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Chemical Pathology

Chemical pathology is the branch of pathology that deals with the analysis and interpretation of biochemical tests for diagnosis and management. It is also known as clinical chemistry, clinical biochemistry or medical biochemistry.

Chemical pathologists tend to have dual roles:

  • as managers of a reliable analytical service - overseeing laboratory staff, test selection and development, ensuring quality of results and providing interpretive advice to hospital staff and GPs. 
  • in a clinical role – providing lipid, metabolic bone, thyroid or diabetes services.  

This clinical role has recently been formalised with the introduction of metabolic medicine as a sub-speciality of chemical pathology training. Metabolic medicine provides formal clinical training in five areas – diabetes, lipids, bone and calcium metabolism, nutrition and obesity services and inherited metabolic disease.

Most metabolic medicine physicians will therefore be doing a couple of outpatient clinics a week as well as TPN ward rounds.  There are no acute medical on-call requirements although some trainees provide an on-call service on behalf of the laboratory, often by telephone.

Trainees in chemical pathology tend to have varied interests:

  • As a modern laboratory is highly automated, some are interested in IT and informatics,
  • others have come from a background in diabetes and endocrinology,
  • some enjoy laboratory work and may wish to develop this further by taking some time out of clinical work to do laboratory-based research,
  • and others enjoy the challenge of managing a large and busy department with staff from several disciplines including clinical scientists and biomedical scientists. 
  • Opportunities also exist for teaching and many chemical pathologists will have links with their local medical school providing core pathology teaching for undergraduates.

The minimum duration of chemical pathology (higher specialist) training is four and a half years.  On completion of training trainees should have acquired Fellowship of the Royal College of Pathologists (FRCPath).

Trainees in chemical pathology (metabolic medicine) must have membership of the Royal College of Physicians (MRCP), MRCP(I) or equivalent before being appointed.  The organisation of training for trainees in chemical pathology (metabolic medicine) is essentially the same as for chemical pathology trainees, but extended by one year to enable incorporation of the requirements of the metabolic medicine curriculum. This is under supervision of the JCHMT of the Royal College of Physicians and the Royal College of Pathologists.

The minimum duration of chemical pathology (metabolic medicine) training is five and a half years. On completion of chemical pathology (metabolic medicine) training trainees would  acquire the  fellowship of the Royal College of Pathologists (FRCPath).