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The Association of Clinical Pathologists

Winter 2010

ACP news

What do people want from pathologists? Histopathology in the financial wasteland How to fail FRCPath Part II exams NHS – RIP?

Association of Clinical Pathologists Officers

Calendar of Forthcoming Meetings DIARY DATES FOR 2011

President Dr R Reid President-elect Professor T J Stephenson Vice-Presidents Dr A Galloway Dr E Watts Chairman of Council Dr W J Fuggle Secretary Treasurer Dr D Bareford Editor/Publications Secretary Dr Julian Burton Assistant Editors Dr E Carling Dr S Enn Low Postgraduate Education Secretary Dr M K Heatley Management Course Organisers Drs A and M Galloway Secretariat The Association of Clinical Pathologists 189 Dyke Road Hove, East Sussex, BN3 1TL Tel: 01273 775700 Fax: 01273 773303 email:

Date 2011 & Organisation



Contact Details

24 February Association of Clinical Pathologists

Hot Topics Management Day ACP Liaison & Branch Officers Meeting

Institute of Physics Rachel Eustace 76 Portland Place 01273 775700 London

2 March Association of Clinical Pathologists

Basic Management Course

Copthorne Hotel Newcastle upon Tyne

Alison Martin 01273 775700

16 – 17 June Association of Clinical Pathologists

ACP Annual Scientific Meeting

RIBA 66 Portland Place London

Alison Martin 01273 775700

28 – 30 September Association of Clinical Pathologists

ACP 25th Management Course

Hardwick Hall Hotel Sedgefield

Jacqui Rush 01273 775700

The ACP accepts no liability for errors or omissions in this calendar of meetings. Readers are reminded that advertised meetings may be cancelled. Those intending to attend are obliged to check the details on booking with the organiser in every instance. There will be a £25 administration fee per issue for entries in this table.

General Administrator Ms A A Martin Administrator – Finance Mrs R Eustace Editorial Assistant Miss J Rush (Correspondence should be addressed to: The Editor, Association of Clinical Pathologists, 189 Dyke Road, Hove, East Sussex, BN3 1TL Email: )

© acpnews 2010 all rights reserved. No part of this publication may be reproduced in any way whatsoever without the permission of the Association of Clinical Pathologists. Charity registration number: 209455

Dr Ed Carling is Assistant Editor of ACP news and Locum Consultant Histopathologist

Dr Su Enn Low is Assistant Editor of ACP news and Consultant Histopathologist at Pennine Acute Trust

ACP news Winter 2010 Contents P4 P5 P7 P7

Invitation to contributors Editorial Style Guide Letters to the Editor

LEAD ARTICLES P10 Peace of mind for non-religious patients: chaplains and pathologists in common cause. Rev David Hoskins P11 What people want from their pathologists: a patient’s perspective. Mr Tom Grew P14 What people want from their pathologists: a general practitoner's perspective. Dr Trefor Roscoe P15 Histopathology in the financial wasteland: a nightmare for the future. Dr Ed Carling ARTICLES P17 Key quality indicators for cellular pathology. Dr Tim Helliwell P19 Pathology ‘Modernisation’ – A good thing? Dr Su Enn Low P21 Doing things differently in the North. Dr Julian Burton

p13 The mask

BURSARY REPORTS P24 The Laboratory paralogues. Mr Lovesh Dyall P28 Using digital pathology to assess the superficial anatomy of the colon. Mr Peter Brown TRADECRAFT AND MEETINGS P30 NHS – RIP? The 24th ACP management course. Drs Chris Carey and Mike Galloway P33 Report of the ACP alumni meeting. Dr David Winfield P35 British Association for Opthalmic Pathology (BAOP) 29th Annual Meeting. Dr Margaret Jeffrey TRAINEES ZONE P37 How to fail the FRCPath Part II examination in Histopathology. Dr Ed Carling

p28 Bursary Reports

BOOK REVIEWS P41 Another positive book review THE COLUMNISTS P42 Password protected! Dr Carl Gray P44 SLOW SLOW QIPP QIPP SLOW. Dame Dorothy Dixon P45 Facebook and I. Dr Mike Harris P46 Travel is supposed to broaden the mind, but it’s getting to be so much hassle. Prof Tim Reynolds P48 Motivation: everybody’s doing it. Dr Simon Knowles P50 Sunday evening paranoia. Dr Su Enn Low CURETTINGS P51 More of the weird and wonderful spotted by readers

p37 How to fail

ACP news - Winter 2010

Cover Story

All alone and finding one’s way in a clear blue sea. Rather like becoming an editor.

Invitation to Contributors In addition to the constant flow of material from ACP Council, ACP committees and ACP branches, ACP news needs new material from you, the members of the ACP. Pathology news items (1200-1500 words): Any items related to the ACP or the College, pathologists in general, or medical and management matters that may have an impact on pathologists. Articles (1500-2000 words): These can be papers, reviews, essays, commentaries, critiques or polemics. Submitted articles are always very welcome, as well as suggestions for articles and/or details of people whom the editor may approach. Reports (1000 words): These may be personal views and reports on interesting meetings, travel or anything else of interest to the readership. Travel reports are specifically for holders of ACP travel fellowships; however, other reports from abroad are welcomed. Columns (600 words): Regular and irregular columnists exercise their thoughts. Please feel free to rant. Pathological creative writing: All literary forms, including short stories, serials, surrealism and even poetry. Appreciations (1000-1500 words): We prefer appreciations on retirement, rather than obituaries. Please discuss these with the editor before submission. Photo-journalism: Favoured subjects include pathologists doing something interesting, or College and ACP officers doing anything at all. Interesting or artistic photographs are welcomed. Cartoons: Suggestions are welcomed. Curettings: Jokes and humorous titbits are always needed. Debate: Letters to the editor are welcomed, but may be shortened for publication, or even converted into articles. Please try to refrain from writing unless you are prepared to be published. All criticisms of organisations or named individuals will entitle the parties to a right of reply. Please


bear in mind the UK libel laws! Trainees: Trainees are especially encouraged to submit material in any and all of the above categories. These will normally be placed in the trainees’ section. Appointments committees in particular value publications in ACP news. Editorial Policy: The editor would particularly encourage overseas contributors, material from trainees, material from nonhistopathologists, commentary on current affairs in pathology, occasional columnists, innovations in pathology, humorous writing on pathology-related topics, and anything downright cantankerous. Format: The ACP news style guide has been revised and appears in this issue on pages 7-9. The publication is a magazine, not an academic journal, and long lists of references are generally considered unnecessary. Where given, references should be in the Vancouver style and should be kept to a maximum of around six per article, unless absolutely necessary. Alternatively, authors may prefer to give a recommended reading list, or a list of relevant internet links. The editor prefers these as they take up less space. All suggestions are welcome; however, the editor’s decision is final. ACP news is published quarterly. Regular publication dates are: Issue SPRING SUMMER AUTUMN WINTER

Publication month February May August November

Copy date 5th December 5th March 5th June 5th September

Copy is best submitted by email, or on disc if the file size is large, in any version of Microsoft Word, although it should be possible to accommodate other formats. Submissions on paper by snail mail will also be accepted. Illustrations should be sent as JPEG digital images or hard copy prints. Please do not embed images in your text. Send them as separate files. Please send email submissions direct to the editor at

ACP news - Winter 2010

Editorial Everyone take one step back It’s that special time again when the editorial blue pencil is passed from one hapless victim to the next. Well you might wonder how such an honour is bestowed. According to Domhnall Macauley, Clinical Editor (Primary Care) with the BMJ “You don’t become an editor because you’re normal”. You may well suspect that every two to three years the entire profession is invited to take a swift step backwards: the slowest person becomes the editor of ACP news. In fact, the honour of choosing the next editor falls to the outgoing incumbent. Over the years several of the editors have tried to persuade me to pick up that oh-so-heavy pencil but I have always politely but firmly declined. Dr Knowles threatened bodily harm and so here I am. Actually, it occurred to me that as horrifying as being asked to be the next editor may be, it might be worse not to be asked. I’ve been told that there actually isn’t much to editing the ACP news, but I have already discovered that when you start to pull an issue together there are an awful lot of blank pages to fill. There is also a steep learning curve, filled with excitements such as discovering publishing formats, deadlines and (a highlight) training on what editors do and how they do it. I’d tell you about the secret initiation ceremony that took place in an abandoned pathology museum but the formaldehyde fumes have destroyed most of my memories of it and in any case I have been cursed with a lifetime’s tenure if I give away too much. Anyhow, it seems that the role of the editor is primarily to variously beg, plead and threaten people to write material to fill the pages. While some of the content comes from our esteemed regular (and irregular) columnists, most comes from you dear readers. While I hope fervently for some controversy that will spark debate in these august pages your articles, musings, travel reports, commentaries and curettings will always be most gratefully received. In November the ACP sent me to Oxford to attend a Short Course for Medical Editors, run by Pippa Smart. Surrounded by the editors of many learned journals from around the world I learnt some of the tricks of the trade. It set me wondering what ACP news is all about. I think that this publication has a multitude of purposes. Its formal purpose is to communicate news about the Association of Clinical Pathologists and to bring its members together. What else? Well, the ACP news is a safe place to spark debate, voice opinion and concern and to share practice. This is a light-hearted publication, and so one of the purposes of ACP news is to entertain. I realise that we’re competing for your leisure time (or the time you spend on the toilet – but let’s not go there).

Dr Julian Burton is Senior Teaching Fellow at the University of Sheffield and a Coronial Pathologist at the Medico-Legal Centre

I hope that under my tenure the ACP news will be able to live up to those aims. I am lucky to inherit the wonderful work of the previous editors who, I am sure you will agree, have done a sterling job. I doff my cap to all of them, and only hope that I can live up to and maintain the high standards that they have set. You will be pleased to know that the format of your favourite periodical hasn’t changed too much but I have exercised my editorial prerogative and revised the style just a little. The biggest change that I have made is to the title of the publication. Shamelessly I have turned my back on approximately 25 years of tradition and changed acpNews to ACP news. I hope that no one is left unable to sleep at night because of this. Letters to the Editor expressing your unbridled joy or dismay will of course be welcomed. You can find the revised style guide on pages 7-9. Almost all change – please mind the gap ... The editorial panel consists of the editor, wonderfully supported by a team of assistant editors and columnists. While in the past there have been three assistant editors, I am hopeful to establish a team of four. Pat Twomey and Kevin Kerr have stepped down after years of dedicated and exemplary service, and as I stepped up four vacancies for assistant editors became available. I am pleased to

ACP news - Winter 2010


Editorial introduce the newest members to the team, handpicked from a cast of thousands. Su Enn Low is a consultant histopathologist at the Pennine Acute Trust and will be familiar to all of you as the author of a column that is largely inspired by her cat. She positively begged to become an assistant editor. I feel somewhat responsible as she approached me for advice as to whether or not she should embark on a career in pathology many years ago. On the understanding that we are treated to only one cat-related item per issue (unless she chooses to write about cat-scratch fever) she is warmly welcomed onto the team. Ed Carling is a locum consultant histopathologist and he tells me that he will report cases for food. That leaves us with two vacancies. If you’d like to fill either of them I’d love to hear from you. Assistant editors must read each issue of ACP news from cover to cover (hardly a chore) and contribute or commission at least one article per issue. Clinical chemists, haematologists or microbiologists would be especially welcomed. Elsewhere in this issue The current state of the nation’s finances is clearly causing people to worry about the impact that this will have on

Cert no. TT-CoC-002420

pathology services. Our new assistant editors share their thoughts on this, and Tim Helliwell gives us some suggestions on how we might assure the quality of our work in the difficult times that no doubt lie ahead. As well as considering what we want our service to become, it’s worth asking what those we work with and for want from the service in the changing healthcare landscape. To that end, Tom Grew and Trefor Roscoe give their views on the impact that pathology services have on their lives as a patient and general practitioner, respectively. David Hoskins demonstrates the importance of peace of mind. In dark times a kind word and thoughtful ear take on a special value that is not to be underestimated. The ACP offers financial assistance to students to support their academic studies, and we learn from Lovesh Dyall and Peter Brown how some of that money has been put to good use. If you want to fail the FRCPath examinations it’s never too early to start your preparation. Ed Carling offers some valuable advice but the ACP news accepts no responsibility if you manage to accidentally pass. Finally, of course, there is the usual selection of meetings, reviews and even a bumper crop of columns from our regular and irregular columnists. Enjoy! ISSN No. 0260-065X


ACP news - Winter 2010

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