Point: Developing a Curriculum in Clinical Pathology

Developing a comprehensive and robust curriculum for residency programs in clinical pathology (CP; 1 also known as laboratory medicine) has been a goal for residency program directors for many years. Although there are many excellent training programs in CP, it is well recognized by faculty and residents that CP training is usually the weakest area of most combined training programs. The proposal by Smith and colleagues on behalf of the Academy of Clinical Laboratory Physicians and Scientists (ACLPS) addresses some of the major reforms needed to upgrade training in Clinical Pathology (1). Although this proposal attempts to be an all-encompassing roadmap to train clinical pathologists in the 21st century, many issues are still apparent that we would like to address here.The ACLPS proposal is an extensive and detailed document. It is not practical to address the fine details of the proposal; rather, we would like to discuss several issues at the mile-high level. First, what defines a clinical pathologist? The answer to this question provides the foundation for defining residency training goals. Second, what, at a minimum, should be included in the CP residency curriculum? Finally, how should knowledge and technical competence be evaluated as part of a CP residency?One can argue whether clinical pathologists are “clinicians, first and foremost” as promoted by the ACLPS proposal. Clearly, one major role for the clinical pathologist is to serve as a consultant to physicians and other healthcare providers in other medical specialties. Of course, a clinical pathologist should have considerable knowledge of medicine, but in our view, the primary expertise and focus of CP residency training should be on clinical laboratory testing and its integration into the practice of medicine. Clinical pathologists can have direct patient interactions in some …