Haematology (doctor)

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

Nature of the work

Haematologists undertake the care of outpatients and inpatients, provide an advisory and consultancy service to all hospital specialists and general practitioners, and manage diagnostic laboratories. They provide clinical interpretation of laboratory data and morphology (form and structure) of blood and bone marrow specimens.

This holistic [1] approach to clinical care is a highlight of the specialty. Clinical haematology is an intensive, exciting, rewarding but demanding specialty that encompasses both clinical and laboratory practice. As a result of this dual role, haematologists take an active part in every stage of patient management, from initial clinic visit, to laboratory assessment/diagnosis and finally to treatment.

Haematologists work with patients of all ages and they manage both benign and malignant conditions.

Specialists undergo training in all aspects of haematology, both clinical and laboratory. As consultants, they are expected to maintain a core competence in both these areas to provide an on-call and emergency service.

Haematologists work closely with biomedical scientists, who generally perform routine laboratory work. They also work closely with a wide range of other specialists in large multidisciplinary teams.

Teaching medical students and trainees is often part of the work, and many haematologists also undertake research. Larger departments may employ academic haematologists.

Common procedures/interventions

These include:

• delivering clinical care, often for life-threatening disease
• formulating chemotherapy [2] protocols and managing their delivery
• managing haematopoietic stem cell transplantation procedures
• providing advice on haematology laboratory results
• sampling bone marrow and interpreting the morphology
• performing diagnostic lumbar punctures and giving intra-thecal chemotherapy [2]

Sub-specialties

Within haematology there is the opportunity to further develop special interests in a wide variety of clinical and laboratory areas. Most haematologists have further competences in one or more sub specialties within the discipline. These include:

• haemato-oncology [3] (acute and chronic leukaemias, lymphoma, multiple myeloma)
• haemostasis/thrombosis [4] (congenital and acquired disorders of haemostasis and blood coagulation and management of antithrombotic therapies)
• disorders of blood production and destruction (including bone marrow failure, anaemias and autoimmune blood diseases)
• transfusion medicine
• paediatric haematology

Want to learn more?

Find out more about:

• the working life [5] of someone in haematology
• the entry requirements [6] and training and development [7]

• Pay and conditions

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  This section provides useful information about the pay for junior doctors (doctors in training), specialty doctors, consultants and general practitioners.

  Find out more about the current pay scales for doctors [8]and there's more information on the BMA website [9]  

  NHS employers [10] provides useful advice and guidance on all NHS pay, contracts terms and conditions.

  Medical staff working in private sector hospitals, the armed services or abroad will be paid on different scales.

• Where the role can lead

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  Consultant roles

  You can apply for consultant roles six months prior to achieving your Certificate of Completion of Training [11] (CCT [12]). You will receive your CCT [12] at the end of your haematology training.

  Managerial opportunities for consultants include:

  • clinical lead - lead NHS consultant for the team
  • clinical director - lead NHS consultant for the department
  • medical director - lead NHS consultant for the Trust

  Most NHS consultants will be involved with clinical and educational supervision of junior doctors.

  Here are some examples of education and training opportunities:

  • director of medical education - the NHS consultant appointed to the hospital board who is responsible for the postgraduate medical training in a hospital. They work with the postgraduate dean to make sure training meets GMC standards.
  • training programme director - the NHS consultant overseeing the education of the local cohort of trainee doctors eg foundation training [13] programme director. This role will be working within the LETB/deanery
  • associate dean - the NHS consultant responsible for the management of the entirety of a training programme. This role will be also be working within the LETB/deanery

  SAS doctor roles

  There are also opportunities to work at non-consultant level, for example as a SAS (Specialist and Associate Specialist) doctor.

  SAS doctors (Staff, Associate Specialists and Specialty Doctors) work as career grade specialty doctors who are not in training or in consultant posts. You will need at least four postgraduate years training (two of those being in a relevant specialty) before you can apply for Specialty Doctor roles.

  Further information on the SAS doctor roles. [14]

  Other non-training grade roles

  These roles include:

  • trust grade
  • clinical fellows

  Academic pathways

  If you have trained on an academic haematology pathway or are interested in research, there are opportunities in academic medicine.

  For those with a particular interest in research, you may wish to consider an academic career in haematology. Whilst not essential, some doctors start their career with an academic foundation post. Entry is highly competitive. This enables them to develop skills in research and teaching alongside the basic competences in the foundation curriculum [15].

  Entry into an academic career would usually start with an Academic Clinical Fellowship (ACF) at ST1-2 and may progress to a Clinical Lectureship (CL) at ST3 and beyond. Alternatively, some trainees that begin with an ACF post then continue as an ST trainee on the clinical programme post-ST4.

  After completion of the academic foundation trainees can then apply for academic core training posts (instead of normal core training).  A PhD is often taken, either during core or specialty training.

  Applications for entry into Academic Clinical Fellow posts are coordinated by the National Institute for Health Research Trainees Coordinating Centre (NIHRTCC). [16]

  There are also numerous opportunities for trainees to undertake research outside of the ACF/CL route, as part of planned time out of their training programme. Find out more about academic medicine. [17]

  The Clinical Research Network [18] [19](CRN) actively encourages all doctors to take part in clinical research.

  Other opportunities

  Haematologists may undertake research, which includes collaborating with colleagues in the UK and overseas, writing papers and presenting work at conferences.

  The opportunities for research within this speciality are good.

  There may also be opportunities to work in the private sector (mostly in London) and overseas.

• Job market and vacancies

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  This section provides useful information about the availability of jobs, how to find vacancies and sources of further information.

  Job market information

  At present, there are 759 haematology consultants and 449 medical registrars in England (NHS Digital, 2016 [20]). Women make up 42% of the consultant workforce and 65% of the higher speciality trainees in the UK (2014/14 RCP census, 2016 [21]).

  In 2016, the competition ratio [22] for ST3 haematology was 1.45 (NHS specialty training, 2016). [23]

  On this section we have information for England only. For information regarding Scotland, Wales and Northern Ireland please click on the links below.

  NHS Scotland workforce information [24]
  NHS Wales workforce information [25]
  Northern Ireland workforce information [26]

  Where to look for vacancies

  Haematology training is open to those who may want to train flexibly on a less than full-time basis [27](LTFT). You can request and apply for this after you have been offered the job. Restrictions apply.

  Registration and applications for haematology training is online via Oriel [28].

  Northern Ireland has its own recruitment process. For further details please visit the Northern Ireland Medical and Dental Training Agency [29] website.

• Further information

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  Organisations

  British Medical Association [30]

  British Society for Haematology [31]

  General Medical Council [32]

  Joint Royal Colleges of Physicians Training Board [33]

  Royal College of Pathologists [34]

  The Pathological Society of Great Britain and Ireland [35] 

  Real-life stories

  Dr Tim Littlewood, consultant haematologist (RCP) [36]