Why would anyone want to pursue Haematology?

Sickle cells under a microscope

“So what specialty would you like to go into?”

The all-too-familiar conversation starter on a coffee break or between patients during a lazy clinic. For the best part of the last 2 years, I have been able to answer confidently that I would like to pursue Haematology. This has been met with shocked, disappointed and confused expressions from seniors as well as peers.

Considering the Clinical Haematologists I have met spend most of their time on wards and in clinics, their average day is not much different from any other medical doctor. However, most medical students and doctors envision them as having purely academic interests and deplorable social skills, perpetually crouched over a microscope investigating rare diseases.

Perhaps these persistent, pervasive misconceptions are partly due to how Pathology is taught in general: dismissively pitched to medical students as the underbelly of medicine. 

The DH Workforce recently categorised Haematology as “oneof the most deficient specialties.” This is not only an issue within the UK but appears to be a worldwide phenomenon. One Student BMJ article on careers in Haematology suggests that “Many modern undergraduate courses fail to provide students with adequate exposure to the various pathology specialties” and I could not agree more. I would be first to admit that my pre-clinical Haematological teaching was less than stimulating.

I recall the printed Haematology lecture notes handed out by my medical school were no more than 10 pages while our copious Neurology notes were so heavy I was unable to carry much else in my bag once it was packed. Not to mention the bore of sitting in front of a microscope on a hot afternoon a couple days before summer break, looking at a blur of red and white cells, enthusiastically agreeing you could distinguish a neutrophil from a basophil when really you wished you could just bring the slide into focus. To supplement my limited knowledge, as well as to explore a budding interest, I applied to spend my Special Study Module in General Haematology. This was arguably my most enjoyable placement so far even though I was pitied by all my peers. Surely it was a great misfortune that I was presumably allocated my lowest ranked option.

While the quality of undergraduate teaching is not entirely responsible for attitudes toward Haematology, I would like to suggest that it is a significant contributing factor. Perhaps it is time to start asking questions about the origins of these misconceptions and what can be done to ensure the future of a specialty essential to clinical medicine.