Specialised training programme for the specialised field

                        PATHOLOGICAL ANATOMY

                                        No. A 052

a) Characteristics of the specialised field and the length of specialised training

    Pathological anatomy is a specialised field of medicine dealing with etiopathogenetic
and morphologico-functional diagnostics of diseases during life and after death of a person
with assessment of the outcomes of laboratory examinations of all body samples of tissues
and cells taken from the patient using morphological and other specialised analyses. It
provides and interprets the results of disease analysis and ascertains its cause together with
predictive-prognostic parameters of a diseased condition and thus assists in optimal therapy

     The minimum length of specialised training in the Slovak Republic is 4 years according
to the decision of the Accreditation Commission of the Ministry of Health SR on further
education of medical workers of 17 May 2006.

b) Determination of education level, length and content of specialist health practice
   required for registering in specialised training

The condition for registering in specialised training in the specialised field Pathological
Anatomy is completion of higher education doctoral study in the study field or in the field
General Medicine and obtaining the title (MUDr., M.D., Dr. Med).
c) Scope of theoretical knowledge, practical skills and experience required for
performing specialist activities which the applicant must fulfil related to the conditions
set by the Faculty of Medicine CU within the specialised field Pathological Anatomy:

Prerequisites for registering in the specialised study:

Knowledge revision from the field of anatomy, histology, pathological physiology.

1. / Scope of theoretical knowledge required for performing specialist activities:

              knowledge of macroscopic, microscopic and ultrastructural             pathology
               and molecular pathology
              biology, morphology and function of human tissues in health
              pathologico-anatomical autopsy
              sampling, sample transport and possibilities of fixation of taken samples,
               processing of material
              microscopic evaluation of necroptic material
              completion of an autopsy protocol and arrangement of diagnostic conclusions
              sampling, transport and processing of bioptic and cytological material in
               laboratories of pathological anatomy
              regressive and metabolic changes in cells, tissues and organs
              progressive pathological changes of cells, tissues and organs
              developmental disorders and growth disorders including teratology
              general and local disorders of circulation
              inflammatory alterations and allergic inflammation
              environmental pathology, aetiology and aetiopathogenesis of diseases,
               development of diseases (case and formal pathogenesis)
              autoimmune diseases, immunity disorders, transplant immunity, antitumour
              cause and nature of tumorous diseases genesis
              systematization and classification of tumours
              determination of type, biological nature, stage of malignity and size of the
               tumour, determination of prognostic and predictive factors with the use of
               histochemical, immunohistochemical and moleculo-biological methods
              diseases of the cardiovascular and respiratory systems
              diseases of the gastrointestinal and uropoetic systems
              diseases of the female and male reproductive organs
              diseases of the haemopoetic and lymphatic systems
              diseases of the nervous and endocrine systems
              diseases of the skin and sense organs
              diseases of neonates and infants
              diseases of the locomotor system
              peroperational biopsy – significance and current possibilities of use
              work management at workplaces of pathology, work quality control,
               consulting activities in pathology
              knowledge of applicable legal regulations in necropsy and biopsy, reporting of
               infectious and tumourus diseases, principles of work security related to the
               work with biological material
              coding, registration, electronic data processing, mandatory reporting in
               infectious and tumourus diseases, principles of personal data protection
              new methods of laboratory analysis in the field and their interpretation and use
               for clinical practice

2. / Scope of practical skills and experience required for performing specialist activities:

            basic principles of fixation and further processing of material in laboratories of
             pathological anatomy
            processing of material from peroperational biopsy
            principles of excision – procedure standardization, material representativeness
           principles of microscopic techniques – conventional light microscopy,
            fluorescence, electronic microscopy
           principles of histological and cytological, cytochemical, histochemical staining
            methods, immunohistological and immunohistochemical methods, their
            possibilities and limitations
           principles of moleculo-biological methods used in pathology
           ability to assess representativeness of the examined specimen
           analysis of clinical and laboratory findings, ability of rational indication of the
            used laboratory procedures and a following creation of algorithms of a
            diagnostic procedure in bioptic diagnostics
           analysis of clinical and laboratory findings, their correlation in
            histopathological diagnosis
           practical skills in diagnosing pathological processes within necropsy and
           principles of autopsy technique and sampling of necroptic material for
            microscopic, microbiological, genetic or other specific examination
           principles of evaluation of macroscopic and microscopic findings, their
            documentation and archiving
           ability to interpret necroptic findings within clinico-laboratory findings
            and evaluation of the level of providing health care
           communication with clinical workplaces, preparation of clinico-pathological
            seminars and their management, interpretation of bioptic and necroptic
            findings in correlation with clinical data
           principles of scientific analysis of bioptic and necroptic examinations, their
            interpretation in the form of lecture and publication outcomes
           principles of collaboration among pathology workplaces
           information systems and management of a pathological workplace

3. / Minimum number of required procedures:

           autopsies and necroptic macroscopic and microscopic diagnostics including
            autopsies of infants – minimum number 200 autopsies
           bioptic cytological diagnostics –minimum number 3,000 examinations, from
            which minimum 1,000 examinations in non-gynaecological cytology
           bioptic microscopic diagnostics with the use of histological, histochemical
            and immunohistochemical methods – minimum number 5,000 examinations,
            from which minimum 1,000 bioptic examinations of materials with
            oncological nature
           peroperative biopsy – minimum number 100 examinations

d. / Organisational form of specialised training:

Specialised study starts according to the beginning of an academic year in compliance with
the study programme. Specialised study in the field of pathological anatomy lasts at least 4
years and has theoretical and practical part, while the practical part is predominant.
Specialised study is completed by a specialised examination consisting of:
     final autopsy performed in collaboration with an accredited workplace of Health Care
        Surveillance Authority (HCSA)
     defence of a written and theoretical examination
       final practical examination in the form of microscopic examination of bioptic
        and cytological sections and wording of diagnostic and differential diagnostic
        conclusions. Minimum number of examined sections is 20, from which at least 5
        sections are from the field of cytology.

    e. / Other parts of pedagogical documentation (pursuant to accreditation principles
approved by a board of the Minister of Health SR of 14 January 2008)

       requirements of admission procedure for trainees are listed in a paragraph b
       a form „ Proposal for registering in specialised study“ – in appendix
       elaborated schedule–topic plan for a specialised study programme – pathological
        anatomy – in appendix
       documentation of lector’s participation in educational activities within the training
        programme – individual book (in appendix) „Documentation of the study programme“
        for each trainee – book pages numbered and sealed by an accredited workplace, signed
        by the guarantee. Particular lectured topics and practical skills recorded according to a
        selected topic, amount of lessons, lecturer’s name and signature.
       protocol proposal on evaluation of specialised training and on taking a specialised
        examination – in appendix
       composition of the examination commission – in appendix
       logbook specimen of medical performances –unified logbook for FM CU – in

e. / Scope and aim of specialist health practice performed at particular workplaces, its
minimum length and schedule:

A physician registered in specialised training:

       performs bioptic and cytological diagnostics under the supervision of a specialist-
        pathologist designated by the accredited workplace, who has a postgraduate specialty
        in a specialised field at his workplace or at a workplace of pathology of the external
        contractual institution, or at an accredited workplace of pathology in Slovakia or
        abroad lasting at least 48 months
       performs autopsies and assessment of necroptic examinations at a workplace of HCSA
        which is part of the accredited pathological workplace or at a workplace of the
        external contractual institution under the supervision of a pathologist with a specialty
        in a specialised field
       continues in a specialised training at an accredited pathologico-anatomical workplace
        within Slovakia after completing specialist health practice performed at his workplace
       the minimum length of practise performed at workplaces of pathological anatomy of
        an education health facility (accredited workplace or workplace of the external
        contractual institution recognised by an accredited workplace is 10 months.

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