Dr Mike Watson
Dr Mike Watson is an Anatomical Pathologist and Trainee Supervisor at Auckland City Hospital. He offers an insight of how he got into this speciality and what it is like to train as a Pathologist....
I'm an anatomical pathologist and my subspecialty area of
interest is paediatric pathology. I moved into pathology training
after working one year as an orthopaedics registrar. I enjoyed
orthopaedics immensely, but I wasn't so keen on the hours, and
decided to change to a specialty that would offer a better life
style. I chose pathology as I had particularly liked the
pathology syllabus when I was studying for the surgical part I
exam. What impressed me the most was that, in the few years since I
had been at medical school, a huge amount of new knowledge had been
acquired and I thought it would be exciting to be involved in a
field that was so rapidly expanding.
Pathology is something of a hidden specialty to the clinician
and I didn't really know much about it. I approached a friend
who was a pathology trainee, and she was very enthusiastic. I
then visited the pathology department at Dunedin hospital.
The pathologists were very welcoming and I was immediately struck
by the positive environment and the exciting career opportunities.
As with most people who decide to specialise in pathology, I found
that once I started, I really enjoy it. I also discovered
that it's actually quite a busy specialty, but the hours are
definitely more sociable, and there is a reasonable amount of
flexibility at consultant level for working part time when one has
a young family.
Pathology cases are presented at clinical meetings, which RMOs
and medical students attend, however they don't really get the full
picture of what goes on in making diagnoses. A substantial amount
of detective work can be involved in reaching an accurate
diagnosis. Fortunately due to the size of our department, there is
always someone here with subspecialty expertise, and having someone
who has a particular interest in your problem often provides
stimulating learning opportunities.
While anatomical pathologists do not have much direct patient
contact, they are still doctors first and foremost, and the
interaction with clinicians in a multidisciplinary setting
emphasises one's involvement in patient care. I enjoy the
problem solving aspect of pathology, I enjoy teaching, and I enjoy
the collegiality within my department. In pathology, you don't
generally practise in isolation. Instead there is a lot of
interaction and sharing of knowledge amongst colleagues in relation
to difficult cases. I really enjoy my interactions too with
the Starship clinicians.
Pathology training is a five year programme. Trainees in
Auckland rotate between four different laboratories in the region
in a series of four monthly runs. The case mix differs between the
laboratories and hence the experience gained is varied. Working
hours are less compared with some other specialties. Pathology
registrars work about 45 hours per week, and in anatomical
pathology, they do not do call.
Pathology has a reputation for having particularly difficult
exams. There are three exams. The pathology sciences exam is a
written exam that is usually sat in the first year, but can be done
prior to starting training. It has about a 90% pass rate.
Then there is the part I exam, which comprises a mixture of written
and practical components. It represents the major hurdle, and
is sat in the third year. For anatomical pathology, the
Australasian pass rate is around 40%. Finally there is the part II
exam in the fifth year which in AP has an pass rate of 60-70%.
The Auckland pathology training scheme is the biggest programme
in New Zealand and the positions are highly sought after. It is
important to us to provide a good learning environment therefore,
and in addition to learning on the job, we have protected teaching
time which in AP involves workshops and tutorials on particular
topics, and a weekly review of difficult and interesting cases.
If you are interested in pathology, I would advise you to come
into a laboratory to meet the pathologists and get a better
understanding of what we do. In my opinion, a broad general
clinical experience is always a good thing prior to starting
pathology training, as it leads to improved clinico-pathological
correlation.
During my time here I have built strong friendships within my
department. It's quite a social workplace. My life outside work is
mainly orientated around raising my children. I'm also interested
in outdoor activities such as tramping, and skiing.