Chemical pathology

Chemical pathologists are qualified doctors who combine practical laboratory and clinical skills. They use biochemical laboratory tests to diagnose disease and to manage patients. Chemical pathologists have a detailed understanding of biochemical processes and changes that occur in disease.

This page provides useful information on the nature of the work, the common procedures/interventions, sub-specialties and other roles that may interest you.

Test-tubes

Nature of the work

Chemical pathologists have two main roles. The first is to run and manage the biochemistry laboratory. Hundreds of samples are analysed each day for testing. The tests can be very wide-ranging but might include measurement of:

Sample analysis is often performed by automated analysers, which are usually operated by biomedical scientists. Chemical pathologists manage the processes and the laboratory staff. They provide guidance on the selection of appropriate tests, and assess the significance of the results. This is particularly the case with more unusual tests. They also provide quality assurance as part of their strategic leadership role.

The second role is clinical - chemical pathologists don’t spend all their time in the laboratory. They have an important role working alongside patients who have metabolic disturbances, relating to the body’s internal chemistry. Chemical pathologists have direct responsibility for these patients, who may be seen on the wards or in outpatient clinics.

Chemical pathologists also work closely with GPs who often request tests. They also liaise with a wide range of hospital colleagues, providing expert guidance where necessary.

They also work very closely with endocrinologists, to oversee specialist tests and help with the development and interpretation of hormone tests.

Chemical pathologists generally work with adult patients, although some with a paediatric background see children.

Metabolic Medicine

Inherited metabolic disease (IMD) is a genetic inherited disorder of the metabolism. It can lead to a dangerous imbalance of chemicals in the body and ultimately organ damage and disabilities.

In the UK 600 children are born each year with IMD and 20,000 adults and children live with this.

One of the most common IMD condition is phenylketonuria or PKU. Sufferers are unable to break down the amino acid phenylalanine which then builds up in the blood and brain and causes brain damage resulting in severe learning disabilities.

Newborn babies are routinely screened for this disease via a heel-prick test given after birth. If PKU is indicated further tests will be carried out by the chemical pathologist. They are then given a special low-protein diet and amino acid supplements to prevent brain damage. Providing advice to pregnant women with PKU is an important part of the work.

We also have role pages for metabolic medicine.

"I particularly enjoy applying clinical biochemistry directly to patient care" Dr Andrew Day is a consultant chemical pathologist at Bristol Royal Infirmary. He is also director of examinations at the Royal College of Pathologists.

Read Andrew’s story

Common procedures/interventions

As well as running tests and seeing patients chemical pathologists may develop particular skills in one area of biochemistry, offering tests and advice over a wide geographical area.

They also develop relationships with GPs, helping them understand and utilise tests in better ways.

New diagnostic tests allow for more specific diagnosis, and opportunities abound to assess the efficacy of new tests. Chemical pathologists also have an important role to play in the development of new tests which allow for more specific diagnosis and improve the lives of patients.

Sub-specialties

Metabolic medicine is the only sub-specialty within chemical pathology. It includes the following clinical areas:

What to learn more?

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Other roles that may interest you

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