Whither pathology in medical education?

To the Editor: All established disciplines that have contributed to medical curricula in the past should play, as Weedon1 argued recently for pathology, a pivotal role in contemporary medical curricula. Indeed, students should be able to acquire better knowledge of a discipline through a problem-based learning (PBL) approach than through traditional teaching methods.

The crux of the PBL approach is that knowledge, skills and the other professional attributes are learnt in a way that puts them into context and thus makes them meaningful and better remembered by medical students. The trouble is, as Weedon pointed out, the number of academics in the discipline of pathology is dwindling. The scarcity of academic pathologists, combined with the increased workloads of private pathologists, means that their input into designing and developing curricula and into pathology teaching may be increasingly inadequate.

Pathology is not the only discipline to be underserved in today’s medical schools. In response to concerns about the medical curriculum, the Royal College of Pathologists of Australasia and other Colleges and interest groups have developed core syllabuses for use in medical programs. These developments are most welcome in view of the diminishing resources available for teaching in universities. In a PBL-oriented curriculum, teaching staff work in a multidisciplinary team in which the aspirations and limitations of each group are acknowledged, respected and acted upon in the context of realistic expectations of what is possible and what is necessary for medical graduates in the 21st century.

Currently, in Queensland, a series of pathology modules for students to use during their clinical rotations would be well received. The use and interpretation of pathology tests are already built into PBL case studies, and could be extended into a module set as prerequisite learning for an attachment to a public or private pathology laboratory. Pathologists may also be able to use the syllabus to guide their teaching in mentorships for the elective components of medical programs.

The needs of disciplines such as pathology will be best achieved through genuine understanding of the aims of medical schools to ensure appropriate, realistically achievable learning for students. When students are motivated to acquire knowledge of a discipline because they can see its relevance to solving patients’ problems, their enthusiasm for the discipline will be enhanced and they will learn well.