When I went through first year of med school some twenty five years ago, one of my least favourite courses was histology. We had a great teacher and great labs, but the problem was that we had so much of it. Eight months if I'm not mistaken, and many hours a week. I remember thinking that this was way, way too much. Apparently somebody was listening.
Our service has only recently become affiliated with a university, and we now have the pleasure of having students and residents on the consult team. I am only now becoming aware of the new curriculum and training methods. While demonstrating crystal microscopy lately I gave our student a quick look at a low power field of white cells to orient her before turning to polarised light. She looked down the tube for several seconds before asking, "you mean those spots?" Okay, not the most technical description but I figured we would move on. It quickly became obvious though that she was very uncomfortable and excused herself because she had not used a microscope since college. In three years of med school, never a practical histology lab, blood smear or gram stain.
This might be what we refer to as the pendulum swinging a little too far to the other side. Now I have no idea if this is of any real consequence in modern clinical medicine, apparently greater academic minds than mine think not, but I have to wonder if it is not the cause of a recent problem, at least in Quebec, with a shortage of pathologists. I have never actually talked to a pathologist about their career choice but I would guess that most were introduced to the field through their first histology and anatomy courses. It seems now though, that a student can get through his entire med school training without ever seeing tissue, healthy or diseased, close up. Where will the pathologists come from. CSI Miami fans?
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