The Autopsy in Medical Education and Training

Abstract

The teaching and practice of autopsy have been claimed to be in peril since the 1950s, encumbered by other activities that draw the attention and energy of practicing pathologists, by economic necessities, and by ever more sophisticated diagnostic methods. Until today, the competency of trainees to practice autopsy has been assessed by documenting a numerical criterion of autopsy cases performed, a method which appears to have had uneven success. Declining numbers of available autopsies and questions about the relevance of the autopsy to the practice of newly graduated pathologists have raised the question whether autopsy competency should be assessed with less reliance on a strictly numerical criterion. An Autopsy Working Group empaneled by national stakeholder organizations showed great variation in autopsy training in US programs with respect to availability of autopsy cases of different types, level of direction and teaching, and autopsy technique. The Autopsy Working Group recommended standardization of autopsy teaching and then for the inauguration of a competency-based criterion for the assessment of autopsy skills in the form of a set of Entrustable Professional Activities for autopsy. Despite predictions of its demise for over six decades, autopsy practice has continued to evolve to meet the changing needs of medical practice. Standardization and redirection of autopsy education will help the autopsy to continue to meet those needs.