CYTOPATHOLOGY There has been an increased uptake of
the LBC QUATE option recently and it is clear that this is due to conversion to HPV primary screening. This has solved a potential problem with slide selection as it was increasingly difficult for UK-based examiners to provide conventional slides for the examination. Conventional smears are widely used in Austria and Germany, and the obvious consequence of this move to LBC is an increase in examinations that must be offered in all three technologies. This increases the complexity of the examination and the time required for preparation.
Careful planning The examination slides and paperwork travel in a suitcase and careful planning is required based on experience of previous examinations and examiners. The first time an examiner sees the venue and meets the local hosts is often the day of the examination. Flexibility and planning for potential issues will not prevent unforeseen problems arising on the day. Fast thinking and the support of the local team is vital in ensuring the success of logistically complex examinations. An expansion of the LBC slide bank is
required to meet the increasing demands of the move to HPV primary screening. This would allow multiple matched sets to be held in different locations in case of delays in transport to the venue by the examiner, or their sudden inability to attend the examination.
QUATE and Eurocytology One of the ambitious aims of the QUATE committee is to link the examination to the Eurocytology website. A mock examination is already available on the QUATE website but it is also hoped to use the teaching resources on the website to address training issues identified from analysis of examination results and the performance in MCQs and slides. For example, from analysis of candidate performance in recent years, there appears to be some issues in location and interpretation of hyperchromatic crowded groups in LBC slides. This will be addressed through the Eurocytology website. The mock examination on the website
could be developed further but there is the risk of giving away the answers for too many MCQs. It must be remembered that our field is narrow and there is a limit to the number of MCQs that can be put on the website. Another suggestion under consideration is the mandatory completion of Eurocytology modules before sitting the QUATE examination.
QUATE and medical staff Although the examination is aimed at primary screening staff, a small number of medical staff have sat the QUATE examination over the past few years. We emphasise to medical staff applicants that this qualification does not permit reporting of abnormal samples or
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medical staff roles in cytology but there is still a steady demand, particularly from Eastern Europe, to sit the examination.
QUATE: non-gynaecological options There is an ambition to develop a QUATE non-gynaecological examination for cytotechnologists, biomedical scientists and cytology screeners, similar to the gynaecological examination, but this suggestion has barely got off the ground and discussions are very much at the preliminary stage. Given that some mainland European countries have better-developed training schemes than the UK, it would make sense to involve potential examiners in other EFCS countries. The option of an examination for cytopathologists would be a logical second phase. The experience of the UK-based and -developed Diploma of Expert Practice (DEP) and Advanced Specialist Diploma (ASD) examinations in non-gynaecological cytology may help in this respect.
Further work As the examination expands in frequency and complexity, and more examiners are involved, documentation becomes vital to ensure the examination is delivered consistently across Europe. The discussion above suggests that we already have analytic tools to assess candidate, slide and MCQ performance. This is far from the truth. A database to hold all the examination data, including morphology features in slides, would permit analysis from multiple perspectives and allow us to focus on gaps in training programmes and problems with MCQ and slide performance. Uptake of the examination across Europe is patchy, partly because some countries such as the UK have their own registry examination, but countries that do not have any exit examinations for primary screener training should be encouraged to adopt the QUATE examination (Table 3).
Summary I have now been an examiner for the QUATE examination for just over a year and have had the pleasure of taking it to Slovenia, Austria, Italy and Denmark. The most recent was in Billund, Denmark, and was held in the Legoland Conference Centre. It has been a pleasure and a privilege to visit these countries and, as with all such visits, there is always something to learn about how cytology is delivered across Europe, and it has been fascinating to watch the evolution of the examination over a relatively short period. I would like to thank Peter Smith for his
hard work in raising the profile of the examination as Mina Desai’s predecessor as lead examiner, and Nick Dudding for his tireless work in modernising and delivering the examination, and for his unselfish approach to passing the baton to Elisabeth Fedl and myself; his quick responses to any questions we have had has led to a smooth handover.
Table 3. Venues and pass rates (%) for the QUATE aptitude test examinations, 1992–2009.
• Aarhus • Rome
• Monaco • Padova • Vienna
• Amsterdam • Lisbon • London • Alghero • Aarhus • London • Naples
• Ljubljana • Genoa
• Messina • Budapest
• Lillehammer • Aarhus
• Copenhagen • Budapest • Odense
• Amsterdam • Antwerp • Turin
• Denmark • Turin
• Denmark • Turin • Turin • Turin • Turin
• Austria • Lisbon
Overall pass rate: 73%. Allan Wilson
(
allan.wilson@lanarkshire.scot.nhs.uk) is Lead Biomedical Scientist in Cellular Pathology and Advanced Practitioner in Cervical Cytology, Pathology Department, Monklands Hospital, Monkscourt Avenue, Airdrie, Scotland. The next QUATE examination will be held on 2–5 October in Liverpool, at the 40th European Congress of Cytology meeting, which is being organised by the BAC. The organisers hope to see as many people with an interest in cytology as possible for the scientific and social programme. Full details may be found online (
www.cytology2016.com). Further information on the QUATE examination can also be found online (
www.eurocytology.eu/en/quate).
AUGUST 2016 THE BIOMEDICAL SCIENTIST
(1992) (1992) (1992) (1993) (1993) (1994) (1995) (1995) (1995) (1996) (1996) (1996) (1997) (1997) (1998) (1999) (2000) (2000) (2000) (2001) (2001) (2001) (2002) (2004) (2005) (2005) (2005) (2005) (2006) (2007) (2008) (2009) (2009)
Details for examinations held in 2003 are unavailable.
66.6 76.4 78.9 47.3 77.7 83.6 93.9 87.5 80.0 62.0 88.8 54.5 50.0 86.6 66.6 77.2 58.8 82.5 85.0 81.4 83.3 77.7 61.5 52.0 84.0 70.0 33.0 100 73.0 71.0 85.0 93.0 25.0
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