What pathology--and pathology for what?

In this short consideration of some problems in medical education it is proposed to deal with what pathology the undergraduate requires and what pathology is needed in postgraduate study for specialization. This subject was chosen for two reasons. First, it appears timely since medical education in general is actively under review. Secondly, with the recent foundation of the College of Pathologists it seems likely that the pattern of education for pathologists will be formulated and generally recognized for the first time. Whatever decisions are taken are likely to influence the course of clinical pathology for the next 25 years. But before dealing with this great problem it might be of value and of interest to look at education in pathology in a more general way-indeed to consider its place in medical education. At the present time it is difficult to imagine the medical course as it was when the medical schools were instituted. Certainly there was great variation in pattern and this was often largely determined by local circumstances. In general there were two main patterns of medical school in Europe in the nineteenth century. First, there was the university type which grew up in Germany, Holland, and the Scandinavian countries. Here the teachers in medicine and surgery were professors of the university who taught by giving formal lectures in a conventional way. In these universities they were in every way similar to professors of non-medical subjects and were of course employed whole time. They tended to be appointed on the strength of original contributions to their subject and so it happened that research was emphasized even at this early stage. With the development of hospitals which followed the professor became head of the university clinic to which were attached clinical and research laboratories. Many people believe that this form of organization was responsible for the great contributions made to medicine by the Germans in the last century. Certainly their research was facilitated by their access to laboratories in basic scientific subjects. In this connexion it is worth noting that in 1824 'This is the slightly abbreviated Presidential address given to the Asso-Purkinje had a physiological laboratory in Breslau; in 1825 Liebig had a chemical laboratory in Giessen, whilst in 1856 Virchow had his famous Institute of Pathology in Berlin. The purpose of these details is not so much to highlight the German system as to provide a striking contrast …