Case studies: Speciality registrar in haematology: Anna Byrne

Anna studied medicine at the University of Southampton. Part of her degree involved an intercalated BSc in biomedical sciences with a focus on immunology. She currently works as a speciality registrar in haematology.

After graduating, I completed my two-year foundation programme in medicine, and then did a further two years of core medical training. As I was interested in haematology, I selected rotations that included jobs in haematology and clinical and medical oncology. I also completed my membership of the Royal College of Physicians exams during this time. To further demonstrate my interest in haematology, I completed an audit that was specific to the speciality.

This was useful when applying to my current five-year training post within the Severn Deanery, which will include rotation through a tertiary haematology centre and several district general hospitals. It also covers four three-month posts in coagulation, transfusion medicine, paediatric haematology and bone marrow transplant medicine.

To work as a haematology physician, you have to have a medical degree. Another useful qualification is a BSc, either prior to your medical degree or as an intercalation, especially if you want to do research as Out-of-Programme Experience during your training. In order to become a consultant, you also have to complete the membership of the Royal College of Physicians exams and the fellowship of the Royal College of Pathology exams.

Depending on how large the hospital is that you are working in, you may be the only registrar or work as part of a team. Currently I am working in Bath with two other registrars so we divide the duties between us, including covering an acute haematology ward, assessing patients with haematological malignancies and other general haematological problems on outlying wards, and reviewing blood films and bone marrow slides under the microscope. I also carry a mobile phone on some days to give advice to GPs. On Mondays we have a multidisciplinary team meeting where we discuss current patients with haematological malignancies such as lymphoma and leukaemia.

In the next three years, I aim to complete my fellowship of the Royal College of Pathologists examinations. I would like to do an MD or PhD in haemato-oncology, as this is the area in which I would like to become a consultant. I am also currently the trainee representative for haematology within the deanery.

I enjoy the variety the job provides, and that I am involved in the diagnostic assessment of the patients I look after. Very often I will have examined the blood film or the bone marrow of the person I am assessing in clinic. As a consultant you are also involved in managing the running of the haematology laboratories, including general haematology, coagulation and transfusion.

The most challenging parts of the job are keeping up with the constant new research and guidelines on the treatment of haematological disorders. There is also a significant amount of breaking bad news to patients and families and supporting people through the terminal phases of their illness, but this can be rewarding if you feel that they received the best level of support available to them.

The best thing about working in haematology is that it is such a broad speciality and has several areas of sub-specialisation - from the challenges of bone marrow transplants to concentrating on the bigger picture and working as a transfusion consultant running national blood services. There are also ample opportunities to continue to be involved in research, the setting of national guidelines and the training of registrars and biomedical scientists at both local and national levels.

If you are considering a career in haematology, I would recommend making contact with the haematology department within your hospital and arranging to go along to clinics and multidisciplinary team meetings, as there is little exposure to haematological disorders on general medical wards. I would also advise asking to shadow a haematology registrar to see for yourself if the laboratory side of the job appeals to you, as it will be an integral part of your work.