Comparing the case materials available from a teaching hospital's autopsies in 1968 and 20 years later

The Accreditation Committee on Graduate Medical Education requires both sufficient volume and variety of necropsy material for training in anatomic pathology. Since the number of autopsies has declined markedly in the last 20 years, the author sought to determine whether the variety of case material available from the autopsies performed at his teaching hospital had changed during that time span. Major diagnoses were abstracted from the reports of 200 autopsies of adults performed in 1968 and from a period 20 years later (1987, 1988, and part of 1989). Comparison between the two eras' diagnoses revealed very few changes in the incidences of various diseases. This was true even though the racial mix of patients had changed markedly. While declining autopsy rates are of concern, this study suggests that medical educators may not need to be concerned over the variety of autopsy case material. The author makes several suggestions for maximizing the teaching impact of each autopsy.