Clinical Pathology in Pre-Clinical Years

Slightly over two years ago, we were learning systemic pathology in year 2. That’s the second of two pre-clinical years, a year before we had our various hospital postings.

At the time, studying for pathology was a drag. Most of the time, it consisted of us committing facts to memory and regurgitating them for examinations.

Now, in the midst of preparations for the year 4 final examinations on Pathology, I’ve come to see it in the light of two years of clinical experience.

For instance, the first pot (a preserved specimen in a glass box) had a uterus with a diffuse, tan mass with dark haemorrhagic areas that was invading the myometrium. The stem read: “65-year-old. Hysterectomy.” Whereas previously my mind would start thinking of various possible conditions – leiomyomas (fibroids), adenomyosis, endometriosis – without understanding the clinical background.

Now, when I heard two friends suggest leiomyoma and adenomyosis respectively, my instinctive response was:

“Eh. 65-year-old woman, so old already, post-menopausal. Simi fibroids? Simi adenomyosis?”

(The medical treatment for endometriosis and adenomyosis can be classified into two categories: inducing (1) pseudo-menopause, (2) pseudo-pregnancy. Without the influence of estrogen, both of these conditions regress. This is something that was only drilled into me during O&G.)

Good thing is, the current batch of M2s have learnt their general pathology (as it should be) but are splitting their systemic pathology with M3, in the midst of their clinical postings.

This should be an interesting experiment. I look forward to seeing how it turns out.


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