Thu, 29 Aug 2019
The advent of competency-based medical education in Canadian residency programs (the Royal College’s Competence by Design initiative) seems an opportune time to standardize the more robust training in molecular pathology and bioinformatics that is crucial to the future of all the pathology specialties. Some initiatives have already been taken by the Royal College, in cooperation with other bodies, such as the Ontario Molecular Pathology Research Network (OMPRN) and CAP-ACP, to address gaps in molecular pathology training. This document , entitled "Draft Molecular Pathology Training Guidelines” will be very useful to educators and CAP-ACP members. This document has been accepted by the Royal College Anatomical Pathology Specialty Committee as a recommended curriculum in molecular pathology for AP trainees.
We present these “Draft Molecular Pathology Training Guidelines” in the form of a table with 6 rows (excluding headers) and 4 columns. Each row is devoted to one of the following broad “Topics”: 1) Human gene and genome structure & function; 2) Genetics and disease; 3) Molecular genetic and cytogenetic concepts and testing methods; 4) Test interpretation and reporting; 5) Molecular diagnostic lab management; and, 6) Molecular scholarship. For each “Topic”, the “Competencies” column lists specific capabilities that all residents are expected to acquire. Rather than teaching molecular pathology by relying exclusively on a dedicated series of classroom lectures and perhaps a rotation in one or several molecular pathology laboratories, we instead envision a scenario in which pathology residents acquire molecular Competencies through participating in a variety of “Learning Experiences”. We suggest that these should include: Classroom Learning (CL), Subspecialty Rotation Learning (SRL), Electronic Learning Modules (ELM), Workshop Learning (WL) and Individual Scholarly Activities (ISA). Below the table we provide examples of specific exercises that might be included under each Learning Experience. Thus, trainees acquire their “bucket list” of competencies progressively and by a variety of means through the course of their residency training. Furthermore, specific elements within rotations that may not be officially designated as “molecular” (for example, conventional Anatomical Pathology subspecialty rotations) are nonetheless recognized for the value they add to the molecular component of residents’ training. For example, Anatomical Pathology subspecialty rotations provide residents with excellent opportunities to learn how to allocate tissue samples for various molecular tests and, perhaps most importantly, to synthesize molecular and conventional histopathology results into a clear, accurate, actionable integrated report. With this in mind, the final, “Learning method” column in our table lists the curricular elements listed above that we suggest are best suited to assisting residents in acquiring the competencies listed for the corresponding Topic.