In a new paper, published in the Journal of Clinical Pathology, NCRI’s Cellular and Molecular Pathology Group (CM-Path) report the results of their survey on the attitudes of UK pathologists towards research and molecular pathology. They highlight the issues facing academic pathology today and potential approaches to help overcome these.
The key issues:
- Pathology research plays a pivotal role in advancing medical research and patient care yet there is an ongoing decline in the number of academic pathology posts in the UK. Between the years 2000 and 2016 this number decreased from over 350 posts, to just over 100. In comparison, the number of academic posts for other clinical disciplines has remained stable over this time.
- The number of pathology trainees that want to be involved in research appears to be declining. Trainee pathologists may not be encouraged into academic posts and there are fewer of these posts available.
- Despite the lack of dedicated and funded time for research, many pathologists are involved in research on an informal basis e.g. on an honorary, short-term basis or outside of core working hours above and beyond their contract. However, with the workload of the NHS pathologist ever increasing, the time they have for research or academic activity is set to decrease unless there is more funded support and dedicated time.
- The skills and training that a pathologist requires are changing with the development of newer, molecular-based techniques for cancer diagnosis and treatment selection, however there is little provision of formal training in these molecular pathology techniques.
- The UK’s current academic pathology workforce is skewed towards more senior individuals, a large proportion of whom are approaching retirement and there is a paucity of junior academic pathologists. Without setting up the ‘next generation’ of academic pathologists, there is a risk that this wealth of research knowledge will be lost.
Almost every cancer patient requires a histological or cytological test from a pathologist for initial diagnosis. Pathology research and development has led the way in our understanding and classification of disease, and this is particularly important as we enter an age of personalised medicine that will be based on bringing together molecular analyses of tissues with microscopic imaging and wider data. We need to rekindle research in pathology and ensure that there is a next generation of pathologists who have the skills to lead in research and molecular pathology.
Karin Oien, Chair of NCRI’s CM-Path Group and Clinical Senior Lecturer in Pathology at the Institute of Cancer Sciences, University of Glasgow
As trainees, the barriers outlined in this paper are important ones to address to ensure that the next generation of pathologists are trained appropriately for diagnostic work as well as to engage with research.
Scarlet Brockmoeller and Caroline Young both histopathology trainees and CM-Path trainee members from the University of Leeds are lead authors on the paper.
Ongoing work through NCRI
NCRI’s CM-Path Group are keen to build on the findings of this survey and further support research in pathology. They are currently doing this in several ways:
- Working with the Royal College of Pathologists to transform the postgraduate pathology curriculum so that it covers the newer molecular-based techniques for cancer diagnosis and to support their research to quantify workforce needs of the future and how to meet the increasing demands for pathology services.
- Working to set up a structured training programme for pathology trainees and consultants to gain experience in research and clinical trials. This will ensure that pathologists have the information and tools they need to get involved in research.
- Provision of an advisory group to support researchers with their clinical trial proposals. NCRI’s Clinical Trial Pathology Advisory Group (CT-PAG) provides researchers with advice on pathology requirements in clinical trials, encouraging more researchers to involve pathologists in their trial design upfront.
- Promoting the Pathological Society mentoring scheme to get more senior pathologists to be mentors to ensure their expertise is passed down to trainees.
- Active recruitment of pathology trainees to CM-Path to ensure that trainees have the opportunity to build collaborative networks with more established pathologists and that they are empowered to play a role in reinvigorating pathology research in the UK.
About the survey
The survey was distributed to all UK-based consultant pathologists via the Pathological Society of Great Britain & Ireland and RCPath networks. Heads of Department were contacted separately to obtain figures for number of academic training and consultant posts.
302 cellular pathologists completed the survey which represents approximately 21% of the total cellular histopathology workforce and 70% of the academic cellular pathology consultant workforce.
Of these, 88% were histopathologists, 7% neuropathologists, 2% oral and maxillofacial pathologists 1.5% paediatric pathologists, 1% cytopathologists and 0.5% forensic pathologists.