Problems in Postmortem Pathology Training.

Emirhan Eskicioglu,Ali Riza Tumer,Tugce Findikoglu,Cenk Sokmensuer

doi:10.5146/tjpath.2022.01569

Abstract

In Turkey, autopsy performers, namely forensic medicine practitioners, are neither pathologists nor have properly received pathology training during residency in contrast to the Anglo-Saxon model of forensic medicine practices, since the current curriculum of forensic medicine residency lacks adequate training in post-mortem histopathology. Likewise, pathologists lack a specific post-mortem pathology clerkship. In this study, we intended to determine whether forensic physicians in Turkey find themselves competent in post-mortem histopathology or were adequately trained during their residencies. Turkish forensic medicine practitioners were administered an online questionnaire whereby self-evaluations of their histopathology knowledge and their views on histopathology training during forensic medicine residency were assessed. The 151 physicians who completed the questionnaire made up the study group. It was found out that the majority of Turkish forensic medicine practitioners (85.4%) did not find the histopathology training during their residency adequate. Similarly, 85.4% of the participants indicated their incompetence in histopathological examination of post-mortem tissue of any kind, and showed their willingness for further training in pathology. 66.9% strongly agreed that post-mortem histopathology requires training that is distinct from surgical pathology. In case of providing post-mortem histopathology training within the scope of forensic medicine residency, topics such as microscopic morphology of post-mortem changes, histological changes related to injuries, and estimation of wound age are expected to be beneficial to 88.7% 83.4%, and 83.4% of the participants respectively. The current curriculum should be revised in a way that the surgical pathology clerkship meets forensic physicians' needs, so that they can then refer more difficult, non-routine histopathological consultations to pathologists who are also well-trained in postmortem histopathology. Consideration should also be given to establishing a subspecialty training - a master's or doctoral degree programs in forensic pathology.

Highlights

Postmortem histopathology is a field of medical sciences that examines tissues retrieved from a deceased individual under a light microscope for various purposes [1]
Regardless of which system is adopted, the Anglo-Saxon or the European one, post-mortem histopathological investigations are executed by pathology specialists, while autopsies could be performed by both pathologists and non-pathologist forensic medicine physicians
In spite of the fact that Turkish forensic medicine practitioners are willing to acquire some microscopy skills, lack of pathologists trained in forensic sciences constitutes a barrier to provide adequate training

Summary

Introduction

Postmortem histopathology is a field of medical sciences that examines tissues retrieved from a deceased individual under a light microscope for various purposes [1]. Postmortem histopathology deals with the forensic evaluation of a post-mortem tissue in any context, and the significance of a particular finding as forensic evidence. Post-mortem histopathology includes basic phenomena such as post-mortem changes in cells and tissues, evidence of vitality at the time a lesion occurred, the mechanism of injuries, and the ruling out or confirmation of any pathological changes in identifying the cause of death [2]. Histopathology is a routine part of post-mortem examination and can provide useful information for case solution, in cases where the cause of death cannot be determined by macroscopic findings, but even when the cause of death is apparent to the naked eye at autopsy [3]

Results

Discussion

Conclusion