Teaching Strategies in Pathology

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Professor, Consultant Pathologist, American Board Certified Pathologist, Fellow College of American Pathologists. Areas of interest Fine Needle Aspiration Cytology, Cytology, Cancer, Ethics, Islam, Humanity

Teaching Strategies in Pathology

Anwar Ul Haque
Pakistan Institute of Medical Sciences, Islamabad.

Pathology is the soul and mind of the
medicine. It encompasses and binds all cells, tissues
and systems of the body. Without sound
understanding of pathology, no one can be a good
physician regardless of the type of specialty. It
therefore becomes immensely important to adopt right
teaching strategies for pathology education from the
very beginning. To teach pathology as a casual,
disinterested, cumbersome, dull “basic science”
subject is perhaps the worst form of schooling of a
subject that is the most thrilling and the most
fascinating.
Mountainous amount of useless, impractical
and to some extent commercially driven knowledge
makes pathology very exhaustive, self-defeating and
boring. How can one remember and perform so many
CD markers on almost every neoplasm? It may be
“reasonable” and affordable in countries like USA
where payment is usually made through Blue Cross
and Blue Shield or Social Security. However, countries
like Pakistan where IMF and World Banks etc. have
made it difficult for common man to earn bread and
butter, let alone to have luxury of all sorts of markers
on tissues just to satisfy lust of some
“Lymphomaniacs”! One wonders how many
mediators, factors, lymphokines and markers one
needs to remember by heart to practice sensible
medicine. Too much trivia is certainly not a wise way
to learn and impart knowledge. Here I must quote
one famous prayer of the most learned person of all
mankind and of all time i.e. Prophet Muhammad
(PBUH) in which he sought God’s protection from
useless knowledge. The useless knowledge can break
the backbone and with breaking of this backbone of
medicine i.e. pathology, entire medicine is paralysed.
Jigr Muradabadi had described such futile knowledge
as “Jahl-e-Khirad” (Stupidity of Wisdom) in an era
where man has shrunken while the shadows have
enlarged!
The teaching of pathology must be fully
integrated with other subjects bridging both so-called
basic and clinical subjects. It is like oxygen that must
reach each cell. In fact some part of pathology
education should begin in pre-medical years. Instead
of teaching botany in detail in pre-medical years, it
would be much better to teach, pathological
microorganisms with their morphology and
classifications, some cellular abnormalities, common
metabolic pathways and a few genetic and endocrine
disorders. We can also teach histology of some
common cells at this stage. It is indeed heartening to
see that schools have introduced basic genetics at early
levels. Most students find it very interesting.
Accordingly, laboratory science practicals may include
preparing karyotypes, doing gram and acid fast stains,
identifying effects of some basic nutritional diseases
e.g. anemia (peripheral smears), fatty change (liver
biopsy) and recognizing basic cell injury pattern in
electron micrographs. A few schools are already
doing this to some extent. This however needs
expansion.

         

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