Introduction

The main role of an H&I laboratory is to provide the services required to support haemopoietic stem cell and organ transplant programmes. In addition, the H&I laboratory provides genetic testing for a number of human leukocyte antigens (HLA) and immune-related genes and plays a role in the investigation of transfusion-related reactions.

The work involved in the support of transplant programmes includes HLA typing patients and donors, assessing the closeness of the match and thus helping to select the most appropriate donor for a particular patient. This is crucial to the success of the transplant, as mismatching can result in immune damage to the patient in haemopoietic stem transplantation or rejection in organ transplantation. In the case of kidney transplantation, the laboratory also performs HLA antibody screening and crossmatching, to ensure that there are no antibodies in the recipient which could reject the kidney. Finally, the H&I laboratory keeps registers of potential recipients of kidneys and volunteer haemopoietic stem cell (both bone marrow and cord blood) donors.

Training

Employment in a recognised laboratory
The first step for an individual interested in pursuing a career in H&I is to obtain employment as a grade A trainee clinical scientist or a trainee medical laboratory scientific officer, in a laboratory which is recognised for training purposes.

BSHI Certificate of Competence
Once in post, the trainee is encouraged to pursue the British Society for Histocompatibility and Immunogenetics (BSHI) Certificate of Competence Training Scheme. This generally takes 3 years.

MRCPath in H&I
Once the trainee has obtained the BSHI Certificate of Competence, or has worked three years in approved appointments, he/she is eligible to train for the Part 1 MRCPath examination of the Royal College of Pathologists. This generally takes 3-4 years. After successfully passing the Part 1 examination, the trainee is eligible to train for the Part 2 examination, which generally takes 2-3 years. On successful completion, the trainee is awarded membership of the Royal College of Pathologists.

Candidates commencing training for the MRCPath in H&I are strongly encouraged to register as a trainee with the College. This facilitates the maintenance of a central list of trainees and, in addition, the trainee can receive relevant mailings.

The College has published a core training programme and a training record, both of which are available from the College website or by telephoning the College. In order to commence training, the trainee must have a nominated trainer recognised by the College.

H&I training days
There are two training day schemes for H&I trainees. One is organised by the BSHI for trainees preparing for the BSHI Certificate of Competence. The other is higher training for individuals who already hold the BSHI Certificate of Competence or who are training for the MRCPath in H&I.

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

The College sub-committee on Histocompatibility and Immunogenetics