Scottish Medical Training

Edinburgh, the Lothians and Fife are on the eastern side of Scotland’s central belt. They are places of exceptional beauty and contrast, from Edinburgh’s historic skyline to the scenic countryside that surrounds it, to the coastline of Fife which stretches north to St Andrews. Edinburgh is famous for its international festivals, fringe festival, numerous museums and its architecturally impressive Old and New Towns.

Pathology services to Edinburgh, the surrounding Lothians and Borders are provided by Edinburgh's two largest hospitals: The Royal Infirmary of Edinburgh (in the south of the city) and the Western General Hospital (located in the west of Edinburgh). The Victoria Hospital in Kirkcaldy, Fife provides pathology services to all of Fife.

There are around 15 trainees in-programme in South East Scotland. Most trainees are based at either the Western General or the Royal Infirmary, and trainees frequently rotate through all of the pathology teams at both these sites.

Senior trainees also spend time at district general hospitals, in particular the Victoria Hospital in Fife, across the Firth of Forth to the north of Edinburgh.  Some trainees are also attached to Forth Valley Royal Hospital, Falkirk just south of the Firth of Forth to the west of Edinburgh. Both are within commuting distance. Most STs choose to live in Edinburgh, and some live in Fife.

Typical duties of a histopathology trainee are specimen dissection (or cut-up), and reporting biopsies, resections and cytology specimens.  Most pathology reporting is checked and supervised by a consultant. After gaining appropriate experience and demonstrating suitable competencies, trainees are expected to take on some reporting independently. Participation in MDTMs is encouraged, particularly in the senior years.

In addition to surgical pathology, trainees spend the first 2 years in core training gaining experience of all subspecialties including forensic/autopsy pathology, cervical cytology, paediatric pathology and neuropathology. Some trainees, who do not wish to subspecialise in forensic pathology, continue with autopsy pathology training after the core years and sit the Royal College CHAT (Certificate of Higher Autopsy Training) examination.  After at least 2.5 years, some trainees may wish to apply competitively for entry into forensic pathology, neuropathology or paediatric pathology.

There is an introductory course for ST1s (usually held in Glasgow) near the beginning of each training year. In addition there are short introductory courses in cervical cytology and neuropathology.  There is also a rolling programme of teaching for all ST1s and ST2s in Scotland, covering topics at an introductory level, delivered as weekly one hour sessions online throughout the year. 

There is formal weekly postgraduate teaching for all STs in histopathology in South East Scotland.  These sessions are usually on a Wednesday or Thursday afternoon . They are delivered in person (usually at RIE, WGH or BioQuarter) or on MS Teams.

Research: There are strong links with the University of Edinburgh, Heriot Watt University, the University of St Andrews, as well as universities further afield.  Approximately 20% of South East Scotland STs spend time out-of-programme, most often studying for a PhD.

Audit: Numerous audit projects are available, and there are opportunities to present findings at QI meetings, departmental grand rounds or at postgraduate teaching sessions.

Leadership and Management:  In a relatively small specialty such as histopathology, there are a considerable number of opportunities to become involved, locally and nationally, in leadership and management roles.  Examples of such roles include trainee representation on various committees (relating to both training and service), co-ordinating postgraduate teaching, and organising the ST rota. Some trainees are representatives on committees at deanery and royal college level, or participate in deanery quality visits to other training establishments in Scotland. There are also opportunities to apply for medical education and leadership fellowships through the Medical Education Directorate.

Training is delivered at:

Royal Infirmary of Edinburgh (RIE) – histopathology, cytopathology, paediatric pathology

Western General Hospital (WGH) - histopathology, cytopathology

Edinburgh BioQuarter (beside RIE) – neuropathology and forensic / autopsy pathology

Victoria Hospital, Fife - histopathology, cytopathology

Forth Valley Royal Hospital, Falkirk - histopathology, cytopathology

Queen Elizabeth University Hospital Glasgow – cervical cytology

Edinburgh City Mortuary - forensic / autopsy pathology