence that pathologists have on the citizen, sorry, on the decision-making matrix in surgery and more.

00:16:29:00 - 00:16:37:02

[Harry Gaffney]

So, look, just get as much exposure as you can, you won’t regret it. It's not much of a time investment and there's so much value as a result of it.

00:16:38:05 - 00:16:52:00

[A/Prof Trishe Leong]

Fantastic. Harry, it's been an absolute delight talking to you. Laboratories of the world. Watch out. In a couple of year’s time. Harry's coming for you. Get ready. 

00:16:52:00 - 00:16:52:08

[Harry Gaffney]

I’m coming! Thank you so much.

00:16:53:14 - 00:17:04:02

[Voiceover]

To find out more about a career in pathology, go to RCPA.edu.au.