It’s often said that when veteran employees leave an institution like Yale School of Medicine, a wealth of knowledge goes out the door with them. That was that case last year when Peter A. Humphrey, MD, PhD, retired after a long and distinguished career as a pathology professor and internationally recognized genitourinary (GU) pathologist.
But some of the knowledge Humphrey amassed over four decades—in the form of hundreds of slides—is being converted to digital form, so training pathologists at Yale and beyond will continue to learn from the rare cases he diagnosed.
“You’re preserving an important piece of a long career of experience and wisdom,” says Andrea Barbieri, MD, associate professor of pathology and director of the Yale Pathology Residency Program. “The digital piece of it allows it to live infinitely, because slides, as you know, are tangible and break.”
Roxanne Wadia, MD, assistant professor of pathology, is overseeing the digital transformation of Humphrey’s slide collection, which numbers in the high hundreds. “We envision this as something that can be shared with our residents, our fellows, and hopefully, as a pathology atlas,” she says.
‘An amazing resource’
So far, around 200 slides have been digitized. The de-identified slides will reside on a secure platform where Yale residents and fellows can access them. It’s still too early to know all the ways in which this resource will be utilized, but it’s expected to initially be used to supplement resident learning as they participate in the GU service.
“We’re being selective about which ones we are uploading in terms of clarity. We may not need 50 examples of one thing, but there are many useful cases,” Wadia says. “We all know Dr. Humphrey was one of the premier GU pathologists of his generation. He’s co-editor of the World Health Organization book Classification of Tumors of the Urinary System and Male Genital Organs. He’s such an expert in the field that he would receive referral cases, some extremely rare entities that he has saved and preserved. It’s an amazing resource.”
Humphrey used the slide collection to teach residents and fellows throughout his career.
“These teaching sessions included daily GU pathology sign-outs and unknown conferences,” Humphrey says. “I also used these teaching slides and static digital images of them in teaching courses at national and international pathology meetings and in presentations for pathology residents when I was a visiting professor at other institutions.”
Humphrey says he’s pleased that future generations will learn from his slides.
“This is very gratifying. And I am very thankful that Dr. Roxanne Wadia is leading this project.”
See disease in full environment
Residents and fellows will view the slides via PathPresenter, software for digital pathology image viewing and management that’s used by many medical education institutions.
“It allows us, without any identifiers on the slide, to share it an educational way, including making presentations with it,” Barbieri says.
“A lot of the teaching materials tend to zoom in on a specific point of the slide,” Wadia adds. “PathPresenter allows us to interact with the sample more, to look around and see it in its full environment.”
Rajendra Singh, MD, PathPresenter co-founder and professor of pathology at University of Pennsylvania, said sharing knowledge—like Humphrey’s slides—is exactly what they had in mind when they created the software.
“Dr. Humphrey’s slide collection represents a lifetime of mastery, an extraordinary legacy that deserves to be more than preserved; it deserves to be shared,” Singh says. “This reflects the vision we set out to achieve—opening access to world-class pathology knowledge so it can continue to guide and inspire the next generation.”
Significant educational value
Pathology Resident Ujunwa Korie, MD, MS, says the slides will have a significant educational value.
“Having access to carefully selected cases with expert annotations helps us understand not just the final diagnosis, but the specific morphologic features that support it and how an experienced pathologist thinks through a case,” Korie says. “The annotations highlight key diagnostic features, subtle findings, and potential pitfalls that are especially helpful for a trainee. When annotation is done right, it’s almost like sitting at a multi-headed scope with an attending as they walk you through a case.”
Although some of the slides are 40 years old, Korie says they remain a useful learning tool.
“While diagnostic criteria and therapies continue to evolve, the fundamental histologic principles underlying many diagnoses have not changed. In some cases, advances in treatment mean that we may not see certain classic disease presentations as frequently during training,” she says. “So, digitizing historical slide collections helps preserve those classic examples so trainees can still study and recognize them, even if they are no longer commonly seen. This is especially important because these entities may still be common in other regions, depending on where trainees end up practicing.”
‘Like sitting there with him’
Wadia, who did her Pathology residency at Yale, had the opportunity to learn from Humphrey.
“I think of all the residents and fellows who have sat with him and used his slides in the past have gained from his knowledge,” she says. “We’re trying to create that on another platform. Unfortunately, Dr. Humphrey won’t be sitting across from you at the microscope. But with his annotations and his guidance, it will be like you’re sitting there with him and he’s talking you through a case.”
Although he won’t be there to teach in person, Humphrey’s timeless advice for training pathologists is imbedded in his work.
“Your diagnoses can change the lives of patients forever,” he says. “Pathologists and GU pathologists should be leaders in diagnostic medicine, teaching, and research. GU pathologists should be innovators and should be on the cutting edge of discovery—and should translate those discoveries into the practice of medicine and pathology.”