Training evolution in pathology needed to deliver precision medicine

Nov. 9, 2017

The future delivery of precision medicine is at risk unless pathology training programs evolve to embrace genomics, warn UK researchers.

In two papers published in the British Journal of Cancer and the Journal of Clinical Pathology, the National Cancer Research Institute’s (NCRI) CM-Path initiative calls for changes in training to enable pathologists to integrate the tissue and molecular approaches that underpin medicine’s genomic revolution, and to fulfill their role in molecular multidisciplinary teams.

Although molecular diagnostic tests are already used to determine treatment options, molecular pathology forms only a relatively small component of most pathology postgraduate training programs. Morphological pathology—the study of structural changes in cells or tissues—remains essential, but for many cancer diagnoses, is often not sufficient.

Inclusion of more molecular pathology in the curriculum will support pathologists to continue to deliver high quality diagnoses for the future and enable the delivery of precision medicine.

The NCRI’s CM-Path initiative is working to reinvigorate academic cellular and molecular pathology in the UK and make these benefits available to a wider community.

Genomic medicine is being adopted across the NHS. This requires new approaches to handling patient samples and performing tissue analysis that incorporates molecular information to guide patient management. Pathologists will need to have the skills to work in this new ‘morpho-molecular’ framework, which poses the most important test for the community in the last 60 years.

If pathologists and training bodies can seize the moment and adapt successfully in this new genomics era, then the field can lead the way into revolutionary ways of diagnosing and treating a range of diseases.

To achieve this, a broad review of pathology training provision in the UK is needed, one that continues the traditional morphology route but also opens up a route to allow trainees to pursue a ‘morpho-molecular’ career.

This will entail a shift in the training environment, including almost one-to-one training plans and evaluation, which is necessary to prepare pathologists for the increased diagnostic complexity of modern medicine.

University of Glasgow has the full story