The Graylyn Conference Report of the conjoint ACLPS, ASCP, APC, and CAP task force is prompted by the growing realization that without reform of the clinical pathology residency curriculum the future of clinical pathology practice may be in jeopardy. The conclusions reached at the ASCP-sponsored Colorado Springs IV Conference on Clinical Pathology Residency Training laid the groundwork for this report on curriculum reform. The goal is the creation of scientifically oriented clinical pathology practitioners capable of serving as consultants to other physicians of managing laboratory resources, and of playing leadership roles in an increasingly complex health-care system. Recommendations are described under the headings of patient care roles, graduated responsibility, analytical and technical training, laboratory management and informatics, and basic and applied research. In terms of reforming the structure and content of the curriculum, it is recommended that basic laboratory rotations be preceded by either a single didactic general 4- to 6-week orientation, or a series of shorter orientations incorporated into each rotation. The introductory and rotation phase should be 9 to 12 months in duration. It is further recommended that the remaining 6 to 9 months of the 18-month core be an integrated experience in which the resident practices Clinical Pathology by assuming service responsibilities for several laboratory sections simultaneously.