Addressing the gaps in cytopathology training: The transition from resident to practitioner.

ABSTRACT

It is not unusual to see young doctors who were confident as residents face the ‘slings and arrows’ of private practice. Much of this is due to the teaching structure and general pattern of education in Indian medical schools. It is unlikely that there have been sweeping changes in the pattern of education in most medical colleges over the past five decades despite overwhelming changes in the practice of medicine during this time. A substantial number of students have limited access to learning new skills or revising old concepts once they leave medical school. There are no reliable data on the percentage of doctors in India in private practice or in the public sector. However, private practice is more popular than government service. A recent study of one specific batch of students showed that 94 of 106 students on whom data were available had opted for the private sector.1 I shall use the subject of cytopathology to discuss some shortcomings of our educational system and some possible remedies. Of course, this approach can be adapted for other areas of medicine and medical education. Our current method of teaching pathology consists of rotating a student through different aspects of the subject, including cytopathology, over a period of three years. That postgraduate training in pathology in India can be improved upon and the manner of doing it have been discussed by Bhusnurmath and Bhusnurmath.2 Their paper deals with pathology in general; however, given that cytology is a part of pathology, all the lessons apply. Some of the deficiencies in the current system include lack of a defined career track in branches of laboratory medicine, absence of teaching of communication skills and professional behaviour. Similarly, a recent paper from the College of American Pathologists also addresses the best practices in preparing residents for practice because of such training gaps that are increasingly obvious.3 Finally, we learn from an editorial from England that cytology is the major reason that candidates for FRCPath Part 2 fail their examinations.4 Clearly, there seems to be consensus among experts across continents that there are gaps in the training of postgraduates in pathology and that these gaps include cold clinical medicine as well as social and practical aspects of medical practice.