The Field
Clinical biochemistry, or clinical pathology as it was until recently known, is a rapidly expanding and extremely exciting area of medicine to work in. As the specialty at the forefront of the study of metabolism, the mapping of the human genome and the isolation of novel proteins has advanced the field of clinical biochemistry considerably, whilst also widening its scope. Training schemes in this specialty are now wider reaching than ever, often including metabolic medicine as a sub-specialism.
Training for a career in Clinical biochemistry has further been altered by the fact that it is no longer a speciality in which doctors spend their time exclusively on analytical, lab-based work, with research and teaching becoming increasingly important aspects of the role.
The Job
Whilst the main body of a clinical biochemist’s work is carrying out the complex analysis of patients’ samples as an aid to the diagnosis and treatment of diseases, there are a wide range of duties attached to most posts.
Laboratory Based Work.
Clinical biochemists are generally tasked with determining the clinical direction of the laboratory. This includes the management of quality control issues and often extends to shaping the procedures for analytical services for the whole hospital. This also feeds into the research aspect of the role, as a lot of this research will be undertaken to determine whether the techniques being employed to measure the sensitivity and specificity of diagnostic tests could be improved upon.
Whilst taking an overview of the labs practices and general quality control is, undoubtedly a huge part of the role, so to is the need to scrutinise samples, as well as specimens of body fluids and tissue. Though a lab will process around 1,000 samples a day using automated techniques, around 100 or so of these will return abnormal results and may require further investigation by a clinical biochemist.
Techniques used to carry out these analyses are varied, from spectrophotometry to electrophoresis. Sometimes this will involve working with other health professionals such as biomedical scientists, in order to, for example, detect changes in glucose levels for diabetes mellitus.
Clinical Work
Clinical responsibilities have, in addition to the traditional advisory aspect of the role, become a much larger part of the job. Duties often include outpatients work, normally in areas related to diabetes, endocrinology and disorders of calcium metabolism.
The job can also include working in nutritional support teams and can sometimes incorporate paediatric clinical work. You may, for instance, assist with the management of rare conditions such as porphyries or errors of metabolism.
Research
Research in this area can delve into anything, from the discovery of new proteins to the newest techniques of molecular biology. Not only do Clinical biochemists conduct research, they also devise projects which can be both basic and applied.
Research work will also break into other areas of the role’s remit, such as submitting funding bids, which may be supported by a research project, and contributing to the wider medical and scientific community by attending meetings and lectures.
Depending on the nature of the research, any given project may involve liaising with other professionals, such as clinical staff.
Teaching
Teaching is an obligation in most roles and will usually involve, as well as staff training, supervising MSc students and giving lectures to medical undergraduates.
Advantages of the Role
There are many advantages to choosing this speciality. For one thing there are many excellent registrar training schemes available, normally featuring two years of initial training, dedicated toward gaining experience in areas such as the laboratory and outpatients, a third year dedicated to a research project, then two more years of rotating in specialist labs. Overall the nature of the training paths is very flexible.
This flexibility is reflected in the job itself, which combines diverse aspects of lab, clinical and research work, the levels of which you can generally tailor to you liking.
The work-life balance of this career is also very reasonable compared with others. For example, on call work is not residential. However, should you decide this specialism is not for you, your training will provide opportunities for various secondments.
Finally, employment prospects have, in recent times been decent for those finishing training as clinical biochemists and, although circumstances can be hard to predict, this looks like it will continue to be the case.