Dr. Downes graduated from the Royal College of Surgeons in Ireland medical school with first class honours and undertook training in surgery leading to her Membership of the Royal College of Surgeons (MRCSI). Following this she completed a two year research fellowship in prostate cancer at University College Dublin and was awarded her Doctor of Medicine (MD) by thesis. She trained in Anatomic Pathology in Dublin, Ireland and then completed a clinical fellowship in genitourinary pathology at the University Health Network, Toronto during which time she was awarded FRCPC. Dr Downes is a Genitourinary pathologist at Sunnybrook Health Sciences Centre with a large uro-oncology practice. She provides expert opinion on GU malignancies to pathologists across the province and to clinicians at the Odette Cancer Centre. She is Division Head of Anatomic Pathology at Sunnybrook Health Sciences Centre and an associate professor in the Department of Laboratory Medicine and Pathobiology at the University of Toronto. She is actively engaged in teaching at the undergraduate and postgraduate level. Her research interests are in prognostic and predictive biomarkers of urologic malignancy, particularly in prostate and bladder, with a focus on immune infiltrates and determinants of therapeutic response. She is also engaged in collaborative work examining radiology-pathology correlation and pre-clinical prostate cancer research.