Dear Philippe and colleagues,
Italian radiologists entered US diagnostics later on, but claimed the US diagnostics is part of “image” diagnostics and then of their exclusive competence. Notwithstanding this claim, today several different medical specialists perform US diagnostics.
A similar time course occurred for cytology.
In Italy, cytodiagnostics was introduced in the early 60s by centers for cancer prevention located in Bologna, Florence and Vicenza, managed by physicians and health biologists (who are DSc. In Italy, DSc is a terminal academic degree of the same level as MD), not by anatomopathologists, who entered cytology much later (early ’70s with prof. Rilke in Milan). For instance at the Institute of Oncology in Bologna we had a very successful PAP screening and non-gyn cytopathology (lung, effusions, urine etc) for 40 years.
In Italy, Pathology includes three distinct teachings with three distinct professorships: General Pathology, Clinical Pathology, and Anatomy-Pathology. Biologists who perform cytodiagnostics, are part of Clinical Pathology and endowed with the National board certification. Most of them are members of the Italian Society for Cytology.
To UEMS, we would argue that, although in 1950 certain activities were exclusively performed by physicians, today, in 2011, they could be performed also by non- physicians, particularly when already demonstrated by real facts, as in Italy for DSc.
We would ask EFCS to include the above observations in its reply to UEMS, noting that today medicine (and pathology as well!) urgently requires multidisciplinary approaches and specialists, as clearly shown by the advances in molecular medicine and mass spectrometry. It is a common view today in the biomedical scientific world that barriers across disciplines should be removed, not added: if we intent to develop criteria to reach a future harmonization for cytopathology in different European countries we should have an eye to the future, not to the past.
To conclude, we think that common cytopathology training should be addressed not only to MD, but also to DSc, and include molecular biology teaching other than morphological practice.
With best regards