Fall 2015
A New Path for Pathology

synapse: University of Nevada, Reno School of Medicine

Dr. Marcus Erling in a School of Medicine laboratory.

Alumnus Returns to Lead: Marcus Erling, M.D., a graduate of the medical school's two-year program in 1976, returns to lead the pathology department. Photo by Edgar Antonio Núñez.

A reborn pathology department stands ready to lead the future in laboratory medicine and teaching

Story by Anne McMillin, APR

A unique public-private partnership has begun between the University of Nevada School of Medicine and Aurora Diagnostics, the nation's leading independent specialized laboratory company focused on anatomic pathology. The new educational and clinical affiliation, effective July 1, 2015, is designed to enrich learning opportunities for students at the School of Medicine, to enhance the anatomic pathology services available in northern Nevada and to serve as a platform for future clinical research partnerships.

Aurora's Reno-based pathologists will join the School of Medicine's faculty, and Aurora's extended network of subspecialty pathologists in Las Vegas will become adjunct faculty members and contribute guest lectures to the medical student curriculum.

This statewide network of pathologists will provide students sub-specialized training in all major fields of pathology: hematopathology, cytopathology, gastrointestinal pathology, urinary pathology, dermatopathology, pediatric pathology, molecular diagnostics, gynecological/breast pathology and transfusion medicine.

Thomas L. Schwenk, M.D., dean of the School of Medicine, appointed Marcus Erling, M.D., managing director of Aurora Diagnostics Western Pathology, as professor and interim chair of the school's Department of Pathology and Laboratory Medicine.

"We are continuously looking for innovative partnerships to enhance educational opportunities for our students," Schwenk said. "Aurora Diagnostics Western Pathology brings extraordinary depth in the field of anatomic pathology to our school. We are looking forward to working with the Aurora team, all of whom will become either full-time or adjunct faculty members, as we educate our students and serve patients and their physicians."

Aurora Diagnostics currently has affiliations with several medical schools across the country, including the University of Texas Southwestern Medical School, the University of Minnesota, Wayne State University, the University of North Carolina-Chapel Hill, the University of Miami and Boston University.

The partnership with the University of Nevada School of Medicine is the first to include a statewide network of pathologists through Aurora's existing operating agreements with Western Pathology in Reno and LMC Pathology Services in Las Vegas. This is the School of Medicine's first affiliation agreement for laboratory services and its second major affiliation in the past year, having finalized a partnership with Renown Health in December 2014.

"Aurora is honored to be chosen by the University of Nevada School of Medicine for this unique partnership," said Daniel Crowley, CEO of Aurora Diagnostics. "We look forward to working with the School of Medicine to serve patients and providers throughout Nevada and expanding our role in helping to train the next generation of physicians."

Aurora Diagnostics Western Pathology will assume responsibility for all School of Medicine pathology operations at its new facility located at 343 Elm Street, Suite 206 in Reno. Founded in 1987, Reno-based Western Pathology has been committed to delivering advanced diagnostics services to northern Nevada, Tahoe and northeast California regions. Western Pathology joined the Aurora Diagnostics network of laboratories in 2010.

For his part, Erling, an alumnus from the School of Medicine's two-year Class of 1976, is happy to come back to Reno following 30 years in Las Vegas.

"This partnership will provide a broad platform to teach students and residents and keep the educational process going with our pathology subspecialists," he said, adding that the science of pathology and laboratory medicine has grown in recent years, making it an exciting time to get into the field for students.

"Students get deep and broad training with far more experience than even 10 years ago," he said. "It is a very exciting time right now because knowledge is exploding."

His ultimate hope is to entice more students to enter the field of pathology as a career track. To that end, his long-term goal is to establish a pathology residency at the School of Medicine.

Without a doubt, Aurora Diagnostics has the expertise to train students and residents: its pathologists have trained at some of the most prestigious universities in the U.S. including Cornell, Brown, Harvard, Yale, Johns Hopkins, MD Anderson, UCLA and Vanderbilt. Aurora's two dozen adjunct pathology professors in Las Vegas, along with the five full-time professors in Reno, now are teaching School of Medicine students and can assist with getting them into the country's premier pathology residency and research programs.

The new partnership immediately provides a new clinical services work platform for conducting lab work in northern Nevada.

Aurora Diagnostics offers a fully functioning anatomic pathology lab with IT support, pathology specialists, a courier service and quick turnaround for physician offices across northern Nevada, as well as three area hospitals, and several hospitals in rural areas of the state and eastern California. This anatomic pathology lab will bring in revenue not only from School of Medicine clinical offices, but other physician offices across the region.

Finally, School of Medicine basic scientists now have access to human tissue for their research efforts via the Aurora Research Institute, which, in turn, works through the University's Institutional Review Board for accepted protocols.

A physical School of Medicine/ARI Tissue Biorepository is being currently planned by an expanded committee of pathologists, basic scientist researchers, department chairs, associate deans and Aurora Diagnostics. This tissue biorepository service and platform will provide numerous biomedical research opportunities for medical students and undergraduates.

Collaborative opportunities between Aurora's specialty pathologists and School of Medicine basic scientists will abound.

Iain Buxton, Pharm.D., chair of pharmacology, sees this new partnership through the lens of going "back to the future" since community pathologists provided teaching for medical students in the beginning years of the School of Medicine.

According to Buxton, the presence of a biorepository through partnership with Aurora Research Institute is particularly tantalizing because the new relationship provides the methodology to get tissue samples into the hands of researchers.

"We will have access to live patient tissue samples and a biorepository of tissue samples through this private-public venture," he said. "It is a smart way of engaging our new community-based pathology department into our research opportunities and will afford for academic collaboration with the Aurora pathology specialists."

Buxton believes the presence of a biorepository through Aurora Research Institute will entice outside entities to come to Reno and the School of Medicine for tissue samples, thus potentially generating new research projects for the area.

"This service is essential to research and gives us tremendous opportunities," he concluded.

Pathology Teaching Faculty

Marcus Erling, M.D., Professor and Interim Chair

An alumnus of the School of Medicine's two-year program, Erling earned a medical degree at the University of Alabama School of Medicine in 1978. He trained as an intern at the University of New Mexico followed by residency in anatomic and clinical pathology at the University of Texas.

He completed a fellowship in anatomic pathology at the MD Anderson Cancer Center in Houston, followed by training in neuropathology at the Armed Forces Institute of Pathology. He specializes in genitourinary pathology and neuropathology. Erling was chair of pathology at Sunrise Hospital in Las Vegas.

Adele Fung, M.D., Assistant Professor

Fung earned a medical degree at the University of Medicine and Dentistry of New Jersey, followed by a residency in anatomic and clinical pathology at Emory University.

She continued training with a surgical pathology fellowship, also at Emory, followed by a fellowship in cytopathology at the University of Maryland Medical Center.

Philip Usera, M.D., Assistant Professor

Usera completed residency training at the University of Arizona Medical Center in Tucson. He extended his training there as a fellow in gastrointestinal and hepatobiliary pathology.

Usera graduated from The Medical School for International Health, a collaborative program between Ben Gurion University and Columbia University Medical Center. His specialized training involved practicing in disaster relief environments.

Michael Powell, M.D., Assistant Professor

Powell earned a medical degree from the University of Texas before heading to Stanford University where he completed his residency in anatomic and clinical pathology.

He remained at Stanford for two more years to complete fellowships in surgical pathology and hematopathology.

Sam Parks, M.D., Guest Lecturer

Parks earned a medical degree from the University of Colorado School of Medicine, before heading to Washington, D.C., for a pathology residency at Walter Reed Army Medical Center.

Parks has been in northern Nevada for more than 30 years and has taught at the School of Medicine since 1986.