Haematology Watch


    Haematology Watch, Vol.6, Issue 1. 


Haematology Training in Pakistan: An Overview


The specialty of Haematology in Pakistan encompasses diagnostic laboratory practice, although physicians and surgeons often seek advice from haematologists about therapeutics.

The haematologists are trained in Pakistan under supervision of College of Physicians and Surgeons, while a secondary body Pakistan Society of Haematology gives guidance to students and supervisors. 


In the United Kingdom the specialty of haematology encompasses both clinical and laboratory 

practice, hence haematologists are both pathologists and physicians.1

 Disappointingly, feedback 

from FRCPath examinations has repeatedly 

highlighted poor performance in areas of laboratory medicine and the 2012 GMC survey demonstrates the majority of trainees spend less than 

20% of their total time in the laboratory, despite 

haematologists being regularly called upon to 

give laboratory-related advice.2

 The recent centralisation of pathology services has removed 

both source (training) material and the need for 

pathology reporting from many hospitals training haematologists, so the question is: what can 

we do to improve laboratory training and maintain patient safety if our dual role as clinician 

and pathologist is to continue?

Using qualitative research methodology,3

focus groups and inter-trainee debates entitled 

‘How do we improve our laboratory training?’ 

were held across the UK in a bid to create nationally relevant recommendations to improve 

laboratory training in haematology. Themes for 

discussion were generated by a preceding anonymous questionnaire and direct quotes from trainees were used in regional reports to illustrate 

opinions. Focus groups were held in London 

(n=30), the North Western Deanery (n=16), Scotland (n=11) and Wales (n=12). This document 

summarises the findings of these reports. The 

findings are grouped into the emergent themes 

arising from this work, with striking similarities 

in different regions. There were several examples 

of excellent laboratory training in busy clinical 

haematology departments. These examples of 

best practice were used to help construct recommendations. The research aims to address the 

relationship between training and service provision; when, where, who and how laboratory 

training can best be delivered and assessed; the 

role of the FRCPath examination and the impact 

of pathology centralisation. From this the authors hope that positive steps towards improved 

laboratory training for haematologists can be 

successfully implemented across the UK. 

1. Impact of service commitments

“The biggest problem is that lab training is always given 

a lower priority than clinical service.”

“Service commitments mean that different jobs have 

varying exposure to laboratory haematology. It’s easy to 

get deskilled and lose your confidence (and competence) 

in the lab.”

“It feels as though other clinical staff think you 

are going for a break if you say you are going to the 


Trainees acknowledge that service commitment and training are closely interwoven, with 

trainees learning in a service context. However, 

the major barrier to effective laboratory training 

was felt to be conflicting pressure to provide clinical service, with laboratory training and experience most readily sacrificed due to pressures of 

service requirements.

2. Role of laboratory induction

“I did get lab induction – but it was very informal.”

“I was overwhelmed by morphology teaching sessions which I attended as a new ST3 – they seemed to be 

geared towards more senior trainees.”

“On paper we had a laboratory induction but there 

were insufficient staff to cover the ward – so I never got 

to attend.”

There were recurrent concerns regarding the 

lab skills demanded of new ST3s. The JRCPTB 

2010 haematology curriculum1

 attempts to put 

increased focus on early laboratory training, although trainees and trainers alike appear to under-appreciate this. Laboratory expertise cannot 

be assumed with new ST3s and there was agreement across the UK that a period of formal induction should be provided for all new haematology 

trainees. At present, this happens with varying 

success in certain training regions, although is 

How can we improve laboratory 

training? Views from Uk haematology



he Trainee Leads for the British Society for Haematology (BSH) and Intercollegiate 

Committee on Haematology (ICH) have carried out qualitative research into how to 

improve laboratory training in haematology. This is a particularly important issue at 

present because recent feedback from FRCPath exams has highlighted poor performance 

in areas of laboratory medicine and there appears to be a drive to separate the clinical and 

laboratory practice of UK haematologists. The research covers all areas of the UK through the 

use of focus groups and has had positive feedback from all who have seen the findings.

Dr Jane Graham

Dr Kirstin Lund

Dr Charles Percy

Dr Tom Butler


Some useful links: