Histopathology

 

Section 1: Information about the writer

Dr M Histopathology Registrar, North West of England

Co Author: Mubashar Abugossi

ST3 in Histopathology, Newcastle Upon Tyne

Section 2: Scope of Histopathology practice in the UK

Here we discuss only the histopathology speciality; AKA, cellular pathology, AKA anatomical pathology. Other pathology specialities have their own training curriculum, application process and exams set-out the royal college of pathologist. There are more than 17 pathology specialties covered under the auspices of the RCPath; please refer to other areas if you require more information about them.

Working in histopathology is a bit different from other clinical specialities and most doctors wouldn’t know what to expect in this field.  Your work will be purely diagnostic. However, you won’t spend all your day under the microscope. There are many other activities and these include:

Cut-up: This is the term we use for taking blocks of the specimens to be processed and examined under the microscope.  The specimens we receive are quite wide ranged and you would expect everything to come to the lab “small biopsies, skin, hysterectomies, colon resections, lungs, kidneys, etc ……”. Don’t panic, there are certain guidelines we follow in general and for specific specimen types. These guidelines are called “datasets” and they are found in the royal college of pathologist website.

Reporting: You will be gradually thought how to write a histopathology report after examining the slide. This is usually challenging and exciting as you need to express your thoughts in words that are specific, simple and easy to understand to reach a specific diagnosis or differential diagnosis.

Post-mortems: You will be expected to perform at least 20 per year. However, this is an optional component and you can drop it after your part 1 FRCPath examination “usually taken during the second year of training”.

Multidisciplinary team meetings: A very important part of the training, and you are expected to attend these with consultants to discuss cases with other health care team “clinicians, oncologists, radiologists , etc ….”.

As in any other specialty you will be actively involved in audits, researches, training of medical students and junior doctors.

Section 3: Type of Training/ Route to Training

Histopathology training is a run through training program “5 and half years” and you start at ST1 level.

Academic clinical fellowships are available in histopathology but in much less numbers and they are usually more competitive. These posts will involve protected time “usually 25%” for research. However, it is a good route if you want to be involved more in academic aspect.