National Standards In
Pathology Education
Barbara Knollmann-Ritschel, M.D.
• The opinions expressed herein are those of the author, and are
not necessarily representative of those of the Uniformed
Services University of the Health Sciences (USUHS), the
Department of Defense (DOD); or, the United States Army,
Navy, or Air Force.
Evolution of Medical School
Education
• 1910 Flexner report
• Traditional Format
– Two years lecture
– Two years Clinical
apprenticeship
New Reforms
• Carnegie Foundation
Report:
“ Learner centered”
• Learners learn in a variety
of ways and may benefit
from a learning
environment different than
the traditional format
• Learning outcomes must be
carefully assessed and tied
to competencies
AAMC and Howard Hughes
Medical Institute
“specific competencies in the sciences
fundamental to medicine that all medical
students should demonstrate before receiving the
M.D. degree”
New Reforms
Moving from didactic lectures in isolated
disciplines to horizontal integration with small
group discussion and case presentation as well as
earlier clinical interaction.
-Online lectures
-Patient simulators
-Shared study material
-Interdisciplinary teams
How does this affect Pathology
Teaching?
• Elimination of Pathology as a course
– Reduced visibility
– Not reduced importance
• Increased the need to identify the essential
contributions of pathology to understanding
and treating disease.
Competencies for Pathology
• LCME ED-11 (Element 7.1)
– “The Curriculum of a medical education program
must include content for the biomedical sciences
that supports students' mastery of the
contemporary scientific knowledge, concepts, and
methods fundamental to acquiring and applying
science to the heath of individuals and populations
and to the contemporary practice of medicine”
– Pathology was specifically named
Competencies for Pathology
• ED 17: educational opportunities must be
available in clinical pathology
– Must learn basic mechanisms of disease
– Disease manifestation in organs
– Application of disease mechanisms to clinical
practice for diagnosis and management
• Requested information in medical education
database, not an Element
ED -1
Element 8.2
• The faculty of an institution the offers a
medical education program must define the
objectives of its program. The objectives must
serve as guides of establishing curriculum
content and provide the basis for evaluation
the effectiveness of the program.
Why National Standards?
• Concern that with integrated curriculum that
pathology is appropriately represented in
curriculum committee to ensure full
integration for teaching pathologic processes
from disease mechanism to organ system
pathology to laboratory diagnosis.
Three Basic Pathology
Competencies
• Disease mechanism
• Organ system pathology
• Application of pathology in diagnostic
medicine
Disease Mechanisms
Learning Objective: Inflammation
• Apply knowledge of the histology and
molecular biology of inflammation to the
clinical presentation of disease.
– Compare and contrast the cellular components of
acute and chronic inflammation to include their
primary function and the molecules and mediators
responsible for cellular recruitment and
interactions.
– Describe the appearance and mechanism of the 5
cardinal signs of inflammation…..
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Competencies Discussion Site
Mark Your Calendars!
Association of Pathology Chairs
2015 Annual Meeting
July 13-17, 2015
Rancho Bernardo Inn
San Diego, CA
INTRODUCTION
Training an individual to become a physician requires the acquisition of a foundation of knowledge, the
understanding of how systems work normally and in pathological states, and the lifelong gaining of experience in
diagnosing and treating patients. The standards for accrediting medical education programs are described in the
document entitled "Functions and Structure of a Medical School" from the LCME. In that document there are
several educational objectives that apply to teaching pathology. In particular, ED-11 states "the curriculum of a
medical education program must include content from the biomedical sciences that supports students' mastery of
the contemporary scientific knowledge, concepts, and methods fundamental to acquiring and applying science to
the health of individuals and populations and to the contemporary practice of medicine."
Pathology is specifically named among the subobjectives of scientific disciplines to which this standard relates.
Thus, medical students must learn the basic mechanisms of disease, their manifestations in major organ systems
and how to apply that knowledge to clinical practice for diagnosis and management of patients. Another
educational objective ED-33 refers to a curriculum committee and states "There must be integrated institutional
responsibility in a medical education program for the overall design, management, and evaluation of a coherent
and coordinated curriculum." With the advent of integrated curricula, Pathology must be appropriately represented
in the curriculum committee to insure that there is full integration for teaching pathologic processes from basic
mechanisms to organ system pathology to laboratory diagnosis.
The first educational objective ED-1 states "The faculty of an institution that offers a medical education program
must define the objectives of its program. The objectives must serve as guides for establishing curriculum content
and provide the basis for evaluating the effectiveness of the program." The following web-based competencies for
Pathology are proposed as a national standard identifying the content for teaching pathology in three basic
competencies: disease mechanisms , integration of disease mechanisms into organ system pathology, and
application of pathology to diagnostic medicine. Each competency will include learning goals, objectives, and
examples to assess the acquisition, integration and application of knowledge to demonstrate the development of
competency.
Learning Competencies Editorial Team
Editor-in-Chief: Michael Prystowsky, MD, PhD
Associate Editors
Competency 1: Michael Borowitz, MD, PhD
Competency 2: Richard Conran, MD, PhD, JD
Competency 3: Michael Prystowsky, MD, PhD
Managing Editor: Jennifer Purcell, PhD
Web Editor: Jennifer Norman, MEd
Platinum Partners
Gold Partners
Why the Effort?
• LCME requirements
• Improved teaching/ assessment (learner
centered – small group)
• Use for leverage to get time for pathology
UMED
• Share objectives/cases
Association of Pathology Chairs - Learning Com petencies
10/ 9/ 14 9:52 PM
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About APC
Next Steps
Practice
Research
Advocacy
Pathology Competencies for Medical Education
Development
Diamond Partners
Education
PRODS Section
GMEAS Section
GME Committee
Fellowship Directors
Committee
UMEDS Section
• Feedback
• Develop Cases
Education
UME Committee
Student Honor Society
Learning Competencies
Competencies Discussion Site
Mark Your Calendars!
Association of Pathology Chairs
2015 Annual Meeting
July 13-17, 2015
Rancho Bernardo Inn
San Diego, CA
INTRODUCTION
Training an individual to become a physician requires the acquisition of a foundation of knowledge, the
understanding of how systems work normally and in pathological states, and the lifelong gaining of experience in
diagnosing and treating patients. The standards for accrediting medical education programs are described in the
document entitled "Functions and Structure of a Medical School" from the LCME. In that document there are
several educational objectives that apply to teaching pathology. In particular, ED-11 states "the curriculum of a
medical education program must include content from the biomedical sciences that supports students' mastery of
the contemporary scientific knowledge, concepts, and methods fundamental to acquiring and applying science to
the health of individuals and populations and to the contemporary practice of medicine."
Pathology is specifically named among the subobjectives of scientific disciplines to which this standard relates.
Thus, medical students must learn the basic mechanisms of disease, their manifestations in major organ systems
and how to apply that knowledge to clinical practice for diagnosis and management of patients. Another
educational objective ED-33 refers to a curriculum committee and states "There must be integrated institutional
responsibility in a medical education program for the overall design, management, and evaluation of a coherent
and coordinated curriculum." With the advent of integrated curricula, Pathology must be appropriately represented
in the curriculum committee to insure that there is full integration for teaching pathologic processes from basic
mechanisms to organ system pathology to laboratory diagnosis.
Platinum Partners
Gold Partners
The first educational objective ED-1 states "The faculty of an institution that offers a medical education program
must define the objectives of its program. The objectives must serve as guides for establishing curriculum content
and provide the basis for evaluating the effectiveness of the program." The following web-based competencies for
Pathology are proposed as a national standard identifying the content for teaching pathology in three basic
competencies: disease mechanisms , integration of disease mechanisms into organ system pathology, and
application of pathology to diagnostic medicine. Each competency will include learning goals, objectives, and
examples to assess the acquisition, integration and application of knowledge to demonstrate the development of
competency.
Learning Competencies Editorial Team
Editor-in-Chief: Michael Prystowsky, MD, PhD
Associate Editors
Competency 1: Michael Borowitz, MD, PhD
Competency 2: Richard Conran, MD, PhD, JD
Competency 3: Michael Prystowsky, MD, PhD
Managing Editor: Jennifer Purcell, PhD
Web Editor: Jennifer Norman, MEd
If you wish to view the competencies in PDF format, please use the links below.
PDF: Competency 1
PDF: Competency 2
PDF: Competency 3
NOTE: These are "living" competencies, subject to regular review and updating by the APC UME Committee and
UMEDS Section Council. To submit a recommendation for change or a new example, please email your
suggestion to info@apcprods.org.
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Pat hology Lear ning Compet encies
A forum to discuss learning objectives and submit example
clinical cases.
GENES NEOPLASIA ENVIRONMENT METABOLIC INFLAMMATION IMMUNE
INFECTION CIRCULATORY REPAIR NECROSIS
Com petency 1: Disease Mechanism s / Processes | Pathology Learning Com petencies
PATHOLOGY
LEARNING
COMPETENCIE
S
Mechanism
Adaptation and
s
Cell Death
COMPETENCY 1: Disease
Mechanism s / Pr ocesses
Inflammato
ry
Com p et en cy
1: Di sease
M ech an i sm s
Et iologies, local / syst em ic
r esponses and consequences,
vocabular y of disease.
Infectious
s
Mechanisms
Inflammatory
Immunolog
Mechanism
Genetic
Mechanism
s
s
OVERVI EW
Infectious
topic includes general learning goals and specific
ntal
Mechanism
s
n, and
Immunological
Metabolic and
Nutritional
TOPIC
Nutritional
# of
# of
GOALS
OBJECTIVES
EM
2
16
FECT
1
8
FLAM
1
6
GM
2
6
HDTD
1
10
IM
1
5
MN
Hemodyna
Mechanisms
mic
Neoplasia
2
10
N
Tissue Renewal,
1
7
RRR
TOPIC
Disorders
CODE
and
Thromboe
ht t p :/ / um eds.st anf or d.edu/ ?lko= com pet ency- 1- disease- m echanism s- processes
9
Mechanisms
for each.
Repair
2
Disease
topic areas and show the number of goals and objectives
Metabolic
and
Hemodynamic
Thromboembolic
Regeneratio
before Step 1 of the Boards. The table below lists the
ACD
Mechanisms
s
Renewal,
objectives that medical students should be able to meet
Environme
Genetic
Disorders and
Tissue
6
Mechanisms
Mechanism
There are 10 topics within this competency area. Each
Neoplasia
3
Mechanisms
Mechanism
ical
/ Pr ocesses
Environmental
10/ 9/ 14 9:59 PM
mbolic
Regeneration,
and Repair
Page 1 of 3
Disease
Adaptation
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and Cell
Death
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Competency
Name *
2: Organ
http:/ / um eds.stanford.edu/ ?lko= com petency- 1- disease- m echanism s- processes
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Acknowledgements
•
•
•
•
•
•
Mike Prystowski
Moshe Sadofsky
Richard Conran
Mike Borowitz
Dan Regula
Margret Magid