How to Get Into: Chemical Pathology ST3

Courses & Conferences to Attend

I attended the National Society for PKU in 2016 and presented there, although this was largely for personal reasons as I have PKU myself! I also attended the ABCD conference and gave a presentation there in 2018, but other than that, I hadn’t been to many conferences or courses.

Chemical Pathology is a broad church, so it depends on what your interests within that are! My primary interest is inherited metabolic disease, so the British Inherited Metabolic Disease Group conference or the Society for the Study of Inborn Errors of Metabolism (which is usually abroad) are the two big ones.

If it's diabetes, then either Diabetes UK or the Association of British Clinical Diabetologists (ABCD) conferences. Heart UK is good if you like lipids. There are also general biochemistry conferences, such as MedLab UK, which are very useful, particularly for those sitting FRCPath exams, but because these are so specialist, interviewers won’t have expected you to attend any of these before starting as a Chemical Pathology SpR.

There aren’t really any specific courses for Chemical Pathology, but if you’re really keen, there is plenty of eLearning available on both inherited metabolic disease and laboratory biochemistry. At the interview, they expect you to have a good basic understanding of electrolyte disturbances and endocrinology (particularly testing for endocrine abnormalities), so I recommend brushing up on those prior to the interview.

If you’ve done IMT, this shouldn’t be too tricky. I was also asked about clinical governance and the staffing structure of the lab, so it's also important to have a good idea about this – the best way to gain an understanding of this is to do a taster week.

How to Maximise Your Portfolio

I think the two most important things for me in succeeding with my application were my elective in medical school and my taster weeks. My elective was in Clinical Genetics and Paediatric Metabolic Medicine – I got 3 publications out of this and won a student summer 'ship with the British Inherited Metabolic Disease Group, so I could continue my research with them after I’d left.

These kinds of opportunities are harder to gain once you're a junior doctor, so the other thing that really helped was doing taster weeks – I did one in Adult Metabolic Medicine in Salford in F2 and also in Chemical Pathology at the Royal Liverpool Hospital as a CMT2.

I also made sure to get to know the consultants locally before applying. It’s a pretty small specialty with not many juniors, so if you seem keen, it's quite easy to be given simple audits or QIPs just by asking. Chemical pathologists are usually a friendly bunch, and as it isn’t on a lot of junior doctors' radars, we get excited if there is someone who shows an interest!

It's also useful to get to know local consultants because the one I did I taster week with was on my interview panel!

Making the Most of Your Day Job

A large part of the Chemical Pathology curriculum involves generic skills such as teaching, leadership, and research. Any opportunities that will help develop these areas will be seen positively when applying.

For example, with some colleagues, I set up a “mock on-call” teaching session for final year medical students to prepare them for F1,1, which the interviewers were interested in, but wasn’t directly relevant to Chemical Pathology.

There are also often times on the ward where you need to ring biochemistry or the lab wants to contact the junior doctor – ask about the tests, the assays, how things are done – we’re always more than happy to talk things through!

You might even get invited to come and have a look at the lab! Picking up these titbits can also make you really stand out at an interview.

Making the Most of Chemical Pathology ST3 Placements

It's pretty much unheard of these days to have a Chemical Pathology Foundation or Core Training job!

However, there is a lot of crossover with lots of other specialties – for example, Diabetes and Endocrinology, Cardiology, General Medicine, Renal Medicine, Paediatrics, and Intensive Care are all really useful specialties for being exposed to biochemistry and to see some of the problems patients will have with things like inherited metabolic diseases, endocrine disease, dyslipidaemia, and electrolyte disturbances.

Have a look at the treatment algorithms for these and try to understand the underlying physiology - even if you don’t become a Chemical Pathologist, it will make you a better doctor.

When I was redeployed back to general medicine during COVID, properly understanding hyponatraemia made life so much easier!

What About Non-Chemical Pathology ST3 Placements?

Metabolism and biochemistry are everywhere in medicine, so there’s always something relevant, whatever specialty you’re working in! For example, when I worked in surgery, I saw plenty of electrolyte abnormalities that I was left to manage, so I became very familiar with the local treatment algorithms!

Whilst I was in GP, I did an audit on metabolic bone disease in the practice, as there were lots of elderly patients with osteoporosis. Wherever you are, there will be things you can do that involve biochemistry!