Clinical cytogeneticist
A clinical cytogeneticist detects and analyses hereditary diseases and abnormalities. This is achieved by studying chromosomes which have been obtained from samples of blood, bone marrow, body fluid, amniotic fluid or foetal tissue samples.
The detection and interpretation of chromosome abnormalities is part of the management and treatment of many illnesses and disorders, including mental health issues, prenatal defects, infertility and malignancies, including some leukaemias.
Cytogenetics, as a scientific discipline, draws its knowledge and techniques from both cytology (the study of cells) and genetics (the science of heredity) and this is reflected in the role. It requires the use of diagnostic screening methods, including cell culture and microscopy techniques.
The work of a clinical cytogeneticist falls into three main categories:
Typical tasks might include:
Clinical cytogeneticists must have a first or upper second class honours degree in genetics, a biological science or another scientific discipline with a major genetics component. In particular, the following subjects may increase your chances:
Entry to the clinical scientist training programme is not possible without a degree or with a foundation degree only, although entry to genetic technologist positions is possible without a first degree.
There are currently two main entry routes to the profession:
As of 2011, in England and Wales, a new graduate entry Scientist Training Programme (SPT) replaced the previous Clinical Scientist Training Scheme. The recruitment for the healthcare scientist training positions takes place early in the year for the September intake. Recruitment usually begins in February, with a closing date in mid-March.
NHS Trusts offer 200 training posts in life sciences, physics and engineering and physiological sciences. Successful candidates join a three-year training programme of workplace-based learning and a Masters degree in their specialist subject.
There is a single timetable for recruitment as well as national guidelines and assessment centres to ensure that all candidates are treated fairly and equally. Candidates can apply for the training posts at the NHS Jobs website, while the selection process is organised by local trusts.
Details of all training posts are available on NHS Jobs and will be advertised in the New Scientist . Further details of the scheme and a list of all the job roles are available on the Training as a clinical scientist page on the NHS Careers website.
Scotland is also adopting the new training programme but will still be recruiting by specialist subject, rather than on a national basis for the time being. Training will be provided by individual NHS boards. Details of each training scheme can be found at Clinical Scientist Pre-Registration Training Schemes Scotland and can also be found in the New Scientist.
Candidates need to show evidence of the following:
Laboratory experience and an insight into the workings of a hospital laboratory are very important, so arrange a visit to a local hospital laboratory before you apply or even arrange work experience in a clinical cytogenetics laboratory
Employment as a genetic technologist can offer an alternative route into cytogenetics. Genetic technologists, who work alongside cytogeneticists, are responsible for sample processing, cell culture and preparation of chromosome materials. Most employers would expect a biology-related BSc but you can enter this role with out a degree or HND.
For more information, see work experience and internships and search courses and research.
The new training programme for clinical scientists leads to a specifically commissioned and accredited Masters degree and certification of workplace-based training. After a month-long academic introductory session, the trainees then do four separate three-month rotations, working in specific specialist areas in the workplace. Following this, they choose an elective for four to six months. The final workplace part is an 18-month placement of the chosen single specialist area. Throughout this, the trainee continues to study part time for a Masters degree.
Following at least four years in a pre-registration post, and having been awarded the certificate of competence by the Association of Clinical Scientists (ACS) , trainees are eligible to apply for state registration as a clinical cytogeneticist with the Clinical Science Board of the Health Professions Council (HPC) . During the pre-registration period, trainees are expected to have completed Part I of their MRCPath (membership of The Royal College of Pathologists ).
Pre-registration trainees are funded centrally by the National Health Service (NHS) (see NHS Careers ) so that securing a post-registration position usually involves moving to a different hospital if no posts are available in the hospital where the pre-registration training was based.
Post-registration training posts, at Band 7, are provided regionally by the NHS. These involve rotation schemes to a number of hospitals to provide balanced training. Again, a training record is kept which covers clinical liaison, service commitment, research and development, communication, clinical audit, laboratory management, critical appraisal of literature and data, and further study towards Part II of the MRCPath, which enables the post-registrant to apply for principal clinical cytogenetics and consultancy posts.
Clinical scientists are expected to achieve at least one further vocational qualification (for example, a Chartered award or membership of an appropriate professional body).
All post-registration clinical scientists are required to take part in continuing professional development (CPD). This is organised by The Royal College of Pathologists.
Career progression is from trainee clinical cytogeneticist (Band 6) to post-registration (Band 7) up to the position of consultant clinical scientist (Bands 8 and 9). Promotion is directly linked to passing exams during pre-registration and post-registration periods. Post-registration positions are advertised nationally and often require relocation.
Progression to the top of Band 7 is based on merit including the completion of relevant specialised postgraduate research and publication in peer-reviewed journals. Networking at all levels is part of successful career development in this role. Maintaining a professional profile by presenting research at meetings, undertaking work exchanges abroad and applying for research grants is also recommended.
Further study and training is likely to follow, with the expectation that clinical cytogeneticists attain membership of The Royal College of Pathologists (MRCPath) or a PhD. The MRCPath is taken in two parts: part I after a minimum of three years' training and part II during the post-registration period of training. The MRCPath allows clinical cytogeneticists to proceed to higher post-registration positions and finally to a consultancy post. Most consultancy posts carry independent responsibility for managing a laboratory and for advising the health authority on policy issues. The status is comparable to that of a hospital consultant.
Progress through the practitioner grades is not necessarily automatic. To progress beyond Band 7 and on to Band 8, cytogeneticists must gain a position with greater responsibility, along with membership of the Royal College of Pathologists (part I examination). Senior grade responsibilities will entail supervising and training a laboratory team, compiling and interpreting reports and advising health authorities on policy matters relating to cytogenetics services through work on appropriate committees.
Heads of department and deputies in larger laboratories are employed at consultant grade, which is equivalent to medical consultant level, and may be involved in university lecturing. These extra responsibilities are reflected in the salary structure. Heads of laboratories would be expected to have the full MRCPath qualification (part I and part II). Full details can be obtained from the Association for Clinical Cytogeneticists (ACC) .
It should be noted that career progression is likely to require geographical mobility within the UK.
Clinical cytogeneticists are employed by The National Health Service (NHS) in cytogenetic units, which are often attached to teaching hospitals. These laboratories are the main source of employment.
Some posts are grant-funded via universities, which are normally attached to teaching hospitals. Private laboratories are not common and tend not to offer training posts, instead recruiting previously trained staff.
The NHS Clinical Scientists Recruitment Service provides a handbook describing each of the posts available in England and Wales. Laboratories in Scotland usually advertise as a consortium in New Scientist and The Scotsman . Vacancies in Northern Ireland will be advertised in the local press.
Career grade posts are usually advertised in the scientific press and on the Association for Clinical Cytogeneticists (ACC) website.
Recruitment agencies rarely handle vacancies.
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