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To give a flavour of what chemical pathology is about, I had intended to write about a typical day, but on reflection realised that this would be difficult - they don't happen! Indeed, it is the variety and unpredictability of the subject that I enjoy so much.

Chemical pathology not only brings together science and medicine, it relates to all the medical specialities. In the course of a day, I may receive calls from GPs wanting advice about the further investigation or management of their patients found to have biochemical abnormalities on 'routine' testing, see patients with dyslipidaemias, diabetes and hypertension in my out-patient clinics, review ward patients receiving artificial nutrition, discuss the introduction of a new diagnostic test with consultant colleagues, review the quality of the laboratory's analytical service with one of our clinical scientists and discuss a research project with one of our trainees.

Chemical pathology is the branch of pathology dealing with the biochemical basis of disease and the use of biochemical tests for diagnosis and management. Doctors in the speciality have dual responsibilities. First there is the provision of a reliable analytical service, for example measuring serum electrolytes, indices of liver function, hormones, drugs and tumour markers in hundreds of patient samples every day. Many of these analyses are performed on automated analysers, usually operated by biomedical scientists, but the management of the process (and the staff), assurance of quality and provision of guidance on the selection of tests and assessment of the significance of the results (particularly with some of the less generally familiar tests) are the province of the chemical pathologist.

Second, we have an important clinical role, not only advising on the management of patients with metabolic disturbances but increasingly having direct responsibility for such patients in out-patient clinics and on the wards.

We work closely with GPs, who are major users of the laboratory services, as well as with hospital colleagues. Management and interpersonal skills are essential for chemical pathologists: we rely heavily on the skills of our scientific and technical colleagues in the laboratory as well as nurses and other health care professionals in clinics and wards. Gone are the days when the chemical pathologist spent all his or her time in the laboratory. We are increasingly pathologists working at the bedside - truly clinical pathologists. It's an exciting and rewarding speciality, and has the considerable attraction of being practised for the most part during socially acceptable working hours!

For further information on training programmes, please contact the Training & Educational Standards Department on 020 7451 6741 or email education@rcpath.org

Dr William Marshall