"I enjoy the diversity of the work too. Histopathology reports have a tremendous impact on a patient’s care and treatment"

Dr Azam also likes the problem-solving aspect of histopathology as well as the variety and that she gets to work across the hospital with many different people. 

Dr Ayesha Azam

Specialty trainee (ST2) in histopathology

Employer or university
Sandwell and West Birmingham NHS Foundation Trust
Dr Ayesha Azam
  • When I started as a foundation doctor, I knew very little about the specialty of histopathology. I came across it during a cancer multidisciplinary team meeting with surgeons, physicians, radiologists, pathologists and a cancer nurse specialist, and  was fascinated by the tremendous impact these tiny tissue sections on a piece of glass have on the diagnosis and treatment of patients. I undertook a taster day in histopathology and it sparked my interest because of its problem-solving nature.

    To explore it further, I decided to do a foundation 2 (F2) rotation in histopathology. I liked the variety of the work, which includes: analysing tissues - biopsies, fluids and resections - under the microscope; ‘cut-up’ of tissues in the laboratory (the examination and dissection of surgical resection specimens to select the most appropriate samples for microscope slides); and some detective work involving post-mortems. 

  • In my first year in histopathology, I received a structured one-week introduction to it as a specialty, including learning how to set up and use a microscope, and lectures about different ‘systems’ in the body so I could familiarise myself with how a ‘normal’ organ looks and how to spot some common diseases.

    Now, my day-to-day duties include examining histology and cytology specimens under the microscope and preparing a clinical report which I then discuss with my supervisor. I also spend a few hours every week in what we call the ‘trim room’ to perform cut-up of biopsy and resection specimens.

    Attending team meetings with other healthcare professionals and performing post mortem examinations are also an important part of my duties.

  • I like the problem-solving aspect of histopathology. We examine each case systematically to arrive at a diagnosis which obviously helps determine the treatment the patient receives.

    I enjoy the diversity of the work too. Histopathology reports have a tremendous impact on a patient’s care and treatment and I like the challenge of making important decisions in patients’ lives.

    The work is very variable as we work with almost all the specialties in the hospital. 

  • The working hours are good in histopathology with no on-call working, which means I enjoy a good work-life balance.

  • If you’re considering a career in medicine, histopathologists are currently in demand and there are excellent teaching and research opportunities.

    The specialty training for histopathology is provided on a ‘run-through’ basis which means it’s possible to obtain a Certificate of completion of training (CCT) after five years without having to apply to get a place on specialty 3 training (ST3).

    There are rapid advancements in digital pathology too with the aim of moving from physical ‘slides’ to digital images.

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