Haematology Clinical Science
The examinations for Fellowship of the Royal College of Pathologists in Haematology are designed to assess a trainee’s knowledge, skills and behaviour in the fields detailed in the Higher Specialist Training Curriculum for Clinical Scientists in Haematology. Possession of FRCPath in Haematology is increasingly a requirement for appointment to a Consultant Clinical Scientist post in Haematology.
‘Clinical Scientist’ is a title protected by statute, and can only be used by individuals registered with the Health and Care Professions Council (HCPC). Candidates for the FRCPath examinations for haematology clinical scientists should be HCPC-registered.
Clinical Scientist training is now structured through the Scientist Training Programme (STP). Entry to this programme in England and Wales is managed through the National School of Healthcare Science (NSHCS), and can either be directly as an external candidate through the NSHCS recruitment process, or through the in-service route, where applicants (usually Biomedical Scientists) are sponsored by their employer. In Scotland and NI candidates follow very similar programmes towards an equivalence process (see below).
Learning is delivered through approved and accredited three years of workplace-based training, with the first year in a range of settings before specialisation in the last two years of training. Scientist trainees are also required to undertake a specifically commissioned master's degree in their chosen area.
There are a number of other routes to HCPC registration as a Clinical Scientist. The Association of Clinical Scientists (http://www.assclinsci.org/acsHome.aspx) assesses candidates who have gone though non-standard training in the UK and have worked in Laboratory medicine for a minimum of 6 years. Similarly, the Academy for Healthcare Science (AHCS, http://www.ahcs.ac.uk/) has developed an equivalence assessment process for scientists who have undertaken training, hold qualifications and/or have considerable professional experience, and who wish to show that these are equivalent to the STP programme.
Individuals who have trained outside the UK can make direct application to the HCPC for registration.
Part 1
This comprises two written papers evaluating candidates’ knowledge and clinical scientific judgement in important areas within the Higher Specialist Training Curriculum for Clinical Scientists in Haematology. The Part 1 Examination is used to determine whether a candidate has attained an acceptable level of knowledge and reached an acceptable level of competence based on the objectives of the training programme.
Candidates must achieve a pass mark in both papers at a single sitting to pass the Part 1 Examination
This examination lasts 3 hours and comprises four essay questions. Candidates must answer all four questions.
This examination addresses important areas of clinical scientific practice, and can include questions in the following four areas:
- general and red cell haematology (including laboratory management)
- haematological oncology
- haemostasis & thrombosis
- blood transfusion
The aim of this essay examination is to determine a candidate’s ability to demonstrate the following skills:
- present a clear and cogent written answer to the question
- select, organise and communicate relevant information or knowledge
- structure an essay that communicates relevant facts clearly without irrelevant information
- display an appropriate knowledge of disease pathogenesis, diagnostic investigation, interpretation of results, and new developments and relate this to clinical and laboratory practice
- select an appropriate course of action and in so doing to display good clinical scientific judgement
- critically evaluate investigational strategies or recent advances.
In addition to evaluating topics from the main areas of Haematology, questions within each paper may include the following areas to provide a balanced assessment of basic knowledge, laboratory practice and clinical scientific knowledge, judgement and skills.
- Focused tasks, e.g. preparation of a letter to a GP/referring consultant, a business case for new equipment/test, an information sheet for patients, a standard operating procedure.
- Focused problems, e.g. describing investigation of a particular clinical or laboratory problem of a common or important nature.
- Basic knowledge of disease patho-physiology in the context of its application to clinical laboratory practice.
- Critical evaluation of investigational strategies with a requirement to demonstrate clinical scientific judgement through selection of an appropriate approach to a specific case.
Essay questions explore a candidate’s abilities to communicate effectively in writing in a structured and clear manner, to critically evaluate investigational strategies and to demonstrate an ability to combine knowledge derived from different sources and experience gained from clinical and laboratory practice to make a considered judgement or recommendation.
Paper 2 of the Part 1 written examination for Haematology Clinical Scientists consists of 20 compulsory Short Answer Questions (SAQs), to be answered in three hours. SAQs are designed to test factual knowledge and understanding across the range of the Curriculum. Each question comprises a stem and usually five or six sub-questions. The stem defines the topic of the question and may include a short scenario or vignette. Each sub-question is designed to elicit a specific piece of information, or demonstration of understanding of the topic and its context. Unless stated otherwise, the answer required will relate specifically to the material provided in the stem and not to the topic in general.
Points to note:
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SAQs are criterion-marked against an explicit model answer
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Marks are only awarded for information required by the question – no marks are available for additional material
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If a defined number of facts are requested (e.g. State two causes of…..), only the first two responses will be marked (e.g. Answer – correct cause, incorrect cause, correct cause, will only receive one out of two marks)
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Answers requiring more than single word or phrase responses will be answerable in a single sentence or a small number of sentences.
Examiners will be looking for key concepts in these answers and no marks will awarded for extra information. Candidates should practise writing short, concise answers, which include only the information requested. Good use of English, avoidance of abbreviations, and clear handwriting are essential. Candidates who write unnecessarily long answers are likely to penalise themselves because these answers waste time.
The mark allocation for each sub-question will be stated in brackets in each instance.
The pass mark for the Part 1 SAQ examination is determined by an Angoff procedure undertaken by members of the College’s Haematology Clinical Scientist Examiners Panel. This is a validated method of determining minimal acceptable competence.
General & Laboratory Haematology Themes
- Bone marrow failure syndromes
- Iron metabolism abnormalities
- Underproduction anaemias
- Haemolytic anaemias
- Obstetric haematology
- Paediatric haematology
- Laboratory haematology
- Laboratory management
Haematological Oncology Themes
- Myeloproliferative disorders
- Myelodysplastic syndromes
- Acute leukaemias
- Lymphoproliferative disorders
- Plasma cell dyscrasias
- Lymphomas
Haemostasis & Thrombosis Themes
- Platelet disorders
- Inherited haemorrhagic disorders
- Acquired haemorrhagic disorders
- Inherited thrombotic disorders
- Acquired thrombotic disorders
Transfusion Medicine Themes
- Indications for blood & blood product transfusion
- Complications of blood & blood product transfusion
- Donor selection
- Blood product production
- Blood product selection
- Blood bank techniques
Other Themes
- Laboratory Practice
- Laboratory Management
- Infectious Disease in Haematology
- Haematological Problems of Systemic Disease
Each question examines a single focus within a theme. For example, within the theme of lymphoma a question may address topics within any of the areas listed below. Many, but not all, areas of focus listed apply to most of the themes listed above. The focus areas within Laboratory Management include health & safety, quality assurance and clinical governance.
- aetiology & pathogenesis
- epidemiology
- ‘routine’ laboratory investigation
- morphological features of blood or marrow
- special techniques for diagnosis
- cytogenetics
- molecular diagnostics
- differential diagnosis
- prognostic factors
- staging
- complications
- natural history
- issues related to diagnosis in pregnancy
- issues related to a paediatric patient
Part 2
The Part 2 FRCPath examination is the core assessment of clinical scientific and laboratory skills and may be taken once a candidate has successfully completed the Part 1 examination and acquired additional significant experience of practice as an HCPC-registered clinical scientist.
The standard required to pass this examination is the standard that would be expected of a Consultant Clinical Scientist in Haematology.
All written papers in the Part 2 Examination are marked by members of the Haematology Clinical Scientist Examiners Panel. The final marks awarded by the examiners must be approved by the College Examination Committee before a final pass/fail decision is made.
Feedback on areas where a candidate failed to demonstrate an adequate standard is sent to candidates who fail the examination.
The Part 2 examination consists of two components:
Submission of either a dissertation on a specific area of haematology clinical science / a PhD thesis / a portfolio of papers or a case book (10 cases) subject to the College regulations for Part 2 written submissions.
The candidate chooses one of the following modules covering laboratory practice
Interpretation Paper - General and Oncological Haematology and Red Cell Haematology
- Eight Short Answer Questions (SAQ) and two Long Case Questions (LC) to be answered in 2 hours
- Each SAQ requires the candidate to examine one or two microscope slides and/or flow cytometry plots and/or genetics data and/or Quality Assurance (NEQAS) reports. Questions will be asked based on the interpretation of the morphology of the case and/or other information provided.
- Each LC question provides a case history and contains several parts each of which require the candidate to interpret microscope slides, laboratory results or other clinical investigations and provide a report, make a diagnosis and/or recommend further investigations.
Interpretation Paper – Haemostasis and Thrombosis
Interpretation Paper - Transfusion Medicine
This examination is closely analogous to that taken by medically-qualified haematologists. The candidate will be expected to demonstrate clinical scientific knowledge and understanding of how the selected module relates to other areas of haematological practice (for example a candidate undertaking the haemostasis and thrombosis module would require knowledge of the pathogenesis of acquired disorders of haemostasis associated with haematological malignancy).
This paper is followed by a structured viva voce:
The Oral Examination is used to explore a candidate’s ability to evaluate problems and demonstrate good clinical scientific judgement. It is also an assessment of a candidate’s ability to communicate clearly and effectively. It provides a further assessment of a candidate’s knowledge in areas of the specialty to complement his/her score in that area in the written examination.
An egregious error in the oral examination will result in a candidate’s performance in the entire examination being reviewed as a borderline candidate. If this error is deemed sufficiently serious by the Examination Board it may cause the candidate to fail the examination overall.
