Pathology

Chemical Pathology involves detecting changes in a wide range of substances in blood and body fluids (electrolytes, enzymes and proteins) in association with many diseases. It also involves detecting and measuring tumour (cancer) markers, hormones, poisons and both therapeutic and illicit drugs.

The largest part of a chemical pathologist's day is typically spent in clinical liaison: advising other doctors about the appropriate tests for the investigation of a particular clinical problem, the interpretation of results and follow-up, and the effect of interferences e.g. by therapeutic drugs on test results.

Evaluation of new technologies and the development of new tests is an ongoing process in chemical pathology. This applies particularly to areas that are now opening up, such as the use of molecular biology techniques in diagnostic tests. Specialist areas of interest include such topics as inherited metabolic diseases, trace metals and environmental monitoring, drugs of abuse, and nutrition.

Training in chemical pathology is completed in two stages:

• Basic Specialist Training in General Internal Medicine (or an equivalent programme) – Two years
• Higher Specialist Training in Chemical Pathology – Five years

Applicants for Higher Specialist Training (HST) in Chemical Pathology must either:

a) have spent a minimum of one year in approved Chemical Pathology SHO/Registrar posts in which they have completed the first year of the Core Training Programme in Chemical Pathology. Furthermore, it is recommended that all candidates for HST in the Specialty should have some post registration training in general medicine including experience in endocrinology, diabetes and metabolic diseases.

Or:

b) have completed a minimum of two years Basic Specialist Training (BST) in General Internal Medicine in approved posts and obtained the MRCPI or (UK*), or MRCPCH. For further information please review the BST curriculum. Those who do not hold an MRCPI or (UK*) must provide evidence of equivalent qualification.

Download Chemical Pathology HST curriculum 2022/2023 (PDF, 807KB)

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Clinical Microbiology deals with the prevention, diagnosis and treatment of human diseases caused by microorganisms including bacteria, fungi, parasites and viruses. It includes the study of microbial pathogenesis and epidemiology and is related to the study of disease pathology and immunology. It is a specialty that encompasses both the laboratory diagnostic aspects and prevention and clinical management of microbial diseases. Training in microbiology is completed in two stages:

• Basic Specialist Training in General Internal Medicine (or an equivalent programme) – Two years
• Higher Specialist Training in Clinical Microbiology – Five years

Download Clinical Microbiology HST curriculum 2022/2023 (PDF, 818KB)

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(Use this curriculum if you are in Year 1 of HST in 2023/2024)

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The study of blood has fascinated people since the beginning of time. The Greek physician Hippocrates (460–370 BC) believed too much or too little blood along with three other body humors (yellow bile, black bile and phlegm) could be responsible for human emotions and behaviours.

Nowadays, the study of blood, which more widely known as haematology, is a unique specialty within the Faculty of Pathology at RCPI. It has equally important clinical and laboratory commitments. Currently there are 54 consultant haematologists and 22 specialist registrars in training working in Ireland.

Patients attending the haematology service are a diverse group of people with benign and malignant medical conditions; this provides many sub-specialties which can appeal to a large number of people. There are adult and paediatric clinical haematology specialties and within these, there are sub-specialty areas of interest including haemostasis and thrombosis; red cell disorders; obstetric haematology; malignant haematology including leukaemia, lymphoma, myeloma and transplantation.

More recently, some haematologists are becoming laboratory specialists, spending more time in the laboratory than on the ward. This area too has sub-specialties including transfusion, coagulation, and molecular diagnostics.

Training in haematology is completed in two stages:

• Basic Specialist Training in General Internal Medicine (or an equivalent programme) - Two years
• Higher Specialist Training in Haematology - Five years

Download Haematology HST curriculum 2022/2023 (PDF, 760KB)

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The three main aspects of this specialty are diagnostic histopathology, cytopathology and autopsies.

Diagnostic histopathology involves making diagnoses based on the microscopic examination of tissues removed during various operative interventions and procedures such as endoscopy, biopsy or resections. The biopsy or surgical specimen is processed and histological sections are placed onto glass slides.

Cytopathology deals with diseases on the cellular level. A common application of cytopathology is the smear test, used to detect precancerous cervical lesions and prevent cervical cancer.

A histopathologist also conducts postmortem examination of the body to determine the cause of death (autopsy).

Training in histopathology is completed in two stages:

• Basic Specialist Training in Histopathology (or an equivalent programme) - Two years
• Higher Specialist Training in Histopathology - Four to five years

Download Histopathology HST curriculum 2022/2023 (PDF, 703KB)

Download Histopathology HST curriculum 2023/2024 (PDF, 683KB)
(Use this curriculum if you are in Year 1 of HST in 2023/2024)

Download Histopathology OBE HST curriculum 2022/2023 (PDF, 610KB)

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The immune system is involved in every branch of medicine. Clinical Immunology is an integrated clinical and laboratory specialty, in which specialists apply a detailed understanding of the immune system to a wide variety of clinical problems. Clinical immunologists are involved in assessing and managing patients, as well as running immunology laboratories.

Clinical immunologists see and assess patients with possible or diagnosed immunodeficiency and allergy. Additionally, they are likely to be involved with patients with complex autoimmune disease, autoinflammatory conditions and other rare diseases, and assessment of patients where the diagnosis is elusive. Consultants take responsibility for running laboratories in which tests are processed to diagnose and monitor patients with immunodeficiency, autoimmune disease and allergies. In some hospitals, immunologists may also be involved in providing a transplant immunology service, where tests for transplant work-up, transplantation and post-transplant monitoring are performed.

Clinical immunology is a rapidly evolving discipline, with new disorders being reported every few weeks – it never gets boring! Clinical work is highly variable as immunology interfaces with every aspect of medicine. Having both clinical and laboratory facilities and expertise, together with collaborations around the world allows you move from the bedside to the bench, and back to the bedside.

Training in immunology is completed in two stages:

• Basic Specialist Training in General Internal Medicine (or an equivalent programme) - Two years
• Higher Specialist Training in Immunology - Five years

Higher specialist training in Immunology takes five years, during which you will complete the FRCPath examination in Immunology. Trainees are encouraged to undertake a research based higher degree, one year of which can be counted towards HST training. During training, trainees gain experience in clinical and laboratory aspects of immunology, as well as laboratory management, accreditation, audit and governance.

Download Immunology HST curriculum 2022/2023 (PDF, 776KB)

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(Use this curriculum if you are in Year 1 of HST in 2023/2024)

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Neuropathology is the study of disease of nervous system tissue, usually in the form of either small surgical biopsies or whole-body autopsies. Neuropathologists usually work in a department of anatomic pathology, but work closely with the clinical disciplines of neurology, and neurosurgery, which often depend on neuropathology for a diagnosis. Neuropathology also relates to forensic pathology because brain disease or brain injury can be related to cause of death.

Neuropathology should not be confused with neuropathy, which refers to disorders of the nerves themselves (usually in the peripheral nervous system). Neuropathology plays a key role in characterising the pathogenesis of neurodegenerative diseases including forms of neurodegeneration with brain iron accumulation. The HST Neuropathology curriculum was developed in 2015 with the neuropathologists in Ireland: Dr Francesca Brett, Dr Niamh Bermingham and Dr Jane Cryan. Trainees in Higher Specialist Training can approach a career as a neuropathologist in one of two ways:

• Part I and Part II FRCPath in Histopathology, followed by an additional period of specialist training in Neuropathology (so that the total minimum training in Neuropathology is two years)
• Part I FRCPath with Part II slanted towards Neuropathology

In circumstances where a trainee has, following a successful aptitude assessment, spent two years in histopathology at BST level, the second of these two years may be assessed for equivalence to a Year 1 programme of Higher Specialist Training. This evaluation will be made at annual assessments.

Download Neuropathology HST curriculum 2022/2023 (PDF, 646KB)

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(Use this curriculum if you are in Year 1 of HST in 2023/2024)

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