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Use of oral pathology services by general histopathologists and their attitudes to training of oral pathologists
1Department of Oral Pathology, Eastman Dental Institute and Hospital for Oral Health Care Sciences, London.
Aims:
(1) To determine whether general histopathologists are aware of oral pathology as a specialist discipline and whether they use oral pathologists to identify lesions of the dental and orofacial tissues which pose diagnostic difficulties to general histopathologists. (2) To establish whether consultant histopathologists would consider dentally qualified applicants for salaried training posts within their department so that they may fulfil College accreditation requirements.
Methods:
A questionnaire was sent to a consultant histopathologist in each of 226 general histopathology departments in England and Wales.
Results:
In total, 167 (74%) consultant histopathologists completed the questionnaire, of whom 98% (163/167) were aware of the specialty and 92% (153/167) perceived a need for it. Oral biopsy specimens formed less than 5% of the workload in 76% (126/167) of departments, but 80% (134/167) of the consultants had referred at least one case to an oral pathologist during 1993. The most common sources of diagnostic difficulty were identified as salivary gland pathology, odontogenic tumours and lesions of oral mucosa. Only 22% (36/167) of consultants were aware that trainees in oral pathology are obliged to spend a year in accredited general histopathology training, but 40% (67/167) said they would consider a dentally qualified applicant for a training post in their department.
Conclusions:
General histopathologists are aware that oral pathologists exist and most will at some time call on their services; thus there is a need for specialists in oral pathology. Consultant histopathologists have a supportive attitude to the problem of providing the necessary general experience for oral pathology trainees, which will continue to be obtained through secondment to a histopathology department outside the trainee's main institution in most cases. Central funding would help the problem of providing cover for trainees spending a year out to complete general pathology training.