Death of the teaching autopsy

Editor—O'Grady's comments on the teaching autopsy resonate for many of us.¹ We in Hong Kong have also experienced the gradual general decrease in the number of hospital autopsies such that this major teaching hospital sees only 20-30 cases a year. This coupled with the switch to a problem based learning medical curriculum in 1997 brought autopsy teaching to the verge of extinction.

We have, however, preserved autopsy teaching for medical students with the help of colleagues in the public mortuaries, where over 4000 coroners' autopsies are performed each year. During the second year rotations, medical students in groups of 8-10 observe a detailed autopsy of a case or in some instances snapshots of many cases. They are required to write about their expectations of such a session and to reflect on their experience afterwards.

We have also redesigned our teaching clinicopathological conferences. Students are allocated a case and are provided with the case notes, radiographs, and biopsy and autopsy reports, etc, for their presentation to the class. Teachers have only a watching brief. A total of nine such sessions are held in the third year of the curriculum.

Figure 1.

Credit: Ms HUNTER 9f.36r/GLASGOW UNIVERSITY LIBRARY/BAL

Unfortunately, the curriculum cannot accommodate more autopsy teaching sessions. Further autopsy teaching is available to students only as special study modules.

This means of resuscitating the teaching autopsy is possible because, as in the United Kingdom, there is no explicit interpretation of our coroners' ordinance that prohibits the attendance of autopsies for the teaching of medical students, police officers, etc.