Histopathology.
The Specialty
Histopathology encompasses a study of disease, makes diagnosis, provides prognostic information and guides management of patients to ensure accurate and timely care of clinical problems encountered by patients in the NHS today.
The lifelong study of disease, combined with the constant requirement to diagnose clinical conditions, creates one of the most rewarding and intellectually challenging career choices for an individual with a genuine interest in the subject of medicine. Histopathologists find their work very rewarding, as they are making a vital contribution to disease diagnosis. Although there is very little patient contact, you are helping patients in a very important way. Because the on-call commitment is minimal and direct management of patients lies with other doctors, this is a specialty where a good work-life balance can readily be achieved. While certain diagnoses can be easy to make, others can be challenging or seemingly impossible. Great mental concentration for sustained periods is required, which can be exhausting even if the physical demands of the day job appear light. However, this means most days are finished with a sense of real satisfaction and achievement. The specialty faces exciting challenges in moving to digital technology, and the fast growing sphere of molecular diagnosis and genomic medicine.
Important information for trainees about The Royal College of Pathologists and the organisation of training can be found on the College website: https://www.rcpath.org/discover-pathology/careers-in-pathology.html
The Programme
Our Histopathology Training Programme in Histopathology has a reputation for delivering a high quality, broad based training with exposure to sub-speciality training governed by trainees’ interests and requirements. A robust process of educational supervision drives the training scheme and is based on the “Gold Guide” and sound educational principles. We are supported by three Training Programme Directors (TPDs). We have strong cohort of Educational Supervisors throughout the region. You will be allocated a named supervisor who will guide you all the way through your training.
The Yorkshire and Humber Histopathology Training Programme comprises six or twelve month placements in hospitals in Sheffield, Leeds, Dewsbury, Bradford, Hull, Halifax, Harrogate and York, Chesterfield, and Doncaster. These are supervised by high quality and dedicated staff.
We are able to offer higher autopsy training module, leading to the Certificate of Higher Autopsy Training (CHAT). Higher cervical cytology training may be facilitated, though would require secondment to a neighbouring region to complete the Certificate of Higher Cervical Cytopathology Training (CHCCT). We also offer the opportunity to sub-specialise in Paediatric & Perinatal Pathology and Diagnostic Neuropathology at ST3 entry point.
Trainees are appointed by national selection process at ST1 level to complete five years of training to award of CCT in Histopathology. Trainees are allocated to a base hospital either in Leeds or Sheffield, according to your preference, made at the point of application. Here you will join one of the ST1 School cohorts, and will retain this principal base for the duration of training. You may choose to swap by agreement with the TPD. All trainees can expect to rotate out from their base to a regional hospital, for at least for six months, though many trainees benefit from the diversity of multiple placements, including a range of teaching hospitals. Typically those based in Leeds can expect a wider range of placements, though we are working to spread this opportunity more evenly.
We have a strong academic training programme based at Leeds University, with a number of Academic Clinical Fellows (ACFs), and Clinical Lecturers (CLs). There are excellent opportunities for Out of programmer experience, leading to PhD.
There is a continuous programmer of formal and informal postgraduate education. A full day seminar programmer is delivered bi-weekly, on Mondays. We have a recommended list of external course which are made available. Trainees have the opportunity to go on a management course attend at least once during their training, which is useful both preparation for consultant jobs, and for interview skills. The School also runs an in-house clinical leadership skills day, biannually for senior trainees.
Progress in training is monitored using assessment practices laid out in the curriculum and reviewed by the Speciality Training Committee at the Annual Review of Competency Progression (ARCP) process.
Please find information on the sites delivering this Programme below:
Trainees' Comments
Find out what 3 of our past trainees thought about the training provided on the programme.
The Leeds Teaching Hospitals NHS Trust comprises the major hospitals of Leeds General Infirmary and St James’s University Hospital, with the pathology department being based at the latter. This department will serve as the base for most histopathology trainees throughout the five year training period, with a number of six-month rotations taking place here.
The department is completely sub-specialised, with opportunity for experience in a wide range of specialist work such as cardiothoracic pathology, haematopathology, neuropathology and paediatric pathology, as well as more common specialities. Leeds acts as a referral centre for most of North and West Yorkshire, giving an opportunity to see a large number of rare and unusual cases. Wide-ranging experience in autopsy work and cytopathology is also available.
The histopathology department functions as a series of specialist teams, the configuration of which may change with time. Team 1 does ENT, Urology, Haematopathology and Soft Tissue pathology. Team 2 does Breast, Gastrointestinal (upper) and Hepatopathology. Team 3 does Gynaecological pathology and cytopathology, and Team 4 is Dermatopathology. Ophthalmic and Neuropathology are separate.
All sites have immunohistochemistry, and molecular pathology established. The adjacent University Section of Pathology in the Division of Genomic Medicine has molecular biology, image analysis and in situ hybridisation. Electron microscopy is available.
As a teaching trust, all of the hospitals have close links to the University of Sheffield, home to Sheffield’s medical school, and Sheffield Hallam University. It is a major teaching centre for future health professionals.
Hull and East Yorkshire Hospitals NHS Trust is one of the largest acute Trusts in England. The histopathology department is based at Hull Royal Infirmary, and is staffed by 13 consultants.
As a regional referral centre the department sees a wide range of specialities, meaning that the trainee will have the opportunity to gain experience in uncommon specialties such as neuropathology and renal pathology, as well as the more common specialties and routine work. Both gynaecological and non-gynaecological cytology are carried out at Hull, and there is ample opportunity for autopsy work.
The pathology department is based at York Hospital, which provides a range of services to a population of 320,000. The department is staffed by 8 consultants, with opportunities for work in most of the common specialties, as well as non-gynaecological cytology and autopsy
Harrogate District Hospital is part of a Foundation Trust providing a range of acute and planned services to the local community. The histopathology department is staffed by five consultant histopathologists, who all maintain a general portfolio of experience.
Regular MDTs are held with the major specialties and cancer centre services are provided in breast and colorectal surgery. Training is also provided in autopsies, to include a range of coroner’s cases. Non-gynae cytology experience is also provided
The histopathology department for the trust is based at the Calderdale Royal Hospital, staffed by five consultants. Trainees gain experience in breast, gastrointestinal, gynaecological and urological pathology, as well as both gynaecological and non-gynaecological cytology. Opportunities for autopsy work are also available.
The histopathology department is based at Bradford Royal Infirmary, and provides a sub-specialised service composed of 10 consultants. Each consultant has particular experience and expertise in one or more areas of histopathology and cytopathology.
Trainees will have to opportunity to become involved in both specialist and non-specialist reporting, autopsy work, non-gynaecological cytology and clinical audit.
The histopathology department is based in Dewsbury, with autopsy work being carried out at the neighbouring Pinderfields Hospital in Wakefield. The department is currently staffed by eleven consultants.
This is a general histopathology department with opportunities for experience in most histopathology specialities (and MDTs), autopsy work, both gynaecological and non-gynaecological cytology, and management. There is a daily multiheader meeting where challenging and interesting cases are discussed. The department accomodates 1-2 trainees at any time, with new microscopes and computers. Independent reporting appropriate to the level of training is actively encouraged
The Medico-Legal Centre in Sheffield houses the offices of the Coroner, the Coroner’s court, offices of the Forensic Science Service (FSS) and the public mortuary. The centre is owned by Sheffield City Council and is not part of the NHS. High quality and specialist training is made available, courtesy of the Coroner and FSS. The public mortuary is licensed under the Human Tissue Act and receives the bodies of those who die outside hospital from Sheffield, Barnsley and local townships.
Chesterfield Royal Hospital NHS Foundation Trust comprises approximately 630 beds, serving a population of approximately 350,000 people. The Trust currently offers the full range of District General Hospital services and has accreditation as a cancer unit. The hospital is also one of the Cancer Centres for Head and Neck Surgery. The department also handles approximately 1000 cases of non-cervical cytology cases, and offers service in the form of sampling adequacy assessment within the weekly head and neck clinic service. There is no cervical cytology specimen assessment offered on site. Routine (non-specialised) immunohistochemistry is carried out on site. The department also has a newly refurbished mortuary, which has dual function serving the hospital and community (750 cases per year).
The Doncaster and Bassetlaw Hospitals NHS Trust serves a population of approximately 420,000 and provides a full range of DGH-level services from five main sites; Doncaster Royal Infirmary (DRI), Bassetlaw District General Hospital (BDGH), Montagu Hospital (Mexborough), Tickhill Road Hospital (Doncaster) and Retford Hospital (outpatient services only).Trust has become an established and credible second hub for a wide range of specialist services alongside the major teaching and tertiary care centre in Sheffield and has recently been granted Associate Teaching Hospital status of the University of Sheffield Medical School. Histopathology has modern histology, immunohistology, cytology and standard laboratory facilities as well as a busy autopsy service, mainly for HM Coroner.