Does your medical school have histology lab?

[OwnerOfTheTARDIS]

For those of you currently in medical school or those who graduated recently, did you study histology/pathology in medical school? If so, how many hours per week do you spend in the histopath lab on average? 

Let me know what school you go/went to and what histology education looked like?

[JohnGrisham]

Same school as you. Histology at UBC is run like a well-oiled machine, and super reasonable. It is one of the few parts of UBC medicine that is actually run well.

[m_jacob_45]

59 minutes ago, OwnerOfTheTARDIS said:

For those of you currently in medical school or those who graduated recently, did you study histology/pathology in medical school? If so, how many hours per week do you spend in the histopath lab on average? 

Let me know what school you go/went to and what histology education looked like?

I'm in pre clerkship at uOttawa and we have 1.5 hours formally for histology every week, though those classes often end early. Our pathology is interspersed throughout the more clinical lectures and variable in terms of how much time is spent on the pathology. Also, I personally have very little interest in histology/pathology, but we are able to do pre-clerkship electives in pathology if desired. 

[Med Life Crisis]

HAHAHA 

[Edict]

McMaster has no histology, for accreditation they probably have a few recorded lectures hidden somewhere but I think i've heard the word histology less than 5 times in med school. 

 

Unless you are into pathology, in which case you can do histology on your own, you really really do not need it at all. 

[rmorelan]

Unless it changed Western had only a few lectures on it that I think most people kind of zoned out about, and no real lab.  It was added to a few comprehensive lectures which is where I think it actually belongs (clinical presentation, exam findings, lab findings, imaging, biopsy, path analysis, surgical treatment/radiation/chemo or if it is a mimic of a tumour whatever medical treatment etc). 

If you just show a hundred path slides you have already lost, ha 

[Sauna]

We have an hour of lab per week to complement the anatomy (i.e. GI histo lab when we do GI anatomy lab) and usually an hour or two of lecture on the same material before that so that we know what we're looking at when we get into the lab. 

[Snowmen]

Only some old pre-recorded classes by a pathologist that's no longer even a professor here and some of the objectives in PBL are histology-related. Not a single lab.

[shikimate]

16 hours ago, Edict said:

Unless you are into pathology, in which case you can do histology on your own, you really really do not need it at all. 

 

I think some basic understanding of how path works would be nice. For example, someone requesting cytogenetics on a specimen that's been sitting in formalin for 7 hours shows that person has no understanding of what a cytogenetic analysis involves.

Doesn't have to involve extensive histo knowledge, but recognizing the limits of H&E interpretation. For example, if it says "indefinite for dysplasia" on an esophageal biopsy, the clinician shouldn't freak out. 

[Mithril]

Histology was one of my favourite parts of pre-clerkship UBC. It was ran really well and our instructor Karen Pinder (I think) was an amazing instructor. 

[Lactic Folly]

5 hours ago, shikimate said:

 

I think some basic understanding of how path works would be nice. For example, someone requesting cytogenetics on a specimen that's been sitting in formalin for 7 hours shows that person has no understanding of what a cytogenetic analysis involves.

Doesn't have to involve extensive histo knowledge, but recognizing the limits of H&E interpretation. For example, if it says "indefinite for dysplasia" on an esophageal biopsy, the clinician shouldn't freak out. 

Agree. Most physicians won't be looking at the slides of their patients, but most will be receiving pathology reports. Being able to interpret test results is very important, and knowledge deficiencies leading to misinterpretation of a report can adversely affect patient care. 

Unfortunately, I feel this was really not addressed very much in medical school (and this is after a few pathology electives). We had a solid histology and pathology component (online modules plus lectures) but this had more a preclinical / basic science focus. Are there any good resources out there? I use labtestsonline.org, but that is more for clinical chemistry.

Fortunately, in the hospital there are test ordering guides from pathology, as well as multidisciplinary cancer conferences where cases are discussed with pathologist in attendance. If all else fails, I have phoned the pathologist before doing a non-routine biopsy. My end of the conversation sounds something like this "how much tissue do you need... how should I send it... the lesion is really deep, do you think an endoscopic biopsy would work as well"

[rmorelan]

3 hours ago, Lactic Folly said:

Agree. Most physicians won't be looking at the slides of their patients, but most will be receiving pathology reports. Being able to interpret test results is very important, and knowledge deficiencies leading to misinterpretation of a report can adversely affect patient care. 

Unfortunately, I feel this was really not addressed very much in medical school (and this is after a few pathology electives). We had a solid histology and pathology component (online modules plus lectures) but this had more a preclinical / basic science focus. Are there any good resources out there? I use labtestsonline.org, but that is more for clinical chemistry.

Fortunately, in the hospital there are test ordering guides from pathology, as well as multidisciplinary cancer conferences where cases are discussed with pathologist in attendance. If all else fails, I have phoned the pathologist before doing a non-routine biopsy. My end of the conversation sounds something like this "how much tissue do you need... how should I send it... the lesion is really deep, do you think an endoscopic biopsy would work as well"

yeah path correlation I find is the skill missing

you want someone who gets the path report back to be able to look at it and go wait that doesn't make sense - no way this clinical picture is inkeeping with that diagnosis. Either the path guy is wrong (happens), the biopsy was targeting the wrong stuff (happens), or something is missed with the clinical picture (happens). The idea that path or rad imaging is the final word on things is kind of dangerous 

[goleafsgochris]

20 minutes ago, rmorelan said:

yeah path correlation I find is the skill missing

you want someone who gets the path report back to be able to look at it and go wait that doesn't make sense - no way this clinical picture is inkeeping with that diagnosis. Either the path guy is wrong (happens), the biopsy was targeting the wrong stuff (happens), or something is missed with the clinical picture (happens). The idea that path or rad imaging is the final word on things is kind of dangerous 

This is a good point and I think is true.  That being said, I still don't really think it means that med students need path.  I think maybe surgery residents and oncologists (and maybe a few other selected specialties) could use the skill you've described.  But most physicians never even need to interpret a path report (I never did in my neuro residency).

 

In that way, I think its really a lot different than radiology.  Lots of docs (like 95% of them) order imaging and should be comfortable critically interpreting the reports.  I don't think the same hold for path.

[rmorelan]

1 minute ago, goleafsgochris said:

This is a good point and I think is true.  That being said, I still don't really think it means that med students need path.  I think maybe surgery residents and oncologists (and maybe a few other selected specialties) could use the skill you've described.  But most physicians never even need to interpret a path report (I never did in my neuro residency).

 

In that way, I think its really a lot different than radiology.  Lots of docs (like 95% of them) order imaging and should be comfortable critically interpreting the reports.  I don't think the same hold for path.

way out of my field  but do family docs get sent all of the path stuff to look over? Do they need to know what to do with it? Neurology wouldn't because they don't request a biopsy of anything (or do they?). 

ha, there is a lot of stuff you learn in medical school that most people don't need to know. I mean ever type of surgeon, radiologists and maybe others(?) would need to know how to read them. On the face of that it sounds like not a super small fraction(?). 

I still would rather they reviewed path reports than the actual slides. Oh look, more small blue cells, with some stain i will never remember or see again.......:)

[JohnGrisham]

Eosinophilic.

[gangliocytoma]

1 hour ago, goleafsgochris said:

This is a good point and I think is true.  That being said, I still don't really think it means that med students need path.  I think maybe surgery residents and oncologists (and maybe a few other selected specialties) could use the skill you've described.  But most physicians never even need to interpret a path report (I never did in my neuro residency).

 

In that way, I think its really a lot different than radiology.  Lots of docs (like 95% of them) order imaging and should be comfortable critically interpreting the reports.  I don't think the same hold for path.

Wouldn't residents on neuromuscular disease rotations conduct many biopsies and have to interpret the results of that? My former PI did dozens of muscle and nerve biopsies (for research and clinical purposes) and said that he was shocked when one of his residents couldn't recognize skeletal muscle on H&E...

[Edict]

I think its nice to learn but if you knew what other things are missing from our curriculum you'd suddenly be less concerned about histo haha

[Mithril]

6 hours ago, rmorelan said:

way out of my field  but do family docs get sent all of the path stuff to look over? Do they need to know what to do with it? Neurology wouldn't because they don't request a biopsy of anything (or do they?). 

ha, there is a lot of stuff you learn in medical school that most people don't need to know. I mean ever type of surgeon, radiologists and maybe others(?) would need to know how to read them. On the face of that it sounds like not a super small fraction(?). 

I still would rather they reviewed path reports than the actual slides. Oh look, more small blue cells, with some stain i will never remember or see again.......:)

I see path reports all the time from the biopsies I do. Learning how to interpret path reports properly and correlating it with the clinical picture is a useful skill to have as a family doc, and the histology course at UBC did really help with those skills.

[goleafsgochris]

14 hours ago, gangliocytoma said:

Wouldn't residents on neuromuscular disease rotations conduct many biopsies and have to interpret the results of that? My former PI did dozens of muscle and nerve biopsies (for research and clinical purposes) and said that he was shocked when one of his residents couldn't recognize skeletal muscle on H&E...

Maybe neuromuscular fellows? Ive heard of them doing muscle biopsies.  I certainly never did one, never saw the results of one, and never had to interpret a report (this I'm assuming would all be done at a highly specialized neuromuscular clinic, and on my rotation I basically saw a ton of myasthenia gravis and nerve entrapments and that's it).

The reality IMO is that edict (the above poster) is right.  It may be interesting for med students to do path, but for most its fairly academic and way outside the scope of anything they'll ever do.  The issue is that there is far more basic stuff not adequately taught in most curriculums.

[rogerroger]

We did, imbedded in the first few weeks of medical school. It was the epitome of useless. 

[rmorelan]

On 11/14/2017 at 5:55 PM, rogerroger said:

We did, imbedded in the first few weeks of medical school. It was the epitome of useless. 

that is a stupid time for histology ha

[GrouchoMarx]

On 11/14/2017 at 5:55 PM, rogerroger said:

We did, imbedded in the first few weeks of medical school. It was the epitome of useless. 

An accurate reflection of the respect pathology gets overall, combined with the beta autism personalities of pathologists. schools are obligated to show it but dont want it to get in the way of useful stuff so they cram it in the front when nobody gives a shit, and the pathologists dont say anything. my school was similar (maybe we went to the same one) but we had plenty of psych and family because at least they whined.

[JohnGrisham]

17 minutes ago, Cain said:

An accurate reflection of the respect pathology gets overall, combined with the beta autism personalities of pathologists. schools are obligated to show it but dont want it to get in the way of useful stuff so they cram it in the front when nobody gives a shit, and the pathologists dont say anything. my school was similar (maybe we went to the same one) but we had plenty of psych and family because at least they whined.

If it makes any difference, UBC has Path spread throughout both preclinical years, and is really well done. Same with histology(with a higher concentration in year 1 term 1), which is also really well done. Nothing to the same depth as the U.S. curriculum which is Path heavy. 

[SunAndMoon]

1 hour ago, Cain said:

combined with the beta autism personalities of pathologists. 

You're so alpha bro