How should I study histology?
Whether your investment in learning histology serves you well or poorly in the future may well depend not only on the effort you invest but also on the attitude you bring to your first encounters with this discipline.
The rare moment is not the moment when there is something worth looking at but the moment when we are capable of seeing. Joseph Wood Krutch
Medical students often feel buffetted by the curriculum, pushed this way and that by many pressing demands on time and attention. As a consequence, students commonly postpone their engagement with histology and then "cram" just before tests. The predictable result of this strategy is a short-term acquisition of "factoids", handy for passing tests but quickly forgotten. Needless to say, this approach is not recommended. For histology to be more than a traditional rite-of-passage, the subject should be appreciated as a meaningful and unique perspective on the human body.
First of all, you should understand why you are expected to acquire a tissue-level perspective on the human body. (See Why study histology?) Then you should let your study be informed by this rationale.
If you desire some further advice, consider the following:
- How should one begin the study of histology?
- How is histology approached in the Year One curriculum?
- How much information should be learned?
- Are all those details really necessary?
How should one begin the study of histology?
First, and most important, histology should be studied within a larger context. You should be studying the human body as a coherent, integrated whole. Histology provides one perspective, but that perspective must be integrated with other perspectives (e.g., anatomy, physiology, biochemistry) to be meaningful. (Don't be like the blind men and the elephant.) Knowledge of histology should not be walled off, to be called upon only for passing histology tests.
- Histology should illuminate other disciplines.
- Anatomy -- What is the cellular composition of those structures that you're cutting through?
- Physiology -- How are diverse bodily functions accomplished by cells, when all cells share a common set of functions?
- Biochemistry -- Where are all those reactions taking place?
- Conversely, most of histology makes much more sense when learned in the context of physiology, anatomy, and biochemistry. For example
- Anatomy -- How does the connective tissue in fascia differ from that in ligaments?
- Physiology -- Why is epithelium columnar in the trachea and squamous in the lung?
- Physiology -- Why are the intercalated disks of cardiac muscle associated with gap junctions?
- Biochemistry -- Why is the cytoplasm of serous secretory cells basophilic?
- Before any of this integration can begin, some basic knowledge and understanding must be acquired. Unfortunately, this basic information may seem disconnected and "irrelevant" until it has been thoroughly digested and internalized, a job which requires both time and effort (and faith that the investment will be worthwhile).
The detailed content of histology is most readily organized (and condensed) by a conceptual framework that recognizes the universal similarity of all eukaryotic cells and the fundamental organization of animal cells into four basic tissue types.
In the long run, it is time-efficient to begin with a overview of the concepts and appearances associated with cells and with each of the four basic tissues. Any information acquired outside of this framework will cost you extra effort and will be more easily forgotten.
Therefore, as soon as possible you should try to establish a solid foundation that includes the following.
- An appreciation of cellular structure and function, including some facility at "reading" electron micrographs. [If your undergraduate coursework did not include a solid grounding in cell biology, expect to invest extra time now, the sooner the better.]
- An appreciation of the organization of cells into four basic tissue types.
- A facility at "reading" tissue specimens, including electron micrographs as well as both microscope slides and light micrographs.
Only with a solid appreciation of cells and basic tissues can you efficiently acquire and retain information about organ-specific details regarding differentiated cell types and differentiated tissue organization.
How is histology approached in the Year One curriculum?
Our current curriculum is based on clinical Problem Cases, which are arranged by organ system into Units. This curriculum does NOT include a formal "course" designed to provide an introductory foundation in histology or cell biology. Instead, your engagement with particular cases will simply presume that you can acquire organ-specific details of histological information, as needed. However, full appreciation of particular details often depends on extensive (and unfamiliar) background information that may not emerge as explicit "learning objectives" in any of the case-centered activities.
A broad-based appreciation of Histology is most directly applicable to topics which are deemphasized in the Year One curriculum -- inflammation, tissue repair, and neoplasm. Be aware that much of the clinical relevance for histology may not become apparent until Year Two of our curriculum.
Therefore, from the very beginning (especially at the beginning) you should extend your study beyond the specifics of each particular case and try to master the underlying patterns and skills. The sooner you acquire a broad sense of both cell biology and histological organization of the four basic tissues, and the sooner you acquire some facility for "reading" specimens and micrographs, the more efficient (and more rewarding) your further investment will be.
What about pathology?
How much information should be learned?
Learn as much as you can, as soon as you can.
Sooner or later you will almost certainly wish you had learned more. And you won't have any more time then (probably much less) than you have now.
But remember, don't try to learn more than you can understand! You're studying to help future patients, not just memorizing for regurgitation on tests. Sometimes less is more.
Rote memorization may sometimes represent a net loss of learning potential, since information thus acquired is poorly integrated and all too soon forgotten.
Seek to appreciate tissue structure and function within the broader economy of the human body. It is up to you integrate histology and biochemistry and anatomy and physiology and pathology into a single subject. It is up to you to maintain a sense of context, so that specific details become meaningful information rather than rote factoids.
That said, only you (and your conscience) can choose the best balance for budgeting your study time among the many competing demands (and delights) of the medical curriculum.
But what about all those details?
Are all those details really necessary?
Histology is notorious for its "microscopic" detail. As in all affairs, details do matter. But, in the case of histology, it is not so much that each detail matters in-and-of-itself as that (as with most things) a deep and intuitive appreciation of the subject can be acquired only through repeated engagement with specific details.
Do pay attention to details. But don't just memorize every factoid you encounter. Try to see histological details as variations on underlying themes of cell biology and basic tissue organization.
An example: The lung and the kidney both have the underlying tissue organization typical of glands. One can memorize each organ in turn, as separate and peculiar entities, or one can recognize functionally meaningful variations on the general theme of gland. An abstract appreciation for how epithelial tissue and connective tissue are organized into glands turns the acquisition (and recollection) of many organ-specific details of lung and kidney into a straightforward task. But understanding such organization in the first place comes from noticing the less-than-obvious similarities among the diverse details of several different organs.
Also, keep in mind that particular details, even details which appear "trivial", may turn out to have unexpected significance -- conceivably by offering insight which benefits a patient, quite plausibly by enabling a better score on the USMLE (which is itself notorious for sampling minutae), almost certainly by enriching your overall appreciation of the human body.
And details of histology are most likely to be remembered, in some time of future need, if they have become interwoven into a rich tapestry that includes related information from other disciplines -- biochemistry, anatomy, physiology, pathology.
If needed: Why study histology?
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Last updated: 5 December 2006 / dgk