It is our conviction that we cannot continue to train pathologists in a manner that has long since become outmoded. There are many different options to achieve a flexible program that would provide both basic training in pathology and opportunities to achieve, within a reasonable time frame, the requisite specialty skills. The current model was proposed at a conference held in Park City, Utah, in 1986.[28] The proposal called for a 3-year "core experience," followed by 2 years of subspecialty training. Whereas the Park City proposal focused on blocks of time, we suggest that this could be revised with schedules determined by the time required to achieve competencies on an individual basis. A modification of the Park City proposal could consist of a flexible "core" experience, with respect to time, in the basic disciplines of "anatomic" and "clinical" pathology. Following the core experience, the trainee could pursue any number of tracks leading to special competence in one or more disciplines including the currently recognized subspecialities and, in addition, molecular pathology and informatics. Concerted efforts should be made to enrich the core experience, while minimizing its duration, through the use of Internet-based distance education, telepathology-based conferencing with other institutions, and case simulations. [17 and 29]
We believe the time has come to re-evaluate the length and content of our training programs in the context of rapidly changing technologies and healthcare delivery systems. Ideally, residency program structure would be based on the achievement of defined outcome expectations rather than on an arbitrary schedule. The goals of mastery of core competencies, including analytical skills, should replace the current emphasis on residents spending 5 years of "hard time" in postgraduate education.
