IQMH brings together experts in the field of laboratory medicine in order to elevate confidence in the healthcare system.
The IQMH Centre for Proficiency Testing Scientific Committees are composed of physicians, technologists and scientists who provide advice to IQMH regarding the fundamental design of Proficiency Testing surveys and ensure that clinically-relevant selection of challenges and appropriate performance evaluation are developed and implemented each year.
IQMH is grateful for the commitment and support of the medical laboratory community and appreciates all the volunteers who donate their time and valuable expertise to our programs.
This month, IQMH recognizes Shahid Islam, MD, PhD, FRCPC, FCAP, The Ottawa Hospital, Eastern Ontario Regional Laboratory Association (EORLA), Ottawa, Ontario who has served IQMH as a volunteer since 2013.
Shahid Islam, MD, PhD, FRCPC, FCAP
Dr. Shahid Islam is currently the Chair of the IQMH Cytopathology Proficiency Testing Scientific Committee. Dr. Islam migrated to Ottawa, Ontario in 2004 and ever since then, has been with the Ottawa Hospital. Currently, he is a permanent full-time senior staff physician in the division of Anatomical and Surgical Pathology in the Department of Pathology and Laboratory Medicine at the Ottawa Hospital of the Eastern Ontario Regional Laboratory Association (EORLA) and an Associate Professor in the Faculty of Medicine at the University of Ottawa. Prior to this, Dr. Islam was the Deputy Head and Site Chief of the division of Anatomical Pathology at the Ottawa Hospital for five years (2007–2012). Dr. Islam also served as the Director of Cytopathology (2005–2010) at the Ottawa Hospital.
Dr. Islam is currently the Director of the Anatomical Pathology Residency Training Program at the University of Ottawa for the Royal College of Physicians and Surgeons of Canada (2011–2021). Under his direction, the residency program has undergone transformational change and is fully accredited by the Royal College of Physicians and Surgeons of Canada (RCPSC). Dr. Islam is the lead for implementing Competency by Design (CBD) Model of residency training at the University of Ottawa. This has led to national and international visibility and recognition of the program and the world-class training that it offers.
Dr. Islam is currently the Chair and the Founder Member of the Specialty Committee, Area of Focused Competency (AFC) in Cytopathology at RCPSC. He contributed to creating the key and enabling competencies, portfolio, assessment tools, accreditation standards and as well as examining the Practice Eligibility Route (PER) for the AFC in Cytopathology.
Dr. Islam has over 100 scientific publications in peer-reviewed scientific journals and over 57 abstracts and platform presentations and has been an invited speaker in national and international conferences.
How did I get to be involved with IQMH?
Cytopathology is my passion! My interest in "Cell" started during my PhD in Cell and Molecular Biology at the University of Toledo, Ohio. After completion of my residency and fellowship training in Anatomic and Surgical Pathology at the Medical College of Ohio, Toledo, Ohio, I went on to do fellowship training in Cytopathology at Parkland Memorial Hospital at the University of Texas, Southwestern Medical Centre, Dallas, Texas. My first job was as a full-time cytopathologist at Northwestern Memorial Hospital at the Feinberg School of Medicine at Northwestern University in Chicago. When I came to Ottawa in 2005, I became the Director of Cytopathology at the Ottawa Hospital and practised as a surgical pathologist and a cytopathologist. In that role, I came to know about the need for a Scientific Committee member, with the former Quality Management Program – Laboratory Services (QMP–LS), and submitted an application for membership on the Cytopathology Scientific Committee and was invited to join in 2013 as a member.
Cytopathology Proficiency Testing Challenges
Proficiency testing (PT) in cytopathology has always been a challenging topic for many years. Challenges include, among others, the inability to replicate normal working conditions, the subjective nature of cytologic interpretation, absence of a "gold standard" against which test results can be compared, and confidence that test performance adequately correlates with proficiency and competency of the practising professional and improves patient care.
Because of the nature of the speciality of Cytopathology, validated slides are important for any PT program to be successful. Despite the extensive training undergone by all cytologists, significant inter-observer variation in the interpretation of cytology specimens is well-documented in numerous studies. Even experienced cytologists often show significant disagreement in their interpretations of some cases. Therefore, validation of slides for PT is extremely important in order to minimize the likelihood of spurious results. As committee members (individually and collectively), we spend a great deal of time in validating the test slides. While the use of a small number of committee members to assign a reference interpretation for slides used in a PT program is an appropriate part of the overall design of such a program, it should not be the only criterion for selection since inter-observer variability amongst examinees can still be quite significant. To address that issue, IQMH has developed a very robust process of field validation, which consists of a statistical assessment of the performance of each slide under actual testing conditions. The members of the committee are extremely engaged in paying meticulous attention to that process to maintain the utmost standard of the PT program.
A related and important issue is the continuous monitoring of the acceptance of slides, with the scientific committee reviewing those slides against the acceptance criteria for use in the surveys. This continuous quality improvement (CQI) process is very well implemented and strictly followed by the consultant technologist.
The IQMH is very mindful in providing an environment that is conducive to scholarly activities for the committee members to actively take part in an evidence-based discussion, without being intimidated, relating to progressive change in the scope of cytopathology practice in Ontario and across Canada to ensure quality patient care is not compromised. Over the years, within the Centre for Proficiency Testing, I have observed many improvements, such as the implementation of LEAN process improvement, the addition of pre-analytical and post-analytical challenges as part of the survey for PT program, the move towards electronic worksheets and on-line submission of survey results, and the continuous publication of committee comments and other highly relevant scientific and educational documents including best practice recommendations, created by the committee members.
Since 2013, I have served on the IQMH Cytopathology Scientific Committee as a member (2013–2016), as the Vice Chair (2016), and currently, as the Chair (2017–2020). As the Chair, I have had the privilege to serve as a member on the Professional Advisory Committee (PAC) (2017–2020). PAC has a role of scientific oversight of all the discipline-specific committees within the Centre for Proficiency Testing. As a member of PAC, I was always impressed by the organizational skills of all the consultant technologists and their depth of knowledge in their respective fields. I always learnt so much in these meetings.
IQMH's vision is to be the Standard for Confidence, within the international medical diagnostic testing community, through its three Centres of Excellence: Accreditation, Proficiency Testing, and Education. Over the years, IQMH expanded services to organizations outside of Ontario and Canada. It has indeed been an excellent experience for me to be able to work and gain invaluable experience with this reputable and internationally-recognized organization.