Questions, doubts & misconceptions you might have about histopathology

Histopathology is often under-appreciated and misunderstood by patients, medical students and doctors alike so it’s understandable that you may have some questions. We did before we applied. Here we answer some of the most commonly asked questions. If you have other questions, contact your nearest Pathology Ambassador or local histopathology department – the consultants/trainees will be happy to chat with you.

Do you miss patients?

No, I don’t miss patients. I found that when I was a junior doctor working on the wards, I’d spend a lot of time with patients, but not much time interacting with other doctors and at times even felt isolated because of this. As a histopathology trainee I interact with my peers, the consultants who train me, the biomedical scientists working in the histopathology lab, the secretaries who manage the cases and produce the reports, mortuary staff, clinicians at the multidisciplinary team meeting (MDT) and the medical students that I teach. It’s a very social job. What’s more, I know that I’m helping patients even though I’m not interacting with them directly – the histopathological diagnosis is essential for patient management and informing the prognosis. However, some trainees find that they do miss patients and some even leave histopathology because of this – I’d therefore recommend arranging taster days in histopathology before you apply, so that you can decide whether the lack of patient contact is something that would trouble you.

Do you have to do post mortems?

Post mortems are compulsory within the first two years of training and they then become optional. It’s human nature to find the idea of post mortems off-putting, however they’re very similar to dissection at medical school and combine a knowledge of surgery, anatomy and pathology. Diagnosing the cause of death is an intellectual challenge and very interesting. If you’re concerned about post mortems, I’d recommend contacting your local hospital mortuary and arrange to watch one.

Are histopathologists eccentric doctors who lack communication skills?

Absolutely not. Communication is a key histopathology skill – histopathologists need to be able to communicate with each other (when getting second opinions on complex cases), with the trainees and medical students that they teach, with the other members of the histopathology department that they work in and with the other members of the MDT (both by written report and verbal discussion of the cases). Histopathologists forfeit patient communication in order to help patients in a different way (by diagnosing their disease), not because they’re not good at communicating with them.

Are pathologists ‘failed’ doctors?

Absolutley not. Our skills might not be useful in a medical emergency, but neither would the skills of some of the other non-acute specialties (e.g. psychiatry, ophthalmology, dermatology etc). Whilst we de-skill in many areas of ward-based medicine (e.g. practical skills such as cannulas, interpretation of ECGs) we develop specialty-specific expertise (e.g. ability to make the histopathological diagnosis, ability to perform a post mortem etc).

Do histopathologists work in a lab?

Partly. Our job is mixed – we spend some of our time in ‘cut-up’ examining and dissecting surgical specimens. A common misconception is that we then process the tissue into FFPE blocks and glass slides ourselves – this work isn’t actually performed by histopathologists, but by the biomedical scientists working in histopathology departments. The rest of our time is spent in offices looking at slides (trainees will often work in a communal office), in the mortuary, presenting cases at the MDT, teaching medical students etc.

Is histopathology a dying specialty?

Absolutely not. Histopathology is a strong specialty – the histopathological diagnosis is the cornerstone of medical management. What’s more, many exciting new developments in histopathology are currently taking place.