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Outside the Lab Training and education, Profession

Lessons in Life

As a medical student, I decided that studying pathology would be my first choice in preparation for my future career. Let’s just say I fell in love with it at first, second, and every other sight. And, now my enthusiasm for teaching pathology continues my love story with the subject and field.

As well as being a practicing pathologist, I am also a senior teaching assistant in the associated medical school. I teach pathology and several other courses, such as medical studies, through the medium of English, dental pathology, pharmacy and nursing. In total, our teaching faculty has more than 800 scheduled student contact hours in the form of lectures, seminars, discussion groups, and practical laboratory studies.

Although I do not take myself too seriously, I am serious about my teaching assignments. I take time to prepare good lectures and seminars, I read extensively, and I try to be as positive as possible to stimulate the students to participate in all the teaching sessions. I don’t just want to explain various diseases from a pathological point of view, I also want to give the students an insight into the wonderful world of pathology, explain what a pathologist does in practice and how we make complex diagnoses just by looking at a gross specimen or microscopic slide. Imparting knowledge to my students is an enjoyable and rewarding venture!

Over the last few years, I’ve noticed that my colleagues from other universities are complaining about the diminishing status of pathology within the medical curriculum. Many of them claim that pathology is being pushed aside by other courses or that it is simply integrated with other basic or clinical sciences such as anatomy, physiology, internal medicine, or surgery. Fortunately, that’s not our experience in Split, where pathology is taught as a self-contained, three-month module within the third year. During the three months, the students live and breathe pathology, spending their days with us in the lecture, seminar, microscopy, and autopsy rooms.

The facts speak for themselves because, year on year, the students have voted pathology as the best course in the medical curriculum.

We treat the students as colleagues, welcoming them to our conferences and meetings, and they partake in the same tasks and daily obligations as the teaching faculty. The students love it and their course evaluations show that they appreciate our attempts to teach them pathology by playing the role of a real pathologist. The facts speak for themselves because, year on year, the students have voted pathology as the best course in the medical curriculum. Also, my colleagues and I have received numerous students’ choice awards, which is further proof that our approach to teaching works.

We aim to teach students basic pathology and to introduce them to the study of various diseases from an anatomic and a pathophysiological point of view, with a strong emphasis on clinical-pathologic correlations. I find that the hardest part of teaching any subject is finding the right balance between the amount of information you want to give the students and the amount of information that is necessary for their further studies. I always ask myself how much “real” pathology should students know? Should they be able to tell the difference between malignant and benign cells under the microscope, recognize basic macroscopic changes in organs or attend autopsies? My answer is yes to all of these! I truly believe there is no better way to explain various diseases than by involving the students in the actual events that led to the outcome. So, our students attend autopsies (at least once a week), and this attendance is considered to be a required part of the pathology course. Before each autopsy, we discuss the patient’s medical history, clinical signs, and symptoms, and predict possible macroscopic and microscopic autopsy findings. During the actual autopsy, the students are allowed to assist. This gives them a complete insight into a patient’s case from the clinician’s to the pathologist’s point of view. I don’t think that there is a better way to learn! Likewise, during the course, students are given a tour of the Pathology Department. We explain and show them what the pathologist actually does, teaching them how to perform frozen sections, dictate the gross and microscopic findings, and formulate the final diagnosis and medical opinion. Our students expect to be taken seriously in their studies, they enjoy active participation, and they assure us that they learn much more than just from reading books. These various activities enhance the quality of the course, which helps the students to understand the subject better, and gives them a clear insight to what we do on a daily basis.

Therefore, I believe it is crucial to teach students by including them in our daily activities, and treat them as partners, keeping all communication channels open, and forming a unified teaching/learning team. That way they will be ready to step into the shoes of qualified doctors, understanding the need to cooperate with colleagues and acting in the best interests of the patients.

I hope that I have convinced you that I truly believe in our full immersion, all-inclusive practice-based, teaching system of pathology. The system has worked well for more than 15 years to the acclaim of generations of medical students and without any burnout among the faculty. Perhaps, our approach would not work at a bigger university with hundreds of students and understaffed faculties, but it seems to be ideal for our small faculty of 20 pathologists, teaching 90 medical students a year.

I’ll leave you with the valuable advice given to me by my own professor, Ivan Damjanov (Department of Pathology & Laboratory Medicine, KU Medical Centre, The University of Kansas, USA). He told me before my very first lecture, “Sandra you have to make the students laugh, if they aren’t happy when they leave your class you’re not doing it right!” I am glad to report that so far, my students are laughing and they seem to be happy.

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About the Author
Sandra Zekic Tomas

A staff pathologist at Split University Hospital and a senior teaching assistant at the School of Medicine, University of Split, Croatia.

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