cXe GGtQFive years ago in late 2016, George J. Netto, M.D., accepted the role of Robert and Ruth Anderson Endowed Chair, UAB Department of Pathology. This would be his first position at the chair level, having previously served as director of surgical pathology molecular diagnostics at Johns Hopkins Hospital for five years. 

Netto made a big leap from Baltimore to Birmingham to join the team at UAB. A native of Damascus, Syria, his path to pathology chair has been filled with many challenges and opportunities- even a global pandemic- that require ongoing adaptation and a steadfast vision for a constantly improving operation. 

Today Netto runs UAB Pathology with a team of more than 300 faculty, trainees, and staff members from his office in the West Pavilion of UAB Hospital. The department is one of the largest academic pathology departments in the country. 

It was word of mouth and reputation about UAB Pathology that first interested Netto in the open chair position, he recalls.

"Dr. Kevin Roth, who had previously been chair, visited Johns Hopkins while I was there and spoke so highly about the department and its achievements, I became interested," Netto recalls. "After a conversation with the Dean [Selwyn Vickers], and the more I explored, the more I became attracted by the vision for the institution, especially the shared value and belief in developing a precision diagnostic pathology program."

His interest in UAB was further enhanced by his idea for the development of a Genomic Diagnostic Lab (GDL), among other highlights.

"Clinically, I wanted to address the future needs of where the field is heading with genomic diagnostics. I recognized that the department has long focused on experimental pathology," he says," and I realized my strengths and experience in the clinical aspects of the field would be valuable for making the changes that were needed in that area to move the department forward. From investing in genomics and subspecialized expertise to attracting new talent, the department was ready for a change of guard."

Netto says he also recognized that UAB Pathology's emphasis could focus more on translational research. In the realm of education he, "wanted to impact how pathologists are trained- I wanted UAB to be a leader in how fellowships were run and in attracting trainees."

Netto rose to the rank of professor of pathology, urology and oncology during his tenure with the Johns Hopkins University School of Medicine, from 2005 to 2016, specializing in genitourinary pathology. An internationally recognized clinician-scientist, he worked with a team to develop a new test for urothelial cancers that is less invasive and more accurate, called UroSEEK- work he continues to advance at UAB. In 2018, Selwyn M. Vickers, M.D., FACS, dean of the UAB Heersink School of Medicine, CEO of the UAB/Ascension St. Vincent's Alliance, recognized Netto as the third-ever recipient of his prestigious "Featured Discovery" award for his work.

That accolade is one of so many that the department has had since Netto took charge, and he credits the faculty, staff and trainees who make up our team for the success. As a leader, Netto has made a policy of ensuring that colleagues throughout the department receive acknowledgment for their hard work. The result is evident in the many teaching, mentoring, research, diversity, and leadership awards our department's faculty, trainees and staff have received during his tenure. He credits the support of his colleagues in the department, and leadership throughout the medical school and hospital. 

"Coming here, I didn't imagine I would have so much support from other department chairs, and engagement and encouragement from the Dean," Netto says. "Pathology is integrated into the leadership here, and everyone has been so knowledgeable about the field and its role in medicine."

The individual successes and, sometimes, struggles of five years of work are too numerous to list, but several highlights stand out from the past half-decade. These include:

  • Growth of our clinical service portfolio
  • Building an expanded leadership team
  • Expanding our training portfolio and establishing new leadership in education
  • Rebuilding our experimental pathology portfolio and establishing endowments
  • Supporting the institutional response to the pandemic
  • Wellness, diversity and inclusion initiatives
  • Faculty development and recognition

In 2020, Netto was named editor-in-chief of Modern Pathology, an international journal with an impact factor of 8.045, replacing prior editor of 20 years John Eble, M.D. As editor, Netto initiated a monthly podcast, “ModPath Chat,” in which he interviews authors of the latest articles published in the journal. The podcast celebrated its one-year anniversary in late 2021.

Netto has established himself as a steadfast, honest, encouraging leader whose ability to elevate individuals’ goals for the greater good of the department has been demonstrated countless times over the past five years.

“From the get go, Dr. Netto’s singular focus was on raising the UAB Pathology profile,” says Vishnu Reddy, M.D., Division Director, Laboratory Medicine, who has been with the department 30 years. “This was very evident in the last five years, through significant growth of diagnostic molecular pathology, anatomic pathology, laboratory medicine diagnostic services, and the expansion of pathology outreach. Now we are moving to improve our digital pathology footprint as well. Overall he has done an excellent job in faculty recruitment, supporting faculty goals and resident/fellow training enhancement.”

Going forward, the dream of a freestanding, multidisciplinary Genomic Diagnostic Laboratory will come to fruition. Netto established the Division of Genomic Diagnostics and Bioinformatics, recruiting Alexander “Craig” Mackinnon, M.D., Ph.D., as Division Director. The team has since grown to include six full-time faculty, a fellow, and an informatics team, and amassed several state-of-the-art platforms in a dedicated hospital space to build test panels that will soon allow for genomic diagnostic testing throughout our region.

In fact, a total of four division directors were recruited or appointed in the past five years, including C. Ryan Miller, M.D., Ph.D., Division of Neuropathology; X. Long Zheng, M.D., Ph.D., Laboratory Medicine (LM) (who has since moved to a chair post at the University Kansas, replaced by Dr. Reddy); Ralph Sanderson, Ph.D., Molecular and Cellular Pathology; and Cristina Magi-Galluzzi, M.D., Ph.D., Anatomic Pathology (AP).


In the clinical realm, the Division of Anatomic Pathology transitioned into a fully subspecialized service, with 18 section heads. Service volumes for AP and LM have achieved a 20 percent increase in the past five years, and the department expanded our community pathology practice to two new locations, in Gadsden and at Medical West.

Our research portfolio has expanded and contracted over the last five years, but the number of awards and recognitions by our team continues to climb. In addition to three Featured Discoveries, we have had two Pittman Scholars—and these are just our internal UAB recognitions. Our faculty, trainees and staff have amassed awards, locally to internationally, for their work during this time as leaders in their respective specialties.

Education has always been a pinnacle of importance for the department and this year saw some changes. Our residency program director, James “Rob” Hackney, M.D., Associate Professor, Neuropathology, served in the roll from 2016 to 2020, when he announced his retirement in June 2021. Hackney handed the reins over to Brandi McCleskey, M.D., Assistant Professor, Forensic Pathology. A dynamic leader, she took on the challenge of an all-virtual recruitment season and, with the support of a dedicated team, hosted recruiting events and interviews for months—all online—before successfully completing our first match in a pandemic in March 2021. The cycle started again in fall, and we look forward to a vibrant, robust new group of trainees incoming in summer 2022.

The department established and assigned five vice chair roles in the past five years, including: Gene Siegal, M.D., Ph.D., Executive Vice Chair; Rakesh Patel, Ph.D., Vice Chair for Research; Yabing Chen, Ph.D., Vice Chair for Faculty Development & Education; Isam-Eldin Eltoum, M.D., Vice Chair for Quality & Patient Safety, and our latest appointment, Shuko Harada, M.D., Vice Chair for Diversity, Equity and Inclusion.

The importance of diversity, equity and inclusion came into stark relief in the past few years, heightened by the protests and events of the Black Lives Matter movement, initiated in 2020. UAB Pathology established a committee of trainees, faculty and staff to help spotlight individual and group perspectives, offer training and opportunities for engagement, and processes to enhance equity across our team.

Wellness became an undeniably important issue in the midst of an international pandemic, and its impact is permanent. Our staff, faculty and trainees serve on collaborative teams to help cull and disseminate timely news about wellness resources; started a softball team to boost morale and have a little (safe, outdoor!) fun, and bought a block of seats in the new UAB Protective Stadium supporting our UAB Football team—go Blazers! We recognized individuals, small groups and large teams for their tireless efforts, both in the pandemic and beyond—a new tradition we intend to carry on.

Netto says his goals for the future include building a digital pathology platform; recruiting experimental pathology research-intensive scientists across divisions; maintaining and growing the talent we have attracted; providing enhanced stability on the clinical side to build a national reputation, and, back to his original goal when he came to UAB in 2016: launching the GDL.

“As we move into a new year, we remain optimistic about so many aspects of all that we have been able to build as a team in this department,” Netto says. “From supporting COVID-19 testing efforts statewide, to growing subspecialty expertise, to expanding clinical and genomic diagnostic offerings, educating a new generation of pathologists, and continuing cutting-edge research in cancer and other areas, UAB Pathology will continue to be a department to watch.”

 

 Path to Pathology Leadership: a Chat with Dr. George Netto

George Netto did not always dream of being a pathologist; as a child, he loved looking to the stars.

“I thought I wanted to be an astronomer or to study astrophysics,” he recalls.

His parallel interests in math and science eventually led to his pursuit of medicine, with a focus on immunology and cellular cancer biology. While his parents were not doctors, they encouraged him to apply his strengths to studying medicine.

“Astronomy and applied physics were so interesting to me, but studying them was not an option in the Middle East at that time,” he says. “Biology was always fascinating, and there was a good medical school in Damascus.”

Born in Brazil to Syrian immigrants fleeing economic and political hardships, Netto lived for six years in South America before moving back with his parents to Syria. Growing up in the capitol Damascus, he attended private schools with French influence. Netto attended the University of Damascus for his undergraduate studies. He pursued a medical degree at the Faculty of Medicine of Damascus University, and upon completion moved to the United States to start a residency program at Baylor University Medical Center in Dallas, Texas.

Dallas was a great fit for Netto, both professionally and personally, once he got over the initial culture shock of living in America.

“I was admittedly amazed when I first came to the US, as I had only been to Europe. I was struck by the lack of public transportation in Texas, and had to buy a car immediately.”

Netto did not begin studying English until he was 19, taking summer language courses at Cambridge University, and working a clerkship at London’s Hammersmith Hospital.

“I really hit the road running,” Netto recalls. “Being accepted to medical school before the match because I was a foreign graduate, I had the opportunity to start working earlier. I was fortunate to match early and was very excited so I worked hard, reading and volunteering for cases.”

By his fifth year at Baylor, he became chief resident. Netto says he gravitated toward research early in residency. “Baylor was a state of the art clinical institution. I developed an interest in liver transplantation, one of the main areas of research at Baylor; research was part of the reason I picked pathology as a discipline.”

Netto was fortunate to have great mentors during residency but he sees his tutelage under Daniel Angel Savino, M.D., an Argentinian native who was director of surgical pathology and of the residency program at Baylor, to be most impactful in shaping his skills and charting his future path. Savino studied pathology under the legendary pathologists Juan Rosai and Louis Dehner.

Following his residency, Netto accepted a surgical pathology fellowship at the Lauren V. Ackerman Laboratory, Barnes Hospital, Washington University School of Medicine in St. Louis, Missouri. The following year, he moved to New York to complete a urologic pathology fellowship at Memorial Sloan-Kettering Cancer Center. Netto served briefly as chief of anatomic pathology at the Northport Veterans Affairs Medical Center in New York, and a year as assistant professor at State University of New York at Stony Brook, before returning to Baylor University as associate attending in pathology in 1996.

He ended up staying in Dallas for nearly a decade, working as director of the residency training program, of the Tissue Bank & Tissue Procurement, and of molecular pathology.

“I continued to be pulled by my interest in academic medicine” he says. So following a brief stint in Washington, D.C., Netto accepted an associate professor of pathology position at the Johns Hopkins University School of Medicine, in 2005. Secondary faculty appointments in urology and oncology followed shortly thereafter.

Given his Middle Eastern and Latin American ties, Netto was tapped into by the Hopkins International team. In 2009, Netto took the position of International Medical Director of Clinica Las Condes Comprehensive Cancer Center, in Santiago, Chile. He visited Chile several times a year and helped build the center’s administrative leadership team there.

“It was an opportunity for me to develop additional leadership skills and to transition some of the knowledge I learned at Hopkins, to help our affiliate institutions”.

In 2013, Netto was promoted to Professor in all three departments at Johns Hopkins, before joining UAB Pathology as the Robert and Ruth Anderson Endowed Chair in 2016.

Senior faculty from the department share in their appreciation of Netto’s leadership.

Ralph Sanderson, Ph.D., Division Director, Molecular and Cellular Pathology, says, “Of the five department chairs I have worked under, Dr. Netto is the best overall. He is thoughtful, balanced and a wise decision-maker. Dr. Netto listens to faculty and always seems to have their best interest at heart. He is benevolent but at the same time decisive when it’s needed. He is also an excellent recruiter.”

Others echo Dr. Sanderson’s sentiments:

Marisa Marques, M.D., Professor, Laboratory Medicine, says “Dr. Netto is very supportive of recruiting faculty members … he understands the importance of having the right number of specialized pathologists to provide the care we strive to give to our patients.”

Isam-Eldin Eltoum, M.D., Vice Chair, Quality and Patient Safety, appreciates Netto’s, “transparent leadership and shared decision making. He has helped promote and recognize our faculty locally and nationally with a focus on taking us to the next level.”

Netto is proud of his editor-in-chief role at Modern Pathology, started in 2020. He also notes his service as Chair, Solid Tumor Division of the Association of Molecular Pathology, and his long tenure as co-director of special course on genomic pathology diagnostics at USCAP.

Netto continues to build the department’s reputation internationally. He has initiated partner institution agreements between UAB and multiple international universities in Europe.

 “Our wish and goal is for the world to recognize the caliber of research, diagnostic, clinical work and teaching of pathology that takes place here at UAB,” Netto says.

Written by Christina Crowe