Academic pathology combines diagnostic histopathology with research activities. Pathologists have made many ground breaking contributions in medicine including discovering the link between H. Pylori and gastric ulcers, characterising variant CJD and improving the quality and outcomes of colorectal cancer surgery. Training in academic pathology requires an extended training pathway to complete a higher research degree (MD/PhD) and secure post doctoral research funding.
Any trainee can get involved with histopathology research by approaching local academic histopathologists. For those interested in a combined academic/clinical career the National Institute for Health Research Academic Clinical Fellowship programme provides an ideal starting point.
Dr Caroline Young is a Wellcome Trust Research Training Fellow and trainee histopathologist in Leeds. This is her experience of academic pathology training:
Why I chose histopathology
When I graduated from medical school, I was considering a career as an oncologist – the mixture of research, medicine and communication/empathy appealed. It was serendipity that lead me to histopathology: my SHO was planning on entering histopathology post-CMT and enthused about it. I’d enjoyed the subject at medical school (my intercalated degree was in clinical pathology), but I’d never experienced it during clinical school rotations or considered it as a potential career.
My curiosity piqued, I approached a consultant histopathologist during an MDT that I was attending as a surgical FY1. He was fantastic – so enthusiastic, passionate and keen for me to explore the option. With his help, I attended a few cut-up sessions, arranged a taster day in histopathology, attended an autopsy, met with current histopathology trainees and started a small research project with one of them. The more I experienced histopathology, the more I realised how much I enjoyed it: it combines knowledge of anatomy, histology and physiology, surgical-type dexterity (for cut-up and post-mortems) and strong communication skills (interacting with other specialties through MDTs and the production of histology reports). The working day is therefore very varied and most trainees and consultants are also involved in additional fulfilling activities such as teaching medical students, management/leadership or research. The training pathway is well-supervised and supported – trainees receive one:one feedback from consultants on a daily basis.
I also took the time to explore some of the initial doubts that I had about entering a specialty of which I had such limited experience. Many trainees have similar concerns: Will I miss the patient contact?; Will I enjoy/show aptitude for the microscopy; How will I feel about undertaking a post-mortem? I discussed these potential issues with the pathologists I met, in order to make an informed choice. For me it was the right one – I love histopathology and can’t recommend it enough.
Whilst exploring histopathology as a potential specialty, I also explored whether I wanted to enter the formal academic pathology training scheme. My experience of academic medicine was relatively limited: I’d undertaken an intercalated degree at medical school, a research elective and a few small research projects as an FY1. I contacted several academic pathology trainees to discuss the pros and cons, the attributes of a good academic pathologist and the merits of the different centres offering ACF posts.
I decided that I did want to embark on a career in academic pathology: I was interested in the opportunity to conduct research, improve practice and to have a varied career (combining research, teaching and clinical commitments). I strengthened my CV towards the Academic Clinical Fellowship (ACF) application, made contact with the centre that I wanted to apply to and was fortunate to secure an ST1 ACF post. During my ACF, I undertook a 6 month research block from April of ST1. This afforded me the time and resources to develop the necessary skills to apply for a PhD Fellowship. I was fortunate to secure a Wellcome Trust Research Training Fellowship and came out of programme to start my PhD in September 2016.
I would encourage anyone with even a small interest in academic pathology to explore this career path, as unfortunately the number of academic pathologists is currently in decline. This is a great pity, as academic pathology has made substantial contributions to healthcare. The ACF scheme exists formally, but alternative routes into academic pathology also exist. The Pathological Society of Great Britain and Ireland offers an ST1 Academic Pathology Day which I recommend if you are considering a career in academic pathology, as well as a number of grants and academic meetings.
Dr Caroline Young
Wellcome Trust Research Training Fellow, University of Leeds