Clinical scientists working in histocompatibility and immunogenetics carry out vital tests to ensure that donors and patients are suitably matched

As a clinical scientist working in histocompatibility and immunogenetics (H&I), you'll carry out tests to support haematopoietic stem cell and organ transplantation. A specialist in tissue typing, your work will ensure that the best donor for a particular patient is chosen.

You'll be involved in the genetic matching of prospective organ and stem cell donors with patients, typing human leukocyte antigens (HLA) and investigating HLA antibodies to enable assessment of the closeness of the match.

To work as a clinical scientist, you must be registered as a clinical scientist with the Health & Care Professions Council (HCPC).

Responsibilities

As an H&I clinical scientist, you'll need to:

  • carry out complex analyses on patient and donor specimens
  • perform HLA typing of organ donors and patients and assign HLA types to them
  • perform HLA typing in support of disease diagnosis or the prediction of drug hypersensitivity
  • perform screening of patient sera for HLA antibodies
  • perform cross-matching to assess patient and donor compatibility for solid organ transplantation
  • participate in the provision of HLA-matched platelets for patients who need platelet transfusion
  • perform isolation, measurement and cataloguing of DNA samples
  • perform isolation and preservation of lymphocytes
  • advise clinicians as to the best match between donor and patient
  • produce high-quality, accurate and timely audits of investigations
  • develop new and existing tests and ensure the quality of clinical investigations
  • record computerised and written reports relating to organ donors, patients and reagents
  • evaluate new technologies (and possibly train or specialise in these)
  • attend scientific meetings and conferences
  • submit bids for funding
  • undertake research to enable the expansion of transplantation as a credible treatment option for a range of diseases.

Salary

  • Jobs in the NHS are usually covered by the Agenda for Change (AfC) pay rates consisting of nine pay bands. Trainee clinical scientists are usually employed at Band 6, starting at £31,365.
  • Once qualified, you're likely to be employed on Band 7 (£38,890 to £44,503).
  • Salaries for senior and consultant clinical scientists range from £45,753 (Band 8) to £104,927 (top of Band 9), depending on your experience and training.

Those working in London and the surrounding areas may receive a high cost area supplement of between 5% and 20% of their basic salary.

Salary levels for clinical scientists working for private companies, universities, government bodies and other organisations may vary.

Income figures are intended as a guide only.

Working hours

Although you'll usually work a 37.5-hour week, you may be required to work on an emergency out of hours on-call rota undertaking work to support solid organ transplantation.

Part-time work is possible.

What to expect

  • You'll work with other clinical and healthcare science staff, such as surgeons, nurses and other healthcare science staff, often as part of a multidisciplinary team.
  • Jobs are available throughout the UK, mainly in large or medium-sized hospitals. However, there is only a relatively small number of jobs available and you may need to relocate to increase your chances of career progression.
  • During training, there are opportunities to experience working in a variety of different hospital laboratories. You may have to travel to fulfil the training requirements and could spend time away from home.
  • There is a variety of research and development (R&D) projects available, plus the satisfaction of contributing to patient care. However, coping with changes in the NHS and a heavy workload can be a challenge.
  • You may need to travel between hospitals but are unlikely to spend prolonged periods away from home.

Qualifications

Training to become a clinical scientist working in histocompatibility and immunogenetics is done via the NHS Scientist Training Programme (STP), a three-year, full-time, work-based learning and training programme that also includes academic study at Masters level.

To apply to the programme you'll need either a first or 2:1 undergraduate degree or an integrated Masters degree in genetics, biology, biochemistry, microbiology or biomedical sciences. You can also apply if you have a 2:2 undergraduate degree in any subject and have a higher degree in a relevant subject.

Entry on to the STP is competitive as there are many more applicants than places available. Evidence of research experience through a relevant Masters or PhD is desirable. For all applicants, getting good academic results and relevant work experience is helpful. 

Applications to the STP are made through the National School of Healthcare Science (NSHCS). Recruitment usually takes place in January, but check the website for details. You must pass all stages of the recruitment process, which includes an online application, aptitude tests and interviews.

If successful, you'll be employed by an NHS Trust (or in some cases by an NHS private partner or private healthcare provider) as a trainee clinical scientist on a fixed-term contract for the duration of the programme and paid a salary. The first year of training is spent on rotation in a range of settings before specialising in years two and three. Training includes fully funded part-time study for an approved and accredited Masters degree in clinical science (blood sciences).

If you already work for the NHS, you can apply to the STP as an internal candidate.

On successful completion of the STP you're eligible to apply for a Certificate of Attainment from the Academy for Healthcare Science (AHCS), which allows registration as a clinical scientist with the Health & Care Professions Council (HCPC). (The AHCS also offers an equivalence assessment process.)

For full details about the STP, advice on how to apply and information on competition ratios for each specialism, see the NSHCS website.

It's also possible to register with the HCPC as a clinical scientist by taking the British Society for Histocompatibility and Immunogenetics (BSHI) Diploma in H&I and then applying for a Certificate of Attainment from the Association of Clinical Scientists (ACS). To take the Diploma you need to have a second class honours degree in a biology discipline and be employed in a laboratory providing H&I services to a transplant programme. See the BSHI website for full details.

At this point, the training pathways converge and the options for higher specialist training are available to clinical scientists who have arrived at this point via either this or the STP route.

For information on STP training in Wales, see Health Education and Improvement Wales (HEIW). There are separate scientist training schemes in:

Skills

You'll need to have:

  • laboratory skills and the ability to design and plan research investigations and experiments
  • the ability to make judgements that impact on patients
  • strong problem-solving skills
  • an analytical and investigative mind
  • attention to detail and the ability to work with speed and accuracy
  • excellent interpersonal and communication skills
  • good active listening skills for communicating with patients
  • the capacity to manage a laboratory project and liaise with a variety of technical colleagues
  • the ability to work on your own with minimum supervision
  • the ability to work effectively as part of a multidisciplinary team
  • the skills to lead and motivate others
  • strong IT skills and a knowledge of common computing packages
  • excellent organisational skills and the ability to plan and prioritise work
  • a flexible approach to work
  • the capacity to work well under pressure
  • emotional resilience and good self-awareness.

You will also need highly developed coordination skills, good manual dexterity and hand-eye coordination.

Work experience

Entry on to the STP is competitive, so to improve your chances try and get an insight into the workings of a hospital laboratory by arranging a visit to a local hospital before you apply.

You could also try and find short-term laboratory work experience in life sciences or pathology. Contact the consultant or principal clinical scientist in life sciences or pathology in your local NHS Trust hospital.

Lab work can be difficult to obtain, so voluntary work with patients, for example, can also be useful. It's good to have a range of life experiences so you can show your range of skills.

If you're studying a relevant degree or Masters programme then you may have the opportunity to complete a placement as part of your course.

If the chance arises, attend an open day for your specialism to gain a better insight into the role and STP programme. Additional experience, such as involvement with research projects and publications, is also useful.

Find out more about the different kinds of work experience and internships that are available.

Employers

Many H&I clinical scientists are employed in the NHS and are typically based in transplantation or immunology departments in large hospitals around the UK. Opportunities are also available with:

There are opportunities in the private sector, for example within independent hospitals or for the Anthony Nolan charity.

Research opportunities are available at universities and departments attached to teaching hospitals.

Look for job vacancies at:

Professional development

Once qualified, you must keep up to date with the ongoing developments in your area of expertise, as well as building on your laboratory and management skills.

Continuing professional development (CPD) is an essential part of continuing registration with the HCPC. CPD activities can be any activities from which you learn and develop and may include:

  • work-based learning, such as in-service training, expanding your role
  • professional activities, e.g. being involved in a professional body
  • self-directed learning, such as reading articles and published papers
  • attending conferences workshops and lectures
  • publication in peer-reviewed journals
  • presenting research and papers at conferences
  • undertaking work exchanges abroad
  • undertaking research at PhD level
  • applying for research grants.

Membership of the British Society for Histocompatibility & Immunogenetics (BSHI) is useful for access to events, conferences, and training and CPD.

Once you've got experience (usually at least one year post-registration), you may apply to train to become a consultant clinical scientist via the Higher Specialist Scientist Training (HSST) programme. This bespoke five-year, workplace-based training programme includes study at Doctoral level at a standard similar to medical speciality training. You'll also need to obtain FRCPath by passing examinations set by The Royal College of Pathologists (RCPath).

Successful completion of the HSST programme leads to the award of Certificate of Completion of Higher Specialist Scientist Training (CCHSST) issued by the NSHCS. For full details, see HSST pathways.

If you decide to progress into academic or research roles within a university setting, you'll need to get your research published in a relevant journal and present it at conferences.

Career prospects

There is a structured career path within the NHS. Once qualified, you can progress through the grades by gaining experience and completing further study and research. Promotion is based on merit and you may need to move to other hospitals to make the most of available opportunities.

H&I offers the chance to specialise in many fields, for example:

  • classical serology
  • type of transplantation, e.g. kidney, haematopoietic stem cell
  • platelet immunology/haematology
  • molecular biology.

As your career develops, you're likely to take on a more supervisory role with responsibility for the work of your department or major departmental section. Progression to consultant and then deputy head or head of department involves further training and is likely to involve the management of a large department or major departmental section. It's possible to gain a senior position by making a significant contribution in your area of expertise.

There are opportunities to move into clinical research or to get involved in training and registration assessments. You can also develop your career by getting involved with professional bodies, taking on external professional roles or moving into advisory roles with government departments and related non-governmental public bodies.

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