An Coiste FeabhaisAcadúil
The Committee on Academic Quality Improvement
The Academic Quality Assurance Programme 2002 - 2003
REVIEW OF
THE DEPARTMENT OF PATHOLOGY
Final Report
8th April 2003
Department of Pathology: Review Group Report
This report arises from a visit by a review team to the Department of Pathology on February
3rd and 4th, 2003. The Department had already prepared and submitted a 'Self Assessment
Report' that, with other documentation, was made available to the review team in advance of
the visit.
The review team consisted of:
Dr Mary Sheppard, Department of Histopathology, Royal Brompton Hospital, London
(Chairperson)
Professor Hilary Humphreys, Dept. of Clinical Microbiology, Beaumont Hospital and
RCSI, Dublin
Professor Emer Colleran, Department of Microbiology, NUI, Galway (Cognate)
Mr. Brendan Flynn of the CFA and Department of Political Science and Sociology
(Rapporteur)
The report is structured to cover the following main topics
1.
2.
3.
4.
5.
6.
7.
1.
Aims and Objectives
Organization and management
Programmes and Instruction
Scholarship and Research
Community Service
The Wider Context
Summary and Concluding Remarks
Aims and Objectives
1.1 The Department of Pathology has in general a clear commitment to excellence.
1.2 However, the absence of a Chair of Pathology in particular has reduced the ability of the
Department to reach a more realistic and balanced achievement of their aims and
objectives.
1.3 In particular we note the imbalance between extensive clinical loads, various teaching
commitments and very little research.
1.4 In our view, one key future challenge must be to ensure a more strategic prioritisation of
aims and objectives. What the Department requires is a commitment to balanced
excellence across the full range of its activities (clinical, teaching, research).
2.
Organization and Management
2.1 There is a clear and urgent need to resolve the issue of the vacant Chair of Pathology.
We find it very unsatisfactory that such a position could lie unfilled for effectively well
over a decade. This is a matter of the utmost urgency. The post should be tied into the
establishment of the Department as a full Academic Unit (see 2.12).
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Department of Pathology: Review Group Report
2.2 Such a position is vital to provide unified leadership, strategic direction, and a
heightened profile to the Department as regards the range of its activities. It is an
essential requirement to address the Department’s commitment to quality.
2.3 We emphasise that the duty for ensuring that this appointment takes place is a particular
responsibility for the University Management Team (UMT), and we urge the UMT to
strongly support any new incoming Chair as fully as is practicable. In our view this
matter must be expedited as soon as possible.
2.4 We note that the imbalanced age profile of the Department poses future challenges as
regards staff loads, further developments and research potential. Several senior members
are close to retirement, and there is a need for a planned approach in liaison with the
Medical Faculty, UMT and the Western Health Board (WHB) to cope with this.
2.5 Allied with this observation, we note the very heavy clinical loads under which many
members of staff in the Department struggle. In such an environment, it is very difficult
for academic teaching, and especially research, to be conducted satisfactorily.
2.6 There is unquestionably a need for a renewed examination of staff members’ clinical
loads and their scope for academic work. Greater emphasis on ring-fencing periods of
protected time for research is a necessity.
2.7 The Review Group believe this may, in the very short term, be achieved through greater
management innovations, better communication and dialogue with the WHB, and with
staff themselves.
2.8 However, in the longer term securing protected time for research and teaching will only
realistically come about if the Department can increase the number of consultants in
specialist areas, as recommended by the Royal College of Pathologists, due to the heavy
workload of the department. This would require several new appointments, with close
liaison between the WHB and UMT. Such growth is quite a challenging goal in
institutional terms, and requires strong support from the Medical Faculty and from the
UMT.
2.9 It is important that there is an established standing forum for regular, structured and
targeted means of communication and negotiation with the WHB. We note that highlevel meetings between the Medical Faculty and UMT staff with WHB management
have increased over the last year. However, we believe this needs to be improved upon
with a more structured framework, which can guarantee the input of the Head of
Department of Pathology or the Acting Head.
2.10 For its own part, the University could also improve this situation by investigating with
the Department and the new Chair, the possibility of appointing contract lectureships
specifically for teaching.
2.11 One important issue that we encountered concerned the status of clinical lecturers. These
staff felt they were not getting adequate recognition from the University for their
commitment. We advocate that the University needs to re-examine this issue to ensure
that such staff are given the required level of status and remuneration consistent with
their experience, skills and contribution. One suggestion might be to ensure that there is
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Department of Pathology: Review Group Report
a means for career progression from the grade of clinical lecturer upwards. A position of
clinical associate professor might also be considered, where extensive research as well as
teaching contribution deserves recognition.
2.12 There is scope for a greater Faculty of Medicine dimension to support and provide
coherence to the Department’s plans and ambitions. For example dedicated
administrative support could be secured and funded, partly on a faculty basis. We noted
the suggested innovation of an integrated academic unit of Laboratory Medicine within
the faculty, which would incorporate both the Departments of Pathology and
Bacteriology. This proposal if it is to be taken seriously, needs closer examination. It
might well be attractive on grounds of efficiency and streamlining of resources.
However, in our view any such new approach to organising the Department within the
Faculty on a more integrated basis, must ensure the integrity of the discipline of
Pathology, and must ensure balance between Pathology, its sub-disciplines and those of
other existing departments within the Faculty. In particular such an innovation should
not be used as a pretext for leaving vacant the Chair of Pathology.
2.13 More generally, we noted a need for greater attention within the Department between its
sub-disciplines, and the need for balance and recognition between histopathology on the
one hand and haematology, clinical chemistry and immunology on the other. This is a
task for the acting head or incoming chair. We suggest one practical way this can be
achieved is through the use of a rotating departmental headship.
2.14 It is clear that Pathology is a discipline that is changing and evolving, and that there is a
need for the Department to anticipate and plan for such developments to ensure the focus
of the Department’s remit corresponds to developments in international best practice.
2.15 In our view there is a need to improve routine internal Departmental communications
and organisation meetings. There is a need for regular scheduled departmental meetings
to be held to address the strategic management issues raised.
2.16 There is also a need for greater communication and participation within the Faculty of
Medicine, particularly as regards participation at meetings. We suggest a clear
assignment of responsibilities is required for attendance at such, and we also have
suggested to the Registrar that at least one Faculty of Medicine meeting per year could
be held in the Clinical Science Institute to encourage maximum participation, especially
considering the busy clinical commitments of staff.
2.17 One substantive area which requires clarification relates to financial data and
management procedures (Student FTEs, etc.). These matters appear to be additionally
complicated in the Medical Faculty. We suggest that the Department should ensure a
structured meeting/workshop with relevant University staff from the Registrar’s Office
and Bursar’s Office to clarify such matters.
2.18 There is a need for a Departmental Strategic plan, which clearly addresses these issues,
and also responds to and links with the Medical Faculty Strategic Plan, the Medical
Faculty Research Plan, and the University Strategic Plan. Such a plan should be prepared
after the appointment of the Chair of Pathology.
3.
Programmes and Instruction
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Department of Pathology: Review Group Report
3.1 Departmental organisation appeared good, as regards students’ needs with respect to
course organisation, timetables, provision of course support material, etc.
3.2 However, the standard and style of teaching appeared uneven. Greater attention should
be focused on ensuring that the standard of teaching, and the approaches used (handouts,
OHPs, power-point), should be more uniform and complementary.
3.3 It would appear there is a need for greater academic coherence and collaboration
between lecturers as regards their respective modules. There is a need to ensure that one
lecturer’s contribution feeds relatively smoothly into the next lecturer’s module. There is
a need for more integration of the curriculum with systemic teaching ( i.e.
Cardiovascular system tying in with cardiology, respiratory system and respiratory
medicine). The Department should play a full role in medical curriculum development.
Our impression is that there does not appear to be a current active process within the
Faculty to update and improve the Undergraduate Medical Curriculum.
3.4 As regards curriculum content, again it would appear there is a need to pursue a more
focused approach, ensuring that core topics received most attention, and are given
enough time. We note that the Department has reduced the number of topics, yet in our
view it would appear there is some slight tendency towards over-teaching in 4th year,
especially of some more marginal topics (e.g. renal pathology which is very extensively
covered over two weeks for an undergraduate course). In addition there should be an
MCQ at end of the general module in year 3. Also more feed back on the MCQ results in
year 4.
3.5 We noted that Pathology was widely seen as challenging by students, and some actively
feared it. While this may be unreasonable, such a mindset needs addressing . Greater
attention as regards course organisation, syllabus coherence, and examination methods
should address this view.
3.6 We advocate serious consideration be given to semesterisation of the 4th year course, as
this would divide the labour and exam burden for students and ensure the basics were
mastered early on.
3.7 We note that the Department’s practicals and tutorials appeared to be working very well
and were praised by students. In particular, the excellence of the Pathology Exhibits
Museum stands out. Equally, the technical staff of the Department are clearly
approachable, efficient and enthusiastic.
3.8 We advocate that attention be paid to the teaching function of autopsies. Students should
have a clear understanding of what to expect before their first autopsy, perhaps through
the provision of supporting documentation/audio visual resources. This would enable
students to get more out of the actual experience. We suggest that perhaps fewer
autopsies, but more clearly organised, might be a better approach.
3.9 If existing trends continue as regards student numbers, the Department’s teaching load
will increase. It is imperative that the Department plan for this now.
4.
Scholarship and Research
4.1 Unquestionably the most significant lacuna in the Department’s performance is with
regard to research. We note that this can be partly explained by heavy clinical loads, the
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Department of Pathology: Review Group Report
absence of a Chair providing a research leadership focus, and other organisational
features. We also note that several members of staff continue to be engaged in significant
contributory research allied with other departments in the Faculty.
4.2 Nonetheless, what is needed is more focused research effort. Unless younger members of
staff in particular, can be encouraged towards research, we feel morale will suffer and
genuine research potential will be stifled. The heavy work-load, and absence of a
significant research focus or programme is currently detrimental to the Department’s
efforts to attract good quality trainees in Pathology
4.3 The Department needs to be made an attractive place for research. To do this requires
renewed leadership, which a new Chair should provide. It may also require teaching buyouts through contract staff to free up protected time. Another short-term avenue to
improve research effort could lie through greater collaboration with the University’s
National Centre for Biomedical Engineering Science (NCBES).
5.
Community Service
5.1 We note the Department’s contribution to the wider community through its clinical
activities and involvement with the WHB, for example participation in the G.P study
day, attendance at inquests, etc. Additionally, many members of staff are extensively
involved in professional associations and learned societies. We were especially
impressed with the participation in the European Breast Screening programme by E.
Connolly, and offering of the Chemical Pathology MCR Path preparatory course and
participation in a Diabetic Information Evening, by Dr. H. Grimes. The Department has
also made significant teaching contributions to the Nursing and Bioengineering
Programme (NUI, Galway).
[this is mentioned in their self assessment report]
6.
The Wider Context
6. 1 We noted the excellence of the medical library and the dedication of its staff. We were
impressed at efforts made to make the best possible use of modern IT in this area to
support students. However, we note that the medical library is constrained by its small
space.
6.2 Support from Computer Services appears more than adequate, and has kept pace with the
Department’s growing demands.
6.3 We noted the growing role of the Dean of Research’s Office as regards furthering a
culture of research in NUI, Galway. In our view however, a more proactive engagement
with departments should be attempted by the Dean of Research’s Office, offering a more
tailored and focused encouragement. [new]
6.4 It would appear that the relationship between the Medical Faculty and line departments
such as Pathology needs greater communication and institutional foundation. The
appointment of a full time Dean of the Faculty could offer the Department a champion to
engage with University and WHB management.
7.
Summary and Concluding Remarks
By way of summary, we stress here a number of crucial insights and suggestions
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Department of Pathology: Review Group Report
7. 1 The Department of Pathology requires a greater commitment to balanced excellence
between its clinical, teaching, research and community activities.
7. 2 The filling of the long vacant chair of Pathology is most urgent and must happen if
quality is to be assured. There are no grounds for delay in appointing this Chair.
7.3 There is an urgent need for new staff, given the recommendations of the RC Path, the
impending retirement of senior staff members, and a possible rise in student numbers.
7.4 The status, career structure and remuneration of clinical lecturers in the Department
requires attention by the UMT. The University needs to re-examine this issue to ensure
that such staff are given the required level of status and remuneration consistent with
their experience, skills and contribution.
7.5 External communications by the Department require greater attention. Participation in
Faculty meetings and direct liaison with UMT is vital and should be much improved.
There is also a need for a more established standing forum for regular, structured and
targeted means of communication and negotiation between the WHB and the University
to which the Department can have input.
7.6 Internal communications of the Department requires greater attention and need to be
formalised. Regular scheduled staff meetings to discuss strategic issues are required.
7.7 The teaching programme of the Department is impressive, in particular as regards the
practical side. There is however, a need to improve the 4th year core Pathology Course to
ensure a more even teaching standard between lecturers, with a more focused core
curriculum. Student’s apprehensions of this subject should be addressed through better
organisation, perhaps by semesterised exams.
7.8 Unquestionably the most significant lacuna in the Department’s performance is with
regard to research. The Department needs to be made an attractive place for research. To
do this requires renewed leadership, which a new Chair should provide in conjunction
with the establishment of an Academic Unit. It may also require teaching buy-outs
through contract staff to free up protected time. Another possible short-term avenue to
improve research effort could lie through greater collaboration with the University’s
NCBMES Institute.
Dr. Mary Sheppard
Prof. Hilary Humphreys
Prof. Emer Colleran
Mr. Brendan Flynn
8th April 2003
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Department of Pathology: Review Group Report
Comments on The Methodology of the Review Process
A. The review of two separate, although related, departments was challenging. On reflection,
the review group felt it was better to proceed with two distinct assessment reports for each
department, repeating observations where these applied to both in common.
B. Provision of detailed statistical information appears to be too late for reviewers, where it is
delivered on the day of the review. It requires time to digest and analyse. Moreover, it
requires explanatory descriptive text to, for example, explain the basic FTE model of student
funding.
C. Other documents or correspondence, that are not confidential or sensitive, and that include
information about the Department’s plans for the future or request for funding or resources
from the Faculty or the UMT, should be included
D. Key Faculty and University strategy documents should be included with supporting
documentation where these exist. These include any Faculty research plans, University
Strategic Plan, etc.
E. There is a need to examine ways and means of reducing the administrative burden of
producing self-assessment reports and the organisational side of the review group visit for
departments.
F. The review group frequently found themselves awash in paper. We suggest a folder system
would help, allowing reviewers to organise materials more efficiently.
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