Andrew Miklos, MD

Bio

My story begins with Kaiser Permanente, because I was born at a Kaiser Permanente Hospital on Sunset Blvd. in downtown Los Angeles. That was 34 years ago and now I have returned to Kaiser Permanente to work. My family moved north when I was 5 years old and I grew up here in Santa Rosa, California. I attended Santa Rosa High School (class of '88) before going to Europe to pursue a career in medicine. Hungarian by birth, I chose to attend medical school in Hungary and was accepted at the Albert Szent Gyorgyi Medical University in Szeged. After graduation I worked for a short time in Cologne, Germany before returning to the United States.

After completing the USMLE (United States Medical Licensing Examination), Step 1 and Step 2 examinations, I was granted certification by the Educational Commission on Foreign Medical Graduates and began my residency training at St. Louis University Hospital, in St. Louis, Missouri. I continued with one year of specialty training, completing a fellowship in (selective) surgical pathology at Barnes Hospital, Washington University Medical Center, also in St. Louis. Upon completion of my training, I was very lucky to find a position in my home town. I am very excited to be back in Northern California and proud to be a part of Kaiser Permanente.

My Medical Specialty

More details about my specialty:

Many people have asked me, "What is a surgical pathologist?" Most people think of pathology as either Quincy or, to my personal dismay, CSI. Well, those people are forensic pathologists and they specialize in autopsy pathology, the goal of which is to determine a cause of death. While a surgical pathologist may do an occasional medical autopsy, the majority of our time is spent looking at tissue from living people. Tissue biopsies and other surgical specimens are sent to the pathology laboratory for examination.

After processing, slides are prepared and the tissue is examined under the microscope. The pathologist will then determine if a given tissue sample contains a lesion, and if so, what is the nature of that lesion. For example, does a breast biopsy contain a tumor? Is it a benign or malignant tumor? Is it localized or has is spread to lymphatics? Does the tumor express receptors for Estrogen and Progesterone? These are common questions a pathologist will address in his report. The clinician reading the report will then be able to deliver the most appropriate therapy to the patient.


I have only recently joined Kaiser Permanente (July 2004), but my decision to become a pathologist was made many years ago. As a medical student my mentor was a surgeon named Dr. Ernest Csajbok. As a student I learned a lot about surgery and how a surgeon utilizes the pathologist to determine the most appropriate surgical procedure. I also saw how the pathology report was used by the oncologist to tailor chemotherapy and radiation therapy for a particular patient. Because the pathologist applies scientific criteria (morphologic criteria) to examine tissue, he serves as a bridge between the basic medical sciences and the clinical disciplines. With a strong foundation in basic sciences, I felt this would be the best career for me.

Going to school in Hungary gave me a chance to see socialized medicine in practice. In most European countries, socialized medicine means that all working citizens have access to the highest standard of health care. As the government is the major provider, nobody is given preferential treatment based on socioeconomic status. This is in stark contrast to our country, where some hospitals have turned away patients who do not have appropriate medical insurance. To me, Kaiser Permanente embodies a philosophy of providing the highest standard of health care at an affordable price, and that is why I chose to work here.

My specialty interests and affiliations within my field:

My main focus is surgical pathology: the gross and microscopic examination of surgical specimens and biopsies. I find hematopathology very interesting. The morphologic, immunophenotypic and now molecular classification of hematopoietic neoplasms is a rapidly changing and evolving area. The recent advances in treatment of hematopoietic neoplasms is very exciting. They have also changed the way we think about solid tumors. I look forward to an era in which molecular phenotyping will taylor the treatment of all malignancies.

Affiliations:
Diplomat of the American Board of Pathology
Member of the US and Canadian Academy of Pathology

Current projects or research:

We are currently working on a project to correlate gross and microscopic assessment of adequacy on fine needle aspiration specimens. We hope to be able to decrease the number of inadequate specimens and increase the specificity of cytologic diagnoses. We also hope to improve the turn around time for all cytology specimens.

Great health resources that I refer to:

Ackermann's Surgical Pathology,
Juan Rosai

A good general resource for anybody interested in understanding the basic pathology and pathophysiology of disease processes is:

Robbin's Pathologic Basis of Disease.
Now in it's 7th edition, this book is standard reading for all medical students.

An interesting story from my training:

During my residency training, I witnessed the development of several exciting developments in the field of oncology. Namely, the introduction of several drugs directly targeted to tumor antigens (Her2neu, CD117 and CD20). The treatment of disease based on targeting of tumor specific antigens was only a research topic when I was a medical student in the early 1990s.

Photos from My Training Years or of Practicing Medicine in My Field:

Albert Szent Gyorgyi Medical University

Interests

Currently reading:
Mikhail Bulgakov

My favorite book or author:
The Master and Margarita

Great movie:
The Man Who Wasn't There

Hobby Photos & Links:

Sierra Nevada

Japanese Gardens

California State Parks home page

Family & Friends

People in my life:

I am single. I returned to Santa Rosa to be close to my family; my mother, my father and my brother.

My children and people I care about:

My girlfriend lives in St. Louis, where she is completing her training in Anatomic and Clinical Pathology. Following residency she is planning to move to Northern California.

An interesting story about my family or friends:

I've been to St Louis once since I finished my training. They're building a new baseball stadium downtown. They've also purchased a Fernando Botero sculpture which is located in Clayton, on Hanley Rd.

We have one cat, which my brother brought back with him from Hungary. The cat needed several vaccinations before she was given a WHO-certified passport. She has lived with us for 9 years now.

Travel

An adventure I've had:

When I first visited Hungary the "Iron Curtain" was a real structure that separated not only political ideologies, but people and places. It was very exciting to watch the fall of the Berlin Wall, the disruption and demise of the Soviet block and the withdrawal of Soviet troops from Hungary. In the euphoria, statues of Communist icons were tumbled and destroyed, street signs torn down, and all the signs of the old regime were literally erased overnight. It was a very exciting time.

Favorite place in the world:

Budapest is my favorite place in the world. It's like a second home and far and away the most exciting capital in central Europe. There are many interesting places to see and things to do.

One of my recent trips:

I've traveled to several countries in Central Europe. One of my most exciting trips was from Budapest to East Berlin, shortly after the fall of the Berlin Wall. I paid $28 for the train ticket. At the time it seemed like everyone was on the move and headed west. My friends and I met a lot of interesting people along the way.

A Photo of One of My Favorite Places:

Budapest

Trip Photos:

station