title: Academic autopsies in Brazil--a national survey.
abstract: OBJECTIVE
  To investigate the number and rate of academic autopsies, general organization, educational and research in Brazilian academic services.
  
  
  METHODS
  Standardized questionnaires were sent to Brazilian medical schools (n=177) and active pathology residency programs (n=53) from March to June 2009. Data were collected for years 2003 to 2008.
  
  
  RESULTS
  Thirty-two academic services in 11 Brazilian states answered the survey. Twenty-one (65.6%) perform less than a hundred autopsies for natural causes and less than fifty pediatric or fetal autopsies/year. Twenty-four (75%) perform less than a hundred adult autopsies/year. Many institutions (46.9%) reported a drop in the number of autopsies in a six-year period. The total autopsy count and autopsy rate in 2008 ranged 1-632 (median = 80), and 0-66% (mean = 10.6%), respectively. A steady decrease in the total count of autopsies in a pool of 19 institutions was observed (p<0.01). Median autopsy rates have fallen from 19.3%, in 2003, to 10.6%, in 2008 (p=0.07). Significant discrepancies at autopsies led to changes in institutional healthcare practice in 37.5% of the services. The low number of autopsies was a limiting factor in undergraduate education for 25% of respondents. A minimum number of autopsies is required to complete the pathology residency program in 34.6% of the services.
  
  
  CONCLUSIONS
  The total number and the rate of academic autopsies have decreased in Brazil between 2003 and 2008. The number of autopsies and the general organization of academic services must be enhanced to improve medical education, research, and the quality control of patient care.
authors.affiliation: anatomic Pathology Service, Hospital Universitário, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Aloísio
authors.initials: A
authors.lastname: Felipe-Silva
authors.affiliation: Department of Pathology, Federal University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Márcia
authors.initials: M
authors.lastname: Ishigai
authors.affiliation: Department of Pathology, School of Medicine, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Thaís
authors.initials: T
authors.lastname: Mauad
mesh_terms: D001344:Autopsy / Q000706:statistics & numerical data* / Q000639:trends; D001938:Brazil; D004504:Education, Medical, Undergraduate; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*; D010336:Pathology / Q000193:education; D011785:Quality Assurance, Health Care; D012106:Research / Q000193:education; D012577:Schools, Medical / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires