Making Pathologists Ready for the New Artificial Intelligence Era: Changes in Required Competencies

In recent years, there has been an increasing interest in developing and using artificial intelligence (AI) models in pathology. Although pathologists generally have a positive attitude toward AI, they report a lack of knowledge and skills regarding how to use it in practice. Furthermore, it remains unclear what skills pathologists would require to use AI adequately and responsibly. However, adequate training of (future) pathologists is essential for successful AI use in pathology. In this paper, we assess which entrustable professional activities (EPAs) and associated competencies pathologists should acquire in order to use AI in their daily practice. We make use of the available academic literature, including literature in radiology, another image-based discipline, which is currently more advanced in terms of AI development and implementation. Although microscopy evaluation and reporting could be transferrable to AI in the future, most of the current pathologist EPAs and competencies will likely remain relevant when using AI techniques and interpreting and communicating results for individual patient cases. In addition, new competencies related to technology evaluation and implementation will likely be necessary, along with knowing one's own strengths and limitations in human-AI interactions. Because current EPAs do not sufficiently address the need to train pathologists in developing expertise related to technology evaluation and implementation, we propose a new EPA to enable pathology training programs to make pathologists fit for the new AI era "using AI in diagnostic pathology practice" and outline its associated competencies.