College of American Pathologists
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cap today

It’s ‘so long’ to business-as-usual at CAP meeting

April 2003
Karen Southwick

For the first time in its history, the CAP is hosting its own annual meeting—CAP ’03, to be held Sept. 10–14 in San Diego.

The CAP has always held its national meetings jointly with the American Society for Clinical Pathology, which planned the program and many of the courses offered. But faced with declining attendance and criticism from members, the CAP approached the ASCP about making changes.

“We’ve been getting multiple and persistent complaints from our membership expressing dissatisfaction with the meeting,” says CAP president-elect Mary Kass, MD, who is overseeing the planning for this year’s event. Among the complaints: The courses were not changed frequently enough and, addressed to a mixed audience of technical people and physicians, failed to reach either group effectively. Many participants felt, too, that the venue, typically a large convention center, was not conducive to networking.

“We felt very strongly that we had to do something to correct the situation,” says Dr. Kass, but the CAP found it difficult to engage ASCP in a discussion. “You can’t fix something if you can’t discuss it,” she adds. “The CAPfeels that an annual meeting is an important event for pathologists to come together, exchange ideas, learn, and see each other. To be able to provide a forum for this is important.”

The result is CAP ’03, a five-day event featuring 107 speakers on a variety of topics, from forensic pathologists’ response to the Sept. 11 disaster in New York to molecular pathology, diabetes, digital imaging, and emerging analytes. The meeting will be held at the Sheraton San Diego Hotel and Marina on the waterfront.

“Our main effort is to make this useful to the practicing pathologist,” says Dr. Kass, director of integrated laboratory services for Medstar, Washington, DC. “We got the best [speakers] out there to offer information that pathologists need to run their practice effectively.”

Among the presenters are several clinicians, such as gynecologist Thomas Cox, MD, speaking on HPV; oncologist Daniel Hayes, MD, on predictive cancer factors; and cardiologist James deLemos, MD, on cardiac markers. There will be a dozen microscope tutorials in which attendees can look at the same slides or other material as the instructors and learn what drove the diagnoses.

“We invited clinicians because it’s appropriate for pathologists to get an idea of what clinicians need to know,” Dr. Kass says. “Sometimes pathologists can be too separated from the clinical side. We thought if we could have clinicians come in and give their perspective, it would stimulate pathologists to go back and talk to their own clinicians.”

The three keywords of the meeting are lead, learn, and connect. “We’re very interested in helping pathologists develop leadership abilities, especially young pathologists and residents,” Dr. Kass says. “There are multiple programs to help them be proactive in their practice and develop a power base within the parent organization.” An all-day program will focus on giving presentations. A few sessions aimed at residents will address issues such as selecting a practice and negotiating a contract.

One of the most important aspects of the meeting is an informal one: the chance to meet with colleagues and the CAP officers and Board of Governors. To facilitate networking, the programs will be held in close proximity. “The meeting rooms are contiguous and we’ve set aside a 20,000-square-foot area called the ‘connection café’ where people can gather in small groups,” says Dr. Kass. In addition, attendees will be able to access the Internet to use e-mail and make appointments.

The CAP is offering menu plan pricing. “You pay only for what you take,” says Dr. Kass. When ASCP controlled the meeting, “they made people pay for a whole day even if you only wanted to take one course.” This year “you can take just one course or register for everything” and pay accordingly.

The planners hope for a turnout of 600 to 800 people, compared with last year’s attendance of 400, she says. The CAP doesn’t expect to break even on the annual meeting for three to five years, Dr. Kass adds, but is spending money now to give people an event they want to come to. CAP leaders hope that investment will pay off in the future, she says.

“When I was a resident in pathology and I attended these meetings back in the early 1970s, there would be thousands of people,” she recalls. But over the years, attendance and interest waned. “We have tried to address every criticism made of the past meetings, the majority of which were valid,” says Dr. Kass. “Our people voted with their feet. They weren’t getting value for their money so they stopped coming. We’re trying to give them real value.”

One course that will be offered for the first time is “Molecular
Pathology: Principles and Practice,” led by James Versalovic, MD, PhD, assistant professor of pathology and microbiology at Baylor College of Medicine and director of microbiology at Texas Children’s Hospital, Houston.

“This is a very comprehensive course,” he notes. Instead of the usual two- or three-hour session, “we’re dedicating two days to one subject.” The session aims to teach the practicing pathologist ‘the A to Z of molecular pathology,’” Dr. Versalovic says. Subjects will include basic methods and technologies; financial concerns and business models, such as how to set up a lab; examples of current diagnostic services; molecular oncology and microbiology; and genetics.

“We’re going to incorporate actual cases” from the experience of the faculty, which includes 11 specialists in the area, he says. “This is for the pathologist who wants rapid immersion in this area.” One afternoon will be devoted to vendor workshops, sponsored by companies such as Abbott Laboratories, on genetic testing and PCR.

With PCR, “it’s possible to do a rapid molecular diagnosis while the patient is still on the table,” Dr. Versalovic says. “It gives you information you can’t see under the microscope.” Having these techniques available “will revolutionize the practice of anatomic pathology.”

The course will be useful even for pathologists who don’t plan to set up a molecular pathology practice, he says. Labs that outsource the testing need to understand the role of molecular pathology and how to interpret results.

The course is cosponsored by the Association for Molecular Pathology and the American College of Medical Genetics.

Last year the CAP’s Strategic Science session on HPV testing had a waiting list, so the highlights of that session will be repeated in a course at the annual meeting. “We will have new information on the efficacy of HPV testing, particularly as a screening test, and any new guidelines available,” says Diane D. Davey, MD, who’s leading the course. She is professor of pathology and laboratory medicine and laboratory director of the cytopathology and bone marrow laboratories at the University of Kentucky Chandler Medical Center, Lexington.

Dr. Davey will also lead one of the tutorials, which will cover squamous cell lesions and specimen adequacy in cervical cytology. Participants will be able to view slides through a multiheaded microscope and learn why a specimen is abnormal or negative. Two other cytopathology tutorials will examine glandular lesions and nongynecologic cases.

For the squamous cell presentation, Dr. Davey plans to bring slides from her own lab and from the CAP Interlaboratory Comparison Program in Cervicovaginal Cytopathology. “We’ll have both common and uncommon cases,” she says. “We’ll learn how to assess specimen adequacy using Bethesda 2001 criteria.” The tutorial is aimed at pathologists, residents, and cytotechnologists.

Oncologist Dr. Hayes will be the featured speaker in the course “Predictive Cancer Factors 2003: What’s Next and What Matters?,” led by M. Elizabeth Hammond, MD, chair of the Department of Pathology at LDS Hospital/Intermountain Healthcare, Salt Lake City.

Dr. Hayes will address the use of predictive markers in treating patients, emphasizing the unique role of these tests in predicting therapeutic responses. The course will focus on currently useful factors such as HER2/neu and those factors that may soon be required by oncologists for patient care, including uPA and PAI-1, EGFR, and Ki-67. Practical approaches for improving diagnostic accuracy will be addressed, including the role of tissue arrays in proficiency testing and better reporting and interpretation strategies.

In an outreach effort, the CAP contacted San Diego science teachers, who will select student projects to be eligible for an award. “The best science students will come as our guests,” says Dr. Kass. “We’re arranging for our residents to be ‘buddies’ to these students and tell them about pathology.” Winners of the awards will attend certain presentations, such as that on molecular pathology, and sit in on the keynote address by Lily Tomlin.

Karen Southwick is a writer in San Francisco.