Decline In Autopsies Robs Med Students Of Final Exam

A dramatic decline in the number of autopsies performed in the United States is worrying medical educators, who bemoan the loss of what they say is a proven, time-honored way of training new doctors.

The rate of autopsies has fallen from half of all deaths in the 1940s to fewer than one in 10 today, according to the American Medical Association. Some medical students graduate without ever witnessing an autopsy.

“Those of us who took our training more than 10 or 15 years ago I think looked upon an autopsy as an essential component of medical education,” said Dr. Irwin Arias, chairman of physiology at the Tufts University School of Medicine. “That’s where you learned about your mistakes as well as your successes, and a lot about disease. As a teaching exercise, it’s the ultimate learning experience.”

In a study of 1,000 autopsies, researchers found that the examination contradicted the presumed cause of death in 36 percent of patients. Another survey of 2,500 autopsies found that 40 percent unearthed a major unexpected finding that contributed to the patient’s death.

“It’s extremely valuable for medical student education,” said Dr. Peter Baker, a professor of pathology at Ohio State University and chairman of the College of American Pathologists’ autopsy committee, which conducted the second of the two studies. “There’s a great wealth of information.”

Yet agencies that accredit hospitals and medical schools no longer require a minimum number of autopsies. Until 1944, medical students were required to witness at least 50.