[A new Approbation Order for teaching medical pathology].

A basic reform and a draft of a new approbation order were developed during the last years to improve medical education in Germany. Aims of this reform are to link the theoretical and practical teaching, to foster the interdisciplinary teaching, to promote case- and problem-based instruction, to reduce written multiple choice examinations, and to promote oral exams. During the discussion about the reform proposals were made to put much more weight on the social and psychological aspects of health care and to reduce the teaching of a science-based understanding of disease, for which pathology stands. In the final draft of the reform, however, pathology was maintained as subject of clinical education. Decisive changes now include, that the traditional distinction between general and special pathology will be abolished, and that a case- and problem-based teaching by interdisciplinary clinical-pathological conferences will be fostered. Thus the education will consist of a systematic lecture and practical sessions in pathology, which have to focus on the basic principles of the etiology, pathogenesis and classification of human diseases. Practical clinical aspects of pathology will then be thought by problem-based and interdisciplinary clinical pathological conferences or demonstrations, which start in the 4th year of the curriculum and have to be continued during the practical year's term until the end of the studies. Presently the new approbation order still requires consent of the Bundesrat. It depends on agreement about the limitation for the maximum number of students, the regulation of admittance to the medical education and the cost effects of the reform. There are some indications that solutions of these problems might be achieved during 2001.