Pathology education in a multisite urban/rural distributed curriculum

To address concerns about regional physician shortages within British Columbia, the University of British Columbia began distributing its undergraduate medical curriculum across multiple campuses (ie, urban Vancouver, small urban Victoria, and rural Prince George) in 2005. The distribution of the pathology curriculum required meeting 3 specific challenges: (i) implementation of high-quality technologies to facilitate distribution; (ii) recruitment of pathologists to teach; and (iii) creation of an electronic pathology learning center. Technological needs were met by a state-of-the-art audiovisual system allowing simultaneous interactive didactic sessions across all 3 sites, and by the use of a digital "virtual slide" system. Recruitment of pathologist educators proved challenging owing to comparatively limited staffing levels at the rural site. A physical and virtual pathology learning center was developed to assist students in self-directed study. Student performance on pathology examinations has proven to be essentially identical pre- and post-distribution, and is equivalent across all 3 sites. Quantitative and qualitative student survey data show that distributed pathology instruction is overwhelmingly well received by medical students at all sites, that pathologists' expertise is very important to students, and that pathology is one of the most popular components of the distributed curriculum. Pathology education continues to be a vital part of a distributed undergraduate medical program, and student grades and feedback demonstrate the value of the teaching and the technologies we have used. To be implemented successfully, the distribution of pathology education requires considerable financial and infrastructure investment, and ongoing commitment from pathologists and university administrators.