College of American Pathologists
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cap today

Backing Bhutan’s soon-to-be-solo pathologist

June 2003
Thomas Dolan

For most physicians, every day is a busy day. But Krishna Sharma,
MBBS, feels the pressure a little more than most. He’s one of two practicing pathologists in his home country of Bhutan, a Himalayan nation with a population of about 800,000 — and his only colleague plans to retire in a year.

When the Los Angeles Society of Pathologists learned of Dr. Sharma’s situation, it was ready to help. Two years ago, the LASOP began the process of establishing a charitable educational fund within the CAP Foundation to support the training of pathologists in developing countries. “We came up with the idea and a way to raise the money, but we didn’t have a recipient,” says Jim Keefe, MD, chief pathologist at Centinela Hospital, Inglewood, Calif.

Through Victor Lee, MD, a pathologist at St. Jude Medical Center, Fullerton, Calif., who volunteers for the nonprofit organization Pathologists Overseas, the society learned of Dr. Sharma’s hopes for additional training in the West. In collaboration with the government of Bhutan, the society in March brought Dr. Sharma to Los Angeles, where he began 15 months of advanced training. Dr. Sharma, who earned his medical degree in India, has two years of formal anatomic pathology training in Myanmar.

Juan C. Felix, MD, professor of clinical pathology at the University of Southern California Keck School of Medicine, Los Angeles, calls the society’s efforts “a shining example of what should be done when trying to help a foreign country. So often you just give money, but you’re not sure how it’s being spent. But this is a very specific intervention, compatible with a country’s social and political needs. For under $15,000, Dr. Sharma will receive training that will have a positive health impact on his entire country.”

Parakrama T. Chandrasoma, MD, chief of anatomic pathology at the Los Angeles-USC Medical Center, will train Dr. Sharma in general pathology, and Dr. Felix will work with Dr. Sharma in obstetrical-gynecological pathology. Dr. Sharma hopes, too, to study fine-needle aspiration, immunoperoxidase technology, flow cytometry interpretation, blood banking, and hematopathology at UCLA, Cedars-Sinai Medical Center in Los Angeles, and City of Hope National Medical Center, Duarte, Calif.

Dr. Chandrasoma has independently sponsored pathologists from his home country of Sri Lanka in the past. He believes that programs like the LASOP’s help pathologists from developing nations “not only increase their expertise, but also implement new technologies in their country. One of the pathologists who came over from Sri Lanka about four years ago went home to set up the first immunohistochemistry lab in his country.”

In line with his government’s plans, Dr. Sharma plans to set up a long-term quality assurance program for anatomic and clinical pathology in Bhutan. “They don’t have any strict programs to ensure the results from clinical tests are accurate and reliable,” Dr. Lee says. “We are also interested in setting up computerization at their central lab. Now all of the reporting is done manually.”

The government of Bhutan, which is actively promoting Dr. Sharma’s training under the auspices of the LASOP, has paid for his travel and his health insurance. It also supplies a stipend that covers part of Dr. Sharma’s expenses while he is in Los Angeles. Before Dr. Sharma’s arrival, the LASOP held two golf tournaments to cover the cost of his training, and Dr. Keefe has other fundraising plans in place to make sure that Dr. Sharma has no financial worries while he’s here. “What has amazed me is how generous people are when they hear about this project,” he says. “People are tripping over themselves to help out.”

The Nikon Corp. is donating a digital camera so that when Dr. Sharma returns to Bhutan, he can e-mail digital images to his colleagues in Los Angeles for consultation. He’ll also, Dr. Keefe says, be provided with about 15 immunoperoxidase stains to help him resolve difficult cases.

Dr. Keefe hopes that other pathology groups will follow the LASOP’s example and offers his assistance to anyone interested in establishing a similar program. “What I like about this is that we’re not going to the Bill Gates Foundation and asking for $100,000,” he says. “We’re doing it ourselves.”

Thomas Dolan is a writer in Anacortes, Wash.