I am here today to talk to you about careers in Pathology and, by showing you some videos to let you hear from some of my pathologist colleagues what they do in the hospital and the labs Careers in pathology

“Is it the forensic work you see on TV programmes like Silent Witness and Midsomer Murders?” Is it the work you see in tv programmes like Silent Witness and CSI? (ask the audience what they think) A recent survey found that 60% of people believe that pathologists only cut up dead people and less than 33% know that pathologists diagnose diseases of living people. (ask audience if they knew that pathologists work with the living). What is pathology?

Pathology is the study of disease Pathologists are either doctors, vets or dentists with specialist laboratory training, or scientists with specialist clinical training Although, pathology is often only associated only with autopsies – this is a misconception. Pathology is the study of disease. Pathologists specialise in the detection of disease through the use of a variety of investigative techniques. Pathology is the study of disease

Prevention, diagnosis, treatment We are the doctors and scientists who work out what is wrong with someone by examining samples from them. They might be samples of blood or urine, or a tissue sample taken from a lump. These kinds of tests and investigative techniques can be vital in finding an accurate and early diagnosis – thus improving the prospects for treatment. Our work can also help prevent disease – for example screening populations for early signs and those at risk of disease. Each of us specialises in one type of pathology , for example, haematologists are blood specialists, microbiologists are experts in bacteria and histopathologists examine tissue samples. So if you hear of ‘sending something off to the lab’, you can be sure there will be a pathologist at the receiving end making the diagnosis’. Prevention, diagnosis, treatment

Histopathologists Look at tissues and cells removed from patients Use microscopes and a trained eye to discover disease Tell the patient’s doctor what is wrong (sum up in one sentence what histopathology is about and try to make it personal e.g. have you ever had a biopsy? A histopathologist would have examined that under the microscope) A Histopathologist looks at tissues and cells removed from patients in the clinic or during an operation and uses a trained eye to discover if a disease is present and what course of action needs to be taken. The tissue is examined first with the naked eye to look for any visible abnormalities and to select pieces to examine in more detail. These small pieces are treated so that very thin slices can be cut. The slices are then looked at under a microscope and the histopathologist tells the patient’s doctor what is wrong and often provides information about the correct treatment. Histopathologists are the people who diagnose cancers and other serious illnesses but they also often have good news, discovering that a lump or mole is completely benign and is nothing to worry about. Some histopathologists also carry out post mortem examinations to find out why someone has died.

Histopathologists Diagnose cancers and other serious illnesses... ..but they also often have good news Carry out post mortem examinations to find out why someone has died Histopathologists are the people who diagnose cancers and other serious illnesses but they also often have good news, discovering that a lump or mole is completely benign and is nothing to worry about. Some histopathologists also carry out post mortem examinations to find out why someone has died.

Skills required Good attention to detail and an eye for patterns Being able to make decisions under pressure Communication skills Being able to work as part of a team A good attention to detail for examining tissue to make diagnoses. Many diseases look very similar so being able to spot small differences will help choose the right answer. Being able to work under pressure as you may be given a frozen section to test while a patient is having an operation. This involves freezing a piece of tissue and looking at thin slices under the microscope while the surgeon, and the patient, wait for your answer. The next step of the operation depends on what you find. Histopathologists spend most of their time working with living people so need good communication skills to be able to explain the results of their investigations. Histopathologists work as part of a team with a wide range of health professionals including other doctors, scientists, nurses, dieticians and secretarial staff. Skills required

Haematologists Study and treat diseases of the blood cells and bone marrow Diagnose and treat blood clotting abnormalities Responsible for ensuring that blood transfusions are safe Start with a question ‘who here has ever had a blood test?’ A haematologist would have looked at your blood) Haematologists are doctors who are experts in blood, they study and treat diseases of the blood cells and bone marrow. Haematologists investigate and treat diseases involving blood cells, including anaemias, leukaemias and other bone marrow diseases. Haematologists also deal with abnormalities of the blood coagulation system, such as haemophilia. Blood transfusion is an important responsibility of haematologists.

Haematologists Care for people with anaemia, leukaemias, thrombosis and bleeding problems such as haemophilia Work in labs diagnosing disease, as well as caring for patients They’re involved in a patient’s care from their first blood test through to diagnosis and treatment. Often, the haematologist who looks after you in the clinic or on the ward will be the same person who has examined your blood or bone marrow under the microscope. Modern genetic testing is also a major feature of all branches of haematology. For example, haematologists’ work on leukaemias and blood cancers helps guide decisions for chemotherapy and other treatments. Because of this unique split of laboratory work and patient care, haematology can be a challenging but intensely rewarding area of medicine. As well as having their own patients, haematologists are a frequent source of advice for GPs and other hospital specialists.

Skills required Interpersonal skills Being able to empathise with patients Interpretative skills Good written communication skills When we asked haematologists what skills are important to work in their specialty inter-personal skills and empathy were highlighted, as were good interpretative skills. Skills required

Clinical biochemists Diagnose diseases where the body’s chemistry goes wrong Test body fluids such as blood, urine, saliva and spinal fluid Work in the lab but also have an important clinical role Clinical biochemistry is about diagnosing diseases where the body’s chemistry goes wrong. Knowing the contents of your body fluids can help your doctor make a diagnosis or indicate which body organ is not working properly. Body fluids such as blood, urine, saliva and spinal fluid are tested in Clinical Biochemistry laboratories. The level of sodium or glucose or enzymes are used by your doctor to make a diagnosis of diseases like Diabetes Mellitus or Renal Failure. As well as working in the lab performing biochemical tests for diagnosis and management of illnesses, biochemists have an important clinical role, advising on the management of patients with metabolic disturbances as well as running out-patient clinics.

Clinical biochemists Spend time looking at patients’ test results to see what is normal and what is abnormal Abnormal results will be discussed with patient’s doctor Clinical Biochemists spend time looking at patient test results to see what is normal and what is abnormal. Abnormal results will be phoned to the patient’s Doctor or Nurse to discuss whether they are expected because the patient has a disease or whether they indicate a new disease for that patient.

Skills required Communication skills An eye for detail Leadership skills Organisational skills Skills that are useful in chemical pathology include communication, which is essential to explain your work to a range of laboratory and medical staff. An eye for detail is important, for example when looking at blood test results to check for patterns and changes over time. Leadership skills, confidence and organisational skills are needed to manage a lab and interact with senior hospital staff. Skills required

Medical microbiologists Used to mainly work in labs but now see patients Give advice about many infection control issues Give advice on the correct treatment of infections Important in combating antimicrobial resistance Medical Microbiology used to be a mainly lab based specialty but now microbiologists are out on the wards seeing patients and advising on the treatment and investigation of all types of infection. Medical microbiologists also give advice about many infection control issues, trying to make sure that infections do not spread from one patient to another. Microbiologists advise on the correct treatment of infections, making sure that antibiotics are not prescribed inappropriately. I am sure you have all heard of antimicrobial resistance and the threat it poses to treating infections. So the work of microbiologists is extremely important to help reduce the prevalence of this.

Medical microbiologists Collaborate with colleagues and deal directly with patients, as well as work in the lab Make new and unexpected discoveries impacting on patients’ health Microbiologists tend to have very varied roles – they collaborate with lots of colleagues in the lab and wider hospital and deal directly with patients. They may also make unexpected discoveries about an infective organism that can have huge positive impacts on patients’ health.

Skills required Patience Curiosity Team player Persistent Good communicator You will need to be patient, inquisitive, a team player, adaptable and persistent in tracking down the results. You will need to be a good communicator to stress to your colleagues the importance of maintaining excellent infection control standards. Skills required

Journey of a Biopsy video I think it is fair to say that team work is key across all areas of pathology and I am going to show you a video now which illustrates how pathologists work with other medical and non-medical staff to obtain an accurate diagnosis from a biopsy sample. This was filmed in a histopathology laboratory in South London and really brings to life the kind of work that goes on in pathology labs.

Pathology – did you knows…? . Pathology is involved in approximately 70% of diagnoses... ...around 800 million diagnostic tests (average of 14 tests per person) each year in the UK . There are 17 ‘specialties’ in pathology… ...including immunology, veterinary pathology and neuropathology Pathology is involved in approximately 70% of diagnoses... That equates to around 14 pathology tests for every person the country per year. Who had a pathology test such as a blood test in the last year? Why do you think the average is 14 tests per person per year? Pathology is very diverse in terms of the areas of human and animal health it covers – there re 17 specialties in total. So in addition to the ‘big 4 specialties’ I have talked about, there are 13 other specialties including immunology, veterinary pathology and neuropathology. Add the personal touch and maybe talk about why what you do is so valuable here . Around 1% of all pathologists work in forensic pathology

www.rcpath.org/careers Find out more royalcollegeofpathologists There is lots more information on our website – visit rcpath.org/careers to read about the wide variety of careers on offer across all 17 of our specialties. We are also giving out free careers booklets and other materials as you leave today so have a read of those and keep an eye on our social media feeds – we often post careers-related content on Twitter and Instagram so follow us @rcpath and on Instagram we are royalcollegeofpathologists all one word. www.rcpath.org/careers

Any questions? Thank you Thank you for your attention; I am very happy to take your questions. Thank you