Consultant Histopathologist, Honorary Senior Lecturer
University Hospitals Coventry and Warwickshire
General overview of specialty:
Try and get into the mortuary; excellent teaching on clinical aspects of pathology and a chance to meet some pathologists. Follow your patient’s biopsy; at the end of it will be a friendly histopathologist. Talk to him/her. Seek an elective in pathology, not necessarily in the UK. We have had 2 elective students at UHCW who said they enjoyed and benefited from the experience. Turn up for multidisciplinary meetings and see how pathologists have “emerged from the shadows” to contribute to patient management. The days of the darkened room and pale, subterranean pathologist are over. Badger a pathologist to run a Special Study Module!
Out of hours
Very little but the “hours” regularly extend from 8am to 6pm. We are available from home for frozen sections and the like but are rarely asked to come in (twice in 5 years so far).
Working a rota system with eight other histopathologists I am responsible for the preparation of complex surgical resection specimens, reporting on histological specimens large and small, reporting on cytological specimens, carrying out autopsies and contributing to multidisciplinary meetings. I also run modules in Phase 1 and 2 of the Warwick Medical School graduate entry course. Any one day may involve several or all of these duties not forgetting some audit and research. Other days might include interviewing for prospective medical students or giving evidence at Coroner’s Court. I work as part of a team within the department of pathology e.g. technicians, laboratory staff, secretaries and as part of clinical teams managing patient care.
A degree of obsessional behaviour.
Ability to communicate well both verbally and in written form.
Ability to know your skills and limitations (I often ask a colleague for an opinion)
Ability to assimilate information from many sources.
Ability to do three jobs at once (on a quiet day)
Pros and cons:
§ Time to think (unless it’s during a frozen section).
§ Flexibility to do routine work around other commitments (like answering this questionnaire!).
§ Getting close to the elusive, absolute right answer to the question “What is going wrong with this patient?”(sometimes not possible).
§ Working closely with clinicians who listen very closely to what you have to say. A pathologist’s opinion may decide whether someone has a radical procedure or toxic chemotherapy.
§ Ability to combine routine work with Medical School commitments.
§ Rarely called in at night.
§ Loss of direct patient contact.
§ Public perceptions that you only do autopsy work.
§ Hardly a glamour specialty.
§ Getting very much busier.
Almost all pathologists specialise now and have responsibility for one or more subspecialties. E.g. I have an interest in lymphomas and head and neck pathology. Forensics appeals to some while others forsake autopsy work altogether. Some generalisation still happens though. For example today I have made diagnoses on biopsies from lymph node, tongue, pleura, colon and salivary gland. Variety remains the spice of life.
Job-wise nothing is a substitute for an F2 post in Histopathology. Several have passed through in the last couple of years. We even managed to turn one would-be surgeon to the “Dark Side” and she is now a trainee in pathology. Any clinical experience is a bonus when entering a pathology specialty. Conversely any clinical job would benefit from a short time in pathology.