Programs: Postgraduate, Agile education, Research: Cancer, Impactful research
This week is Resident Awareness week (also known as Resident Doctor Appreciation Week). To celebrate, we highlight some of the resident doctors from our programs in our Resident’s Q&A!
Today we feature Dr. Trevor Teich a PGY3 Resident in Diagnostic & Molecular Pathology.
Why did you choose this residency?
I had a fairly strong wet-lab research background before applying to medical school. I worked in a lab for seven years starting as a volunteer, then undergrad thesis student, to MSc student, and then a research assistant. Through that, I gained extensive experience with performing immunohistochemistry (IHC) on rat pancreatic tissue.
In medical school, I thought I would go into internal medicine or general surgery, but I was often struck by how regularly the management of patients would be dictated by the results of their pathology reports and this sparked my curiosity. While on a general surgery rotation, I began to follow specimens from the OR to the surgical pathology area and was absolutely blown away by this seemingly well-kept secret world of pathology (it is really unfortunate that pathology rotations aren’t one of the core rotations of the clinical years of medical school – it’s such a crucial specialty in medicine but there’s often limited exposure for students).
I booked multiple electives in my final year of medical school in different areas of laboratory medicine (anatomical pathology, cytopathology, and a clinical laboratory rotation) and I’ve been in love with pathology ever since.
I really think my early research and IHC experience planted the seed for me to ultimately return to a laboratory-related field. I immediately felt right at home and inspired while on my pathology rotations and that continues to be true to this day.
What’s the best part of being a lab medicine resident?
There are endless examples I could choose from for what I love about being a lab medicine resident, so it is very challenging to choose an absolute favourite part.
One aspect that I love, that is a daily constant, is the unique style of relationship between the resident and staff when compared to other specialties. It really feels like a expert and apprentice educational style. I think it creates a great educational experience where I have the ability to read extensively around cases that are assigned to me. For example, to generate a differential diagnosis, determine how certain types of tumors are graded and staged, stains / additional testing I could order to help pinpoint a diagnosis, etc. I type up my reports, and ultimately have the ability for extensive one-on-one time with the staff pathologist at the microscope to review my work. During ‘sign-out’, the pathologist can then probe and fill gaps in my knowledge, hone my ability to analyze both simple and complex cases and develop practical problem-solving skills. It’s a unique mentor-mentee relationship that really resonates with me and matches my learning style very well.
What research are you working on right now?
I have two ongoing projects at the moment. One is comparing standardized operating procedures (SOPs) for the workup of suspected lymphoproliferative disorders (LPDs) involving the central nervous system (CNS) across multiple collaborating institutions. For this project we have highlighted how variable SOPs can be from institution to institution and we are aiming to create a consensus statement on best laboratory practices for workup of LPDs in the CNS to optimize the use of laboratory resources as well as the detection of these neoplasms.
The second project is a case study that highlights a pitfall of using p16 as a surrogate marker for HPV involvement in oropharyngeal squamous cell carcinoma (OPSCC). Specifically, it is a case that focuses on a patient that had an HPV-positive OPSCC that was p16 negative, and we determined that the cause of the p16-negativity was a heterozygous deletion of the gene that produces p16, CDKN2A. Both projects were selected for platform presentations at different conferences and my supervisors and I aim to draft manuscripts some time this year for hopefully ultimate publication.
Why should someone do a residency in Laboratory Medicine?
I would highly recommend taking an elective during medical school to get a better feel for what the day-to-day is like in pathology. And if you really enjoy that rotation, I would say you should strongly consider applying.
Pathology has phenomenal research opportunities, you get to learn so many areas of medicine, encounter so many interesting pathological entities that you wouldn’t see in other specialties, you have the opportunity to develop an incredible depth of knowledge, and the extensive one-on-one time with staff pathologists is an excellent educational experience.
What do you do when you’re not in the lab?
I mostly spend time with my wife and son. My wife and I are both into running and we typically go for runs together (plus our son in our jogging stroller) on the weekend and we usually register for a couple of races every year in Toronto (most commonly the Sporting Life 10K and the TCS waterfront marathon).
I’ve also gotten really into audiobooks in the last couple of years and am surprised with how many books I’ve been able to finish just by listening while on my daily commute – and this is coming from someone who, prior to starting to listen to audiobooks, read maybe a couple of books in the last 15 years (I highly recommend the app ‘Libby’ if you don’t already have it! Free access to almost 60,000 audiobooks through the Toronto Public Library – just need a library card).
What would people be most surprised to know about you?
I’ve broken the same collarbone three times! (Hockey, hockey, and being pushed by my older brother after beating him in a race when we were little kids). Also, I was born at Mount Sinai.
