Addressing the ‘Pathology Gap’ in Clinical Education and Internship: The Impetus to Develop Digital (3D) Anatomic Pathology Learning Resources

Globally, most medical schools and medical boards endorsing internships for junior doctors fail to consider pathology or laboratory medicine as a core clerkship rotation. Irrespective of specialty, all practicing doctors need to depend on their knowledge of pathology to order and interpret tests or investigations for patients; to make competent diagnoses for patients based on the etiology and pathogenesis of a disease; to practice patient safety and infection control; and in some rural remote areas to be able to perform an autopsy. Thus, this ‘pathology gap’, evident during the pre-internship training of medical students and persisting after they graduate into their internship and junior traineeship years, needs to be seriously addressed. Challenged at times by scarcity and inaccessibility to gross pathology specimens, pathology education is turning towards technology to capture high resolution images of gross pathology specimens and histopathology sections. Access to a digital anatomic pathology repository may provide part of the solution to improving pathology education during the pre-intern and internship phases. The purpose of this literature review is to provide a framework for analysis of existing digital gross pathology repositories and make clear the various integrated components which are often packaged with such repositories. A search of health science and educational elec¬tronic databases was conducted with set limitations. From this search, 188 articles on digital repositories were acquired but only 21 were related to the topic of “digital gross anatomical pathology”. This review reported on the functionalities of each repository and on the existence of any integrated components; including image labeling, interactivity, associated radiology and histology as well as any evidence of evaluative research conducted on its possible role as a learning tool. It was concluded that a comprehensive and well-organized repository which integrated annotated gross anatomic pathology with histopathology, radiology and three-dimensional rendering of gross pathological specimens was needed to aid bridging the “Pathology Gap’’ in clinical education.