The history of neuropathology in Canada

Dr. Edward Johnson (modified from CAP newsletter, autumn 2007)

The history of Neuropathology in Canada as a recognized discipline has been intertwined, in many aspects, with that of the clinical neurosciences and of the other disciplines in Laboratory Medicine. The initial impetus came in 1924 following the arrival of Dr. K.G. McKenzie, Canada’s first neurosurgeon, at the University of Toronto. Requiring assistance in examining brain specimens and biopsies, Dr. McKenzie sought the help of the neuroanatomist, Dr. Eric Linell, in the Department of Anatomy, a collaboration that in 1931 begot Dr. Linell’s transfer, along with the neurohistologist, Dr. Mary Tom, to the Department of Pathology to create the Division of Neuropathology. With the establishment of the Specialties of Neurology (1944) and Neurosurgery (1945) under the auspices of the Royal College of Physicians and Surgeons of Canada, and the expansion of these clinical neurosciences across the country in the post-war years, so did the need for neuropathological expertise in examining tissue specimens from the nervous system. This need was met by neuropathology practitioners of diverse backgrounds: neuroanatomy, clinical neuroscience, and anatomical pathology, practitioners from the latter discipline either receiving supplemental training outside Canada or being autodidacts. Paralleling the emergence of national specialty societies in the clinical neurosciences (Canadian Neurological Society, 1948) and Laboratory Medicine (Canadian Association of Pathologists, 1949), was the coming together of eighteen of these practitioners to form the Canadian Association of Neuropathologists (CANP) in 1960 under the inaugural Presidency of the distinguished Polish-Canadian neuroanatomist and neuropathologist, Dr. Jerzy Olszewski.

From the early annual meetings of the CANP, a major priority was the establishment of a recognized program of training in Neuropathology in Canada, with fellowship and/or certification by examination under the aegis of the Royal College. This initiative came to fruition in 1965 when Neuropathology was recognized as a Specialty, the same time period that Anatomical Pathology, Hematological Pathology and Medical Biochemistry were granted Specialty status. Although the first fellowship examination occurred in 1968, it was not until 1976 that a separate Specialty Committee in Neuropathology was created by the Royal College to oversee accreditation of training programs, program curriculum, and certification examinations. The outcome of this activity has been a progressive shift in the provision of neuropathology diagnostic services from practitioners of variable levels of experience towards those fully trained in the broad spectrum of Neuropathology with integration into the training programs of the clinical neurosciences, as well as Anatomical/General Pathology, and the emergence of investigative researchers of international renown. At present there exist five active training programs, and approximately fifty neuropathologists in practice, two-thirds of whom hold Royal College certification in Neuropathology. Although many of the older practitioners had a background in anatomical pathology, the preponderance of younger neuropathologists has been that of graduates of direct entry programs with a prior foundation in academic neuroscience.

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The history of neuropathology in Canada