Pathologist

Pathologists are specialist doctors that work to assess, diagnose and treat various human diseases. There are several types of pathology, from blood focused (haematology) to tissue focused (histopathology) and several more.

What is a pathologist?

Pathologists combine laboratory expertise with patient care to clinically assess patient’s tissues and cells. By doing so, they can determine any potential diseases, as well as the progression of a disease. There are various forms of pathology, some requiring more laboratory work and less patient facing work than others. Your main role will be overseeing a medical laboratory connected to a hospital, and its associated staff. You will delegate and carry out your own tests, check in on the tests being run and manage overall workloads of junior staff.

Different forms of pathologist jobs include:

• Microbiology and virology: assessing and treating infections and viruses, playing a major part of infection control.
• Histopathology: examining organ and tissue cells for disease.
• Forensic pathology (a subset of histopathology): determining cause of death, usually under suspicious circumstances.
• Haematology: assessing blood and bone marrow cells for disease.
• Chemical pathology: using biochemical tests to assess for biochemical markers that are indicative of disease.

Responsibilities

Your responsibilities as a pathologist span across patient care and the overall running of a hospital laboratory. The ratio between patient care and lab work will depend on your personal speciality.

You will begin your training as a pathologist in medical school with a medical degree.

Common duties in the role overall include:

• Meeting patients and taking a diagnostic history to work out which samples or tests need to be carried out to gather further information on their conditions.
• Managing biological scientists and laboratory technicians as they assess various clinically requested tests.
• Running outpatient clinics for your area of speciality, meeting patients and signposting them to the right test runs.
• Giving advice and guidance to other medical colleagues on your choices of test and why this will be beneficial to the patient.
• Working within a wider multidisciplinary team of specialists within your area.
• Providing a diagnosis to patients following on from the pathology lab work you and your team have conducted.
• Overseeing the running of a medical laboratory, such as staffing levels, workloading and further training requirements.
• Undertaking research in your specialist field to further contribute to the discipline.
• Training up medical students during their foundation years of medicine.

Salary

A pathologist salary is set by the NHS Agenda for Change pay scale. Your starting salary will be during your foundation years as a doctor, after your training in medical school. This will be £29,384 - £34,012.

On completion of your foundation training (two years), you will be eligible to apply for a pathology specialism. Your initial salary during specialist training will be £40,257 - £53,398. Once you complete your training and reach consultant level, you should expect to earn £88,364 - £119,113 per year.

Qualifications

You will begin your training as a pathologist in medical school with a medical degree. Medical schools are attached to universities. A medical degree usually lasts at least 5 years, and requires a minimum of 3 A levels at grades A and A*, including chemistry. Some medical schools will also require A levels in all or some of the following subjects: biology, physics or maths. Some medical schools will also require you to sit entrance exams such as the University Clinical Aptitude Test (UCAT) or the BioMedical Admissions Test (BMAT).

If you already hold an undergraduate degree, you may also be eligible to apply for graduate entry to medicine, a condensed four year course. You will need the same A Level grades in order to enter.

Training and development

Your training towards becoming a pathologist is clearly set out with the NHS. Once you complete your medical degree, you will start your foundation training. This covers two years as a junior doctor, where you will have at least six placements across different areas of medicine. On completion of your first year of foundation training you will need to register with the General Medical Council (GMC). This is so that you can operate as a fully practising doctor.

Medical degrees usually require applicants to have evidence of time spent in a patient focused setting before applying.

Once you have completed your foundation training and are GMC registered, you are eligible to apply for a pathology specialism. The type of pathology you choose to specialise in will dictate how long this aspect of your training lasts. Chemical pathology training lasts eight years, haematology and histopathology are five years, and microbiology and virology lasts four years.

On completion of your specialist training, you will be considered a consultant. The training doesn’t stop there, though. As part of your membership with the GMC you must complete regular continuing professional development (CPD). For all doctors this usually constitutes 250 hours within a five year period, average at about 50 hours per year. CPD can cover shadowing senior colleagues, attending conferences, conducting your own research and pursuing further sub specialist training if applicable to your role. You could also join The Pathological Society of Britain and Northern Ireland (Path Soc) for further development opportunities, access to research and conferences.

Skills

Your skills as a pathologist will usually combine excellent laboratory skills with strong patient support.

These include:

• A robust working knowledge of human disease and how this can affect the various tissues of the body.
• An ability to keep on top of current research.
• Excellent attention to detail.
• Problem solving skills for assessing patient’s potential illnesses, and ordering tests accordingly.
• Strong laboratory skills, including awareness of assessing for different diseases and technical tests.
• Ability to work decisively and independently, such as when making diagnostic decisions.
• Ability to work collaboratively with a wider team of medical colleagues, such as working in outpatient clinics or supporting patients with a wider team of clinicians involved in their care.
• Excellent verbal communication skills, particularly when passing on key information around testing plans or diagnosis.
• Excellent written communication for compiling laboratory reports to be used by various staff members.
• Strong organisational skills - you’ll be overseeing laboratory staff as well as potentially outpatient clinics, so your ability to handle multiple cases at once will be vital to your role.
• Research skills - especially if you plan to conduct your own studies and research as part of your CPD.

Work Experience

Medical degrees usually require applicants to have evidence of time spent in a patient focused setting before applying. It’s key to your initial application that you access some work experience. If you have a contract in medicine already, it’s a good idea to reach out and ask if they can help you arrange some shadowing of a relevant doctor or healthcare practitioner. Alternatively you can reach out to hospitals, GPs and other care providers to ask if they would allow a prospective medical student to observe their work. You could ask to shadow pathologists specifically if this is something you feel passionate about from an early stage in your medical career.

If you struggle to access a shadowing opportunity with healthcare professionals directly, there are other options too. You could shadow patient care in other areas of support, such as care homes. You could also work in part time, non clinical roles in medical settings, such as working as a porter.

Pathologists combine laboratory expertise with patient care to clinically assess patient’s tissues and cells.

Once you have joined a medical degree, it’s a good idea to see if there are any pathology focused societies. Membership will help you build contacts in your area of interest, and potentially support further learning opportunities.

Career Prospects

Your career prospects in pathology are varied. As you move through the various stages of medical training you will build on your skill set and knowledge. Once you become a consultant, you could take on further managerial responsibilities. Some consultant pathologists take on further hours within the private sector as a private pathologist.

If you particularly enjoy the academic side of your role, you could pursue research. This could involve conducting studies within your own practice as CPD, or looking for specifically research pathology jobs.

You might find that you get real job satisfaction out of training up foundation year doctors. This could lead to working in medical teaching positions, either within your hospital or as part of a medical school.