Histopathology

Phil da Forno
SpR in Histopathology
Leicester Royal Infirmary

During my year as a house officer, I decided that the two specialties I was most interested in were accident and emergency and pathology. It would be hard to find two more dissimilar specialties, but I found it much easier to decide what specialties I didn’t want to do for a career rather than those areas of medicine I wanted to practice for the rest of my life. In the end I decided that histopathology appealed the most because it seemed the most interesting and unusual of the two. I applied for a one year job as a pathology SHO with the idea that if I didn’t like it, I could always put it down to experience and go find a job in A E. I am now a year three SpR in histopathology.

Why pathology?

Pathology is extremely interesting with enough variety within the different sub-specialties to constantly produce cases of interest. An inquisitive mind is essential, along with an ability to appreciate mechanisms of disease at the macroscopic, microscopic and molecular level. Histopathologists require good diagnostic skills, not only for determining the type of disease, but also for characterising its severity and extent in order to ensure patients receive the appropriate treatment. A keen eye for diagnosis is also required in the mortuary for determining the presence and type of disease at post mortem. It is the science- based, problem-solving nature of the specialty that first drew me into histopathology and sustains my interest today. Decisions made by the histopathologist can have profound implications for the patient. However, being based away from the wards, the outcome of these decisions is not usually made apparent.

Training:

Currently only one year is spent as an SHO during which time an aptitude assessment is made and if the candidate is successful, they are free to apply for an SpR post. Specialist training lasts four and a half years, during which time the two membership of the Royal College of Pathologists examinations must be passed, with the part two exam being taken towards the end of the specialist training period. I successfully took the part one exam early which has enabled me to spend 6 months of specialist training undertaking a laboratory based research project, something that is encouraged in most teaching hospitals with a histopathology department. I hope to continue to undertake research projects in collaboration with the University of Leicester Department of Cancer Studies alongside my diagnostic work within the University Hospitals of Leicester NHS trust.