Throughout medical school I constantly encountered new puzzles, but in these instances, the answers had serious implications--the physical and mental well-being of my patients. For example, an elderly patient presents complaining of abdominal pain, intermittent bloody stools, and weight loss over 3 months. A colonoscopy shows multiple polyps and the pathology of the biopsies shows colorectal cancer. However, the diagnosis is not complete without proper staging of the tumor and it is this important piece of the puzzle that intrigues me the most. To ensure my patient receives the most effective treatment, a thorough and accurate determination of invasion and spread of the tumor is required. It is this need for precision and attention to detail that is captivating about pathology.

My fascination for the field began during my senior year of college. I had registered for what was widely considered to be one of the most demanding courses offered at VCU--Honors Vertebrate Histology with Dr. Conway. As expected, I was challenged on a weekly basis. However, unexpectedly, I was enthralled not only by the course material but also by slide review in the lab. Since I always considered myself a visual learner, being able to reinforce the lectures with actual tissue samples was an opportunity I embraced. Also, never before had so many classmates unselfishly tried to teach others what they had observed. Through these experiences, the images of basic cell types and complicated tissue structure such as pancreatic acini interspersed with islets of Langerhans are forever ingrained in my mind. My histology course, along with its unique social environment in the lab, was truly the only undergraduate course I didn’t consider to be “work” but rather an enjoyable and rewarding learning experience.

My experiences in medical school have only reinforced my experiences from my histology course. During M1 year, the chance to observe and dissect a human cadaver in anatomy gave me an appreciation of the intricacies that make up the human body. As an M2, pathophysiology was taught by organ system allowing us to focus on one aspect of the body at a time. The most satisfying part of each course was the inclusion of pathology labs led by residents and faculty, which provided gross and microscopic samples of the disease processes we learned about. Using tuberculosis an example, images of caseous necrosis of the lung supplemented by visualization of acid fast bacilli helped to cement disease process with pathology in my mind. My clinical experiences as an M3 on the wards helped me to recognize various presentations for the same disease processes and to appreciate the clinical workup required to make the correct diagnosis.

With the culmination of my medical school career approaching quickly, I have many activities I would like to pursue during my last year. To further increase my exposure and learning within the field, I will be taking a number of pathology electives during my M4 year which will incorporate various subspecialties, including Surgical Pathology, Cytopathology, Transfusion Medicine, and Forensic Pathology. To gain perspective on the academic aspect of the field, I will be assisting members of the pathology department at VCU in research projects. As the best outcome for patients is the prevention of disease, I am excited about the numerous research opportunities within the field to help accomplish that goal. Lastly, having provided supplemental course instruction in the past and realizing the importance of teaching in medicine, I am excited about the opportunity to teach clinical medicine to M2 students this year. It will provide me with a chance to share my knowledge and experiences while at the same time reinforcing clinical knowledge through collaborative case discussions. I hope this experience can be a basis for future teaching as I would love to share my enthusiasm for medicine and pathology with future students and/or residents.

Transitioning from medical school to residency will be a process filled with new unknowns. However, with my hard work ethic, determination, amiable personality, desire to build upon my medical knowledge, and investigative tools accumulated through years of puzzle solving, I feel prepared to succeed in any combined AP/CP program and beyond. Simultaneously, it will provide me with the opportunity to act upon the best advice my father has ever given me—-to find a career that you will not only excel at but one you love enough to enjoy working in for many years to come. For me, that career is one in pathology.