Never let a good crisis go to waste: Decreased autopsy exposure necessitates TheAutopsyBook.com, a novel educational resource

Acad Pathol. 2025 May 16;12(2):100179. doi: 10.1016/j.acpath.2025.100179. eCollection 2025 Apr-Jun.

Abstract

The American Board of Pathology decreased the number of autopsies pathology residents must complete before board examinations from 50 to 30, despite recommendations from the Association of Pathology Chairs' Autopsy Working Group to the contrary. We present findings from a survey of pathology trainees who will begin independent practice under this criterion. The survey was composed of Likert and free-text questions. An invitation to complete the survey was disseminated on two autopsy-related national listservs, and 85 United States-based trainees responded. Respondents felt autopsy rotations had high educational value (64% of respondents) and that significant learning is required to perform a high-quality autopsy (74% of respondents). Approximately half of trainees (54%) feel prepared to independently perform autopsies after completing 30 procedures during residency. Only 36% of trainees felt that the existing educational resources were sufficient to learn autopsy pathology. In the survey's free-text questions, trainees identified attendings' attitude toward autopsy, rotation structure, and a lack of study resources as major barriers to learning autopsy pathology. The feedback on educational resources has informed the creation of TheAutopsyBook.com: a case-based, online, freely accessible learning resource for medical autopsy which affords residents access to efficient, high-yield information. The website content is vetted by a diverse group of leading autopsy educators and should be shared widely by program directors and educators to help bridge identified educational gaps.

Keywords: Academic hospitals; Autopsy; Autopsy rate; Hospital autopsy; Resident curriculum.