About Critical Values

Critical Values is the go-to resource for the entire laboratory team, providing insight and information on the latest research, information, and issues within pathology and laboratory medicine. The print and online magazine invites submissions on topics including, but not limited to, advocacy, education, technology, global health, workforce, workplace best practices, and leadership.

Critical Values Staff

Molly Strzelecki  Editor 

Susan Montgomery  Contributing Editor

Martin Tyminski  Creative Director  

Jennifer Brinson  Art Direction and Design  

For Cullen Lilley, MD, pathology resident at UCLA Health in Los Angeles, the intellectual challenges of pathology are not only fulfilling, but also bring him so much joy. The unique perspective pathology has on healthcare provides the privilege of identifying and naming the causes of a patient’s suffering and rings true to the origins of the word itself--the Greek “pathos” meaning “suffering” and “logia” meaning “study” or “teachings.” For Dr. Lilley, the beauty of human tissues and pathology stains is an added bonus. He recognizes that for patients on the other side of the slide, awaiting diagnosis is challenging, but for him there is solace knowing that the pathologist’s diagnosis will help guide their treatment.

Here, Dr. Lilley shares his thoughts on his career path to pathologist, how he got involved with ASCP, and more.

What initially drew you to the field of pathology and inspired you to pursue it as a career? Can you share a specific experience or moment that solidified your decision to choose a career in the laboratory?

This is often one of the first questions I’m asked when I mention my career choice. Over time, my answer became more succinct, but while writing my personal statement, I realized that my path to pathology was shaped by a series of fortunate coincidences and pivotal moments. Along the way, there were detours, periods of doubt, but also moments of pure awe, incredible joy, and immense pride.

My love for the microscopic world began in a simple seventh grade biology lab, funny enough. We were examining pond water under a microscope—what most students saw as just another day in class sparked a lifelong fascination in me. I was captivated by the microscopic world, teeming with life, each organism bustling about with its own purpose.

This passion carried me through high school and into college, where I majored in biology and music on a pre-med track. During college, I worked in a research lab focused on the molecular biology of arthritis, which deepened my interest in biomedical research and laboratory techniques. One day, while walking through the biology department, I came across a pamphlet from the ICPI, introducing me to a career in pathology. It felt like the perfect blend of my interests—laboratory methods, research, and patient care.

After undergrad, I worked in a diagnostic microbiology lab, gaining hands-on experience with diagnostic techniques. This led me to pursue a master’s degree in microbiology and eventually to a position as a microbiologist at the Centers for Disease Control and Prevention, contracted through IHRC, Inc.

When it came time to apply to medical school, I explored other specialties, but I found myself consistently drawn back to pathology. In every patient-facing experience, I was more curious about what happened to the patient specimen after we sent it off—how samples were analyzed, who determined if surgical margins were clear, and when the tumor slides would be ready for microscopic examination. It became clear that my passion was in pathology, and every step I’ve taken since has only solidified that decision. Once I started interviewing for pathology residency, and I started to meet all the amazing pathologists from across the country, I knew I had found my professional home. I truly love the pathology community, and I am so grateful to be working with such incredible people every day.

How did you first get involved with ASCP?

I first learned about ASCP after earning my initial phlebotomy certification during undergrad to gain more experience in healthcare. As I gained experience in diagnostic laboratory techniques, I eventually earned a molecular technologist certification. ASCP was always an organization I wanted to get involved with, but I wasn’t sure how. It wasn’t until medical school, after some encouragement from Dr. Kamran Mirza, that I attended my first Annual Meeting and realized just how many opportunities there were to get involved. I started by volunteering with the Social Media Committee, where I met some amazing laboratory professionals, pathologists, and trainees from across the country. This involvement led to multiple professional connections, academic projects, and both virtual and in-person events with ASCP, not to mention some truly great friendships. Following my initial experience with the Social Media Committee, I joined the Patient Champions Steering Committee, which has been incredibly rewarding. It allows me to bridge my interests in bioethics and health policy while connecting with patients and learning their stories. Given how well pathology has fit as a career for me, I’ve also gotten involved with the ASCP Pathology Ambassadors program to help spread the word about this career path to medical students, undergraduates, and beyond.

What excites you about incorporating scientific advancements into your daily practice?

There are countless exciting advances in pathology, each holding significant potential to enhance patient diagnostics. The integration of adjunct molecular diagnostic techniques, such as microbiologic identification, tumor mutation detection, and molecular signature analysis, is already improving patient care and will continue to do so. In the same vein, it will be interesting to see how spatial omics will play a role in pathology diagnostics in the future, but as of right now, that technology still needs more development before it is fully integrated into clinical practice. However, digital pathology stands out as a game-changer with the potential to transform the entire field.

While challenges like turnaround times, slide loading speeds, and the monetary and environmental costs of data storage exist, these are likely to be resolved as technology evolves. The benefits of digital pathology are already becoming evident. One of the most exciting aspects for me is its impact on pathology education. Digital slide collections could be used to develop standardized curricula for pathology residents and medical students, helping residents learn more efficiently and improving expectation setting in residency training. Digital pathology also revolutionizes how we save and share interesting cases, particularly rare diagnoses, precious specimens, or those prone to destaining over time. Additionally, it offers opportunities to streamline expert consultations and integrate artificial intelligence into histologic examinations. The possibilities for innovation, including the creation of new career paths within pathology, are virtually limitless.