Published On January 27, 2020
IT’S NOT OFTEN THAT THE IMAGE OF A SURGICAL PATHOLOGIST is plastered on coffee mugs and T-shirts, much less with a caption calling him “my homeboy.” But Husain Sattar holds a revered place for recent medical students. Collectively, they have viewed eight million hours of Sattar’s Pathoma, an online prep course for the STEP 1 licensing exam. Many credit him not only with their surviving the test but also with changing how they think about the body and medical education itself.
Sattar is a leading pathologist for breast cancer at the University of Chicago Medical Center, where he teaches clinical pathophysiology. Every major medical publisher has knocked on his door to ask for the secret behind the success of Pathoma—which includes a 218-page textbook and an engaging library of videos. But Sattar says the context and the groundwork for his course would be hard to replicate.
Q: You took time away from medical school to study Islam in Pakistan. How was that an influence for you?
A: One of my teachers never used any notes and would speak about his topic as if he was talking about his own children. He spent so much time and energy synthesizing the material that he could be perfectly comfortable with it. Also, he would present with excitement, regardless of who was sitting in front of him. You would think there were thousands of people in the room, but there were six of us.
Q: How did Pathoma come about?
A: When I was studying in Islamabad, I forgot everything I knew from med school. That allowed me to relearn it from a different perspective when I came back. I was removed from how I had been studying for decades, so I was able to see the bigger picture, an ability I think I had lost as a medical student.
I’m not a trained educator, but when I was interacting with students later, a few things became obvious. I saw that they were caught up in the trees and not seeing the forest, as I had been. They were missing the big principles. One pulled me aside and said, “I don’t really understand the difference between leukemia and lymphoma,” and I said, “Let’s take a step back. What’s carcinoma?” They couldn’t explain it. I came back to my desk and said, “That’s it. I’m making Pathoma.”
Q: Did you have any principles that guided you?
A: I wanted to create something that was a conversation instead of a lecture, as exemplified by my former teacher. I have a minimalist, simplistic view of things, and that drove me to produce the material in a similar vein. In the book, I’ve organized every page the same way. The videos all have the same structure and tone. These things are soothing to the students. That little bit seems to have made a big difference.
I also wanted to keep the course slim and light. Knowledge has expanded, while the time we have to teach that material has remained constant. Sometimes there needs to be a bridge that allows students to get ahead, a simple idea before things become too complicated. It’s nice to know there’s a sequence to eventually mastering a topic. I think the students find that very beneficial.
Q: What other improvements might we make in how we teach medicine?
A: Medical students are highly accomplished individuals, but they’re kindergartners in the medical field. When I bring in lecturers, they’re often not in the same place as the students. I can bring in a world expert to talk about nephrotic syndrome, but it’s hard for them to remember what it was like before they knew what that was. It’s important to start from zero and review basic principles, recognizing that students are going to learn nuances throughout their lives. Medicine is a marathon, not a sprint.
Q: Has your teaching influenced the way you practice?
A: I do think that it informs the way I look at a slide. I don’t want any patient history; I want to assess what I’m seeing without preconceived notions. That allows me to be very broad, and has saved me from a misdiagnosis on many occasions.
Q: What’s it like to be a medical celebrity?
A: I’m a relatively introverted, private person, so it’s very odd for me. I don’t really know much about what goes online, but wherever I go in the world, there are people asking for selfies. I prefer to be alone in a room with my microscope.
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