08 FYi • Career


Histopathology involves more than peering down a microscope…


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T IS estimated that half of the UK population will be diagnosed with cancer in their lifetimes. This is a sobering statistic – and yet cancer survival is currently at its highest level ever. Recently Cancer Research UK commissioned some research on the implications of these trends on pathology services and found that the NHS faces some serious challenges in terms of capacity. Staffing estimates suggest that the number of consultants in cellular


pathology (encompassing histopathology and cytopathology) have increased but only by 1.2 to 3 per cent per year. In the next five to 10 years it is estimated there will be a serious shortage of consultants across all areas of pathology. The Cancer Research UK report concluded this will have the largest impact on cellular pathology as there is a shortfall of trainees compared to those leaving the profession. No wonder the Royal College of Pathologists is keen to attract


interested Foundation year doctors into training – and it is certainly worth considering whether histopathology might be the career choice for you. Histopathology is essentially the study of changes in human tissue


caused by disease. Histopathologists examine tissue sampled in clinics or removed during operations, assessing it both macroscopically and using sophisticated microscopic techniques. They work mainly in the laboratory in partnership with scientists and doctors from other clinical specialties and have an in-depth knowledge of both pathological and clinical aspects of disease. The specialty is integral to cancer management through staging and


the grading of tumours. Histopathologists also have key responsibilities in disease screening, such as for breast or cervical cancer.


DETECTING DISEASE


Entry and training Following successful completion of foundation training, Health Education England (HEE) states that candidates applying for ST1 training in histopathology would be expected to have or develop a range of skills including: • extensive breadth of knowledge, not just of histopathology, but of clinical and surgical practice


• an interest in the mechanisms of disease at the macroscopic, microscopic and molecular level


• an inquisitive mind and self-motivation • good visual pattern recognition • manual dexterity and hand-eye co-ordination


• good diagnostic skills to determine not only the type of disease, but also its severity and extent to ensure the right treatment is given


• excellent organisational and time management skills • good problem-solving and decision-making skills


• the ability to work well alone and also within multidisciplinary teams (MDTs). Entry into one of the UK’s histopathology training programmes is


competitive and candidates would be expected to demonstrate an interest by involvement in activities, achievements and scientific meetings relevant to pathology, attendance at pathology courses and evidence of participation in audit/research projects that are relevant to pathology. You can download a full “person specification” from HEE at tinyurl.com/h4m76sj. Training in histopathology normally takes five and a half years on the


assumption that candidates will also be undertaking two optional training packages of three months each, either in cervical cytopathology, higher autopsy training or research methodology. A Certificate of Completion of Training (CCT) is awarded on the


recommendation of The Royal College of Pathologists following: • evidence of satisfactory completion of the histopathology curriculum and the minimum training period


• satisfactory outcomes in the requisite number of workplace-based assessments (including multi-source feedback)


• attainment of the College’s Year 1 Histopathology OSPE • FRCPath by examination in histopathology


• acquisition of annual review of competence progression (ARCP) outcome 6. Doctors applying for a Certificate of Eligibility for Specialist


Registration (CESR) in histopathology must be able to demonstrate equivalence to the requirements for the award of a histopathology CCT.


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