[00:01:43] Aleksandra Zuraw: Welcome, everyone, to the podcast. Today, my guest is Dr. Kate Baker. She is a veterinary pathologist. She’s a clinical pathologist. I’m a veterinary pathologist as well, but anatomic pathologist. So, the story behind how we met is I had another guest on my podcast, Dr. Cade Wilson, a veterinarian, and he is involved with Skoped Micro. This is a phone case to take pictures from the microscope, and he mentioned to me that he was also talking to Dr. Kate about it. I’m like, “Dr. Kate? She’s a veterinary pathologist. Let me look her up.”
[00:02:21] I did look her up, and I saw her very successful Facebook group with over 60,000 members in the Facebook group. I saw her website, and I learned that she is now actually a digital pathologist, digital clinical pathologist. So that’s why I have Kate in this episode, and if you are looking at this on YouTube, you’re going to see our funky backgrounds. I have a funky background that is anatomic pathology, and she has one that is clinical pathology. Welcome, Kate. Thank you so much for joining me on the podcast. How are you today?
[00:03:00] Kate Baker: I’m good. Thank you for inviting me. I’m super excited. Yeah, I love the dueling backgrounds.
[00:03:06] Aleksandra: Yeah, they’re crazy. Check it out on YouTube. So let’s start with you. Tell me about yourself.
[00:03:12] Kate: Well, as you said, I’m a veterinary clinical pathologist. How far back should we go? Back when I was a baby. No, I’m kidding. So I have had an interesting journey to where I am in my career now. One that I didn’t really expect or anticipate, but I’m super happy with where I am now. I currently, as you said, work as a digital pathologist, and I also am an online and in-person educator. So I teach veterinary professionals, both veterinarians, veterinary specialists that are non-pathologists, and veterinary technicians more about cytology, and hematology, and how to get more comfortable with it in their own practice. That’s the gist of what I do now. How far back should we go? How much do you want to know about me?
[00:03:59] Aleksandra: So I want to know this like… because you were a regular veterinary pathologist, a diagnostic pathologist, right? I am a toxicologic pathologist. So I’m not really doing diagnostics in the common sense of diagnostics. So let’s talk about when you were a diagnostic pathologist on glass slides, and how did you transition to your online digital pathology business and to reading slides digitally? Let’s talk briefly about this transition, and then I’m going to ask you questions in detail about everything.
[00:04:32] Kate: Perfect. So, yeah. So when I finished my residency in 2016, I started working with a large diagnostic lab. In that role, for about four years, I was reading glass. So it was submissions on glass, cytology samples, hematology, so blood smears, and I was using my microscope. So there was no digital component to that. Towards the end of my working with that lab, they started to incorporate digital cytology and digital hematology. Actually, I should say most of the time that I was working there, I was doing digital hematology, but towards the end, they started incorporating digital cytology as well. So I started to get more exposure or really, initial exposure to digital cytology towards the end of my working with them. I then had to move back to my home state where my family lives and my extended family, and ended up making a transition to more of just all digital cytology by working with the digital cytology company, Scopio. Through working with them, all I do digital cytology with them.
[00:05:44] Aleksandra: So no glass work anymore?
[00:05:46] Kate: No glass. Yeah, no glass. Yeah. So it’s all digital. It’s all digitized cytology slides and blood smears, and so I don’t have… I don’t even own a microscope now, which sometimes people say, “Does that make you sad?” I mean, I’m in the camp of I had it this transitionary period, right? So I wasn’t spending the majority of my career on a microscope, and I’m not in the new camp where pathologists that are coming out of their residencies now and in the future may only do digital. I know we’re going to get to that, the future of digital pathology, digital cytology in particular, but I’m in that transition. So I had a short period of my career being on the microscope and now moving into digital. There was a transition there, but to answer that question that some people have, yeah, I do. I mean, I love the microscope, but this is still microscope-based.
[00:06:40] Aleksandra: You can buy one if you want to.
[00:06:43] Kate: Right. I have some art, some microscope art, like a picture of a microscope, and my kid has a toy microscope. So, yeah, we have microscopes around.
[00:06:52] Aleksandra: Yeah. Actually, I’m getting one. So yeah, you can buy one. So let’s talk about the Veterinary Cytology Schoolhouse, which is your Facebook group, right?
[00:07:03] Kate: Yeah. So there’s a lot of houses.
[00:07:04] Aleksandra: I know because…
[00:07:06] Kate: Yes, I’ll tell you. So the Veterinary Cytology Coffeehouse is my Facebook group for veterinary professionals. So if you’re a veterinary professional and you’re not in it, feel free to request to join.
[00:07:16] Aleksandra: We’re going to link all the links to all the clubhouses or houses in the show notes.
[00:07:23] Kate: Perfect.
[00:07:23] Aleksandra: I’m sorry. I prepared for this interview, but I confuse them.
[00:07:27] Kate: No, I know. Sometimes even I confuse them. I’m like thinking, “Maybe I should change some of these names, so it’s not confusing.” But yes, the coffeehouse. So think you go and get a casual cup of coffee with your friends. That’s what the Cytology Coffeehouse is on Facebook, and that’s the group that has over 60,000 members. That came about by when I was working in the digital… or as a diagnostic pathologist, I was missing that teaching element. I love looking at cytology all day, but I really love teaching as well, and I love sharing the things that I was seeing.
[00:08:00] So I was really feeling like I was missing that, and so I started this Facebook group just solely with the intent of sharing interesting cases with the veterinary community. That was several years ago, and since then, it just really developed into this really cool space where the intent of it is for learning more about cytology and hematology, sharing of seeing cases. It’s not supposed to be a free diagnostic board or anything like that. It’s meant to help veterinary professionals understand the utility of cytology and blood smears, and not only that, but get more in depth comfort and knowledge about what we do as clinical pathologists and what they can feel comfortable doing in their practice.
[00:08:44] So it’s really neat how it developed, and then during that time, shortly after that Facebook group came to be, I had people asking me, “Do you have any courses? Do you have any more formal CE opportunities for anybody?” At the time, I didn’t. I was working full-time. I have two young kids. It sounded fun, but it wasn’t something that I had even thought about. But about a period of a year went by where I was really mulling on this. People kept asking me, saying… and it was very humbling and nice to hear people said they liked my teaching style, and so they wanted to know if I had anything that they could take on a more formal sense.
[00:09:21] So fast forward, I created one course, and people, the feedback was really great, and it was very sweet. I was just so, again, humbled to have that type of feedback that it was really helpful for the community. So I made another course, and so I have two main courses now, Mastering Cytology and Mastering Hematology, and then another house comes in. So I started a monthly membership just to give more in-depth learning for people who were interested to learn smaller bits on a more regular basis, and that’s the Veterinary Cytology Clubhouse.
[00:09:54] Yeah. So that’s my membership. Where you can find all of this to make more sense of it is, again, a different house. It’s the Veterinary Cytology Schoolhouse. So my schoolhouse is just where… It’s my website, where I offer free resources, but also these more formal learning. When I say formal, I don’t mean boring. We have a good time. So yeah, that’s the Veterinary Cytology Schoolhouse, and that’s where I house all this stuff, and that’s where how this all came about. It’s been a lot of fun.
[00:10:25] Aleksandra: Yeah. So, you know what I found? that in your group, there are people that I studied with in Poland.
[00:10:31] Kate: Oh, really?
[00:10:32] Aleksandra: Yes. I looked at my Facebook friends list because I was inviting them to my Facebook group about digital pathology, and I saw, oh, you and this person are both members of the Cytology Coffeehouse.
[00:10:48] Kate: Oh, that’s so fun. Well, it’s funny, and there’s two things about that. One, what I think is really cool about this group is that there are people from all over the world, and so what… I mean, sharing stuff with people that are on the other side of the world than you is just cool to me, and you also get to see some really neat infectious stuff that you wouldn’t see where you are. So that has been really neat and just that extension into places where there isn’t a lot of continuing education opportunities for people and just being able to see this type of case exposure and stuff. It’s really neat. The second thing about that is that my sister, she was buying something off Facebook marketplace, and she lives in Indiana. She clicked on the person’s profile that she was selling this item too, and she saw that person was in my group. So that was pretty funny. She was like, “Kate, they’re in your group.” I don’t know. It’s just really small world.
[00:11:44] Aleksandra: Yeah, yeah. It is, and with social media and with this connectivity, totally. That made me smile. So let’s talk about digital pathology.
[00:11:54] Kate: Yes.
[00:11:55] Aleksandra: We briefly touched on it, but what was your first encounter with digital pathology or digital cytology? Let’s start with your first impression, and then what happened since then?
[00:12:08] Kate: So if I think about when I was first exposed to digital pathology, it was back in veterinary school. So they actually incorporated digital histology slides into our histology lab. So that was my first exposure through that instruction setting, and I thought that was really neat. I mean, I remember I… When I was in veterinary school, I knew I wanted to be a pathologist. So I was especially interested in that lab. I remember thinking it was a little bit weird that we weren’t using microscopes, but being able to cruise around on the slide, and see different areas, and have the instructor there to see what we were seeing and project it on their screen was really cool. I thought the utility, that that was neat. In fact, fast forward to now, as I’m on the Education Committee for the Clinical Pathology College, and this has been a common discussion, how we can incorporate digital into the veterinary curriculum more so even than just that.
[00:13:07] So that’s been an interesting full circle thing, but as far as from a diagnostic standpoint or dealing with it myself and my career, my first exposure was back, like I mentioned, in my job as a diagnostic pathologist. My first exposure was reading digital hematology, and then later on, digital cytology. Initially, with a digital hematology, I mean, there was a bit of a learning curve in the sense it’s just not what you’re used to, right? Anything that you’re not used to, at least for some people like me, feel scary initially. You think, “Oh gosh, I don’t know. This is different.” It didn’t take too long though to get more comfortable with it and to realize how great it really is. It makes things… at least for hematology. At the time when I was getting used to this modality, I was quickly realizing how more efficient I could be with maintaining quality and thoroughness, sped things up not at the detriment of quality, right?
[00:14:05] So sometimes speed is bad because you miss things, but it actually helped me make sure that I was seeing everything. So, for example, the program that we used would take the white bloods cells in the monolayer, and it would put them on a grid. So we could see all of the white blood cells in this big square, and we could evaluate them. Normally, under a microscope, I would be looking. Yeah, and I would… and you can’t look at every single cell. So I would invariably miss some of those in the monolayer. But in this way, it took those cells and put them right there in front of me. So I could just quickly go through, but more thoroughly go through them.
[00:14:42] Aleksandra: This is so interesting that you’re saying that because I didn’t know that… and let’s talk about image analysis now because this is totally image analysis.
[00:14:54] Kate: Yeah, sure.
[00:14:54] Aleksandra: I know that, actually, for pathology, it started with cytology. It started with blood smears, and I know couple of companies that are doing this. But because I’m an anatomic pathologist, I don’t really know what’s going on there. So what you just said that, “Oh, we get all the white blood cells in a grid,” that helps you not mix up. So do you have any other applications that are part of your routine? I didn’t know it was part of your routine. In anatomic pathology, it’s still not part of the routine. We’re working on it, and you just told me, “Oh, without even asking for it. It was there.”
[00:15:35] Kate: Yeah. So that was definitely part of our routine in the sense that for blood smears, that was how we evaluated blood smears. When I first started that job, I don’t think that we were using that technology yet, but it wasn’t long before we started using it. So in my mind, I had been using it most of the time I was working there.
[00:15:53] Aleksandra: Do you remember the name?
[00:15:54] Kate: Yes. It’s Television.
[00:15:55] Aleksandra: Okay.
[00:15:56] Kate: Yeah, which I think is… and I don’t know a ton about them, but I’m pretty sure that they’re mostly on the human side, and we were extrapolating this to veterinary, but all of the nuances of quality control and all those things, those were behind the scenes. So that was all being done on the back end that I’m not familiar with. But from the pathologist perspective, as the diagnostic pathologist, it was great for those reasons, and getting used to that digital interface and… There are some subtle differences, and they’re not big. You just have to get used to them. But for me, what was really helpful was that initially, when I was getting used to reading blood smears in this way, I would have the actual slide as well. So I could look at the digital images, and I could scan them on a layer and the feathered edge. I could scan the slide as well, but I could also click over to a different screen where it was the grid. So I could go back and forth.
[00:16:51] Then, if I saw something or even if I just wanted to be certain that what I was interpreting was how I would interpret it on glass, which for me at that time was the gold standard because that’s all I was used to, I would then look at the slide, scan it quickly, make sure that I was interpreting it the same way on each, and then I would do… I did that for some time before I started to feel comfortable. “Okay. I don’t need to check myself on the glass slide to make sure that I’m…” because it’s so consistently the same, and that would apply for things. Like if I saw something, like I was concerned about intercellular parasite, like a morulae in a neutrophil, is that just a Döhle body or is that truly morulae?
[00:17:29] Aleksandra: So a question here.
[00:17:30] Kate: Yeah.
[00:17:30] Aleksandra: Because this is something that at least in the anatomic pathology part of pathology, it’s always like, “Oh, cytology. What about the focusing, and what about the scanning at different layers, so-called Z-stacking?” Is it the limitation? How do you work with that because obviously, you use your micrometer screw a lot, right?
[00:17:54] Kate: Yeah, yeah, yeah. So that is a big discussion in the clin-path world. Again, I’m on the diagnostic side, not the technology development side. So I’m a little bit naive to some of those concepts, but from the rumblings in the cytology world that I had caught wind of, I knew that was a concern is the layering with histopath. You have the ability to control the size of the layers. In cytology, specifically, in cytology, when you’re taking a fine-needle aspirate, you’re spraying it on a slide, there’s difference in thickness all over the place. For blood smears, they’re usually similar thickness, right? So I don’t think that they had as much of a difficulty with digitizing blood smears, and I think that’s probably why from the clin-path side of things, that we were seeing digital hematology before digital cytology has become more mainstream because they were still trying to work out that technology.
[00:18:48] Now that we’re in this period of time where digital cytology is very much happening, and it happened very quickly, it feels like. I mean, people that have been working at this for a long time might not feel like that. But from my perspective where I was doing all glass cytology to all of a sudden there’s opportunities to work as a digital psychologist and not just blood smears, but also doing digital cytology, it was, I felt, very fast. All of a sudden, everybody is talking about digital cytology.
[00:19:17] So I know the technology varies between the different types of analyzers. Different companies have different technology. I’ve had experiences with several different companies. Some just like in the surface-y way. Like I was at a conference, and I was looking at them demonstrating all the way to doing actual diagnostics for those companies on different machines. I do think that there is a difference in quality between them. All of them are good quality, I believe. I mean, all of them are to the point where…
[00:19:45] Aleksandra: You can do your job on them.
[00:19:47] Kate: You can do your job. Yeah, and you can do it well. So it’s not that anybody is doing pathology on one system that they shouldn’t be because it’s so pixelated when you get up close and you just can’t see anything.
[00:19:57] Aleksandra: No, I think we’re beyond that point.
[00:19:59] Kate: Right, we’re beyond that. But then, there are some… In my opinion, with the ones that I’ve worked with, there are some that are just better quality or higher resolution when you’re up closer.
[00:20:10] Aleksandra: Higher magnification?
[00:20:11] Kate: Yeah, higher magnification, better resolution. Yeah. Not to favor one company over another, but I just will say now with my experience…
[00:20:19] Aleksandra: If you have a preference, go ahead and say.
[00:20:21] Kate: Okay, because I know people probably are wondering. I really enjoy working with Scopio in particular. They’re not paying me to say this. It’s just true. I really enjoy…
[00:20:29] Aleksandra: Do they have their own system?
[00:20:31] Kate: They do. So, actually, I just had a discussion with them the other day to say what exactly is happening on a technological level to make this such good resolution at like a 100X type objective because I… When I started reading for them, I was zooming on the way in and thinking like, “This is really good,” because one of the things that people, pathologists and then by extension, veterinarians are concerned about is, “Well, can you see things that you need to see at a higher objective, like bacteria or organisms that are very small?”
[00:21:08] Honestly, I don’t spend a ton of time on 100X. When I have a microscope in front of me, a lot of time, I’m spending… scanning it or evaluating mostly at 50 or 60X, which are pathology lenses. Those are not ones that you’re going to have in a clinic, but yeah. I’m not really usually going down to 100X, but sometimes I need to. So even so, these digital scanners have different, in my experience, clarity at those higher zooms. I mean, I know that they’re standing at a lower objective, and it’s digital zoom, but at that digital zoom, I found really superior resolution with Scopio System from a pathologist perspective. I’ve just been really impressed with that.
[00:21:53] Aleksandra: I have another episode I recorded with another company that has a cytology scanner I’m going to link to this one. It was BioInnovation. I’m not sure if you have ever worked with them.
[00:22:05] Kate: Mm-mm [negative].
[00:22:06] Aleksandra: I’m just going to link as a research to this one.
[00:22:09] Kate: Yeah, yeah. There’s lots of different… Yeah, different scanners for the different companies, and it gets out my wheelhouse to know all the in and outs of them, but…
[00:22:16] Aleksandra: As long as you have an image good enough to do your job.
[00:22:20] Kate: Exactly.
[00:22:20] Aleksandra: That’s what somebody who’s not involved in the technology should have delivered.
[00:22:26] Kate: Right.
[00:22:26] Aleksandra: That you are confident. That you’re not missing anything. If you need this transition period or this way of working should be incorporated in any system validation, and if you personally need that as well, then you should be able to do that.
[00:22:40] Kate: Right.
[00:22:41] Aleksandra: This is how you gain confidence.
[00:22:43] Kate: Yeah, yeah. It’s been a lot of fun. It’s been really… It took, on that same note of what what was that transition like, because I went from… We talked about the digital hematology, but then moving into digital cytology, which is a little bit of a different beast. There were some differences, and one of the bigger I think differences as a clinical pathologist is that… Not all of the companies work this way, but Scopio in particular, clinic has a scanner in their office, and so they are stain the slides themselves, and then loading them into the scanner, and they’re doing the scan inside of that machine. So the slides never come out of the office. They never go anywhere. So one of the things that just as a picky clinical pathologist took a little bit of getting used to, but it really wasn’t that big of a deal was just evaluating Diff-Quik slides because…
[00:23:30] Aleksandra: Oh, true.
[00:23:32] Kate: Yeah, yeah, so.
[00:23:34] Aleksandra: I remember for my days as a clinical veterinarian before I started my residence even. Yeah, Diff-Quik.
[00:23:41] Kate: Yeah. So they have Diff-Quik in their clinics, and the stain that most like diagnostic labs, large diagnostic labs use is [Wright beam] .
[00:23:49] Aleksandra: So just for those who don’t know what Diff-Quik is. So is this the modified [unit set] stain?
[00:23:55] Kate: Yes, it is.
[00:23:56] Aleksandra: Yeah, so this is… but this is a stain that veterinarians, practicing veterinarians have in their clinics where you can make a smear and stain it within like 15 minutes, 10 minutes?
[00:24:09] Kate: Oh, quicker than that.
[00:24:10] Aleksandra: Even less? So, basically, you have three containers of different colored liquids. You put your slides in one, in the other one, in the third one. You put them there in a microscope, and you evaluate?
[00:24:21] Kate: Right.
[00:24:21] Aleksandra: But obviously, if you did your residency and you are a pathologist, this is not the method you’re using anymore.
[00:24:29] Kate: No, and Diff-Quik is a great stain. It’s a good stain. It’s quick. That’s why it’s called Diff-Quik. It’s a quick stain, and it’s great for in-house use for the veterinary clinic. Wright Giemsa is what we tend to use in the labs, and there are some subtle differences, but the staining quality and the staining properties, the tectorial properties is very similar. But to a pathologist who looks at cytology all day long, even really subtle differences in purples, and blues, and hues can make our minds go, “Mmm.”
[00:25:02] It’s not bad or good. It’s just different, and it’s probably not even that noticeable to people who don’t read cytology all day, but it is something to get used to when you switch from your routine stain to reading cases that are Diff-Quik. But again, it really didn’t take that long to get used to, but you’re also relying on the clinic to stain appropriate amount of time, not under-staining, not over-staining, and they give training on that. That’s usually not an issue, and if there is, we just troubleshoot that, but that’s a little bit of a difference in the two.
[00:25:34] Aleksandra: Okay. So to recap and put it in the perspective for people outside of the field, Scopio is like a reference lab, right?
[00:25:43] Kate: Yes.
[00:25:44] Aleksandra: Would be a reference lab where clinics, veterinary clinics are sending samples for evaluation?
[00:25:51] Kate: Yes, but digitally.
[00:25:53] Aleksandra: Exactly. So they don’t really send specimen anymore. They do the specimen in their clinic.
[00:25:58] Kate: Exactly.
[00:25:59] Aleksandra: They scan and send the scan for evaluation through, I assume, some cloud solution, and then you get the scans from the cloud. So the slides, like you said, never leave the clinic. Nobody has to order a courier, or FedEx, or anything. You don’t have to pick up slides. You just open your computer.
[00:26:15] Kate: Exactly. Yeah, and so as a result of that, it makes it really fast too. So not having to package up your slides, send them… even if you do overnight, it’s still… The lab have us to receive the slides. They have to unpackage them, process them, accession them, assign them to a pathologist, and even… and it’s not saying that’s bad because usually, the turnaround time is still two to three days. But when you have, especially from an emergency standpoint, when you have a patient or even an urgent care type situation, when you really need some more information quickly, they offer… At least at this point, Scopio is offering a one-hour turnaround time, and it’s been that way since they’ve been in operation. So that’s huge, right? Like from the clinic standpoint, that’s really great.
[00:26:59] Aleksandra: Yeah. So most of the veterinary clinics do not have pathologists. It’s not like a hospital.
[00:27:05] Kate: Right.
[00:27:05] Aleksandra: Like a human hospital or you have all the specialties. The pathologists are somewhere else at a company that hires pathologists in the diagnostic or working as consultants. Mm-hmm [affirmative].
[00:27:17] Kate: Right.
[00:27:18] Aleksandra: Fantastic.
[00:27:19] Kate: Yeah. So that’s one of the real benefits that digitizing this has offered because you focus on digital in particular and the applications in veterinary medicine. That’s the big one. One of the big ones, but definitely a big one.
[00:27:33] Aleksandra: So you mentioned once to me that you are going to be a co-author of a paper about digital cytology.
[00:27:39] Kate: Yeah.
[00:27:40] Aleksandra: I wanted to ask you about, how do you improve your knowledge about digital pathology? Even though you’re in the diagnostic side, you are curious about the technology side, and now you probably will have to dig deeper for the publication. Do you need to know, or do you just want to know? What’s your take on that?
[00:28:00] Kate: That’s a great question. So yes, I was invited to co-author a paper on digital cytology with one of my pathologist friends who’s wonderful. We both have experience in digital pathology, but again, we’re not… From a technological standpoint, that’s not what we do in particular. We are from the diagnostic side of things as a pathologist, but we… and this is in its very early infancy stage. So we haven’t even started writing it. We’re in the outlining stage. We have plans to make sure that we feel comfortable enough with the technology side to give that information to the audience in an appropriate way.
[00:28:37] It’s a journal that the audience is most of the general practitioners. So we’ve discussed this, and we said, “Digital cytology is up and coming in a really big,” and I truly do think that digital cytology will be the main modality of doing cytology in the future, probably near future. Just depending. There’s lots of things to work out with that, but I think that’s where it’s headed. Just similar to digital radiology.
[00:29:01] So I think that general practitioners as the audience should have some understanding of how this works mostly because some of the questions that I’ve even gotten from general practitioners and general veterinarians, there’s not a strong just general understanding of what digital is. Is it pictures? What exactly is happening? So I think it is, and we definitely, in this paper, will address the technology, but probably not super technology heavy because that’s…
[00:29:29] Aleksandra: I am going to piggyback on that a little bit.
[00:29:29] Kate: Yeah.
[00:29:30] Aleksandra: What is digital pathology for you? Then, I’m going to tell you what it is for me.
[00:29:37] Kate: That’s also a good question because I think this is something that I’ve been thinking a lot about because of this paper, and then also just in general, my own things that I work on myself. So, digital cytology. I don’t know that I have a strong, quick definition I can pull out of my hat, but yeah, I think that it applies… I think the word “digital” applies to anything that is done via a screen, basically, in my mind. The assessment is not via microscope in the sense that you’re looking through a microscope. You’re actually accessing that information through a screen.
[00:30:09] So whether that’d be a digitized slide where the whole slide… either the whole slide or portions of the slide are scanned, stitched into an image that can be then viewed on in a very detailed way, both in zoom and… not zoom. Having that capacity to do zoom. That is one application. I personally think that image capture cytology is also digital. If we use that definition, then image capture. So the client is actually taking an image of what they’re seeing and sending that in through email, or through app, or something like that. That’s actually one application as well. Of course, you’re not getting a scan. It’s not something you can zoom in and out of. It’s not something that you can move about the slide, but it is digital. It’s capturing that information in a digital format. What is it to you?
[00:30:56] Aleksandra: I’m totally on the same page, and actually, recently, with a friend, Famke Aeffner covered a review in Veterinary Pathology about digital pathology. At the beginning, we elaborated what this is from the very beginnings like in the ’90s where you had the first microscope cameras that basically, like you said, capturing a digital image of what you have on the slide is digital pathology. Then, you use it for different purposes. You can use it for tox-path. You can use it for diagnostic. You can use it for social media and education, but this is digital pathology. So that’s what my website is about a little bit. If you do digital pathology, this is your place, the Digital Pathology Place.
[00:31:41] Kate: Yeah.
[00:31:42] Aleksandra: So yeah, we’re on this same page.
[00:31:43] Kate: Good.
[00:31:44] Aleksandra: I was just curious because we are both…
[00:31:45] Kate: Oh, did I get it right? You’re the expert.
[00:31:47] Aleksandra: You did. You did. Very well. No. I mean, we are both active on social media, so I just was curious. Do you consider this digital pathology or not? I totally do, and in the MD world, in the human medicine world, they are even bigger than us on that. They share a lot of stuff on social media, and toxicologic pathologists are very restricted in that regard because the decisions we make help decide whether a drug is moving on in a pipeline or not. So this is strictly confidential information. There is no taking pictures of your slides.
[00:32:26] Whereas in human medicine and especially in veterinary medicine, this is not a concern at all. The owner of this tissue that you are looking at is the dog. The owner of the dog is the owner of the dog, but there is no confidential information included there. So yeah, I was always a little bit jealous. They can take all those pictures, and post all this stuff, and just educate each other. Like you said, across the globe, people that do not have access to these resources just follow somebody on Twitter, and they can get access to all those resources. So it’s fantastic, and it’s like a whole new dimension of digital pathology, and I love it.
[00:33:11] Kate: I agree. I feel the same way. That’s definitely, like we were talking about earlier, just one of the most fulfilling pieces of all this. I know that social media can be a very toxic, very not good place, but there’s a lot of really great applications for it, and education is one, and exposure to information that you would not normally have access to or that just doesn’t exist in a format that you really have the time to explore. So, like for instance, a busy practitioner wants to come home. I live with a busy practitioner. Okay? He is an emergency veterinarian. He wants to learn. He wants to be the best that he can be. But sitting down with our two young kids with a textbook at night is just not something that…
[00:33:52] Aleksandra: Just not happen. Mm-mm [negative].
[00:33:55] Kate: So if you can find a creative way to incorporate learning into what people are already doing, scrolling social media, they’re looking at things that their friends are doing or whatever, and they happen to scroll past one of your educational posts about this. They get to take that piece of information and move on with their night. That’s really neat to me. That’s one thing that I really found very gratifying about teaching via social media, and I think sometimes it might be poo-pooed like, “Oh, teaching via social media,” or it’s a joke.
[00:34:25] Aleksandra: I was studying for my boards with YouTube.
[00:34:28] Kate: Yeah.
[00:34:28] Aleksandra: I was falling asleep reading the books.
[00:34:31] Kate: Me too.
[00:34:31] Aleksandra: I’m like, “I just cannot do this. I’m going to fail,” and I failed the first time. But the second time, I passed because I was looking at YouTube’s videos.
[00:34:40] Kate: Well, people learn in different ways, right? I mean, there’s people that learn visually, auditorily. Sometimes people need a combination of both. Our attention spans just in general these days as humans is much shorter, and so having that, having those little bits of information versus having to self-motivate, I think it’s really valuable. It’s something that people should take seriously in education in general.
[00:35:06] Aleksandra: Totally, and you just stay consistent, and you can reap the benefits. You know what? When I was a practitioner still, the person I was working for, he used to go to conferences, and I started going to conferences as well. I was always frustrated that there were so many lectures. After the third lecture, I don’t understand anything anymore, and he told me, “If you go to a conference, regardless how much it costs, and you take out one actionable thing, it was a good conference.” So same counts for any way of learning. If it’s social media, if you take one actionable thing, it was time well spent.
[00:35:45] Kate: Right, right. Yeah.
[00:35:46] Aleksandra: Whatever it is. If it’s a webinar, post, a newsletter, whatever it is, if it goes into your head, then it was worth it.
[00:35:56] Kate: Yep, I completely agree.
[00:35:58] Aleksandra: I have another story with digital slides and digital learning. So when I was studying for my boards, I was bad at histology. Because you have done five parts of the exam, when I was studying, one of them was histopathology, and that was the one I was worse at. I started hating looking under the microscope, but I was like, “Okay. If I don’t…” and I stopped doing it. I was focusing on other stuff for my boards, and I was like, “Okay. Let’s be honest. If you don’t do it, you’re going to fail again.”
[00:36:32] So what I did with a friend, we started looking at digital slides, and I was like, “It doesn’t matter. It doesn’t matter if I recognize it on the digital, then I’m going to recognize it on glass.” So I went the other way around. I was like, “It’s more important to recognize the entity, to learn it than to stick to a modality, and this other modality, the glass, I don’t know.” I developed some reaction, and I didn’t want to do it. So I went digital, and I passed.
[00:37:02] Kate: Awesome. Yeah. That’s a great story to just demonstrate how this is just a different type of learning resource that you can utilize. One that made me think of this conference. We have ACVP Pathology Conference coming up, and they just… I guess it was the ASVCP mystery slides. We do these mystery slides every year, and you usually get a box of slides that you pay for. Then, they ship you this box of slides, and then you review them. Then, at the conference, they go over the answers. It’s a really fun exercise.
[00:37:35] It’s neat to be able to be part of that, but one of the things they started incorporating… I don’t think it’s all digital. I just got this email the other day saying that the digital slides were ready for review, and I thought that was really neat because there’s a link, you click on it, and then you get to review the digital slides. It’s the same thing. You still go to the conference, and you hear the answers, and you discuss, and you have that really robust discussion, but it’s accessible in a way that you can widely distribute it, and from the submitters…
[00:38:03] Aleksandra: It’s scalable.
[00:38:05] Kate: Yeah, scalable. Exactly, and when I was considering cases when I was a resident of ones that I could submit for the mystery session, you had to have enough sample to make… I think it was a hundred slides. So I would have these really cool cases that I’m like, “Oh, this would be great to present at the mystery session, but there’s no way I can get a hundred slides out of this, and I don’t have access to the animal. These are slides that are submitted to us.” So unless they submitted a hundred slides, which nobody does, I didn’t have enough material to submit. So that information was lost. That cool case was just not allowed to be a part of that. Through digitizing this, it makes it so that you need one slide, and so that’s great. I mean, that’s just another way that… and making that learning experience more robust and being able to share more. That’s just an application for that.
[00:38:58] Aleksandra: Is there anything else that I should have asked, but I didn’t? Anything that we missed?
[00:39:03] Kate: I don’t think so. This has been fun. I mean, the thing that’s neat about this is… I don’t know. Digital is just such an up and coming thing. It’s been around for some time and probably more so in the… I’m guessing more so in the human world, and then with anatomic histology, histopathology has been digitized for more longer than cytology has. So it’s still new to us as pathologists and I think as clinical pathologists as well. I think that there’s still a bit of some resistance.
[00:39:31] We want to do things the way they’ve always been done, and I think that there’s going to be some interesting discussions in just the pathology world about making that jump, and people that been used to the microscope for a long time, and if they’re going to be able to be comfortable on digital. But I think honestly, it’s just a matter of trying it and seeing it’s very similar. You can get used to those, those small differences just like anything else, and then realize how much benefit there is to reading digital as well. So I don’t know. No, I think that we covered a lot, and it’s been a fun conversation.
[00:40:03] Aleksandra: I probably could spend an hour talking about different things.
[00:40:07] Kate: I know. I agree. I can’t believe it’s already been an hour.
[00:40:10] Aleksandra: But before we go, let the listeners know where they can find you online. What are the houses? I’m going to include all the links to the houses in the show notes.
[00:40:19] Kate: Sure. So my website is www.veterinarycytologyschoolhouse.com, and that’s where you can find learning resources, both free and paid courses, and membership. There also is my digital case of the month that I post there every month that’s completely free. So you can go, and you can actually cruise a digital slide yourself, which is really fun. It’s sponsored by Scopio, and so that’s there on that website. If you’re a veterinary professional and you want to join the Veterinary Cytology Coffeehouse, that’s on Facebook. I’m also on Instagram, @clinpathkate, where I share cool cases there too.
[00:40:59] Aleksandra: Okay. This is all going to be in the show notes. Thank you so much, Kate, for your time, and I wish you a great day.
[00:41:07] Kate: Thank you. Thanks for having me.
