1. Starting a career in clinical biochemistry (I’ve a PhD, get me out of here!) Neil Syme Royal Infirmary of Edinburgh

2. What is clinical science? Clinical science encompasses several disciplines. It forms part of Laboratory Medicine/Pathology Services within the hospital. The lab is responsible for receipt and analysis of samples required for the diagnosis and monitoring of disease.

3. What does a clinical scientist do? Advise clinical staff on test results and investigations. Perform and interpret laboratory tests. Develop assays Clinical and laboratory audit Research Teaching/training Service development

4. Career structure in clinical science Pre-registration clinical scientist (4 years) Complete structured training in all aspects of chosen discipline to attain state registration with the HPC. Senior clinical scientist Take responsibility within a section of the laboratory. Work toward completion of FRCPath. Principal clinical scientist Take responsibility for a section of the laboratory. Work toward completion of FRCPath. Consultant clinical scientist Lead for the local laboratory/regional services. Equivalent to medical consultant.

5. How did I get into clinical science? October 2000Undergraduate in Biological Sciences at University of Edinburgh Autumn 2003Clinical biochemistry/PhD?? October 2004 Started a 4-year PhD at the University of Leeds, in biophysics. September 2007Began to worry about what to do after my PhD. Considerations –Careers service/recruitment websites/careers fairs –GCHQ –Patent law

6. How did I get into clinical science? Winter 2007/8Emailed consultants asking to come and visit the lab and speak to current trainees and clinical scientists. February 2008Applied for training posts in clinical biochemistry. February 2008Switched from worrying about a job to worrying about my thesis. April 2008Interviews for clinical biochemistry. August 2008 Submitted my thesis. September 2008Started as a trainee clinical biochemist in Edinburgh.

7. My training so far Base hospital –Practical experience of all laboratory sections –Duty biochemist/reporting –Other lab disciplines/clinical areas Completed an MSc in Clinical Biochemistry –Immunology, genetics, haematology Spend time in different hospitals –Teaching, district general, paediatric Passed the FRCPath part 1 examination

8. My training so far Training courses, tutorials, seminars. Regional and national meetings. Take part in routine laboratory services. Audit/research Portfolio of evidence for state registration

9. A typical day… … probably no such thing. Duty biochemist Audit Lab work/method development SOPs/guidelines Teaching/training Public engagement

10. Modernising Scientific Careers

11. Infection sciences –(microbiology, infection control and epidemiology, virology, mycology and parasitology) Blood sciences –(clinical biochemistry, haematology/transfusion, immunology, genetics) Cellular sciences –(histopathology, cytopathology, reproductive science, genetics) Neurosensory sciences –(audiology, neurophysiological science, opthalmic and vision science) Cardiovascular and respiratory sciences –(cardiac science, respiratory and sleep science, vascular science, GI physiology and urodynamics, perfusion) Clinical engineering –(rehab engineering, clinical measurement and development, device risk management and governance) Medical physics –(radiation safety, radiotherapy physics, imaging, clinical measurement)

12. Modernising Scientific Careers 1st intake on the new training scheme started in September 2011, in England. –Scotland, Wales and NI have yet to formally set up a programme. Trainees were recruited nationally Interviews consisted of a “speed-dating” format –4 stations, 2 interviewers at each, 10 minutes per station –Scientific knowledge, experience, suitability, leadership MSc courses in Nottingham and Manchester. 51 blood science posts in 2012 (24 in biochemistry)

13. Pearls of wisdom? Do your homework –Know the career pathway/structure –Current changes/issues –Visit labs and talk to people doing the job Take advantage of your current position –Academic structures/collaborations –Career services –People Be enthusiastic!

14. Expect the unexpected!

15. Useful websites Association for Clinical Biochemistry –http://www.acb.org.uk/default.aspxhttp://www.acb.org.uk/default.aspx Association of Clinical Scientists –http://www.assclinsci.org/acsHome.aspxhttp://www.assclinsci.org/acsHome.aspx Health Professions Council –http://www.hpc-uk.org/http://www.hpc-uk.org/ Healthcare Science (NHS Careers) –http://www.nhscareers.nhs.uk/hcsci.shtmlhttp://www.nhscareers.nhs.uk/hcsci.shtml Royal College of Pathologists –http://www.rcpath.org/http://www.rcpath.org/ Get in touch –neil.syme@luht.scot.nhs.ukneil.syme@luht.scot.nhs.uk –nadine.wilkinson@luht.scot.nhs.uknadine.wilkinson@luht.scot.nhs.uk

17. 17-hydroxylase Cholesterol Desmolase Pregnenolone 3βHSD Progesterone 21-hydroxylase Deoxycorticosterone 11β-hydroxylase Corticosterone Aldosterone synthase 18OH corticosterone Aldosterone Aldosterone synthase 17OH pregnenoloneDehydroepiandrosterone 17OH progesterone 11-deoxycortisol Androstenedione Testosterone Oestradiol Aromatase 17βHSD Cortisol 17-hydroxylase Dihydrotestosterone 5α reductase Cholesterol = 27 carbons Progestogens = 21 carbons Mineralocorticoids = 21 carbons Glucocorticoids = 21 carbons Androgens = 19 carbons Oestrgens = 18 carbons