**4.4 Impact on pathology**

As both a medical science and a clinical discipline, pathology is seminally important in linking the basic biomedical sciences to clinical medicine and providing an understanding of the pathobiological basis of disease [1]. Since a solid understanding of pathology is core to the practice of medicine in any specialty, all medical students must learn the basic mechanisms of disease, their manifestations in major organ systems, and how to apply that knowledge to clinical practice for diagnosis and management of patients. However, the place given to the pathobiological basis of disease and pathophysiology of mechanisms of disease in the new curriculum models is undervalued.

Although a traditional curriculum includes a formal pathology course, students generally have little exposure to pathology or pathologists in the professionally formative clerkship years. In the new curriculum, the goal of grounding medical students in principles of pathology, including pathogenesis and pathophysiology of disease, has been made considerably more difficult. The resultant discontinuance of pathology courses and their replacement by elements of pathology scattered episodically in the pre-clinical years likely has resulted in the dilution of core scientific principles and a decreased appreciation of pathophysiology.

The assessment of pathology educators is that the new LCME-driven curriculum is producing a medical graduate who is being taught to think differently, but is deficient in subject-specific knowledge for a variety of medical specialties [11]. Pathology educators are striving to adapt pathology teaching to changes brought about by the new curriculum and compounded by the disruption caused by the COVID-19 pandemic [12]. While these approaches cannot fully substitute for the coherent presentation of the pathobiological basis of disease in a pathology course, it is imperative that pathology educators make this effort.
