By - November 21, 2023
ASCP 2023-2024 President, Robert A. Goulart, MD, MASCP, sat down for a round of Critical Values’ “3 Questions With...” to talk about how he got into pathology, lessons he’s learned throughout his career, and more.
I suppose I was the prototypical “science geek” during my junior high school and high school years. You could always find me glued to the TV for “Creature Double Feature” every Saturday, to the disdain of my father on sunny days when he would have preferred my being outside. I remain a “Monsterverse” addict to this day and see every new Marvel or DC superhero movie on opening night. Although I can understand and empathize with the struggles inherent in figuring out one’s life path, I was lucky for the inner voice in my mind pushing me to become a medical doctor. I attended a primarily engineering university for which I received a strong background in chemistry, physics, and math, and spent my senior year in a research lab completing a thesis studying cellular slime molds. Interesting yes, but I knew something was missing. I wished for a career which combined the best of two worlds: science and patient care. At that time however, I didn’t quite know what that field was.
While attending medical school, I was enthralled with the Pathology courses. I enjoy problem solving and decision-making. To me, that is the foundation of Pathology. Through the lens of a microscope, a pathologist deeply impacts the lives of dozens of patients daily. I thought, “How do some not see this as direct patient care…”, as to me the process of determining an accurate diagnosis is the paramount act of caring for a patient.
As my second year of didactic courses was winding down, I made an early but very important career decision. Determined but a bit nervous, I walked down the lecture amphitheater staircase, approached Dr. Gerald Nash, Chief of Anatomic Pathology at the University of Massachusetts Medical Center at that time, and offered my hand while introducing myself. I enthusiastically asked to be enrolled in the year-long post-sophomore/pre-doctoral Pathology fellowship. Interestingly, I was the only student who had made this request for several years. It was a significant decision as I would not move on to clinical rotations with my medical school friends, but in the end, it taught me a profound life lesson: Don’t be fearful of the unknown, take a chance, commit, challenge yourself, for the road less travelled very often offers the most reward.
I worked closely with a wonderful group of residents, fellows, and attending staff, which reinforced that my decision was the correct path for my own professional journey. I was fortunate to complete my Anatomic and Clinical Pathology residency and Cytopathology fellowship at Beth Israel Hospital/Harvard Medical School. During medical school, residency, and fellowship, I was immensely fortunate to have fantastic mentors and role models, including but by no means limited to Drs. Nash, Martin Bur, David Gang, Stuart Schnitt, James Connolly, Helen Wang, Donald Antonioli, Seymour Rosen, and ASCP Past-President Melissa Upton. Not only were these individuals highly accomplished diagnosticians, researchers, and educators, but they were also pleasant, unassuming, and collegial. I can state without hesitation that many of the most sincere, caring people I have encountered in medicine are within the field of Pathology and Laboratory Medicine.
I first became involved with ASCP as a volunteer cytopathologist committee member of the GYN Cytopathology (STAR) Committee some 20 years ago. Dr. Thomas Bonfiglio, a great in the field of Cytopathology and ASCP Past-President, recruited me and was the committee chair at the time. He led with a quiet, respectful, and contemplative demeanor — a true gentleman. I was fortunate to work alongside other renowned cytopathologists including Drs. Ritu Nayar, Syed Ali, and Eva Wojcik. Dr. Bonfiglio subsequently invited me to become committee chair as he stepped down, which then led to an invitation to join the newly formed Commission of Continuing Professional Development (CCPD) which oversees the entire live and enduring educational portfolio of ASCP. This opportunity led me to the ASCP Scientific Advisory Committee, the Board of Directors, the Executive Committee and now the Presidency. My career is an example as to how small, individual steps may lead you to unanticipated, phenomenal experiences. When the gold ring comes by in the carousel, please don’t hesitate, just reach out and grab it.
As a cytopathologist, I enjoy and value the collaborative relationships with my colleague cytologists (formerly cytotechnologists) and lab professionals and have spent my career advocating for the transformative growth of these fields and the critical importance of ASCP certification. ASCP and the American Society of Cytopathology have been my own professional homes, where I have always been impressed by the “team” values both societies hold at their cores. ASCP’s theme “StrongerTogether” resonates with me. This society is truly a professional home where all are welcome. This is the most important lesson I have learned — the value of respect, collaboration, and inclusivity in our field. I am very fortunate to have made many life-long friendships with wonderful individuals, including ASCP staff, pathologists, and lab professional colleagues. If you are actively involved with ASCP, you know exactly of what I speak. If you are not yet a committee volunteer, a member of our local chapters, or a pathology career ambassador, I encourage you to do so. For my ASCP journey, I have received far, far more than I have given, and it is my utmost honor to become President of your society, the largest and oldest in the world dedicated to excellence in the field of Pathology and Lab Medicine.
As a surgical pathologist and cytopathologist, I have spent my career at the microscope. My primary role in each patient’s care has been answering the question which they fear most – do I have cancer? This is an incredible honor but also a tremendous responsibility for which the patient and the clinical team have entrusted me. Although I do not routinely lay hands, I do lay eyes on thousands of patients a year. I am constantly reminded of how fortunate I am to be allowed to see the art and science of the histopathology and cytopathology of their tissue and fluid specimens. Whether you evaluate specimens in the form of tissue biopsies, fluids, blood tubes, microbiologic cultures, flow cytometry, molecular studies, etc., we all participate in the most critical aspects of a patient’s care — the accurate diagnosis, appropriate personalized treatment, and response monitoring for their cancer, acute disease, or chronic condition.
The legacy I hope to leave is not that I was perfect in my efforts and diagnoses, for I was not, but that I did my best, being cognizant of my limitations, trusting and utilizing my pathologist and lab professional colleagues, and treating each patient as I would a loved one. At some point in each of our lives, we will all be a patient in need of compassionate, high-quality care.
If you wish to make a difference in the health and well-being of many, if you wish to enjoy a rewarding career that is science and technology-based, and if you enjoy working in a team-centered, collaborative atmosphere, there are many opportunities to do so through a rewarding career in Pathology and Laboratory Medicine. We at ASCP welcome you.
Team Critical Values