The journey of a biopsy

Most people know what a biopsy is, but who makes the diagnosis and how? This short video takes you to South West London Pathology's hub laboratory and speaks to the various pathologists, scientists and support staff who work in the lab and contribute to making a diagnosis.
.
#DiscoverPathology
.
Thinking about a career in pathology? Go to www.rcpath.org/discover-patho...
.
To find out about the different services South West London Pathology offer, visit: www.swlpath.nhs.uk
.
Produced by:
The Royal College of Pathologists @RCPath
South West London Pathology @SWLPathology
.
Credits:
Stock footage: Falkenauge, Wikimedia Commons, Alex Alexandrov, Radiopaedia.org
Music: / ehrling
.
If you want to find out more about this specific test, visit: labtestsonline.org.uk/

[@ilovepathology]

Tell us what you think about the journey of a biopsy! We'd love to hear from you.

[@hakimchannel]

Wow, these people work hard, well done friends

[@drea2578]

you guys are admirable!! working at the pathology section looks so challenging and scary to me, but you guys made me want to try working there

[@NENAakaPOET]

Thank you so much for this! God bless you all for your hard work and efforts.

[@habibi7791]

God bless you guys 🙏🇨🇦🙏❤️🙏🌷🙏 it’s a very hard work and big responsibility.. no place for a mistake. God bless all of you and keep people healthy and heal all sick 😷 people.🙏🙏🙏🙏🧿🧉

[@stephaniewilson5284]

I've had four biopsies I have had skin cancer three times I am waiting for an excision right now in a month. Fascinating what happens behind the scenes.

[@tyoobarcyalosas603]

I took these notes 4 myself, but if u dont wanna watch the full video use this if u want: biopsy - tissue extracted for testing. a mass/issue may be discovered, but they aren't certain what it is. biopsy samples are booked in and prioritised if necessary. larger, more complex samples are dealt with by consultants/specialists. smaller tissue samples, like biopsies, are cut up by scientists. all water content is removed from the tissue to make it rigid (under high pressure). hot wax is poured over the tissue to embed and support it. helps to preserve it. the wax block has the tissue inside it, its then sliced into thin sections. (3 microns). slices are put onto slides. the slides are dyed to make them more visible under the microscope. then there is quality control, to make sure the process so far is accurate. good staining, good slices, good sample etc. the consultant then looks at the sample through a microscope to diagnose the disease.

[@victorparraga2992]

I am very thankful for my pathologists

[@tato33uk]

I'm in awe of this people. Intelligent and hard working people. I was wondering what the risks of contamination are for themselves...

[@mendesarmy1235]

The risk of contamination is generally very low. We are fully vaccinated against potential infectious hazards such as Hep-B and TB. Also, wearing personal protective equipment (gloves, lab coat) drastically reduces the risk as well. :)

[@mutegabriel4812]

God bless you all 🙏🌹♥️

[@drmohit21583]

Our side most of the job is done by residents, part by technicians reporting by consultants

[@asenathnyandika5944]

It's wonderful support to say the least.

[@gracio1231]

Loved this

[@semiatyusuff863]

i admire this alot

[@Rerawing]

Thank you, very nice video.

[@davidbyrne9155]

It does surprise me that the embedding is done manually? Especially when you consider that there are staff shortages and people need to be using their time on more skilled jobs than repetitive factory style work and scraping? Automated embedding can free up 5 hours a day of staff time and standardise the blocks, as well as fix the orientation from cut up onwards, avoiding mix-ups later down the line?

[@douglivingstone2706]

I am a histologist with over 40 years experience and there is nothing factory like about it,,These samples can be as small as 2 or 3mm and have to be orientated carefully.Dependent on what you are embedding some samples are on edge, some on end, some flat, and if you get it wrong peoples results are compromised.These days blocks are all scanned to elliminate mix ups.

[@williamshadestreet1462]

More videos pls. Let us learn more pls

[@dikshaprabhu3054]

Where are the autopsies conducted?

[@muchuialbert3819]

so much interested in this line of specialization, am an experienced Medical laboratory technologist in kenya.In scholaship in study of this.

[@joelwagura9477]

Human pathology is a diagnostic program. I think you need to have done a medicine course for you to be eligible.

[@stizandelasage]

now I see try and cure myself

[@tanviprabhu5622]

How can I become a genetic pathologist in UK? Is genetic pathology a specialisation in histopathology?

[@ilovepathology]

Hi Tanvi. Here's some more info on this: www.rcpath.org/discover-pathology/careers-in-pathology/become-a-consultant-clinical-scientist/dr-philippa-may-clinical-scientist-in-genetics.html

[@dikshaprabhu3054]

What is the difference between MD histopathology and MD clinical biochemistry or chemical pathology?which of them involves patient contact?

[@shashishekhar----]

Diksha.....better consult some practitioner to have a clarity if you haven't already, cheers !

[@tanviprabhu5622]

If I clear my frcpath part 1 and 2 whilst studying md pathology in my home country can I get a job directly as a consultant in UK or do I have to work for a few years as a registrar in the UK?

[@ilovepathology]

Hi there. We are checking this with some of our colleagues and we will get back to you soon. Thanks :)

[@ilovepathology]

If you want to practise as substantive consultant in the UK health services, you may be able to apply through the specialty equivalence route for entry onto the Specialist Register with a certificate Confirming Eligibility for Specialist Registration (CESR). CESR allows any combination of qualifications and/or training and experience gained anywhere in the world to be evaluated as part of an application for entry to the General Medical Council’s Specialist Register. For further information please go to the GMC website: www.gmc-uk.org/doctors/24630.asp

[@tanviprabhu5622]

@@ilovepathology Thank you for the information..... If I have completed my frcpath 1 and 2 while studying in India, can I get a job in UK directly as a SAS doctor or registrar or will I have to start from ST1 histopathology again? Is it possible to enter the training program directly at ST3 or ST4?

[@tanviprabhu5622]

@@ilovepathology Thank you

[@ilovepathology]

@@tanviprabhu5622 Recruitment for Histopathology is only at ST1 level via a nationally coordinated recruitment process run by the London and South East Postgraduate Medical and Dental Education - www.lpmde.ac.uk/laserecruitment/how-to-apply . The posts are normally advertised towards the end of the year for an August start the following year. You can find the person specification on the Health Education England website: specialtytraining.hee.nhs.uk/Recruitment/Person-specifications Regarding Specialty Doctors. UK trained doctors should have completed at least four years’ full-time postgraduate training at least two of which will be in a specialty training programme in a relevant specialty. Non-UK trained doctors should have equivalent experience and competencies. Further information can be found on the College website as follows: www.rcpath.org/profession/employing-pathologists/employing-specialty-doctors.html . Also Doctors wishing to come and train in the UK must be aware of the requirements for obtaining work permits and registration with the General Medical Council (GMC). We hope this helps. Please feel free to contact our training team for more information: [e-mail]

[@davidbyrne9155]

I am curious to know why UK Pathology is not embracing money and time saving technology like other EU Countries, while talking about the challenges faced, but still manually embedding? Does not make sense? Automating embedding has got to be one of the single biggest things that can be done to answer many of the current challenges. Typical Lab could save in excess of 300 staff days per year, they could be doing cut up? or even up-skilling to aid in diagnosis, or clearing microtomy backlogs? And obviously with cancer numbers growing, increasing backlogs, automating here can avoid increases in wait time for patients? I don't get why we are not automating more in UK?

[@rosalindsim9153]

Automation rarely frees up staff to do more interesting things- generally its a cost cutting exercise an excuse for employing less staff- staff are more expensive after all!

[@davidbyrne9155]

@@rosalindsim9153 Thanks for your comment. There are lots of Labs that have automated because they need to keep up with rising cancer numbers, staff shortages, backlogs, reduce embedding repeats, and conserve material. And of course standardisation is another benefit. Some labs have moved embedding staff onto cut up, and others have been up-skilled to get more involved in diagnosis, some have even been able to reduce their time to result. I think the key is that Labs are struggling with not enough staff and there is also a retirement crisis approaching with many Histo staff due to retire. And reducing repetitive work reduces staff sickness and stress.

[@MrJusticex1]

There are places in the UK that have automated embedders - this may be one of the smaller histopathology labs. I do agree that automation should be embraced but there is still a lot of limitations with automated embedders. They work well with pieces of tissue that are straightforward, but unable to embedd tissue which needs to be embedded specifically (on edge on end).

[@MartinRigden]

@@MrJusticex1 the technology allows for specific orientation in most cases. Achieved by the use of Paraform embedding cassettes.

[@declanbaldwin9209]

yyyyyes rachyyyyyyy

[@rosss825]

Tissue sections are not as thin as hair! HAIR IS SO MUCH THICKER!

[@sibusisothulani8996]

LARGER,MORE COMPLEX SAMPLE AND SMALLER TISSUES ARE DEALT WITH BY CONSULTANTS

[@oldschoolfoil2365]

Kinda need a strong stomach to cut up and handle these nasties from peoples bodies. yuck