Passport to pathology: transforming the medical student pathology elective from a passive educational experience to an exciting, immersive clinical rotation

How influential are medical school curriculum and other medical school characteristics in students' selecting pathology as a specialty?

There has been a significant decline in the number of United States allopathic medical students matching to pathology residency programs. Data acquired from the American Association of Medical Colleges (AAMC) show sustained variation in the medical school production of students who go on to pathology residency. When divided into groups based on the medical school's historical volume of graduates entering pathology, the schools in groups labeled Group 1 and Group 2 produced significantly higher and lower proportions of pathology residents, respectively. This study aimed to identify what medical school curriculum elements and other medical school characteristics might explain the differences observed in the AAMC data. The Dean or another undergraduate medical education contact from the Group 1 and Group 2 schools was invited to participate in an interview. Pathology Program Directors and Pathology Department Chairs were also included in communications. Thirty interviews were completed with equal numbers from each group. Interview questions probed pathology experiences, existence, and structure of a pathology interest group, options for post-sophomore fellowships, recent curriculum changes, and the extent of mentoring programs. Surprisingly, the curriculum does not appear to be a predictor of a medical school's production of students who enter pathology residency. A significantly greater percentage of Group 1 schools are public institutions compared to Group 2 schools. Other factors that may increase the number of students who go into pathology include mentoring, active learning versus observation, and post-sophomore fellowships or other opportunities to work in the capacity of a new pathology resident.

Pathology Rotations Embedded Within Surgery Clerkships Can Shift Student Perspectives About Pathology

PURPOSE

Medical school curricula have focused more on early clinical exposure with compressed didactic curricula, raising questions on how pathology can be effectively integrated into clinically relevant medical education. This study highlights how a required 1-week pathology rotation embedded within a surgery clerkship can impact students' knowledge base and perspectives of pathology.

METHODS

One hundred ninety-two medical students rotated through a newly designed mandatory 1-week pathology rotation during surgery clerkship. Post-rotation feedback and survey data from students were collected to evaluate their perspectives of pathology. Pathology residents and faculty were surveyed about changes on workflow imposed by the new rotation.

RESULTS

Eighty percent of student respondents agreed the rotation improved understanding of pathology workflow and its integration into the larger picture of healthcare delivery. 62% and 66% reported the rotation had a positive impact on their perspectives of pathology and pathologists, respectively. However, a significant number pathology resident respondents noted that integration of students into clinical activities either slightly (42%) or significantly (5%) decreased their own learning. Both pathology faculty and residents also noted medical student presence either slightly (19% and 37%, respectively) or significantly (63% and 58%, respectively) decreased workflow efficiency.

CONCLUSIONS

Integration of pathology rotations into surgical clerkships is a viable strategy to remedy decreased pathology contact and education due to curricular restructuring that condenses preclinical time while offering medical students a more integrated and practical perspective of pathology as a field. It is essential for pathology departments to prioritize and actively participate in both preclinical and clinical curricular development.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-022-01569-y.

Undergraduate medical students' perception of pathology

With the current trend of internationalization of medical school curricula, pathology role tends to gradually shrink. This potentially could negatively influence the students' decisions of selecting pathology as their prospective career. Besides, a pathology-related knowledge gap might be created as a side effect. In 2013, the College of Medicine in Imam Abdulrahman Bin Faisal University launched a new curriculum adopted from Monash University in Australia. Consequently, the pathology time was compromised to be 72 instead of 138 h in total. This study was planned to investigate the students' perspective of pathology that address the aforementioned concerns. A survey was distributed among the targeted participants. The response rate was 90.4%. While 8.7% of the students considered pathology as a possible prospect clerkship program, only 2 students elected it as their first option. Out of 230 participants who either chose not to consider pathology or were not sure to consider it or not, 172 declared their reasons. For almost half of them the cause was another favored specialty. The vast majority of students chose traditional lectures as their preferred way of learning. Twenty-six and 85 students identified themselves as either not aware or not sure if they discern the exact role of pathologists in clinical care; respectively. While 86.6% of the students think that providing relevant clinical data and differential diagnoses is necessary for the pathologists as they are not pure morphologists, only 13.4% of the cohort were aware of the indications of intra-operative consultations. In conclusion, the majority of students selected lectures as the preferred way of learning, but their responses regarding their knowledge of the exact role of pathologists, and the indications of intra-operative consultations, as well as their response toward considering pathology as future career all are implicit for combining hands on, active learning along with the passive lectures.