Education and training
Postgraduate specialty training in haematology is focused on obtaining the FRCPath examination. This is required for completion of specialist training and obtaining a CCT in haematology. The examination comprises written papers, practical elements (such as microscopic diagnosis) and an oral test. Training rotations aim to provide experience in all areas of haematology. Trainees rotate through different subspecialty areas including:
- diagnostic haematology (morphology and laboratory medicine)
- malignant haematology (transplant and non-transplant)
- non-malignant general haematology
- haemostasis and thrombosis
- transfusion medicine.
Experience in paediatric haematology is also provided, with the opportunity for further subspecialist training. Haematology registrars rotate through both teaching hospitals and district general hospitals, gaining different experiences. Most rotations provide in-house education programmes and diagnostic microscopy training. There is a range of external courses and training events, and most trainees attend at least one of these. In parallel with other specialties, training is directed by a nationally agreed curriculum, with an electronic portfolio used as a record. Haematology is a particularly academic specialty and a higher proportion of trainees compared to other specialties undertake a period of research, usually resulting in a higher degree, prior to obtaining their CCT.
Continuing professional development (CPD) for haematology consultants varies depending on the size of the unit. Larger units usually have a regular educational programme and perhaps greater capacity for attending regional, national or international meetings and performing academic duties that support CPD. In smaller units it may prove difficult to obtain adequate CPD, although web-based learning is improving in quality.
Management opportunities are broad. The dual clinical/laboratory role gives opportunities for leadership in both areas, in addition to audit, research, governance and educational roles. Malignant haematology services require leads for chemotherapy and multidisciplinary team meetings. The wider patient safety aspects related to haematology, such as venous thromboembolism prevention and transfusion, require clinicians to provide leadership on a trust-wide basis and beyond.
The workload in haematology has expanded markedly over recent years. This is due to an ageing population combined with a huge growth in the number of novel agents for treating malignancies, thrombotic and haemorrhagic disorders and migration. The increased workload is a real threat to training and development as clinical pressures impact on time and capacity for CPD and trainee education.
The Academy of Medical Royal Colleges (AoMRC) has produced a cost of training document setting out the mandatory costs of training involved in college enrolment fees, examination costs and GMC fees. Published in October 2017, it has been compiled to help pre-specialty doctors make fully informed career selections, with a clear understanding of the mandatory costs of their future training pathway.