Introduction

Welcome to the realm of Histopathology.  This hand-book is aimed as a guide to your way around this new field.  I hope you find it both useful and informative and that you enjoy your chosen career path in this most interesting and challenging of specialties.  We hope that you enjoy your time here, and find it worthwhile.  These are some introductory notes on various aspects of the Histopathology Department to help you settle in as quickly as possible. 

History of Leeds Teaching Hospitals NHS Trust

Overview of the ST1 year

The Leeds Training School is based on the 5th Floor of the newly built Bexley Wing of St James’ University Hospital (SJH).  Most of the in-house ST1 teaching will take place in Bexley Wing.  However, there are occasions when you will be required to attend sessions outside of the region.

The department operates a high degree of sub-specialty reporting, such that all specimens (except routine skin cases) will be assigned directly to the relevant specialist Pathologist.  In order to maintain the involvement of the trainees in these cases, all trainees will work with specified consultants, changing approximately every 3 weeks.  A copy of the rota showing ‘rotations’ through these specialties will be provided on your first day.

Induction Programme – 5th – 7th August and Beyond

You will commence your first year of training by attending the mandatory trust induction, details of where and when to report, should have been sent to you by the Central Recruitment Department.  Following on from this will be an in-house induction

Following the initial induction programme, there will be a series of formalised ‘introductory’ events – you will find more details about the various activities below.

Autopsy Training

 

During 2007, we experienced problems with providing sufficient autopsy training in Leeds due to the retirement of the Forensic Consultant.  This made delivery of introductory autopsy training in Leeds difficult.  Whilst a new Consultant has been appointed, it was felt that the arrangements outlined below, should continue.

To ensure that we provide sufficient opportunities to complete the requirements of the Royal College’s curriculum, arrangements have been made for the trainees to spend time over in Sheffield (Northern General Hospital).  The Training Programme Director – Dr Kim Suvarna – will undertake to deliver basic training including H&S and introductions to toxicology and autopsy histology.  You will also have the opportunity of visiting the Medic-legal centre later in your training.  He will provide an assessment as to what you are each able to competently achieve by the end of the sessions. 

Cytology Teaching

Cytology is another area where it is difficult to provide sufficient experience on-site.  Arrangements will be made for you to have block teaching weeks at our laboratory situated in Morley, as well as one2one teaching sessions with the Consultant Cytologist based at St James’ Hospital – Dr Avril Cullen.   Some of the sessions may be carried out at the laboratory based at Britannia House, Morley.

Block Teaching Weeks

There will be a series of block teaching weeks, both national and regional, as follows:

  • National Introductory week – for all ST1 trainees (England and Wales), to be held in Bristol from .  Further details on the programme will follow from Bristol. 
  • Regional block 1 –
  • Regional block 2 –

For the block weeks, the Leeds training school will pick up the cost of the hotel, one return travel (unless you specify prior to attending that you intend to travel daily, in which case expenses for daily travel will be allowed), and an evening meal allowance (to be agreed at a later date) if staying over.

FRCPath Teaching

You will be expected to also attend any local FRCPath teaching.  These sessions will be held in term-time only, on a Wednesday afternoon between 2.00 pm – 5.00 pm.  A programme of events will be available later.  However, in 2009, we aim to pilot a parallel programme for ST1s so that you are exposed to more basic histology for the main systems, so you will not participate in the FRCPath course until approximate October/November.

ST1 black box 

A black box session runs on a Friday afternoon, by ST1 trainees.  These will be facilitated by Dr Nick Griffin or Dr Nafisa Wilkinson.

Rotas

Key to groups:

Group 1 - Breast

Group 2 - GI
Group 3 - Skin and soft tissue Group 4 - Head and Neck
Group 5 - Liver/Renal, Urology and Gynaecology

A copy of the ST1 rota will be sent to you as soon as possible. The rota is based around the different specialty teams.  Once you commence in diagnostic teams, you will spend 3 weeks in each of the major specialties.  After the Histopathology Year 1 Assessment (HY1A or sometimes referred to as the OSPE), there will be a period of electives, giving you the opportunity of catching up on surgical and autopsy numbers prior to the Annual Review of Competence Progression (ARCP). 

If you are taking annual leave it is your responsibility to inform the consultants on the prospective teams as soon as possible.  We do strongly advise that you should try and spread your annual leave over the year, avoiding the block training weeks is a must.    

 

Undergraduate Teaching

All ST1s will be expected to participate in undergraduate teaching.   You will be receiving an introductory session by Phil Burns during your induction period.  Following this, you will be given a timetable, allocated subjects etc.

Audit and Research

All ST1s are expected to complete an audit and / or research project during the year and will be strongly supported if you wish to present the findings locally and nationally, if appropriate.  A selection of projects will be provided in due course.  Alternatively if you have innovative ideas on what you’d like to do, support will be provided, if possible.

Monitoring of Progress

To monitor your progress throughout your first year of training, an assessment form will need to be completed at the end of each diagnostic team placement.  This should be completed and signed by a consultant who has supervised your worked closely during the attachment.  Once completed a copy of these forms need to be returned to Mrs Sue Cossins during the week after completion of the placement.  The original should be put in your training portfolio.  Further Work-place based assessments will be required, see further information in the ‘Record keeping’ section of this hand-book.

School Staff Contacts

The main contacts for the ST1 School are:

Lead Trainer Dr Nick Griffin (ext 67579
Lead Clinician Dr Nafisa Wilkinson (ext 67435)
Non-clinical Mrs Sue Cossins (ext 64891)
Chair of Specialty Training Committee Dr Judy Wyatt (ext 67834)

 

Educational Supervisors

You will be assigned an Education Supervisor once in post, we try and work this so that you have the same person throughout your training whenever you are based at the Leeds Teaching Hospitals within your 4.5 years of training.

You should also try and meet with your Educational Supervisor at various times throughout the year to discuss progress and any problems that you may encounter.

Registration with the Royal College of Pathologists (RCPath)

Trainees must ensure that they register with the RCPath as soon as possible after commencing in post.  Likewise with the e-PathSPRAT (or MSF – multi-source feedback, 3600 appraisal) and HY1A – without registering and payment of fees for each event, you will not be eligible to participate and as these are essential requirements of your training.

Recording Training Achievements/ Log Book

 

It is recommended that you use make use of the ST1 log book.  It is a useful record in your end of year appraisal but also helps you to keep track of the range of specimens that you have cut up and reported. 

The log book will give you an idea of the types of specimens that you may encounter in each specialty.  You will naturally find that as the year progresses you will be able to tick off the vast majority if items but please remember that some of the specimens listed arrive in the department rather infrequently so it is not necessarily expected that you will have ticked every box by the end of the year.

In addition it is useful to track how many specimens you have reporting during the year.  This can easily be retrieved from the CoPATH computer system but please do not rely soley on the electronic forms.  In general terms we would expect an ST1 to report between 500 and 750 cases by the time of their HY1A and you should have also completed 20 autopsies (or on track to complete).

During induction, you will be given a presentation on Year 1 Survival from a trainee perspective – a session given by a more experienced trainee.  You will be given a folder with a guide to content.

Mid Year Review

About 6 months into your training we will hold a mid-year review to assess your progress.  This will be an informal review with the Training School Leads/ Educational Supervisor.

Mock OSPE

For a number of years, the training schools have given trainees the opportunity of sitting a ‘mock’ OSPE to enable them to get a feel of how the actual OSPE is run, the format of questions and the types of materials which you can expect to use.   This is usually around the middle of February (24th February 2010) and will be run regionally ie, for the northern group of trainees – Leeds, Manchester, Liverpool and Newcastle.

RCPath Assessments

The Royal College of Pathologists Year 1 Assessment will take place on 26th March 2010.  A Multi Source Feedback (MSF EPATH-SPRAT) will also be carried out around this time.  You will also undertake workplace-based assessments including 6 x Direct Observation of Practical Skills (DOPs), 6 x Case-based Discussion (CbD) and 6 x Evaluation of Clinical Events (ECE).  Click the link for the relevant page on RCPath website.  http://www.rcpath.org/index.asp?PageID=1464

Annual Review of Competence Progression (ARCP)

This will happen usually around mid-June, and will be a formal review with the Training School Leads, Training Programme Director and also an external representative from another training school.  There will be paperwork relevant to this review but this will be sent out nearer the time.

Minimum Data Sets

These documents are prepared by the Royal College of Pathologists with the aim of standardising reporting of all cancers to include all of the prognostic and diagnostic information needed for accurate staging and grading.  The MDS is generated using research to achieve an adequate evidence base.  Enclosed within this section are all of the current MDS published and their associated research.  They can be downloaded from the College web site at www.rcpath.org.uk in Word or pdf. format.

  1. Bladder
  2. Breast
  3. Cervical
  4. CNS
  5. Colorectal
  6. Gastric
  7. Lung
  8. Prostate
  9. Renal
  10. Endometrial
  11. Head and Neck
  12. Lymphoma
  13. Pancreas
  14. Skin Cancer
  15. Testicular
  16. Vulva