4/18/2017
Background:
Jorge Yao, M.D. is a former URMC Pathology fellow-turned-faculty member. He first came in 2003 as a genitourinary pathology fellow and was offered a faculty position in 2004.
He worked closely with the Urology Department on research and clinical projects, helping to set up the institutional biospecimen repository. After a productive decade, he left in 2013 as an associate professor with an MBA from Simon Business School. He now works for Pathline Emerge in Ramsey, New Jersey.
Education & Training
Dr. Yao received his MD from University of the East - Ramon Magsaysay Memorial Medical Center and completed an internship in general medicine at St. Luke’s Medical Center in the Philippines. He did residency in pathology at Brooklyn Hospital Medical Center and Philippine General Hospital and completed internships in surgical pathology and cytopathology at New York University.
Where are you from originally?
I was born and raised in the Philippines and came to the U.S. to finish my training.
Family:
Wife, Grace Candelario
What first sparked your interest in pathology?
My uncle is a pathologist and visiting him at work sparked the interest, but I like anatomic pathology mainly because it is like being a consulting detective.
How would you describe your job to someone who’s never heard of it before?
I push around bits of people under the microscope then write a report about it.
How do you like to spend your free time? Do you have any hobbies/interests?
I have become a kaizen nerd lately, so most of my free time is spent reading and trying to find small improvements I can implement in my life. I used to have hobbies but they are getting together to file a class action suit for neglect.
What’s one piece of advice you have for up-and-coming pathology trainees looking to start their careers?
The best piece of advice I can give to new pathologists is that no matter how specialized the field becomes, there will always be a need for anatomic pathologists with a good grasp of basic pathology and an excellent foundation of general surgical pathology.
1/16/2017
Name: Krisztina Hanley, M.D.
Hometown: Originally from Hungary and now lives in Decatur, Georgia
Family: Husband, Jim, and daughters, Aideen, 6, and Maeve, 3
Occupation: Assistant professor of Pathology & Laboratory Medicine, medical director of macroscopy and gross rooms, Emory University Hospital and Emory University Hospital at Midtown, rotation director of Gynecologic Pathology, Emory University Hospital.
Education: M.D. from University of Pecs in Hungary (2001), AP/CP residency at University of Rochester Medical Center (2003-2007), Cytopathology Fellow; Emory University School of Medicine (2007-2008), Gynecologic Pathology Fellow; University of Virginia (2008-2009).
Current research: A phase II clinical trial examining an agent that targets folate receptor alpha. She is also working with residents on a project that’s looking at certain pathways that might be connected to a certain pattern of invasion in endometrial cancer. Finally, she is researching a marker called OTP that can distinguish pulmonary versus non-pulmonary well-differentiated neuroendocrine tumors.
What first brought you to the U.S?
My husband is from Rochester and we met when I was still in medical school (in Hungary). It was a long-distance relationship. We wanted to live in same city so that’s what brought me to Rochester. We got married when I was a first-year resident in 2003.
Now you work at Emory in Atlanta, GA, where you completed a fellowship after residency. What aspects of that program made it attractive to you?
At Emory, the cytology fellowship is unique because we see a lot of patients. We have a clinic where we do fine needle aspirations. We perform the FNA ourselves, look at it, and talk to the patient. Sometimes we tell them the results right away. It’s very unique that as pathologist we actually see patients.
A lot of people think pathologists just sit in their office and look at slides or do autopsies in the basement. We actually do see patients. Also, the FNA clinic is in the cancer center (Winship Cancer Institute) which gives us the chance to have a very close relationship with the clinicians, the oncologists.
When you reflect on your time as a resident, what do you think has prepared you most for your career?
In retrospect, there are things I am glad I did even though I may not have liked them at the time. For example, in the gross room we were really busy with gross specimens. I remember very heavy days that made me miserable! I’m glad because even now after many years, I can still handle most of the specimens without any problems. I became very efficient. That’s also true with autopsies. We had a lot of autopsies at UR compared to other programs, and I think that really helped me get through things even when it gets really busy. I don’t freak out anymore.
For frozen sections it was the same way. We used to cut our own sections at UR. At Emory, they have a lot of help from PAs. I’ve been out of training for seven years now and I don’t have a problem cutting a frozen section. This is huge because when residents aren’t available or we have multiple frozen sections in the same time, I can help out.
Did you have any mentors during your time at URMC?
A few people had a major impact on me and the way I approach things: Dr. Thomas Bonfiglio who is retired, Dr. Ellen Giampoli, and Dr. James Powers. From a clinical pathology (CP) side, there was Dr. Marilyn Menegus, Dr. Neil Blumberg, and Nedda Howk from the Blood Bank. I don’t do hematopathology but I can thank (the late) Dr. Ray Felgar and Dr. Arnaldo Arbini for everything I know in hematopathology. The cytotechnologists at UR are outstanding. They are very engaged in resident education. Michael Facik, Donna Russell, and Mary Ann Rutkowski had major impact in my training in cytopathology and fellowship choice.
How do you like to spend your free time?
I love to bake. I cut back on that because my husband and I end up having to eat everything or it goes to waste, since my kids may or may not like what I bake. I started running after my older daughter was born. In Georgia you can run or hike outdoors pretty much the whole year, so we have hiking sticks for the girls and try to spend as much time outdoors as we can.
What do you think it’s going to take to draw more young people to the field of pathology?
I think they need to get early exposure. Exposure in medical school is very limited and there’s a lack of understanding for what pathologists actually do. So, we need to reach out to medical students and allow them to have hand on experience in our department. This could be sign out, gross room activities, participate in frozen sections, attend tumor boards and come to FNA clinic. Most people, including physicians from other specialties, have no idea how diverse and complex the work of a pathologist is.
11/17/2016
Name: Lawrence (Ben) Fialkow, D.O.
Hometown; Originally from Columbia, S. Carolina and now lives in Brighton
Family; Wife, Alice Rutkowski, son, Duncan, 8
Occupation; He is Medical Director of Blood Services (East Division) for the American Red Cross. This coverage area spans seven states in the Northeast including NY and PA.
Education; He earned his D.O. degree from Des Moines University and began post-graduate training in Internal Medicine at Maimonides Medical Center and at the University of Louisville. He spent the first year of his pathology and laboratory medicine residency at the University of Pittsburgh and finished at the University of Rochester. He later did a fellowship in Transfusion Medicine at Emory University Hospital.
Connection to UR; He was a resident in Pathology and Laboratory Medicine from 2004-08. He now serves as faculty for the Transfusion Medicine Fellowship at UR and is a regular judge for Pathology Research Day.
What first brought you to Rochester?
I had never heard of Rochester before I came here for residency and my wife. She’s a tenured professor at SUNY Geneseo, but even before she got tenure we knew we wanted to stay in the area. I targeted this Red Cross job after my training and it’s worked out very well.
Describe a typical day for you at the Red Cross.
I am part of a team of three physicians located in the Upstate NY, Boston, MA and Farmington, CT, who are responsible for all the Red Cross issues in NY, PA, Massachusetts, Maine, Connecticut, Vermont and New Hampshire. Basically, I’m responsible for any donor issues, blood product issues, or any issues with blood products being transfused at the hospital. During the day I get numerous questions about donors – if they’re okay to donate or how to handle some sort of reaction to a donation. I spend a lot of time on the phone with hospitals giving them recommendations. I’m not necessarily in the office a lot
Why did you choose blood banking?
I was actually trained in internal medicine. I wanted to pick something that would allow me to stay as close to patient care as possible. With transfusion medicine, you’re essentially involved with patient care all the time, and that’s why I went in this direction.
What’s something people may not know about your job?
As a medical director at the Red Cross, I’m one step removed from patient care. A lot of times when I’m discussing issues over the phone, it’s hard for people to understand that I don’t have an office where I see patients on a daily basis. I’m almost more of a manager where I oversee the laboratory and the blood products, but it’s more of a managerial role with a little bit of patient care. I don’t fit into the mainstream of what most consider a physician to be.
What advice can you give medical students or trainees?
If you’re not already decided on a field in medicine, when you go out and do your different rotations, pay attention. I went into internal medicine because I liked the lifestyle and the attitude of internal medicine docs, and was turned off of other careers because I didn’t necessarily see myself as that type of individual.
It’s the same thing with pathology. When you’re going through your pathology residency, think about whether you want to be a clinical pathologist because you like the laboratory side of things versus the anatomical side. Really pay attention to what you what you see yourself being in 10 or 10 years because, ideally, this is the job you are going to keep for the rest of your working life. Make sure you’re happy.
Do you have any professional goals for the future?
I did a lot of research when I was in training, and I’d like to get back more into the research field and maybe publish more.
Do you have any hobbies?
I am an avid runner. In the rain or snow, I am out there running every day. Otherwise, I love reading cheap science fiction and horror novels. The rest of my time is spent being a fulltime dad. It keeps me busy but it’s very rewarding.
9/16/2016
Dr. Darrell Triulzi, M.D., gets excited when thinking about the direct impact his work has on patients.
The former URMC Pathology resident (1986-1990) now serves as the director of Transfusion Medicine at the University of Pittsburgh Medical Center Department of Pathology and medical director of the Institute for Transfusion Medicine.
He originally intended to work in internal medicine but switched to pathology during his second year of residency. After a rotation in the Blood Bank, Triulzi says he found his calling.
“I immediately fell in love with the Blood Bank because it combined clinical medicine and pathology," he said. "It was one of those niches where you could do both clinical and laboratory medicine, and there aren’t many places where you can do both.”
After residency, he completed a fellowship at Johns Hopkins University and later joined the faculty at University of Pittsburgh, where he's worked for the last 25 years. His driving inspiration is finding ways to improve patient care and safety in transfusions, and a practical way to do that is by participating in clinical research.
He has taken part in a number of multi-institutional NIH-funded clinical trials since the 1990s. These studies have addressed such questions as: Will HIV patients who receive transfusions progress to AIDS more quickly? The findings said no. Or, a study published in The New England Journal of Medicine asked, what’s the proper platelet dosing strategy for cancer patients? What about the storage duration of blood in cardiac surgery patients?
A follow up study published in Blood questioned whether it made a difference if platelets are apheresis or pooled, fresh or stored or ABO matched. When results showed that it did not, a number of providers responded positively, saying this information helped them strategically manage platelet inventory. Triulzi most recently began working on an NIH study examining the use of an antifibrinolytic agent to reduce bleeding in cancer patients.
He is co-chair of a multidisciplinary health system-wide patient blood management (PBM) committee at UPMC alongside fellow co-chairs, an anesthesiologist and a trauma surgeon. Like many PBM groups across the U.S. the committee has worked to promote restrictive transfusion practices in clinical settings.
While blood transfusions can be life-saving, there are safety risks linked to using them. Physicians are therefore encouraged to only administer transfusions when absolutely necessary for the patient. Triulzi says this effort is having a real impact in recent years as UPMC has reduced total transfusions by more than 30 percent.
“I’ve always enjoyed taking care of patients and the clinical side of medicine,” said Triulzi. “I think one of the reasons I chose blood banking is because it’s a consultative service to the clinicians that’s not so much looking at slides like most pathologists do. There is a more outward focus.” He added, “Most physicians at the hospital think that I’m a hematologist as opposed to a pathologist, and I take that as a compliment.”
Triulzi has fond memories of his time in Rochester, where he met his wife Mary, a dietician. He continues to keep in contact with longtime mentor, Dr. Neil Blumberg, director of Clinical Pathology, and credits Blumberg with triggering his interest in academic pursuit within his career.
An Albany area native, he and his wife have three children, Leah, 23, Ben, 20, and Sam, 15. In his free time Triulzi enjoys studying American and European history, attending University of Pittsburgh football and basketball games, and playing fantasy football.
9/6/2016
Former Pathology resident, Dr. Lorraine Lopez-Morell, is achieving her dream of being a forensic pathologist right in Rochester.
Dr. Lopez is the Associate Medical Examiner in the Office of the Monroe County Medical Examiner.
She was raised in Puerto Rico and came to the U.S. at the age of 18 to go to Michigan State University for undergrad. While she was very young, her father passed away while waiting for a heart transplant.
This tragedy inspired her to pursue a career that would allow her to help other people. The field of pathology drew her interest.
"I love taking things apart and figuring out how everything works in the body like a machine, and that's what pathology essentially is," she said. "You have to know every single aspect of the human body."
After earning her MD from Columbia University in NY City, Dr. Lopez came to UR for residency from 2010-14. During that time, she was impressed by the work ethic that played a big part in shaping the culture there.
"Most of the attendings taught me what it means to be a real professional; how to do the hard work and appreciate what you've done at the end of the day, and go home satisfied with that,” she said. “I think that was really important to everyone as an overarching theme – to leave no stone unturned and be really at peace with what you've worked on that day."
As a medical examiner, she is doing just that. From testifying in court to dealing with police, attorneys, jury members and those who are laypeople in terms of medicine, she is able to take something as complex as an autopsy and make it easy to understand.
The Office of the Medical Examiner follows statues on what cases require autopsies or what examination is required for a given case. While the chief medical examiner (whom, in Monroe County, is fellow alumna, Dr. Nadia Granger) has discretionary power over what kinds of cases require autopsy, there are several types of cases in which it’s always required: If a person is killed or suspected to have been killed at the hands of someone else, killed by their own hand, or dies accidentally. Dr. Lopez says these requirements are not likely to change anytime soon.
Every autopsy is very hands-on. And while some see digital imaging as a feasible alternative (in some cases), the necessary equipment is costly and the image resolution not up to par with an actual autopsy.
Part of her role includes explaining the cause of death to family members of the deceased.
"Here, if families have a lot of questions, we're happy to speak with them about interpreting what's in our reports," she said. "I find it rewarding, to listen to someone come to the realization that they understand what really happened to their loved one."
In addition to her daily workload, Dr. Lopez is interested in doing research. This month, she will present research on a heart condition called left-dominant arrhythmogenic cardiomyopathy to the National Association of Medical Examiners.
She hopes to explore public health issues in the future, such as the rising number of opioid-related deaths in the county.
After finishing residency, Dr. Lopez completed two forensic pathology fellowships; first at Wake Forest Baptist Medical Center, and at East Carolina University. A self-proclaimed Northeasterner, she now enjoys living in Rochester.
Her work requires the sort of strength and composure that doesn't waver in the midst of tragedy and the need to find answers. For her, though, it’s nothing to be afraid of.
"I'm not affected as much by thinking of death because it's an inevitable part of life," she said. "We can come to accept it, and talking about it is the first step."
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