**** Some Notes on the Practice of Pathology in Japan ****

Akio Hasegawa, MD


1. Certification in the Specialty of Anatomic Pathology in Japan

Post-graduate education of pathology practice is different from one country to another. Actually, here in Japan, major career path for pathologists after graduation from med school is;
(1) National examination of medical license at the time of graduation from med school, that is M.D. (at least 6 years after high school graduation).
(2-1) 4 years of post-graduate course of pathology, providing education of research and practice (actually pathology residency or apprenticeship), which is probably equivalent of MD/PhD course of the US. After finishing original papers, i.e., thesis, we are usually given PhD (Strictly speaking, Dr.Med.Sci. degree).
(2-2) 5 years of experience of anatomical pathology as a clinical resident after graduation from med school is also valid, but this path is rather minor at least till lately.
(3) After receiving PhD, board certification of anatomical (surgical and autopsy) pathology diagnosis by the Japanese Society of Pathology is waiting, which requires 5 years of training in which 4 years of post-graduate course can be included.
In short, the interval from entering college or university to receiving the basic board certification of pathology is apparenly;

College Med School Residency Total (yrs)
total 6 ----|

2. Who gross the specimen?

Pathologists are sometimes curious about persons to cut gross (qualifications) at other labs.
"Personally, I am happy with the techs doing the small biopsies. I dislike reporting larger specimens that I have not cut-up myself." (by one of UK practicing pathologists)
Our empirical rule in my current lab is as follows;

I have never seen techs (MLT/Histotechs) cut larger surgical specimens here in Tokyo/Kanagawa area, fortunately. At teaching university hospitals, smaller specimens too are usually grossed by pathology residents with assistance of techs. In Japan, no equivalent of pathologists' assistant (PA) in the United States exists. In the autopsy room, techs usually help us very positively in the general hospital settings, especially for solo-practice pathologists, while so-called dieners do so rather flatly at the traditional universities.

3. Turn Around Time for Routine Specimens

My group (1 full, that is me, and 2 part timers who cover half a day per week) is covering a local community hospital with 417 inpatients and 1,650 out-patients on average a day, the pathology dept of which is receiving with compliance circa 3,500 surgicals including 150 frozen sections, 2,000 cytologies and up to 20 autopsies a year.
Although our setting with minimal educational burden is completely different from those of large university hospitals, for one of which I had served up until a decade ago (it was fairly sluuuu-ggish), our data here are apparently still unsatisfactory judging from the information gained from publications by ASCP and CAP.

4. Forensic Pathology in Japan

I was asked on the mailing list PATHO-L ,
"Dr. Hasegawa, please tell us about FORENSIC MEDICINE/FORENSIC PATHOLOGY practices in Japan!" (by one of my colleagues in the US)
"What proportion/category of forensic autopsy examinations get brain tissue sent for examination by a neuropathologist in different countries? If this is small (as I suspect) what are the reasons?" (by a famous neuropathologist in the UK)
The following comments are just my conjecture, and are never based on any objective evidence. ;)

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Copyright 1997-1999, Akio Hasegawa. This material may be freely quoted via online services or other media, as long as it is not substantively altered, but I would ask for acknowledgment in any published work. Commercial use is not allowed without the prior written consent of the author.

version 1.22 2008/10/05

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