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Unison or cacophony: postgraduate training in pathology in Europe

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With the free movement of people in the European Union, medical mobility has increased significantly. This is notably the case for disciplines for which shortage of well-trained staff has occurred. Pathology is among those specialties and effectively the discipline is confronted with a striking increase in mobility among trainees and qualified specialists. The presumption underlying unlimited mobility is that the competencies of the medical specialists in the European countries are more or less equal, including significant similarities in the postgraduate training programs. In order to assess whether reality corresponds with this presumption, we conducted a survey of the content and practice requirements of the curricula in the EU and affiliated countries. The results indicate a striking heterogeneity in the training program content and practice requirements. To name a few elements: duration of the training program varied between 4 and 6 years; the number of autopsies required varied between none at all and 300; the number of biopsies required varied between none at all and 15,000. We conclude that harmonization of training outcomes in Europe is a goal that needs to be pursued. This will be difficult to reach through harmonization of training programs, as these are co-determined by political, cultural, and administrative factors, difficult to influence. Harmonization might be attained by defining the general and specific competencies at the end of training and subsequent testing them through a test to which all trainees in Europe are subjected.

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  1. Wick MR, Bourne TD, Patterson JW et al (2005) Evidence-based principles and practices in pathology: selected problem areas. Semin Diagn Pathol 22:116–125

    Article  PubMed  Google Scholar 

  2. Ruiter DJ, Roald B, Underwood J, Prat J, UEMS Section of Pathology/European Board of Pathology (2004) Histopathology training in Europe: a lesson for other specialties? Virchows Arch 444:278–282

    Article  PubMed  Google Scholar 

  3. Van den Tweel JG (2008) Autopsy pathology should become a recognised subspecialty. Virchows Arch 452:585–587

    Article  PubMed  Google Scholar 

  4. Saikia B, Gupta K, Saikia UN (2008) The modern histopathologist: in the changing face of time. Diagn Pathol. 3:25–28

    Article  PubMed  Google Scholar 

  5. Marchevsky AM, Wick MR (2004) Evidence-based medicine, medical decision analysis, and pathology. Hum Pathol 35:1179–1188

    Article  PubMed  Google Scholar 

  6. Gallagher PJ, Dixon MF, Heard S, Moore JK, West KP (2003) An initiative to reform senior house officer training in histopathology. Hosp Med. 64:302–305

    PubMed  CAS  Google Scholar 

  7. Ducatman BS, Ducatman AM (2006) Longitudinal case-based evaluation of diagnostic competency among pathology residents: a statistical approach. Arch Pathol Lab Med 130:188–193

    PubMed  Google Scholar 

  8. Van Den Tweel J, Taylor CR (2002) Globalization of pathology training and examination: the time to begin is now. Hum Pathol 33:861–862

    Article  Google Scholar 

  9. Lockard WT Jr, Lunz ME, Burke MD et al (1989) The first six years' experience with the pathology residents' in-service examination, 1983–1988. Am J Clin Pathol 92(4 Suppl 1):S11–S22

    PubMed  Google Scholar 

  10. Association of Directors of Anatomic, Surgical Pathology (2003) Curriculum content and evaluation of resident competency in anatomic pathology: a proposal. Hum Pathol 34:1083–1090

    Article  Google Scholar 

  11. Wick MR (2003) Curricula for pathology training: an editorial comment. Hum Pathol 34:1091

    Article  PubMed  Google Scholar 

  12. Alexander CB (2006) Pathology graduate medical education (overview from 1926 to 2005). Hum Pathol 37:923–928

    Article  PubMed  Google Scholar 

  13. Hamza S, Anderson P, Reddy VV et al (2001) Use of the Internet in pathology resident training and education. Adv Anat Pathol 8:290–297

    Article  PubMed  CAS  Google Scholar 

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The authors wish to thank the representatives of the national postgraduate pathology training bodies for their help in collecting the data.

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Correspondence to Fred T. Bosman.

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Bosman, F.T., van den Tweel, J.G. Unison or cacophony: postgraduate training in pathology in Europe. Virchows Arch 454, 497–503 (2009).

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