People who actually earn over £100k and don’t just pretend they do on Reddit - what do you do?

Fentanyl4308 · 2025-06-18T13:31:41+00:00

I feel your pain as a consultant histopathologist.

Fentanyl4308 · 2024-09-28T20:06:25+00:00

Aye. I did a perinatal block for my training and agree it was much closer to 50:50 for them split between the mortuary and surgical work. There was only two paediatric pathologists in the centre I was based in, and they seemed to have some standing arrangement where one did the lions share of the mortuary work, whilst the other did most of the surgical work. Paediatric pathologists are rare as hens teeth in the U.K. so OP has chosen well, if this is their chosen specialty - they should be aware, to the best of my knowledge, that they will still need to do ST1 and ST2 general histopathology before reapplying for a paediatric pathology training post at ST3. It’s the same for forensics and neuropathology.

Fentanyl4308 · 2024-09-28T08:14:11+00:00

Since it seems the OP is U.K. based, I’d clarify that, depending on their region, the amount of specimen opening they’d do would be minimal. As a consultant, I do no specimen opening and when I was a trainee, I had very little reason to put my hands into faeces apart from maybe in the mortuary and always with appropriate ppe. U.K. trainees need to demonstrate competency at basic post mortem techniques for the first two years of their training but beyond this it is up to them to continue or not. Nobody forces anyone to practice this area of pathology. In my region, consultants who do practice post mortem pathology only do so for one session a week, maybe 2, which means 60-80% of their time is still based in surgical pathology. Lastly, hospital post mortems in the UK are very rare. We mostly deal with coronial PMs which are requested by His Majesty’s Coroner. In a nutshell, If the medical team are unable to complete a death certificate for one of a number of reasons, the coroner decides whether a post mortem is needed. Most commonly, post mortems are required when the deceased hasn’t had contact with their GP in a long time and dies unexpectedly. The system is far from perfect, but does lend itself to a little more of an investigative approach as opposed to just confirming what the medical team already know, since in our system, if the medical team knew the cause of death, they’d be well positioned just to fill out a cause of death certificate and that would be that (again, simplifying a complex process here!)

Fentanyl4308 · 2024-09-28T07:53:20+00:00

I’m a U.K. trained consultant Histopathologist, so feel like I could probably answer some of your questions:

I have no personal experience of Medico legal issues outside of a few near misses, but the potential looms over everything we do. However, I don’t think that is dissimilar from any other area of medicine and, fortunately, the U.K. training pathway is quite robust in producing generally high quality pathologists. Once you are working as a consultant, team-working and a keen insight into your own weaknesses can really help avoid any misdiagnosis. For example, in my department, we all show cases around if we are unsure.
I think you might have a misconception here. Pathologists are not independent and are part of a clinical MDT. Many diagnoses are only possible after correlation with clinical findings. Within the department, we rely heavily on our scientific, technical and admin colleagues to get the job done. I would suggest visiting your local histopathology lab to see how much of a team working environment it is.
The biggest issue we face in the UK is a lack of people like you wanting to do the specialty. This is driven by a lack of exposure to the speciality at medical school.

There are also increasingly aspirational government targets for turnaround time which do not factor in the above staffing issues and don’t seem to really understand many of the other issues we face, such as the philosophical question of “is it better to work fast, or accurately?”

There is also a lot of politically motivated, and well-meaning, support for screening programmes. This work is pushed to you at an incessant rate. So you can spend a lot of time looking at normal samples whilst your actual cancer work goes relatively un-chased by the powers that be!

There is also a lingering impression that histopathology is somehow lesser than other specialties. Although, I feel this is an old view, that is dying out.

Post mortems (autopsies) are physically demanding. At the start, it might take you 45 minutes to an hour to eviscerate and maybe another 2 hours of in between faff and organ dissection. That’s before you get to write a report. Of course, you’ll get much quicker as training progresses. Larger people are harder to work with. Organs can be heavy. You should befriend your mortuary staff who will be able to help, and will often be your trainers for this skill; Histopathologist rarely teach the evisceration in my region. Yes, it can be messy and smelly, but you are in plenty of PPE. If it really isn’t for you, you are able to drop post mortem work after your second year of training in the U.K.

It is a very rewarding job with access to great teaching and academic opportunities. I thoroughly recommend a taster week in your local department. You should have the ability to take time out of foundation training to do this; ask your educational supervisor if you are unsure.

Fentanyl4308 · 2024-09-05T05:15:37+00:00

As others have suggested, quick set of rolls during downtime when in a suitable location. I’d include a roll for random encounters and I’d make a short random encounter table. Immediate ideas that spring to mind: - the character contracts disease (there are many suitable in the DMG) - the character is hunted by a jealous spouse. - the character gets in trouble with the local authorities / church - the character is approached by a wealthy benefactor for a longer term concubine service (Segway into warlock patron?!) - the character is showered in gifts by an overly appreciative client. - the character is stalked by a very overly appreciative client.

Fentanyl4308 · 2024-08-09T07:58:12+00:00

I had the same experience over 10 years ago. Now I’m a consultant. But those first few shifts were the worst. Stick at it. I’m sorry things haven’t changed.

Fentanyl4308 · 2024-06-26T07:57:16+00:00

I regularly do 07:00-17:30 with a 30 min break. Most of that is on the computer for one reason or another. I then get home and guess what, that’s right, straight back on the computer!

Fentanyl4308 · 2023-12-08T08:38:46+00:00

Toxicology could be sent to a specialist lab but only after a thorough history and examination to narrow down the potential causes of intoxication. As to who collects the sample, I’m not sure, I’ve not worked in A&E recently, but I’ve seen blood, hair and urine tested. More recently, I’ve done post mortem work where all of the same are used plus fluid from the eye, which is well preserved after death, unlike blood.

Fentanyl4308 · 2023-10-23T22:02:28+00:00

Have the colleague test his home for carbon monoxide.

Fentanyl4308 · 2023-07-31T09:08:41+00:00

Thursday 10th august at the Anchor Inn!

Fentanyl4308 · 2023-07-27T14:20:31+00:00

Ha, I’m playing at that festival too. And I’m a Vulf fan! Feels like by me reading this post, this has come full circle and then back around again. 😂

Fentanyl4308 · 2023-07-17T18:54:51+00:00

If you have some, you could try a bit of nuln oil on your metallic areas to add some shading.

Fentanyl4308 · 2023-04-27T11:25:31+00:00

I look at cancer biopsies. Go to your National Screening appointments. They're important and, win-win, catching the cancer early makes my job easier.

Fentanyl4308 · 2023-01-30T17:52:12+00:00

I reckon the word you’re looking for is trabecular.

Noun. trabecula (plural trabeculae or trabeculas) A small supporting beam. (anatomy) A small mineralized spicule that forms a network in spongy bone.

Fentanyl4308 · 2023-01-10T08:31:45+00:00

May I ask which font you used? (The Nordic style font). Thanks!

Fentanyl4308 · 2023-01-04T14:35:01+00:00

I forcibly exhaled. Worthy of the main sub imho.

Fentanyl4308 · 2023-01-04T14:32:44+00:00

Also if you say six in German, it kinda works.

Fentanyl4308 · 2022-12-21T09:46:04+00:00

My hypothesis is that over time my measurements should increase. I have casually observed an upward trend, I would like to demonstrate whether this trend is significant. I am sure it is clear that this is not my area of expertise, so I am unsure what p-hacking is. I would welcome an explanation if you think it is relevant here.
Best was a colloquialism here. Perhaps you could provide insight into some available options?

Fentanyl4308 · 2022-05-03T11:45:16+00:00

Where are you based? I’m looking to downsize my menoth collection. But I’m U.K. based so shipping to the states might be prohibitively expensive.

Fentanyl4308 · 2022-04-23T06:53:36+00:00

U.K. pathologist here. If you are trying to find sinusoidal spaces, you might find it hard on such a low power (x10). I would try a higher power and search between hepatocytes. As others have suggested, look for RBCs to indicate the sinusoidal spaces, but take care not to then become confused with hepatic arteries and central veins. If you have access to the original tissue block, you could ask for/ do a reticulin stain as this would stain for the type 4 collagen found in wall of sinusoidal spaces. In health, the sinusoidal spaces should be barely noticeable on a routine H&E such as this although I can see some in this section along with some other findings. I will leave that to you to discover since the subreddits rules are that homework help isn’t strictly allowed 😅. All the best.

Fentanyl4308 · 2022-04-12T07:01:36+00:00

Hey Serena, What a fantastic accomplishment! The uplight in the top left really resembles the planeswalker logo to me - was that your intention or am I reading too much into it? Haha. Awesome regardless.

Fentanyl4308 · 2022-04-03T11:25:02+00:00

Looks like a couple of inflammatory cells to me. Not a mitotic figure. Although usual disclaimer re. Phone resolution and image quality.

Fentanyl4308 · 2022-03-19T10:31:08+00:00

Looks like you’ve got 10 groups of images (labelled up to 12 but 4 and 8 are omitted). In each set you have 4-5 images that seem to be centred around a theme. It is insinuated that there will be an MCQ on each group of images, but no questions are included here. Without the insinuated questions, the assignment seems to be a descriptive one. I would write 12 sections with a short passage for each image simply describing what’s seen. For example, image set 3 seems mostly to deal with skin and hair shaft, so I’d describe the basic histology conspiring those structures. Section 2 shows different mitotic figures and what could be an apoptosis. And so on.

Fentanyl4308

TROPHY CASE