The document discusses several key challenges in harmonizing pathology training on a global scale, including variations in training duration, requirements, certification processes, and lack of a defined knowledge base or universal curriculum. While competency criteria and educational materials are increasingly shared between countries, full harmonization has yet to be achieved due to numerous stakeholders and slow decision making between regulatory bodies.

1. Clive R Taylor, M.D., D.Phil. University of Southern California Jan Van den Tweel, M.D. University of Utrecht, Netherlands Pathology as a model for the challenges of post graduate medical training in a global context.

4. 1400 medical schools on Planet Earth, + greater number of teaching hospitals all conducting GME graduates practice locally , in disciplines that increasingly are global in scope, - a troublesome divergence of education and real life experience.

5. These are the ‘technologies’ that made us what we are --and make our students what they are TECHNOLOGY DRIVES EDUCATION

6. AUTOPSIES ‘ preserved specimens’ MUSEUM MODELS MICROSCOPY Courtesy Robin Cooke

7. Museums ----are just museums

8. Henry Crouch London 1870 Benjamin Martin B 1747 Simple barrel scope made early 1800s R K Beck London 1840? Technology of teaching

9. CARSWELL, Robert Professor of Pathology, University College Hospital Pathological Anatomy. Illustrations of the Elementary Forms of Diseases. London: Longman, Rees, Orme (and others) 1838. But ‘gave up pathology’ as living too poor - copy sold on ebay 2004 $25,000

10. Standards of practice are similar at many major institutions across national boundaries Globalization of medical specialties has occurred - international journals international meetings World Wide Web increased mobility of doctor increased mobility of patients

12. Variously defined - the period of specialty training after medical school --differs among specialties TWO COMPONENTS of TRAINING **Experience -partly defined **desired knowledge base – not defined . TRAINING EXPERIENCE -- 4 - 6 YEARS ?? PATHOLOGY

13. International Bodies - with an interest in Pathology Training ? Royal College of Pathologists (& Australasia) European Board of Pathology American Board of Pathology Prescribe some elements of training/experience Administer examinations for ‘certification’ But offer no written curriculum

17. George N. Papanicolaou (1883-1962), Advances in medical knowledge Occur Worldwide Yet Medical schools are parochial Medical degrees are ‘national’ No Accepted International Curriculum / Certification PAP smear

18. If we do not have a detailed curriculum - perhaps we do not need one ?? A Google search for ‘curriculum’ yields 16,700,000 hits !!!!! So the ‘Globe’ is interested in ‘curricula’ for something or other – even if we are not. Curricula seem to be a ‘good thing’ – globally. Serious educational programs have serious curricula

22. SYMPOSIUM 20 - Wednesday 8.30 – 12.00 room P POST-GRADUATE TRAINING IN PATHOLOGY Chairperson: C.R. Taylor (USA) TESTING APTITUDE FOR DIAGNOSTIC HISTOPATHOLOGY S.S. Cross (UK) ADAPTING TRAINING PROGRAMS TO THE FUTURE PRACTICE OF PATHOLOGY C.D.M. Fletcher (USA) TESTING AND MAINTAINING COMPETENCE AFTER COMPLETION OF TRAINING C. Du-Boulay (UK) HARMONIZATION OF PATHOLOGY TRAINING ON A EUROPEAN AND GLOBAL BASIS J. Prat (Spain) THE STATUS OF PATHOLOGY TRAINING IN THE ASIA PACIFIC REGION R.J. Collins (Hong Kong) THE ROLE OF THE EUROPEAN SCHOOL OF PATHOLOGY AND EUROCELLPATH IN INTERNATIONAL TRAINING M. Sobrinho-Simoes (Portugal)

23. Jan Van Den Tweel. MD. University of Utrecht. Clive R Taylor MD D Phil Unversity of Southern California Human Pathology, 33: 861-862,2002.

25. 1. Competency criteria 2. Universal Educational Materials 3. Universal courses / online 4. Online examinations – available World wide.

26. 1. Competency criteria ------ advanced in the American and British systems, are similar, - - offering opportunities for harmonization of medical school and post graduate training around the world

27. Good professional practice Maintaining good medical practice Relationships with patients Working with colleagues Teaching and training Health Probity www.rcpath.org Medical Knowledge Patient Care Practice-Based Learning & Improvement Interpersonal & Communication Skills Professionalism Systems-Based Practice www.acgme.org/Outcomes/ UK US

29. Spanish Society of Pathology (SEAP), 9th European Congress on Telepathology and 3rd International Congress on Virtual Microscopy Toledo, Spain, May 15th–17th, 2008 3 . Universal Courses - online

32. -enhancement of the quality of the specialty around the world - Improved patient care World wide -movement of pathologists around the world -exchange of fellowships -sabbaticals of senior pathologists seeking specialist experience. Adoption of ‘International Standards’ for training , or a ‘global curriculum’ would facilitate --

34. We are still a long way from a “Global Training Program”.

35. “ 640K (of memory) ought to be enough for anybody.” Bill Gates 1981 CEO Microsoft.. The ‘experts’ are beginning to look at the problem – But no solution is in sight.

37. Three different examinations Royal College Pathology (MRCP) American Board of Pathology European Board Examination - (s imilar to American Board (is derived from it in part) , but 1 day, instead of 2) no oral/practical component (unlike MRCP) General curriculum published Not - KNOWLEDGE BASE ---No syllabus No objectives - defined by examination ---

39. DMIN'06 The 2006 International Conference on Data Mining WWW.DMIN-2006.COM WORLDCOMP06 Programme Parallel & Distributed Processing Techniques & Applications and Real-Time Computing Systems & Applications (PDPTA'06 + RTCOMP'06) Grid Computing & Applications (GCA'06) Software Engineering Research & Practice (SERP'06) Programming Languages & Compilers (PLC'06) Internet Computing (ICOMP'06), Semantic Web & Web Services (SWWS'06), and Computer Games Development (CGD'06) Engineering of Reconfigurable Systems & Algorithms (ERSA'06) Computer Design (CDES'06) and Computing in Nanotechnology (CNAN'06) Artificial Intelligence (ICAI'06) Machine Learning ; Models, Technologies & Applications (MLMTA'06) Data Mining (DMIN'06) Information & Knowledge Engineering (IKE'06) e-Learning , e-Business, Enterprise Information Systems, e-Government,& Outsourcing (EEE'06) Bioinformatics & Computational Biology (BIOCOMP'06) Image Processing, Computer Vision, & Pattern Recognition (IPCV'06) Modeling, Simulation & Visualization Methods (MSV'06) Computer Graphics & Virtual Reality (CGVR'06) Security & Management (SAM'06) Wireless Networks (ICWN'06) Communications in Computing (CIC'6) Embedded Systems & Applications (ESA'06) Pervasive Systems & Computing (PSC'06) Scientific Computing (CSC'06) Frontiers in Education : Computer Science & Computer Engineering (FECS'06) Foundations of Computer Science (FCS'06) beyond the microscope

40. The Department of Pathology and Laboratory Medicine at Indiana University General and Systemic Path Numerous images by category TEACHING MATERIALS ARE EVERYWHERE AVAILABLE

41. Globalization of medical specialties has occurred - international journals international meetings World Wide Web increased mobility of doctors increased mobility of patients quality of education at most US and EU medical schools is comparable standards and quality of the practice are similar at many of the major institutions across national boundaries