Strategies for a Successful Anatomic Pathology Subspecialty Workgroup: The 26-Year Collaboration of "The Elves"

Abstract

From 1990 to present, 14 liver pathologists and 2 clinical hepatologists from 9 countries have met annually to hold thematic 2.5-day meetings centered on case-based discussion. The goal of these meetings has been to identify gaps in knowledge in our field and fuel scholarly effort to address these gaps. The founding principles were worldwide representation, good representation of women, compatibility of participants, commitment to stable membership and regular attendance, mutual education and friendship, and free exchange of ideas. A summary report of the 2.5-day meeting constituted an enduring document that captured the free flow of ideas discussed. These ideas were open to all participants for the pursuit of scholarship back at their home institutions. However, any idea borne out of an Elves meeting merits open invitation for other Elves to participate in, using established standards for meaningful coauthorship. Over 26 consecutive meetings (1990-2015), themes covered the breadth of liver pathology. With retirement of 2 individuals, resignation of 3, and death of 1, six new members were nominated and voted into membership. Over these same 26 years, active members published 2025 articles indexed in PubMEd Central under the topic "liver;" 3% of these articles represented collaborations between members. This international group represents a successful model in a subspecialty of anatomic pathology for open exchange of ideas, mutual education, and generation of topics worthy of scholarly investigation. We conclude that a self-selected group of subspecialty pathologists can meet successfully over 26 years, maintain a high state of engagement through each annual meeting, self-renew as a result of retirement or resignation, and provide a creative stimulus for highly productive academic careers.

Keywords: case presentation; education; faculty development; international; liver.

Figure 1.

Time of case discussion, 2014 annual meeting. The start time and end time of each case were recorded, exclusive of midsession breaks or meal breaks. The x-axis denotes the chronological sequence of cases discussed over the course of 2 days; the y-axis denotes the fractional hours for each case discussed. The sequence of thematic topics for this meeting on “steatosis and the cirrhotic liver” is shown, including the “great cases” discussed at the end of the sequence. NASH indicates nonalcoholic steatohepatitis; ASH, alcoholic steatohepatitis; N-ASH, both nonalcoholic and alcoholic steatohepatitis.

Figure 2.

Compiled case discussion times, 2009 to 2015. Using the same methodology as in Figure 1, the times of case discussions over 7 consecutive years are shown.

Figure 3.

Academic productivity in the field of liver disease of active membership. PubMEd Central was searched for all publications by active membership, under the topic of “liver.” Publications by active membership on topics elsewhere in the alimentary tract or otherwise unrelated topics were excluded. Every citation was verified for authorship and relevance to the topic of liver disease. For the years 1980 to 1989 (“before” the group was formed), the indexed authors searched were of the founding 1990 membership. For all subsequent years, the indexed authors were those actively involved with the Elves during that year. In this stacked histogram, the lowest part of each bar (in red) is published papers involving more than 1 member of the Elves. The total number of publications, inclusive of collaborative papers, is the total height of each bar. Publications by the mentor for this group, professor Peter J. Scheuer, are excluded.