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1)What is involved in Pathology?

Pathology is the study of the cause and effects of disease and involves the examination or analysis of human biological specimens in order to provide information that can help in diagnosis, prognosis, monitoring and overall management of patients. Quite often people have a narrow view of pathology as the study of dead people which comprises a very small component of pathology.

2) What are the specialities involved?

Pathology has several areas of specialization that continue to evolve with advancement in medicine. Broadly, it can be divided into Anatomic and Clinical Pathology. Anatomic pathology The major sub-specialities under anatomic pathology include histopathology, cytopathology, forensic pathology and molecular pathology. Clinical pathology is sometimes referred to laboratory medicine in order to distinguish it from anatomic pathology. It general includes haematology which examines different characteristics of blood, blood bank and transfusion medicine which is largely considered with collection, storage and manufacturing of blood and blood products that can be given to a patient in need of supplementation, microbiology which deals with micro-organisms such as bacteria, fungi, viruses, mycobacteria and parasites, and clinical chemistry which deals with the biochemical basis of disease, and the application of biochemical and molecular techniques in diagnosis.

3) What type of education and training prepared you for this career field?

In order to pursue a master of medicine degree in any branch of pathology you need an undergraduate medical degree i.e. MBCHH or MBBS. Most of the core areas in Pathology form a significant portion of an undergraduate medical degree curriculum and this is the reason it Is a prerequisite to pursuing a post graduate degree in Pathology.

4) What do you look for in a path program?

First thing is to be sure that you want to be a Pathologist. Pathologists spend the bulk of their time inside the laboratory with significantly reduced patient contact compared to the other common clinical disciplines such as internal medicine, paediatrics, surgery or obstetrics and gynaecology. So if you love seeing patients regularly and have a passion for active involvement in patient management it is worth remembering that more often than not pathologists work in the background as the consultants consultant. Once you are sure that pathology is the right career choice for you then you need to decide which branch of Pathology you would like to pursue and where you would like to study. Important considerations when selecting where to study include the faculty to student ratio, research capacity of the department and extent to which students are involved in faculty projects, diversity of tests conducted in the department and the case mix representing a wide spectrum of disease.

5) Why did you choose Pathology?

I chose Pathology for 2 reasons. One, I have always been interested in pursuing a research career and pathology offered me an opportunity to pursue this interest. Secondly, I strongly believe that Pathology is the science behind the cure. The effectiveness of treatment depends on a right diagnosis. We now know that reliance of clinical acumen on its own in diagnosis has numerous limitations ranging from inaccuracy and subjectivity which affects reproducibility. Pathology plays an important role in supplementing clinical diagnosis and helping to improve patient outcomes.

6) Can you describe a typical day at your job?

I work in a university teaching hospital which means that I have both teaching and service responsibilities. Typically, I will report to work around 8.00 am and start my day by attending the morning hand over by the technologists working at night to the day shift staff. In this meeting we discuss any challenges or concerns that occurred during the night shift. If a clinician needs to be called to discuss a specific result or to clarify any queries, this is usually done before 10.00 am. This is followed by reviewing critical values that were released during the night. Once this is done, I review internal quality control data from the chemistry analyzers to ensure that results generated are analytically accurate and precise. Any pending results are also signed out together with the resident in the section for dispatch to the patients or doctors. The time between morning tea break and lunch hour is usually spent doing academic work like reviewing interesting cases and trouble shooting, giving lectures, journal clubs, reviewing research student proposals and dissertations. The afternoon is mainly spent signing off results and consulting with colleagues in the department and hospital at large who need to discuss any results. It is also spent discussing administrative issues in the section with the chief technologist, reviewing the performance of the section in external quality assurance and reviewing key performance indicators. Most administrative and research meeting are scheduled in the afternoon. If there are any lectures or presentations to be prepared, I usually do this in the afternoon. My day usually ends after 6.00 pm as I like doing my research work after normal working hours when the laboratory is less busy.

7) How much are you required to work outside normal business hours?

Very often due to academic and research pressure. Preparing a lecture for instance requires a lot of background reading and literature review that cant be done during normal working hours due to the ususal hustle and bustle of a regular day. Writing research proposal, analysis of data and drafting of manuscripts is best done after 5.00 pm or before 8.00 am as they require utmost concentration. Sometimes service issues such as machine breakdown or reagent shortages male me stay late in order to organise contingencies to ensure disruption of normal service is kept at a minimum.

8) What are some of the biggest challenges you face in your job?

One of the big challenges is finding sufficient time to keep abreast with new knowledge in the very rapidly evolving field of laboratory medicine. There is a global push towards personalized medicine which on the diagnostics side involves a lot of new molecular technologies that analyse the human genome which results in production of enormous amount of data. In order to remain relevant as a laboratory physician, it is mandatory that one keeps abreast with new technology and analytical methods as well as gaining an understanding of bio-informatics which traditionally have been the preserve of scientists..

9) What types of skills are necessary for succeeding in this career?

A pathologist .beyond possessing broad and in depth knowledge in Pathology, needs to be compassionate as the job often involves breaking potentially life changing news to patients or their doctors for example telling someone that they have cancer or HIV, `a Pathologist needs to be an astute professional at all times as they are the consultants consultant, a Pathologist should be a good communicator as the job involves regular interaction with patients, doctors, nurses and laboratory technologists, a Pathologist needs to be inquisitive like an investigator so as to be able to look beyond the obvious and provide a sensible diagnosis and finally a Pathologist must be a team player to be able work with fellow clinicians to do what is best for the patient.

10) What is the employment outlook for this career field? How much demand is there?

Kenya is the country in East and Central Africa with the highest number of Pathologists. It has a population of over 42 million but less than 100 Pathologists. This highlights the dire need for Pathologists in the region as there is an acute shortage that wont be filled for several years to come due to the paucity of medical schools offering a post graduate qualification in Pathology. So the future does look bright for anyone choosing to join this noble profession. Jobs are in plenty and increasing the salaries for Pathologists are on the up as their importance continues to be recognized.