CAREER: Dr Kanini makes sense of specimens from oral

You probably know many general pathologists in Kenya but when you get down to the specialisations – oral pathology, in particular, you can only count to five, which is the number of oral pathologists in Kenya.

Quite small is the number that Mary Kanini is the only oral pathologist at Kenyatta National Hospital. We caught up with her and she shares more on this career path.

You are only five oral pathologists in Kenya. Why do people shy from this career path?

That is one thing I keep wondering because this is such a wonderful profession. However, it could be attributed to the fact that the specialty is not offered in the country. I went to South Africa at the University of Capetown for my Master of Science (MSc), oral pathology.

Why did you settle for this particular specialisation?

After graduating from the University of Nairobi with a bachelor of dental surgery in 2001, I interned at Kenyatta National Hospital. The hospital still had one oral pathologist and I reckon that his absence brought about a lot of delays and confusion. I felt that there was a gap that needed filling and he fostered me into the specialty.

What does your work involve?

As an oral pathologist, you assess the tissues of the biopsy specimens that are brought to you either by a dental surgeon or a clinician. You then study it under the microscope to be able come up with a diagnosis.

However, before making any conclusion, you have to correlate the clinical features that have been presented and any other investigation, say radiographs, CT scan and what you are seeing under the microscope for a definitive diagnosis.

On a typical day, where are we most likely to find you?

At the laboratory, my eyes on the eyepiece lens analysing a specimen or writing reports. However, that is dependent on the number of biopsy specimens on my table. When not in the laboratory, I am out there practicing general dentistry.

What do you find exciting about oral pathology?

I like the idea that I am able to make a difference in terms of what do to do with the patient after making a diagnosis. I also ensure that I make the diagnosis within the shortest time possible so that I don’t become a stumbling block between the surgeon and patient care.

For someone who wishes to follow in your wake, what are the pre-requisites?

You cannot enrol for an oral pathology course without having gone through dentistry. To secondary students who wish to pursue the career path, they need to perform well in sciences, math and at least one language. Besides the academic qualifications, pursuing a career in oral pathology calls for attention to detail and a keen eye. Sometimes, something can be so tiny that you almost ignore it only to realise later that is the root cause of the patient’s problems.

What are some of the challenges you face in your line of duty?

I would say the greatest challenge, just like many other pathologists is the process of reporting complex cases, which must be accurately analysed and documented. We cannot afford to miss even a single detail because this would mean a false diagnosis.

What was your biggest obstacle towards the journey of becoming an oral pathologist?

Besides the fact that the course is not offered within the country leaving behind my young family for two years was a tough decision to make. Thankfully, Kenyatta National Hospital had sponsored my studies so I didn’t have to worry much about tuition fees.

Does oral pathology offer opportunities for growth?

It depends on where you are and what other courses you have done to complement it. But, like in other specialisations, there are opportunities for advancement. The only downside with oral pathology is that as for now, you cannot go into private practice since you are mostly dependent on dental surgeons. Most people who follow this career path end up as lecturers or working in health institutions.

Are there some choices you’ve made that have been influenced by your choice of career?

I try to be very particular about what I eat. I don’t consume much processed foods and I am trying to instil the same in my family. If you ask me, most of our health problems stem from what we allow into our bodies.

As the only oral pathologist at KNH. Do you even get to have ‘me’ time?

Yes, I do. I even take leave! However, I ensure that I take short breaks and stay close to the phone just in case my guidance is urgently needed. I also have very supportive colleagues who, while I am away on leave, try to do their best and only call when they need clarity of a concern.