Let's Talk Micro
151: Ace the Boards: Microbiology
[Music] Welcome to Let's Talk Micro! Hello dear listeners, welcome to another episode of Let's Talk Micro. As always, I hope you had a great week. And you can always find Let's Talk Micro on Apple Podcasts, Spotify, Amazon Music, Good Parts, whatever you listen to podcasts, you can find Let's Talk Micro. As for our social media, I am on Instagram, TikTok and YouTube as Let's Talk Micro, a LinkedIn as Luis Plaza on X as Let's Talk Micro 1. And I have an email address which is Let's Talk Micro at Outlook.com. So either via social media or via email, you can send any feedback, any topic suggestions, they are always welcome and appreciated. So please go ahead and subscribe to the podcast, download episodes and if the app allows you to do so, please go ahead and leave a review. Thank you so much for the support. And of course, if you are looking to learn more about antibiotics, please check out www.learnatibiotics.com and the Learn Antibiotics book available on Amazon. These resources include cheat sheets, practice tests, games and more. And they are being used by thousands of people worldwide and may be helpful for you or your colleagues. Great resources from Dr. Timothy Gothier, a very passionate pharmacist. And if you haven't checked out the previous episode, please go ahead and do so. It was a great episode where Dr. Joel Mortensen and he was a guest before in the podcast. If you remember the name or if it sounds familiar, he was a guest in the two episodes that I did about a laboratory in Guinea, which is in Africa. And in those episodes, he talked about his experiences and helping set up a hospital and training laboratory technologies in microbiology. Those are wonderful episodes. So definitely, if you haven't checked them out, please go ahead and do so. But in this episode, the last episode, he came in along with Christina Cox and they talked about a study they did. And those of you that work in the lab and you deal with blood cultures, you know, you have blood culture instruments and then you have blood culture bottles. And then when they're positive, you typically perform an identification in a molecular system that you have. We have mentioned them before, you have the E-plex, you have the biofire. So by the time you get the plates on the bench, you might have an idea already, depending right on on the organism, if that system has targets for it. And at that point in time, you confirm that idea, you proceed to the step-tabilities. Maybe you're doing direct step-tabilities, depending on the organism. But the point is that you also sometimes, you know, you get body fluids that are placed in blood culture bottles and then you place those on the instrument. And if they're negative, right, you result them after, let's say, five days, they're negative. And if they're positive, then you go ahead and play them and then you evaluate them on the bench. So in this episode, Joel and Christina, they talked about a study that they did. And what they did was, they took those body fluids that were incubated in blood culture bottles, and they perform identification on the E-plex system. And then they talk about their results. So this is a very interesting topic, because you imagine if we were able to do this, not only this, maybe place like all body fluids in blood culture bottles and they incubate them in the instrument, that will free up so much time for the text. As you know, especially if you're working in a large facility where you have a lot of body fluids, you know, you get a lot of negative. And that's a lot of time that you spend, you know, scanning plates, looking at plates. But definitely with the study, if the instruments, those systems, you know, like the E-plex or the BioFire, if you could place those samples there and get an ID, then that can help the patient receive the appropriate therapy, you know, even earlier. Sometimes, you know, you can take depending on your process, you know, you can take over a day to get an ID. Because as you know, once that that fluid, you know, if you put in a blood culture bottle and then it's positive, you have to plate it. Or if you're doing a regular method, you receive it in the lab and then you have to play it. And then the next day, you look at it. And then, you know, thinking maybe you have mold it up and you can ID it right away. If not, you maybe have to do something like the ITEC or another system. And that takes longer. So definitely, I would love to see more studies like this done up there. Maybe someone can do one with the BioFire and see how it compares. So definitely a very interesting episode, very interesting topic. So please check it out if you haven't already. Okay, so I'll go ahead and be brief. So today's episode, we are here to talk about a textbook, a microbiology textbook. And the guest is Dr. Colin Lilly. And he is actually a listener to the podcast. So Colin, thank you so much for listening and for your support. I appreciate it. But he joined the podcast to talk about his book, which is titled Ace the Boards, a concise review of clinical microbiology. And Dr. Lilly is a resident, pathology resident. And he talks about a resource that is called Ace My Path, you know, where it has some tools for pathologists to study and has a lot of information. It's a very a lot of educational value. And in those resources, you have something that is called Ace the Boards, which is a series of textbooks. So this microbiology textbook is part of it. So in the episode, he talks about the whole process, the challenges of creating a textbook, you know, what's in the textbook. So definitely a very interesting resource. And I'm putting the links on the show notes. So please check them out. So all in all, it was a great episode. Such a pleasure talking to Dr. Lilly. So let's go ahead and listen to it. So one thing that I love about doing this podcast is that I always, you know, at some point in time, I get to talk to people that either follow social media or, and you know, this person had been following for a long time, and they actually listen, you know, listen to the podcast. And I also love when people, you know, they do initiatives and they do things like coming up with textbooks and then doing things that make the profession better. So I saw recently that a textbook of microbiology came out, titled Ace Divords, a concise review of clinical microbiology by Dr. Colin Lilly. Today he is here to talk about the book. Dr. Lilly, welcome to Let's Talk Micro. Thank you so much for having me. I'm so excited to be here. My pleasure. Like I was saying of the of before we started recording on, thank you for listening to the podcast. I appreciate the support. So let's go ahead and start with a quick introduction about what you do and anything else that you want to tell the audience about? Yeah, so I am a current pathology resident at UCLA. I am pursuing anatomic and clinical pathology. I before this went to medical school at Loyola University Chicago. I pursued a MD as well as an MA in bioethics and health policy. But before that, I was actually in the lab. So I was a microbiologist. I worked at the CDC for some time. And before that, I was actually working in a lab and I received a master's in microbiology as well. So I definitely have a long history with microbiology and I definitely love it. And it's been interesting kind of growing with it along in my career because I took microbiology courses in undergrad and then worked in the lab and saw it in a different perspective. And then seeing it in grad school is completely different. And then medical school is a whole new world as well. And now moving on into pathology, kind of the clinical microbiology side and also now kind of the management side of things. So it's been a really fun time so far at least. And it's been cool kind of having microbiology there as I grow. You know, I definitely love microbiology. I'm a nerd. So I like all that stuff. And it's really cool to get to see the clinical side as well, you know, during medical school and all of that. So it's been cool. And I know we're going to probably talk about pathology in general in a little bit, but it's a great field. And as you know, the clinical microbiology realm is amazing. And all the people that work in it are super cool. So it's always great to meet new people. Yeah, I definitely agree with that. And you know, and I said this over and over on the podcast. And you know, before this pretty much I was who I knew was from people from my lab and things like that. And then once I started doing this and going to conferences, you know, I see that this this whole world up there. And a lot of people, yeah, they're so they're always so nice. And people want to talk about what they're doing, the research and everyone is just from it's been a really positive experience. And and yeah, I also understand what you're saying as someone that's I'm doing a master's in microbiology myself. And the way that you start seeing things a little differently and and all the different perspective. So definitely an experience. And you know, working at the CDC, that was quite the experience I've been. I mean, I I had the fortune of having some guests from the CDC, also a great team of people that always say yes to the episodes and very interesting work they do. Yeah, it's an incredible place. They do amazing work. I know it's been a challenging few years for them as well, you know, dealing with pandemics and outbreaks, but they're, you know, they always truck through, they make it through, they do great science there. They make great discoveries and they're really, really good diagnosticians. Yeah. And you know, like I said, I do want to ask about, you know, what pathologists do. And, you know, in the lab, we do have contact with pathologists. And we definitely know, like, for example, when we're in hematology and, you know, we have those slides that we send to the pathologists, we know that they also work as, you know, medical directors and, and things like that. But outside of that, maybe for the audience, and so they know pretty much, you know, what kind of training do you need to do to become a pathologist, you know, after completing medical school and what are the career options as women? Yeah. Pathology is really a very diverse field. And it's a very, you know, a small group of people that go to medical school and up pursuing pathology. I think it's around 1% of medical graduates. So it's a very small group of people. But it is an incredibly diverse field, like I said, so you can pursue anything in anatomic or clinical pathology, which is kind of the big umbrellas that split the fields in pathology. So anatomic pathology kind of deals with more of the tissues. They also deal with autopsies and cytopathology as well. So any of those specimens that come out of the body during a surgery would go to pathology, and then we would make some kind of diagnosis on it. That's the anatomic pathology side. For the clinical pathology side, it's anything in the lab. So that includes clinical microbiology, hematology, chemistry, toxicology, immunology, those kinds of things, as well as like immunogenetics and molecular. So there are many, many different things you can do once you go into pathology residency, and you can kind of sub-specialize with a fellowship, or you could practice general practice pathology, where you kind of just do everything. With that said, it is kind of overwhelming learning every single thing in any diagnostic field, you know. So it is challenging in residency, because you really do have to get at least a bare grasp of everything to pass boards, a bare minimum grasp of everything, I guess, to pass boards. But it is a great place if you love to learn. It is an amazing field if you really like to tie laboratory medicine, basic science, and clinical care altogether. The diagnoses we make change patient care every day, and it's a very exciting and also rewarding field to be in. And on top of that, I mean out of the medical specialties, it has a pretty good lifestyle. So you're not working really long hours like surgeons, and you don't have to worry as much about outpatient clinics and stuff like that, because we don't really have those kind of interactions with patients as much. You can interact with patients, and you can do stuff like see patients inside of pathology if you want to do ultrasound-guided fine needle aspirations, or if you want to do transfusion medicine, you can do apheresis clinics. But in general, it's a good lifestyle. It generally has a pretty low burnout rate. So as someone going through medical school, seeing a lot of people pretty burnt out during COVID, it was kind of a breath of fresh air to see the pathologists all happy. So yeah, that's kind of the general overview of pathology, and it's kind of how I chose it. But I also was interested in it before, because I knew pathologists at the CDC who were laboratory directors, or they decided to kind of go down that clinical pathology route. But there's also infectious disease pathologists, people with Emory and CDC, they kind of work together with those things. So it's very diverse. You can get involved with microbiology. You could also not, you know, play if people don't. But that's kind of how I ended up choosing the field. Thank you. Thank you for that. That was great. You know, I'm just going back real quick to something that you said earlier. You know, I love how you said, you know, like, I am, I am a nerd. And that's, you know, I loved that one. We embrace that and just, you know, so am I. And I just like, I love this. And that's one of the things that I just want to put out there when I, when I talk to people like yourself, or, or if I go to events where, you know, microbiology just gathering, it's like, you know, everyone is just embracing their, their nerdiness. And I just, I love it. So as I was preparing for this, you know, like, I was doing a little bit, a bit of research. And I saw that there's something called Ace My Path. Maybe can you talk more about that? Yeah. Yeah. Ace My Path is a group of pathologists and trainees, kind of from around the world, honestly, who help put together resources for pathology trainees. As I said, pathology is a very broad field. So every single rotation you go through, you really do have to learn as much as you can. There aren't a ton of resources out there for trainees to kind of have a focused learning objective for each of the rotations. And it can be really daunting because you'll pick up a textbook that's thousands of pages long for every single rotation. And that is overwhelming for sure. And so the Ace My Path group, their goal was really to make pathology boards preparation more attainable and kind of a little bit easier and have these resources and various fields from experts around the world to kind of help guide trainees to their eventual board certification. And it started with Himado Pathology because Dr. Akung Shgupta, the founder, is a himado pathologist. And I worked with her actually as an illustrator on one of their first books. So it was a natural kind of match to kind of work with them in the future. But they're a great group of people and their main goal is education. And they've actually adopted a very multimodal approach now. They have digital slides. They fully embraced the whole, you know, digital education. They have a ton of free resources as well. So check out their website. It's really great. And they work very closely with path presenter who has a really beautiful and elegant digital pathology pipeline, but also user interface. And for the listeners, I'll put the link to the website on the show notes. If you want to go ahead and check it out. But yeah, you know, right, it's great with technology, so many different ways that you can use to educate and spread information. And I know that all the resources that is my path is one of them is like a series of textbooks, right, called Ace the Boards. Okay, maybe talk a little bit more about those. Yeah, like I kind of mentioned before the Ace my boards. I guess it was really how it started. It was just offering textbooks to help study for different board board certifications and pathology. And one of the first ones was hematopathology. As they've grown, they have over 20 books. I'm pretty sure they have about 27 books now. They're all available on Amazon. And they're basically just a brief intro to kind of study for the board exams. And they really do embrace this kind of collaborative approach to these because textbooks can take a very long time to make. They can be very cumbersome to build and to edit. And so they have a great team of people who basically, you know, work on peer review, they'll work on editing, they'll help you with illustrations. And it's a really a great team. They put out a lot of work. They're very prolific. And that's basically kind of how they've built this Ace the Board's empire. They definitely have some remarkable books that are like really changing pathology education, especially their surgical pathology reimagined book, which, you know, surgical pathology is probably the most challenging specialty in pathology. And so having that as a resource as a training has been really great. Excellent. So let's go ahead and talk about your book. And you already kind of mentioned some things about the challenges that I will ask more about that in a bit. But as far as, you know, hearing you say about the purpose of Ace My Path and how it helps and things like that, you know, there are so many microbiologists out there. So what led you or inspired you to create one? Yeah, that's a great question. I mean, microbiology is such a diverse field. And there are so many different people working in it. You know, there's the laboratories doing that, you know, frontline work every single day. There's also the infectious disease doctors who are ordering a lot of these tests. And then there are pathologists who can be involved with lab management or you can be medical director. So it's a really diverse field. And there's also basic science as well. So, you know, having a really broad variety of microbiology textbooks can be challenging for a pathology trainee because you could pick up one of these, you know, laboratory textbooks that are 4,000 pages long and they're talking about all the methods and everything involved and it can be really overwhelming. And then you can go on the other side and have an infectious disease book where they don't talk at all about the methods, which is kind of what we have to know about. So kind of finding something to balance and blend all of these things together is what kind of sparked this idea. It was initially actually going to be part of a kind of just a resource. I was trying to get a bunch of people together to make a kind of easy approach to clinical microbiology in pathology training. But as things grew, it became a little bit broader than I initially planned. And so, you know, we were just making an outline at first of what we wanted to talk about and what we wanted to kind of mention. And it ended up being, you know, 200 pages long. And I was like, well, we have all of these amazing people contributing to this resource. Why don't we just make it into a book? And so, you know, obviously that's a nice thing to think about, but it's a really, a really hard thing to do. But that's kind of the idea of what, how this came about. And with that said, you know, it can be a challenging thing for, you know, is this the right book for me? So basically, what I'll just kind of give an overview of what it is, and that can help people decide if it's something that they want to get. So basically, it goes over the major divisions in microbiology, from bacteria, viruses, fungi, and parasites. And it offers a short introduction to the field. And it gives some of the, you know, basics about the terminology used and kind of helps elucidate some of those challenging terms in microbiology, because there's a lot, there's a lot of them, especially for a new trainee. And then for the second part of that, like section, it'll just offer bulleted points about each of the microbes. So it'll go over their phenotype, some of the important pathogenic factors, some of the diseases they cause, and then some of the geographic distribution, or how it's transmitted. So this is really helpful for people who are studying for, you know, certification exams, especially involving laboratory techniques, because we have a lot in there about laboratory techniques as well, because for, you know, pathology trainees, we have to know about that. But also people who want to learn more about pathogens, and all the things involved with clinical microbiology and their diagnoses. Yeah, and I saw that, you know, definitely a collaborative effort. And right, I saw, because when you posted on social media, that Rodney Rodriguez, he contributed to the book, which, you know, he's been a guest in the podcast, and he's great, you know, it's been, from when I started this, like, immediately I was introduced to him, and he's like, yeah, if you need a guest, he offered, and that was very nice of him. And every time he's on, you know, I enjoy talking to him, and definitely great. So I saw his name, I'm like, oh, okay, that's pretty cool. Yeah, yeah, I mean, that was probably the most exciting part about this whole process. It was meeting these people from all around the country, and honestly, even the world. But the authors that went into this, I mean, where a lot of them are experts in their field, like Rodney Rodie, Dr. Yi, she's one of the chief microbiologists at her hospital. And, you know, then we also have PhD trainees, PhDs, we also have some pathology trainees as well. And so you really do get kind of a broad variety of perspectives in this book. But, you know, that's the coolest part is because microbiology is such a broad field, you can really get all of these amazing perspectives about these exciting and cool bugs that we get to see. Yeah, definitely. And I think I actually, I met when I was in microboard in 2023, I had the chance to meet Dr. Yi, which I know she's listening to this when it comes out because she listened to the podcast. So, Rebecca, thank you so much for listening. Shout out. Okay, so definitely, thank you for that. I think you answered definitely a lot of the questions that I had. Maybe we can expand a little bit more about video. You mentioned that when you're creating a textbook, you know, you mentioned some of the components, and maybe you can be a little bit tedious. So maybe you can expand a little bit on the challenges that you had as you were making this book. Yeah, I think the first challenge is organizing everything. So, you know, if you're trying to put together a textbook, at least understanding one who your target audience is, which we kind of understood at first. And then two, what you want to cover. And so that was initially going to be a subset of microbes, which ended up growing to become a lot more and almost comprehensive. It's pretty long now, but, you know, that was the first challenge of just outlining everything. And then the second challenge is organizing the book, but also if you have collaborators organizing their contributions, going back through everything, making sure there's accurate, everything's accurate, and, you know, there's proper references and all that. And then the other challenge is putting it all together. So the actual making of a textbook requires a lot of peer review, editing illustrations, and then finally putting it together in a book. So as the main editor for the textbook, I had to approve all those changes kind of as they went, which can be overwhelming at times because, you know, there's people reviewing multiple chapters and all of this stuff going on. But it also is exciting. You know, I can't, you can't be an expert in every single thing. So it's exciting hearing from, you know, Dr. Rody, who's talking about all of their stuff with the rabies and all of his, you know, exciting contributions there. And then hearing how he even thinks about virology in general, when he was putting together his introduction for virology. So it's exciting, you know, being on the other end of reading everything. And then, you know, it's challenging to get everything and get everyone all together and everyone all in kind of one place. And in the timeline kind of all together. But Ace, my boards and, you know, sorry, Ace, my path was really there kind of helping us all along the way. They're very organized and got everything together. So it was a great group to work with, especially since we had kind of had most of the content ready. They were really there to help us with the more challenging things, especially with me being in residency and not having a ton of time to devote to putting a textbook together. What about any, do you have any future plans, anything else that maybe you're trying to come up with in the future or anything like that? So I think one of the next steps for this textbook would obviously be hearing what everyone has to say. One of the biggest parts about textbooks and medical education in general is getting feedback. So, you know, I'm always happy to hear what people think. If there's any improvements they would like to see any additional information, I would love to hear it. We can always include it in the second edition. That's definitely, you know, always on the horizon. Other things, you know, I love medical education. So I'm always interested in novel approaches to teaching medical students about pathology and microbiology in general. So some of that stuff, you know, I work with Path Elective, which is now part of the association for academic pathology. So we're always thinking about ways to expand microbiology education on that platform as well, and, you know, tying together some of the resources that are from this textbook. So, you know, there's always always improvements to make. And then there's always, you know, different ways to approach training. And I think that as a new generation of medical students and medical technologists and medical laboratory scientists, as we're all kind of progressing, we're going to have different ways of learning. So I think that we're going to have to adapt to how people think. We're going to have to adapt to how people learn and attention spans. And I know that it's challenging for senior educators to adapt to that stuff because they've been doing a lot of things the same way. I think that's just something we have to try to battle and we're going to have to work on it together. So that's kind of the next step would be figuring out a way to improve medical education with microbiology and pathology for the next generation and continue to get people inspired and provide the best patient care, whether it be in the laboratory or in the clinic. Yeah, that's definitely one of the challenges. And I guess I never realized because I wasn't teaching before when, you know, in the lab, it's always like the same kind of group of people, but then when you go into a classroom, you have a wider bit of a rate of people. And but definitely, yeah, the attention, that was something that I had to kind of work with the attention span and find different ways. And definitely, in my case, also get you started using more technology like for for education and stuff like that. I mean, years ago, I only use social media for like a personal profile and just, you know, as a way of maybe relax, watch a little video here and there and whatnot. But I definitely discover that how people are using it and the wonderful uses and how you can transmit information and definitely many different ways of learning out there. And where if someone wants to purchase your book, where can they find it? The easiest way is Amazon. So that's the easiest way to find it. You can also go to the Ace My Boards website and yeah. Excellent. And as I said to the audience, you can find the show notes or you can find the link to Amazon and you can also find the link to the website if you want to check those out. And by you do. Well, you know, Dr. Willy, as we come to a close to the episode, is there anything else that you want to have or talk about? Well, first, I just wanted to say thank you for having me. Second, I love the work that you're doing. This has been a really fun podcast to follow. I've learned a lot from you. I've learned a lot from your guests. And you know, obviously, I love learning. So that's that's a good thing. But also, you know, for anyone out there excited about this conversation, you know, definitely reach out to me on social media. If you want to talk more about pathology or clinical microbiology. Also, if anyone's interested in pursuing pathology, I think it's an amazing field. So there's plenty of different resources out there. If you're in medical school pursuing or thinking about pursuing pathology, or if you're in undergrad or if you're in the lab and you're thinking about going back to school, there's so many different pathways to choose from. It's a really exciting field. So if you ever have any questions about that, don't hesitate to reach out. Yeah. Well, first, you know, thank you for that. And, you know, it's always, you know, I love doing this. And as I said before, even if no one listened to it, you know, the process itself and what I have gained from it just by doing research and meeting people, you know, it's just like my education hasn't increased so much. But definitely very wonderful when I actually meet people that actually listen to it and say, oh, yeah, you know, this has helped me somehow. So it's, it's definitely great. And for the audience, yeah, you know, I've been following Dr. Lilly from even like, he was still in medical school. So from a few years ago, and he always responds very quick. So if you have any questions, you know, feel free to reach out and you will definitely get a reply. Well, this has been great. And, you know, it was nice meeting you in person. And thank you so much for taking the time to being less than micro. Thank you so much for having me. My pleasure. And that my dear audience, it's the end of this episode. I hope you enjoy listening to Dr. Lilly talked about his textbook, a concise review of clinical microbiology. As always, I enjoy sharing this information with you. Stay tuned. Great things come in your way. Keep that passion. Thank you to those of you out there. Everyone that listens that supports the podcast. I'm so grateful. With this episode, the third season concludes. And then after this, for the next coming weeks, I'll be playing some older episodes. So it's a great time to catch up if you haven't. Some, maybe some episodes from the back catalog. Great time to listen to other episodes. But in August, a new season will return. But in the meantime, as I said, maybe some older episodes playing. Once again, thank you so much. What a great season for the great content. Great people. I am so happy. So please continue bringing that passion to what you do. It's so important. You do such great work. So, as always, stay motivated. Stay safe. And, of course, continue talking, Michael. Until the next time. Bye.