CORE MORPHOLOGICAL CONCEPTS OF DISEASE FOR 2ND-YEAR MEDICAL-STUDENTS

With the increasing emphasis on independent learning and early patient contact, the time in the undergraduate medical curriculum for formal teaching of morphology of disease is decreasing. Thus, we thought it a dvisable to identify those core morphological entities of disease that should not get lost in the new paradigm. Our approach was to list all disease processes in Robbins Pathologic Basis of Diseases, 5th editio n, that have distinguishing gross or microscopic characteristics. Appr opriate portions of this list of 952 morphological entities from the B obbins textbook were distributed to 46 clinical specialists and pathol ogy faculty. Each of these was asked to strongly agree, agree, disagre e, or strongly disagree with the following for each entry on the list: ''For purposes of developing concepts of disease, an M2 physician in training should recognize classical examples or a diagrammatic represe ntation of the following lesions, and distinguish them from each other .'' Responses resulted in a consensus core list of 63 general disease process lesions and 545 organ system lesions, far a total of 608. Thes e 608 core morphological entities were incorporated into our course by means of (1) a computer program with over 1,022 images and clinical-p athological correlations, and (2) a core list of morphological objecti ves for each unit in the course. In general, entities were judged nonc ore material if they were rare or were microscopic lesions of primary interest to pathologists and provided no major pathomorphologic concep ts. The computer program as a supplement to glass slides and gross spe cimens has been very well accepted by students, and satisfactory perfo rmance on examinations has been maintained in spite of a 25% reduction in pathology course contact hours. Copyright (C) 1998 by W.B. Saunder s Company.