Pathways to Excellence | Summer 2019

Pathways to Excellence URMC DEPARTMENT OF PATHOLOGY AND LABORATORY MEDICINE

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SUMMER 2019

New Central Laboratory Officially Open A new chapter has begun as UR Medicine has officially opened the doors of a newly expanded and renovated building that will serve as the health system’s regional central laboratory.

The long awaited move completed its first and largest phase in June, as approximately 500 staff from Strong Memorial Hospital and other department sites began moving into the building, located on Bailey Road in West Henrietta. Clinical lab testing officially went live on June 24.

“Consolidating our operations to a centralized facility will allow for sustained growth as we strive to become the laboratory of choice in our region,” said chairman Bruce Smoller, M.D. “Moving is no small task, and I would like to thank our faculty and staff for coming together to make this effort a reality as we look toward the future.”

Bringing different specialized labs under one roof is expected to encourage greater collaboration and allow operations to tackle growing volume in an open-layout space with new automation.

All inpatient and acute testing will remain at Strong Memorial, where lab sections that are staying permanently will relocate to areas that are now being constructed.

Much of the ground floor lab space that was previously home to clinical laboratories and faculty offices will be occupied by the hospital’s emergency department starting in mid-2021.

The physical move coincides with a larger push for system wide consolidation. Our testing volumes surpassed 8 million tests in 2018, and that number continues to grow as more affiliate partnerships form.

Above: Officials cut the ribbon for UR Medicine’s new Central Laboratory on Bailey Road on June 14, 2019. From left, Melissa Allen, Director of Operations for Pathology & Laboratory Medicine, Steven Goldstein, President and CEO of Strong Memorial Hospital, Kelley Suskie, Vice Chair for Administration for Pathology & Laboratory Medicine, Kathy Parrinello, COO and Executive Vice President of Strong Memorial Hospital, Bruce Smoller, M.D., Chair of Pathology & Laboratory Medicine, and Vicki VanDeWalle, Director of Performance Improvement and Projects for Pathology & Laboratory Medicine.

IN THIS ISSUE From the Chair.................................................................. 2

New Fellowships............................................................... 5

Meet the Residents........................................................... 3

Research Day.................................................................... 5

Med Tech Pipeline............................................................. 4

Focus on Faculty ............................................................... 6

CHAIR’S COLUMN

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“At long last, and only with the incredible efforts of innumerable people, we will enter a new phase in the history of our department.”

appy springtime (as I am writing this)! Finally, some flowers in bloom outside, and as is annually the case, a feeling of starting over with excitement pervades the department.

This year, the excitement is even more palpable as the UR Central Laboratories at Bailey Road is a reality.

The building is opened and new equipment arrives daily and begins its validation process. The building is beautiful, spacious, light and airy and has the feel of the state-of-the-art modern laboratory. We held a ribbon cutting ceremony on June 14 and the official opening date is June 24. At long last, and only with the incredible efforts of innumerable people, we will enter a new phase in the history of our department. A special mention to Vicki VanDeWalle who was just awarded a Meliora Award from the University for her central role in this process!

In concert with the new facility, we continue to move forward with our efforts to consolidate laboratory functions across the enterprise of affiliated hospitals. The efforts of Drs. Zhang and Paczos, our Enterprise Committee and our laboratory colleagues at the affiliated hospitals have moved us a long way towards this goal. This is an evolutionary process, but all of the affiliates are participating to various degrees at this point. Ultimately, the goal is to standardize test reporting and improve the processes across the enterprise, while relying on decreased costs for testing through consolidation to realize better laboratory revenues for the entire enterprise.

I am very pleased to introduce two new faculty members. Dr. Rossana Kazemimood is joining our GI pathology section from Indiana in July. Dr. Zoltan Oltvai will be joining the team as the Director of Molecular Pathology in October.

He is joining us following a fellowship at Univ. Minnesota and 14 years on the faculty at Univ. Pittsburgh.

I am also pleased to report that we entered this year’s residency match in search of three candidates and we filled these spots with wonderful people. Dr. Anthony Cardillo will be joining us as will Drs. Irene Chen and Chauncey Syposs. All were ranked highly on our list and our team is excited at their upcoming arrivals.

On a sadder note, I want to share the decisions of Drs. Sherry Spinelli and Paul Rothberg to enter into retirement. Sherry’s last day was in April and Paul will be leaving URMC at the end of December. I want to thank both of them for the wonderful contributions they have made to the departmental missions.

Finally, just a quick personal note to share. I was officially re-appointed to the position as Chair of the Department of Pathology and Laboratory Medicine for another five-year term set to begin on July 1, 2019. I want to sincerely thank everyone in our pathology community for this honor and privilege. I have said this many times, and I truly believe it. This is the best job I have ever had and I am eternally grateful to all who make it feel that way for me. I hope I will do right by the department moving forward. We have a great team and they deserve nothing but the best. Thank you, again, for this opportunity.

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MEET THE 2019 RESIDENTS Name: Chauncey Syposs Hometown: Tonawanda, New York Medical School: Rocky Vista University College of Osteopathic Medicine What was your Plan B for a career: Molecular Biology PhD at SUNY Buffalo Hobbies or interests: Cycling, hiking, cooking, gardening, collecting records, reading Family: Hopefully starting one soon with my fiancé Jessica Fun fact about you: I’m a big history and philosophy buff

Name: Tony Cardillo Hometown: Cabot, Arkansas (30 min. from Little Rock!)

Medical School: University of Arkansas for Medical Sciences What was your Plan B for a career: Computer Science Hobbies or interests: Fencing, 3D printing, hiking Family: Just me and my fiancée, Angelica Fun fact about you: I have seen every James Bond movie; it’s the reason I got into fencing as a hobby!

Name: Irene Chen Hometown: Taipei, Taiwan Medical School: St. George’s University What was your Plan B for a career: Interior designer or Industrial designer if not in the medical field Hobbies or interests: Cooking, traveling, building paper models, building and collecting Lego Family: Parents and one younger brother Fun fact about you: I went to school in different countries, including Taiwan, Australia, USA, and Grenada. I was also a medical technologist before medical school

WHERE THEY’RE HEADED Sohaib Abu-Farsakh (fellow) – Hematopathology fellowship, University of Indiana Joseph Blitman (resident) – Forensic Pathology fellowship, Pittsburgh Caroline Bsirini (resident) – GI Pathology fellowship, URMC Andrew Dunn (fellow) – Dermatopathology fellowship, Duke University Monisha Bhanote (fellow) – MD Anderson, Jacksonville Hani Katerji (resident) – Hematopathology fellowship, URMC Hasan Khatib (fellow) – Breast fellowship, URMC Sung Eun Kim (fellow) – X-Cell Laboratories of Western NY Rana Ajabnoor (fellow) – Breast fellowship, URMC Adel Malek (fellow) – Future plans to be determined Shira Winters (fellow) – Laboratory director, CSL Plasma of Western NY Heba Mostafa (fellow) – Faculty position, Johns Hopkins School of Medicine

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THANK YOU, DR. KIRKLEY! This summer, Residency Program Director Scott Kirkley, M.D. passes the torch to Associate Program Director, Linda Schiffhauer, M.D. We appreciate and thank him for his leadership!

MED TECH PIPELINE PROVES SUCCESSFUL In an effort to combat a statewide shortage of licensed technical staff, the strategy to grow our own medical technologists is paying off.

Since it launched in 2017, the one-year advanced certificate program housed at URMC has led to the addition of 20 licensed staff to UR Medicine Labs. This is welcome news as clinical labs face a critical shortage of qualified med techs.

“It’s so important for us at URMC to be able to have this program,” said Kathy Parrinello, executive vice president and COO of Strong Memorial Hospital. “We’ve learned the best way to fill the pipeline of medical technology professionals is to train our own.”

This year, the program also celebrated national board accreditation through NAACLS through 2024. Parrinello offered encouragement to the newest cohort of program graduates, saying, “You are well trained and very well equipped as you go out into the world.”

Led by education coordinator and program director Vicki Roberts, students receive hands on instruction from department faculty and technical staff.

“It’s wonderful when you can watch a long term plan come to fruition, especially when we have a shortage of technologists across New York State,” said chairman, Bruce Smoller, M.D., to the graduates. “Your futures in healthcare are bright and stable.”

The training program has already filled each of its 12 spots for the 2020-Kathy Parrinello, executive vice president 21 academic year. Learn more at www.MedTech.urmc.edu. and COO of Strong Memorial Hospital

NEW FORENSIC PATHOLOGY FELLOWSHIP Our department is pleased to announce a new partnership with the Monroe County Office of the Medical Examiner has led to a new one-year ACGME forensic pathology fellowship.

The fellow will train primarily at the Medical Examiner’s Office, which investigates 3,000 deaths each year, and actively participate in on-scene death investigations and court appearances. He or she will accompany forensic pathologists and later give testimony in court cases in which they have participated. The fellow will also train at the County’s Crime Lab in areas including forensic anthropology, forensic

toxicology, and firearms.

This is only the second forensic pathology fellowship available in the state.

Dr. Nadia Granger, Monroe County’s chief medical examiner and a graduate of our pathology residency program, hopes the opportunity will draw graduating residents to the region.

“The University of Rochester is well known for graduating pathology residents who pursue forensics as careers,” said Granger.

“Exposing a graduating resident to an entire year under our tutelage would improve the odds of that resident staying in the Upstate area for work.”

The department is now recruiting a fellow to start in July 2020.

ALSO COMING SOON • • •

Our department has submitted two new fellowships for ACGME approval for fall 2020: Pediatric pathology and dermatopathology.

Pending final approval, these would bring the total number of department fellowships to nine, six of which will be ACGMEaccredited.

Additionally, the Medical Center has given approval for our department to increase its number of 16 residents from 16 to 20 over four years moving forward.

THANK YOU FOR GIVING BACK We are grateful for philanthropic support that allows us to maintain and accelerate clinical, educational, and research initiatives. To make a tax-deductible gift today or as part of your estate plans, please visit www.pathology.urmc.edu and click the “Make a Gift” button, or contact Melissa Head at (585) 273-2890 or melissa.head@rochester.edu.

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RESEARCH DAY 2019

Residents, graduate students, and fellows presented at the annual Pathology Research Day at URMC on Monday, June 10, 2019.

GRADUATE STUDENT TRAVEL AWARDS – POSTER PRESENTATIONS John Bachman, MS - Juvenile Radiotherapy Damages Mouse Muscle Stem Cells, Impairing Muscle Maturation and Regenerative Capacity Madison Doolittle, MS - Zbtb40 Loss-of-Function Inhibits Osteoblast Mineralization, Affecting Lumbar Spine Bone Mass in Mice

Felicia Gilels, MS - The role of JAG1-mediated Notch signaling in the maintenance and function of cochlear sensory cells Jerry Saunders II, MS - MSTP 16, 16-Dimethyl Prostaglandin E2 (dmPGE2) and Lisinopril Cooperatively Improve Survival and Mitigate Injury in Hematopoietic-acute Radiation Syndrome (H-ARS)

RESIDENT ORAL PRESENTATION AWARDS Mushal Noor, M.B.B.S. Clinicopathologic Characteristics and Outcomes in Appendiceal Neuroendocrine Tumors: What’s in a Name?

Phoenix Bell, M.D. - Analysis of Histology Processing Quality: A Regional System Perspective

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Anna Israel, M.D. - PD-L1 Expression in Salivary Duct Carcinoma: Does the Scoring System Matter?

Department of Pathology and Laboratory Medicine University of Rochester Medical Center 601 Elmwood Avenue, Box 626 Rochester, NY 14642

FOCUS ON FACULTY: HUINA ZHANG, M.D., PH.D. Dr. Huina Zhang has two loves in her professional life: patient care and research.

Today she is a breast and gynecologic pathologist at URMC, where she continues to study widely on breast cancer – most recently on lobular cancer and its relationship with HER-2 overexpression. While Zhang says her desire to help people is what first inspired her to go into medicine, she fed her interest in research pursuing her MS and Ph.D. in pharmacology in China.

She ultimately ended up going back to clinical care but says she’s thankful for that time to develop her skills as a researcher.

“I learned how to think in a rational way, how to design a study, interpret the results and have them published,” said Zhang. “It laid a foundation and helped me later with interpreting pathology findings using logical thinking.”

She moved to United States first as a postdoctoral fellow, then as a research faculty at the University of Michigan. When her husband took a job in San Diego, Zhang followed and entered pathology residency in 2013 at nearby Loma Linda University.

“A major reason I chose pathology was because I wanted to do research and clinical work, so that made it the best specialty for me,” she said. While there, she was named chief resident and recognized as the “Most Valuable Resident” and “Best Team Player” by her department. Loma Linda also provided opportunities for her to do rotations in an outpatient clinic, where she found her interest in breast and gynecologic pathology, as well as an elective rotation in women’s health pathology at UCLA. 6 URMC DEPARTMENT OF PATHOLOGY AND LABORATORY MEDICINE

After finishing residency, Zhang continued pursuing her interest in women’s health by taking a gyn/breast clinical instructorship at the University of Pittsburgh, Magee-Women’s Hospital – where Zhang says she greatly enjoyed her training.

While there, she also did extensive research in breast and GYN pathology and published several articles including three as the first author.

It was fellow UPMC alumnus and breast pathologist, Dr. Ioana Moisini, who played a role in recruiting her to come to URMC when a breast pathology faculty spot became available.

Zhang will celebrate her one year anniversary at URMC this month, and she says she’s grateful for the chance to work alongside leaders in the field (such as David Hicks, M.D. and the rest of the faculty).

Her current research explores HER2 positive nonpleomorphic lobular cancers, which challenges the widely held belief that these cancers are generally HER2 negative. She and other researchers have found that 5 or 6 percent of nonpleomorphic lobular cancers fit the first category, which helps to better inform targeted therapy for treatment. Zhang presented these findings at USCAP 2019.

In the future, she wants to further explore her interest in the lobular breast cancer and HER-2 in the breast and gynecologic cancers–including HER-2 mutation.

“I want to know the role of HER-2 in these cancers and see if more tests can help to select the appropriate patients for getting HER-2-targeted therapy,” she said.

Outside of work, Zhang enjoys biking, jogging, and watching movies with her husband, Yabo. They live in Brighton and enjoy family games of badminton together with their eight-year-old son, Alvin.