Are We Learning Enough Pathology in Medical School to Prepare Us for Postgraduate Training and Examinations?

Medical schools responded to the first publication of Tomorrow’s Doctors with an abbreviated syllabus and a reduction in didactic teaching hours. Prescribing errors, however, have increased, and there is a perception amongst clinicians that junior doctors know less about the pathological basis of disease. We asked junior doctors how useful they thought their undergraduate teaching in pathology had been in their postgraduate training. We had 70 questionnaire responses from junior doctors within a single deanery and found that although almost every doctor, (96%), thought that pathology formed a major component of their postgraduate exams, most, (67%), thought that their undergraduate teaching left them unprepared for their postgraduate careers, and they had to learn basic principles, as they revised for postgraduate exams. Few used a pathology text for learning, most doctors, (91%), relying on question and answer revision resources for exam preparation. Perhaps, as revision materials are used so widely, they might be adapted for long-term deep learning, alongside clinical work. This presents an opportunity for pathologists, deaneries, royal colleges, and publishing houses to work together in the preparation of quality written and online material readily accessible to junior doctors in their workplace. 1. Introduction There have been two revisions since the original publication of the GMC’s Tomorrow’s Doctors in 1993 [1–3] when medical schools that revised their syllabus and curriculum to reduce the volume of facts medical students were required to learn and to reduce the amount of didactic teaching in favour of self-directed learning [4, 5]. Two subjects that have suffered are clinical pharmacology and pathology, and in subsequent revisions Tomorrow’s Doctors have sought to redress this. In the wake of increasing prescribing errors [6], medical schools and some NHS Trusts seek to teach and test clinical pharmacology and prescribing [7], and a national prescribing exam is set to be launched in 2014 [8, 9]. What about pathology? Several authors lament that the reduction in taught courses in histopathology and chemical pathology has resulted in a generation of junior doctors who do not really understand what is wrong with their patients or how to interpret the results of investigations [4, 5, 10, 11]. Postgraduate training assumes a certain level of knowledge; however, membership exams rely on a grounding in pathology that they examine in detail. So how well do their undergraduate courses prepare junior doctors preparing for membership exams and life on the