Careers, Education and Training
Clinical Scientist is the generic term for healthcare workers involved in Clinical Biochemistry, Clinical Immunology and Clinical Microbiology as well as other Life Sciences and those in the Physiological Sciences (Audiology and Clinical Physiology) and the Physical Sciences (Medical Physics and Clinical Engineering). They have a similar set of requirements to enter the careers since they all become registered as "fit to work" through the Health & Care Professions Council UK (HCPC). The HCPC provides security of patient safety in a similar manner as the General Medical Council (GMC) does for the medical profession.
The ACB Education, Training & Workforce Committee, together with the Regional Tutors and Trainees Committee, can often provide information and advice for those wishing to pursue a career in healthcare science.
If you would like to read some real life career stories of key healthcare scientists, please browse the NHS publication Extraordinary You.
In 2011, under the Modernising Scientific Careers initiative, the National School of Healthcare Science (NSHCS) was established to support the implementation and delivery of the NHS Scientist Training Programme (STP).
Links
- The National School of Healthcare Science - coordinates the recruitment of clinical scientists in England and Wales and collates applications.
- Pre-registration training posts for clinical scientists in Scotland are advertised in New Scientist early each year (Jan/Feb) with more information obtainable from the NHS Education for Scotland.
- Also take a look at the section on the NHS Careers Website for other information on Clinical Biochemists, Clinical Immunologists and Clinical Microbiologists.
- The Institute of Biomedical Science (IBMS) - for information and advice pursuing training as a Biomedical Scientist.
- The training of Medical Graduates wishing to specialise in clinical biochemistry, immunology and microbiology is coordinated through the Royal College of Pathologists with some information on the appropriate pages on this website.
MSc courses in laboratory medicine
Biochemistry, University of Manchester
In the first year, 5 weeks are spent undertaking modules in laboratory techniques and general healthcare science, alongside an overview of general biochemistry, haematology, genetics and immunology. Assessment in first year takes the format of both assignments and exams.
The second year modules are delivered in a 5 week block and cover the specialist biochemistry areas of endocrinology and major organ systems and cancer, alongside a module introducing research methods. A practical project is then undertaken in an NHS Trust during the second and third years of study and submitted towards the completion of the MSc. The third year modules are delivered over a 4 week block, and include paediatric and neonatal biochemistry, drug investigation (toxicology) and nutrition. Performance during the second and third years is assessed by examination and project dissertation only.
Immunology, University of Manchester
The second and third year modules provide specialist teaching modules in Immunology. Modules include Autoimmunity, Allergy, Immunology and Infection, Haematological Malignancies and Transplantation. These sessions underpin and deliver specialist clinical knowledge, which complements the trainees’ work-based experience. Trainees undertake an MSc research project during the second and third year. This will be overseen by an academic from University of Manchester but will be conducted at the trainee’s base hospital.
Microbiology, Queen Mary University of London
An MSc course is available at Queen Mary, University of London. Students are delivered lectures and practical material one day per week. First year modules include research skills, an introduction to microbiology, molecular biology and pathogenesis.
Second year modules are delivered on day release and include clinical microbiology and infection, antimicrobial therapy, epidemiology and public health. A research project is undertaken in the third year after the taught components have been completed.
Careers in Toxicology within the NHS
Analytical toxicology is concerned with the role of the laboratory in the diagnosis, treatment and prevention of poisoning. Analytical toxicologists spend much of their time measuring compounds such as alcohols, drugs and poisons in biological samples and in providing an interpretation of any results generated.
Most Clinical Biochemistry laboratories within the NHS will perform a degree of analytical toxicology as part of their routine workload, usually for patients who present to the emergency department having knowingly or accidentally ingested a poison. Most analysis performed in these circumstances is done by automated analysers and requires a fast turnaround time. Commonly encountered compounds include ethanol, paracetamol, salicylate and lithium. Clinical Scientists who work within this setting may be required to oversee the performance of the assays as well as provide interpretative advice on the results generated.
There are a number of more specialised analytical toxicology laboratories within the NHS which are able to offer a much greater range of toxicological testing. The range of compounds which may be used by the poisoned patient is vast and the numbers of compounds used is increasing all of the time. This means that the identification of the compounds that an individual may have taken and the interpretation of the results generated is often highly challenging and requires specialist equipment and expertise. Clinical Scientists who work within this setting may be required to develop and update specialist assays, often using more manual techniques and instrumentation including high resolution and tandem mass spectrometry, high performance liquid chromatography, gas chromatography-mass spectrometry and inductively-coupled plasma mass spectrometry. They may also be required to troubleshoot and monitor the performance of these assays, interpret data generated by assays, as well as provide interpretative advice to service users. In some rarer circumstances, they may also be asked to give expert opinion in court. The types of tests performed by these more specialist laboratories include screening for drugs of abuse in samples submitted by substance misuse patients, therapeutic drug monitoring of compounds which require regular review if being taken by a patient, screening of samples from acutely unwell patients presenting to the emergency department or other clinical settings, and post-mortem analytical toxicology to assist in the Coronial investigation process.
Most individuals who choose to specialise in analytical toxicology first complete a more general Clinical Biochemistry training programme such as the Scientist Training Programme. This gives the trainee a broad understanding of Clinical Biochemistry. In addition to clinical knowledge, this training also covers a range of skills including analytical techniques, professional practice and research methods. Individuals may also come from a medical background, with exposure to Clinical Biochemistry often coming in the form of placements in laboratories during foundation training. Upon completion of a training programme, an individual may work as a Clinical Scientist or Medic in an NHS laboratory and undertake further training in a more specialist field, such as analytical toxicology. For Clinical Scientists, this may take the form of the Higher Specialist Scientific Training programme, a 5 year training course in which the individual is required to demonstrate increased specialist knowledge in their chosen field, complete a Masters level course in Leadership and Management, conduct a research project, and take exams set by the Royal College of Pathologists. Upon completion of the HSST, the individual obtains a Doctoral level qualification, fellowship of the Royal College of Pathologists and admission to the Higher Specialist Scientific register maintained by the Academy of Healthcare Sciences. Further training may also take place in a more informal department-based setting in which the trainee passes the exams set by the Royal College of Pathologists to become a Fellow of the Royal College of Pathologists, at which point they can apply for roles as a Consultant Clinical Scientist. Individuals who pursue this route and who want to specialise in toxicology may choose to demonstrate competence by other routes including by joining the European Register of Toxicologists. Medically qualified individuals who wish to become Chemical Pathologists may train as a Specialist Registrar, during which time they will also take Royal College exams and become fellows of the Royal College of Pathologists.
A career in analytical toxicology within the NHS is particularly suited to those who enjoy the hands on aspects of Clinical Biochemistry, particularly assay development and data interpretation. The reporting of results generated often requires the Clinical Scientist or Chemical Pathologist to offer expert advice to clinicians and Coroners to a level that may not always be required in more commonly encountered tests. The cases that a toxicologist may encounter can be sad and, therefore, it is important to maintain good mental health when working in this field. However, those who choose to specialise in analytical toxicology find it to be a fascinating and challenging area to be involved in, with a large variety in the work that they perform day to day.
Links:
Academy for Healthcare Science
National School of Healthcare Science
The Royal College of Pathologists
The International Association of Forensic Toxicologists
Society of Forensic Toxicologists
LTG
UKIAFT
Trainees
Visit Our Resources or the Science Knowledge Hub to find material to support the training of Clinical Scientists and Medical trainees in Clinical Biochemistry, Microbiology and Immunology.
It provides information from the ACB Trainees' Committee, links to ACB documents and events that will help your training and career development.