Medical Professions Resources Directory: Histopathologist
How to Become a Histopathologist
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Histopathology, which in some hospitals are called cellular pathology, deals with thetissue diagnosis of disease. Histopathology is a key specialty involved in the diagnosis and management of patients, especially those with cancer. This can be made on the basis of a biopsy or cellular aspirate taken from a patient or from autopsy material. Biopsy diagnosis is by far the larger component of the workload of a Department of Histopathology. The final diagnosis in many patients is made by the histopathologist and has a most important bearing on clinical management. A Professor of Surgery is reported to say to his patients “you won’t meet the most important person involved in your treatment – that’s the histopathologist.
Autopsy is a small but important component of the work of ahistopathologist, establishing the cause of sudden or unexpected death. It provides a valuable audit of clinical practice by monitoring disease progression or response to treatment. Some young doctors are unwilling to enter histopathology because of the prospect of performing autopsy examinations. In the future it is likely that many histopathologists will not perform post-mortem examinations, concentrating on surgical histopathology and cytopathology. Do not therefore let the prospect of postmortem examinations dissuade you from a career as a histopathologist. On the other hand if you are attracted to pathology because of the forensic aspects of the work you should begin your career as a conventional histopathology SHO, specializing in forensic pathology towards the end of your SpR training.
Histopathology is an intellectually satisfying discipline. Trainees rapidly becomeaccustomed to microscopic work and develop a fascination for the different histological patterns of disease. It is a rapidly changing specialty with new immuno-histochemical and molecular methods coming into routine use on a continual basis. Histopathologists need a broad-based knowledge and understanding of both the clinical and pathological aspects of disease. You will be involved in the management of patients of all ages and provide expert advice to most clinical departments in the hospital. Clinicians often remark that histopathologists are the most valuable consultants in a hospital. Much of the work of a histopathologist is now centered around regular multidisciplinary team meetings in which the diagnosis and clinical management of patients are discussed in a multi-professional setting.
Histopathology offers flexible working with relatively little out of hours work. It offersan increasing variety of challenges which require a robust approach to problem-solving and decision-making. A wide range of specialties is covered and there is an increasing trend towards subspecialisation, even in District General Hospitals. Although opportunities for direct patient contact are limited, liaison with other clinicians through multidisciplinary meetings is now a large part of the work of every histopathologist.
Twelve months as an SHO in histopathology is a pre-requisite for SpR appointment.Some of the successful applicants for SHO School posts have come straight from Pre- registration posts whereas others have had further clinical experience before embarking on histopathology training. Additional clinical experience is invaluable and will not count against you in the application procedure. Higher specialist training lasts for four and a half years, making the total training time five and a half years.
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