Pathology Training

Agnieszka_88

I think I would like to go into pathology after medschool, I like the more scientific approach for diagnosing disease. I've been reading about it for a while now, but I don't really understand the Irish training process. While the NHS process is quite straightforward (5 years histopathology, then you can specialise further if you want to), I honestly don't get how this specialisation works in the HSE. I understand that you have to obtain a training post in a pathology lab, train for about 6-7 years, but there was no word about further specialisation. Do you choose it from the beginning? What if you want to go into Neuropathology or, I don't know, chemical or forensics?

Also, I understand that officially the job situation for pathologists is quite good, but what is the reality?

Dingle_berry

There's a specific Non Consuultant Hospital Doctor training programme. I think its supervised by the royal college of pathologists? It's generally two years as an SHO, five years as an SpR. There are different programmes around the country like Dublin south, Dublin north, Munster and Connaught. In Dublin the 7 years is divided into rotations of 6 months (6 months SVUH, 6 months SJH, 6 months Rotunda, 6 months tallaght etc etc.)
Pathology NCHDs duties are generally specimen cut up (dissection of surgical specimens), microscopically screen specimens cut the day before, request and follow up on further investigations, review MDT material, sign out cases with a consultant, act as a prosector at autopsies, study, train other staff members....
Chemical pathology AFAIK is seperate to Histopathology - it's more a consultant biochemists role and they have a mix of lab duties and clinics like consultant Microbiologists and Immunologists.

Most pathologists are very happy to spend time showing med students what their job is like. I would strongly recommend that you contact a large teaching hospital like SVUH, the mater, CUH, etc and request to spend about a week with a pathologist and their NCHDs.

Agnieszka_88

Thank you! So it's pretty much a general training programme, yes? Or do you just drift into one of the specialisations as you go, during those 7 years?

Dingle_berry

Agnieszka_88 wrote: »

Thank you! So it's pretty much a general training programme, yes? Or do you just drift into one of the specialisations as you go, during those 7 years?

No it's general. I think at least some exams take the format that you're given slides. You examine them microscopically and answer questions like identify the stain, tissue, pathology present, any further investigations you'd request. You wouldn't know what the slides would be. And as everything is so inter-related you'd need a very good general basis.
Specialisation would be based on getting a job. Like SVUH has pathologists with interests in liver, pancreatic, colorectal and breast pathology but they would still do general pathology too. Possibly getting a post like breast pathologist in SVUH and the merrion breast check would depend on you demonstrating knowledge and interest in breast pathology through research you've conducted etc.

Agnieszka_88

Guess I will be moving to the UK after all, seems like a much more straightforward route... And the training is shorter, of course.

masterboy123

is there any tuition fees involved in these type of training programmes?

Vorsprung

masterboy123 wrote: »

is there any tuition fees involved in these type of training programmes?

There are annual fees owable to the particular college, but if you're on a training programme these are covered by the government.

Dingle_berry

Agnieszka_88 wrote: »

Guess I will be moving to the UK after all, seems like a much more straightforward route... And the training is shorter, of course.

Like other branches of clinical practise (eg surgery with surgeons assistants etc) Histopathology is slightly different in the UK. The biomedical scientists are trained to do most of the cut up (specimen dissection) and in some places they screen a lot of slides. Ireland is slowly moving in that direction but it being Ireland and the current "situation" has progress almost halted. So the training you get over there could be different to what you'd get here. The same exams at the end though.

I can't emphasise enough the benefit of getting some experience in a pathology department. You have studied pathology and histology, you may have read and understand what goes on in the lab but it is a different environment! One that med students and interns don't get experience of. We're an unseen, publicly unknown but key part of medicine (that our colleagues on the wards and in clinics like to use as scape goats!). We don't have patients dropping dead on us but there are different sources of stress (as with every job!). Since time seems to be important to you getting first hand experience will help you to be sure that its what you want. More NCHDs swap into pathology (mostly from surgery) but I've seen some swap out of it too.

Agnieszka_88

Thanks, all that was really helpful! I'll try to organise myself a couple weeks in a pathology department in the summer.

Dingle_berry

Agnieszka_88 wrote: »

Thanks, all that was really helpful! I'll try to organise myself a couple weeks in a pathology department in the summer.

No bother!
I'd start with whichever teaching hospitals your uni is attached to. Try the bigger ones first as they will have more variety like dermatology, oncology, etc as well as specialities like neurology or hepatology. As well as frozen sections, fluorescent assays, etc.
if they only offer you a week and you have more time to spare try another hospital, maybe a smaller one.