Dr. Abraham Loo is a practicing surgical pathologist/hematopathologist at Monmouth Medical Center in Long Branch, NJ. He was a fellow in Hematopathology at URMC from 2014-15. Here, he shares more about his career and what makes his work rewarding.
Residency: AP and CP from Madigan Army Medical Center
Fellowship: Hematopathology, URMC (2014-15)
Medical School: SUNY Downstate College of Medicine
Where are you from originally and where do you live now?
I was born and raised in NYC. After medical school, I went active duty in the United States Army and lived out west for eight years before returning to the east coast to do a Hematopathology fellowship. I currently live in Red Bank, NJ.
What was something that made your experience at URMC a positive one?
I really enjoyed my time as a fellow and I left feeling well prepared to sign out heme path cases. I am grateful to have met many wonderful people as well. Dr. Richard Burack was a supportive fellowship director, Pat Leary was a patient teacher of flow cytometry, and Leslie Antinarella was always a kind person in the department. After finishing residency, I did not feel prepared to work with residents, but as a fellow with prior experience as a staff pathologist I enjoyed working with the residents (Sapna, Nisha, Chad, Hani, et al) that rotated through.
When did you first “discover” pathology and what or whom first sparked your interest in it?
I had limited exposure to pathology in medical school and I cannot remember when exactly I “discovered” pathology, but I can say I genuinely enjoy my job. There are good days and bad days, but I enjoy doing impactful work that uses my education and can positively affect people’s lives while keeping me divorced from the emotional aspect of medicine.
How would you describe your job to someone who knows nothing about pathology?
After a biopsy is performed, the tissue (breast, prostate, etc.) is processed and read under a microscope by a doctor, who is the pathologist. The pathologist renders a diagnosis to the clinicians, who directly take care of the patient. If a clinician is concerned for blood cancer (leukemia or lymphoma), I am the pathologist in my practice that looks at those specimens.
Tell us about your family.
I have two wonderful daughters, Calista (7 years old) and Naomi (5 years old), who are my everything.
How do you like to spend your free time? Do you have any hobbies/interests?
I have been practicing Brazilian Jiujitsu/No-Gi grappling since 2006. There are few things as pure as a combat sport, and there aren’t many venues where people from all walks of society can share space engaged in a physical struggle, yet not have any social, political or personal conflicts.
What’s one piece of advice you have for pathology students or trainees looking to start their careers?
Have long term goals in your professional and personal life, but there will be unexpected twists and turns. Don’t neglect your soul on the journey.
Can you imagine working in a lab that has no electronic database and limited technology?
That’s exactly the case in many parts of the world, which is why a subgroup of the American Association for Clinical Chemistry (AACC) traveled to three different countries in Asia this summer to provide training in areas of need.
URMC's Dr. Victoria Zhang leads the Asia Pacific working group, which is part of the AACC's Global Lab Quality initiative. In August, the group of clinical lab professionals delivered two-day workshops in Nepal, Sri Lanka, and the Philippines. The sessions included interactive lectures on laboratory quality specifically designed and targeted to their audiences - many of whom lack basic instrumentation and resources so commonly found in labs across the U.S.
“It is amazing what they can do with what they have,” said Zhang. “They are so excited about the AACC team being there to help. People were so eager to learn and absorb information like a sponge. I was truly humbled by this opportunity to work with a talented team to support this initiative for developing countries.”
The workshops covered topics like assay selection and validation, how to establish and monitor quality control programs, proficiency testing, reference intervals, ISO standards, and total quality management.
The team also visited local hospitals and labs during the tour. The photos shown below were taken during the group’s visit to an academic teaching hospitals at Kathmandu, Nepal.
The specimen management work is very manual.
Test results are entered by hand into the medical tracking book.
The surgical pathology grossing area.
The chemistry lab has one automated analyzer.
In July, a group of 10 high school students from across the U.S. participated in the Explorations in Pathology (EIP) Pre-College Program at the University of Rochester.
The three week program facilitated by Pathology and Lab Medicine faculty, residents, staff, as well as medical students from the School of Medicine and Dentistry included didactic and hands-on activities that not only exposed them to what careers in clinical and anatomic pathology have to offer but showed how pathology fits into patient care.
Students toured laboratories (including a visit to the American Red Cross) and had the chance to get their hands dirty in wet lab sessions in which they handled and examined gross specimens including lungs, hearts, and eyeballs, to name a few.
They were also introduced to microscopic examination and the ways in which pathologists provide diagnoses based on what they see. Students completed group projects with help from faculty mentors that they presented at a poster session.
“What I liked most about my time here were the opportunities I got to have and the mentors I got to work with,” said Hanora Chapman, a rising senior from New Jersey whose group project explored Lynch Syndrome in colonic adenocarcinoma. “This program has opened me up to a different area of medicine,” she said.
The EIP program is led by Jennifer Findeis-Hosey, M.D., a GI pathologist at URMC and instructor for the School of Medicine. For the past several years, Pathology has hosted a summer program for both high school and college students. This is the first year the department has partnered with the University’s existing Pre-College programs.
“Through the intensive 3 week program, we are able to immerse students in all facets of Pathology, not only teaching them ‘what’ of pathology, but also the ‘how’ and the ‘why,’” she said.
During their stay, the students had the chance to meet and learn from residents, as well as medical technologists, pathologists’ assistants, and others.
“I learned that there’s more than being a doctor,” said Maggie Hoare, a junior from Honeoye Falls, NY. “I had a great time and loved how we got the perspective of a ton of people who are in pathology.”
Learn more about the Explorations in Pathology and other intensive pre-college programs offered at UR.
Why Rochester? In this new video produced by the Department of Pathology and Laboratory Medicine, Pathology residents share their reasons for choosing the University of Rochester Medical Center as a place to train and advance, both professionally and personally.
"My biggest piece of advice is go to a program where you like the people you work with and where you feel comfortable, a place where you feel at home."
-Bennett Wilson, D.O.
First Year Resident
"They care about you as a person. They think about you as a person, along with all of your skills, your entire package. And that's a level of attention which I really appreciate that we get here."
-Mushal Noor, M.B.B.S.
Second Year Resident
"I would recommend the program because of the culture. It's a really great place to work. The environment that we work in every day is not only engaging and inspiring and academically stimulating but the people that we work with are wonderful people."
-Linda Schiffhauer, M.D.
Associate Director, Pathology Residency Program
It was a record-breaking year for the flu in the Greater Rochester Region. Just ask anyone working in the Clinical Microbiology Laboratory at Strong Memorial Hospital (SMH), which saw a 37 percent increase in the number of flu tests performed at SMH between July 2017 and June 2018 over the previous season. Our labs performed 17,862 tests in total.
Why the increase? Kim Handley is the supervisor of Clinical Virology, and her team collects weekly data to report to the CDC and also post online. This year’s testing volume was even higher than when the swine flu epidemic hit in 2009.
“It was a record breaking year for testing volume due to several factors,” said Handley. “It was the perfect storm.”
As is typical for the time of year, there was a sharp increase in flu cases during and after the holiday season, when family and social gatherings lead to germ sharing.
Locally, there were more than 6,600 confirmed flu cases in Monroe County, with Influenza A-H3N2 being this year’s primary strain. There were also many cases of seasonal Influenza A-H1N1 and an unusually high number of Influenza B and RSV at SMH.
Handley said that although the lab ran lots of tests, the number of patients who actually had flu was much lower. “Our volumes were up so much but our positivity rate was lower because we were testing so many people,” she said. This could be due to many patients coming to see a doctor when they experience flu-like symptoms.
Flu Hit Country All at Once
Normally, flu season starts in one part of the country and spreads to other regions. But this season, the majority of the United States experienced a simultaneous onset of influenza. This put pressure on manufacturers of the flu testing kits (which contain plastic pipettes and cartridges that are loaded into a machine that gives the results) and the collection swabs and transport materials used to gather the samples from patients.
Testing Materials in High Demand Nationally
The demand for all of these materials grew not only locally, but across the country. In fact, so many people were being tested for flu that URMC was one of many healthcare institutions placed on allocation by their main kit manufacturer. This means the hospital received a limited number of testing kits because demand was so high.
One interesting byproduct of these shortages was collaboration among neighboring healthcare institutions. Lab personnel at Strong shared testing kits and supplies with Rochester Regional Health’s ACM Laboratories and vice versa. When one was running low on something, the others would share.
“It’s not unusual for labs to call each other up when flu season is at its worst,” explained Handley. While this has happened in years past, the collaboration this season was noticeably more frequent.
Lab volumes were high for other reasons. In February, the Food and Drug Administration pulled a widely used rapid antigen test from distribution because it was found that the test had poor sensitivity. This forced several UR Medicine-affiliated hospitals that relied on these tests kits to send their specimens to SMH.
Through it all, however, the laboratory team of medical technologists at SMH rose to the challenge during this particularly difficult season. This according to Nicole Pecora, M.D., Ph.D. is the Assistant Director of Clinical Microbiology at SMH.
“I am proud to be part of such an amazing team,” said Pecora. “Not only did our clinical virologists rise to the challenge of an exceptional flu season, but virtually every member of our laboratory pitched in to deliver the best care for patients, starting from those who received and accessioned the samples to those who picked up extra work and shifts to get through such a tremendous volume. It truly showed the patient and team-directed mentality of our staff.”
In photo: Medical Technologist, Lauren Brooks loads a specimen into a flu testing analyzer at the Clinical Microbiology Lab at Strong Memorial Hospital. This year, the hospital’s testing volume was almost 40 percent higher than last season.
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