Courses & Conferences to Attend
To enter diagnostic neuropathology training, you need to have completed two years of training in histopathology and passed the FRCPath Part 1 examination. Therefore, getting onto a training programme in histopathology should be the initial focus. My entry into histopathology came via an alternative route, having spent time as a core surgical trainee. I had also completed a FY2 post in histopathology (which I loved), and this also influenced my decision. I did not attend any courses at this time, as there were very few focused on helping a trainee to get into pathology. This is very different now, and there are several events which are worth attending; many of these also feature information about diagnostic neuropathology, so they are helpful to learn more about the specialty, too. I subsequently spent 6 months at the ICR to learn about molecular pathology; this turned into a 4-year PhD with a neuropathology theme, and led me to apply for neuropathology training.
Each year, the British Neuropathological Society hold an Annual Meeting where the neuropathology community gather to attend themed symposia, present research, hear about interesting cases and meet up with colleagues. It is a great networking opportunity for those who want to meet existing trainees and also speak more with those who work in the different neuropathology centres across the UK and the world. I attended a couple of these meetings when I was considering applying to neuropathology and it was definitely worth it!
The following events will be really helpful for you to consider on your journey into histopathology and then onto neuropathology. You don’t need to attend all of them, but some may be helpful as you consider your next steps.
- RCPath Pathology Summer School – a free annual event aimed at undergraduates, held at the Gordon Pathology Museum in London. Delegates get the opportunity to learn more about the different pathology specialties, including neuropathology, and how to make the most of training opportunities. There are also interactive pathology pot sessions where you can learn some actual neuropathology!
- Path to Success – a free annual event in Newcastle aimed at resident doctors and undergraduates who are interested in exploring what a career in pathology can offer you. Advice is provided about interviews and applications and includes a Q&A session with existing trainees. There are also opportunities to submit a pathology-related poster which will be entered in the prize competition. It is a really good networking opportunity for those thinking about joining pathology, and there is normally neuropathology representation.
- PathQuest; exploring careers in diagnostic neuropathology and paediatric & perinatal pathology! – a free virtual event supported by the RCPath and BNS to encourage existing histopathology trainees to consider applying to train in one of these smaller specialties. The event consists of interactive talks focussing on what each specialty can offer as a career, interesting and unusual cases studies, information about why to subspecialise and what steps to take next. There is a live panel Q&A session where delegates can ask the panel anything they wish regarding the job, training, exams and applications.
- RCPath / BDIAP Foundation & Undergraduate Taster Event – an annual free virtual event aimed at anyone wanting to explore the opportunities that pathology can offer. It provides introductory talks about what pathology is, a mystery case discussion which highlights the value of the different specialties in the diagnostic process (including neuropathology), and a live panel discussion featuring consultants and trainees from the different specialties.
How to Maximise Your Portfolio
Spending some time in a neuropathology department, on a placement/taster days, will help you to learn and experience more of the day-to-day work of the specialty, including the pathway different specimens take as they go through the department. It may also provide opportunities to undertake a themed audit, which could result in a presentation/poster/publication. Neuropathology is a very academic specialty and liaising with your local neuropathology teams will help to open up opportunities to engage with small research projects or develop plans for an academic career in the specialty. However, you do not need to have a PhD to enter the specialty – this is a myth!! There are also several pathology-themed magazines including ‘ACP news’ and the ‘RCPath College Bulletin’ which are always interested in hearing from the next generation about their interest in the pathology specialties – you could consider writing an opinion piece with a neuropathology theme. Attending some of the previously listed events, including the BNS annual meeting, would be helpful to show your interest, potentially even delivering an oral or poster presentation. Showing interest and engagement in teaching is very valuable, and there will be lots of opportunities to get involved with this via local departments. The different pathology organisations are also frequently involved in public engagement work with schools and colleges; supporting some of these, potentially from a neuropathology perspective may help to show your interest and commitment, as well as recognising the importance of showcasing the work we do.
Making the Most of Your Day Job
Pathology is a specialty which is linked to all other specialties of medicine and surgery. Therefore, all the knowledge and experience that you gain whilst treating patients as part of these different specialties in your early years of training will help you on your journey to entering histopathology, and subsequently neuropathology. It is important for a neuropathologist to have a good general knowledge of different medical conditions and this can be provided during your early years of training; when you enter neuropathology, you will then see how some of these might be important to consider in relation to our specialty.
When you are preparing to apply for neuropathology whilst a histopathology trainee, all the skills that you are acquiring and developing in this role are crucial for a neuropathology trainee and so the hours invested in this aspect of training are not wasted in any way; learning how to use a microscope and identify microscopic signs of pathology are relevant for all systems of the body. When you come across different pathologies, perhaps consider what impact this might have on the nervous system. Building up your autopsy skills and experience will also be hugely useful as this is also part of the neuropathology training curriculum.
Making the Most of Diagnostic Neuropathology ST4 Placements
As a foundation doctor, you may have the opportunity to have a rotation in histopathology. This is a fantastic opportunity to get started and learn how to recognise different types of pathology! Learning what normal tissue types look like is an important first step before you will be able to recognise what an abnormal tissue or cells look like. If you are already set on a career in neuropathology at this time, perhaps seeing if you might be able to spend part of your rotation in this department would be worth exploring! Also, try and attend a few autopsies; this is such a valuable way of learning what macroscopic pathologies look like, and you may also encounter several that have a neuropathology theme. They are a great way of revising your anatomy too, which is another very valuable area of knowledge needed for training.
What About Non-Diagnostic Neuropathology ST4 Placements?
It is important for a neuropathologist to have a good general knowledge of different medical and surgical conditions and this can be provided whilst part of any of the different rotations you may encounter as a resident doctor in your early years. When you come across different pathologies in these different specialties, perhaps consider what impact this might have on the nervous system. Also, if patients who you are helping to look after undergo a biopsy or surgery, take some time to familiarise yourself with the pathology report; this might be useful later when you enter training, and for your interview preparation! Demonstrating a sound clinical knowledge will be something that the panel will be looking for both in your application and at the interview for both histopathology and neuropathology, so all of this knowledge and experience you are gaining will be very useful.
Top 3 Tips for Getting Into Diagnostic Neuropathology ST4
- Make sure you spend some time in a neuropathology department.
We are a very friendly group of pathologists and always enjoy meeting those who are considering entering the specialty.
- Talk to existing neuropathology trainees
We have been through the application, interview and training processes more recently and are a valuable source of advice and mentorship for you as you navigate the next steps.
- Keep an open mind!
Neuropathology is one of the most cutting-edge and fast-paced specialties; it is leading the way in terms of advances in the use of molecular pathology, digital pathology and artificial intelligence. With this comes huge opportunities as a trainee and specialist! Don’t ever worry that you will be replaced by one of these new technologies, because you won’t! They are very valuable tools to help us in our specialty, not tools which will replace us!
