Clinical Biochemistry/ Clinical Biochemist



Clinical Biochemistry

Disease causes changes in the complex biochemistry of the body. Clinical Biochemistry is concerned with detecting these changes in blood and other body fluids thus aiding in the diagnosis of disease and monitoring of therapy. These changes can often be detected by alterations in the concentration of substances in the blood - for example, glucose increases in diabetes mellitus and diseased organs, such as the liver, can cause increased tissue enzymes levels. Some diseases, for example, cancers cause different substances to appear in the circulation. Increasingly, Clinical Biochemistry tests are been used as a means of determining which patients would benefit from and as importantly would not require more invasive procedures and/or expensive therapies.

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Clinical Biochemistry Departments

Clinical Biochemistry Departments (usually based within a hospital) are responsible for providing rapid analytical results of high quality, interpreting the significance of the data obtained and advising on whether further investigations are required. Such departments make extensive use of information technology and robotics. Tests required in large numbers (such as potassium and urea in blood) are analysed on highly sophisticated automated equipment. Other techniques used in Clinical Biochemistry include absorption spectroscopy, electrophoresis, many types of chromatography, mass spectrometry, immunoassay and DNA analytical technology. Most Departments will also carry out fundamental or applied research, and develop and investigate new analytical methods for the detection of disease. A number of sub specialties exist within the general area of Clinical Biochemistry including Paediatrics, Endocrinology, Toxicology and Molecular Biology.

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Clinical Biochemists

Clinical Biochemists, together with other laboratory professionals, are involved in providing the Clinical Biochemistry service in hospitals and other institutions. The role of the Clinical Biochemist involves carrying out specialist analyses; developing and implementing new methods of diagnosis and treatment and liaising with clinical staff both advising on relevant analyses and interpreting laboratory results. Clinical Biochemists also actively participate in research and clinical audit either initiating it from within the laboratory or collaborating with clinical colleagues. Clinical Biochemists play an important role in teaching activities both within hospitals and outside and are active members of multidisciplinary teams such as hospital nutrition teams. More senior members of the profession participate in management and as Heads of Department are responsible for the provision of an efficient, cost effective and high quality Clinical Biochemistry service.  The work is interesting, rewarding and extremely varied and its direct benefit to patients brings a particular satisfaction to scientists involved in health care.

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Becoming a Clinical Biochemist in the Republic of Ireland

The minimum qualification requirement for becoming a Basic Grade Clinical Biochemist (as laid down by the Department of Health and Children) is a Bachelor of Science (BSc) degree in which Biochemistry was taken as a subject in the final examination or degree equivalent. In reality, in recent times, most new entrants will have attained either a MSc or PhD relevant to Clinical Biochemistry prior to their first appointment.

Clinical Biochemist posts in public and private hospitals are usually advertised on the website www.irishjobs.ie and in national newspapers. A significant number of new entrants gain experience in temporary locum positions prior to obtaining their first Clinical Biochemist post. Locum positions become available on an ad hoc basis and it is advisable to contact the HR Departments / Head of Clinical Biochemistry Departments in the various hospitals to inquire about their policy on filling locum positions.

Clinical Biochemists are one of twelve professions included in the Health and Social Care Professionals Act 2005 which provides for statutory registration of the named professions. Coru, the Health and Social Care Professionals Council was appointed in 2007. The aim of Coru is to set and enforce the standards of education, practice, performance, conduct and ethics for each of the professions. One of the first steps towards registration is the setting up of individual Registration Boards for each of the twelve designated professions. The Social Workers Registration Board was set up in August 2010 with the remaining Boards to be set up on a phased basis. Up to date information on the regulation of the Clinical Biochemist profession can be found on Coru’s website, www.coru.ie.

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In- service Training

After appointment, a Clinical Biochemist will spend time studying for further professional qualifications, generally a suitable career–focused MSc followed by the Fellowship of the Royal College of Pathologists, UK (FRCPath). The Association of Clinical Biochemists in Ireland (ACBI) runs regular scientific meetings, including a two day Annual Conference each October, together with specific staged tutorials to support Clinical Biochemists preparing for the FRCPath examination. During the course of their studies, Clinical Biochemists also normally attend UK National training courses (currently a rolling series of six one week courses over three years) in addition to a management issue focused course. Attainment of the FRCPath qualification requires at least five years of registered postgraduate study and indicates the individual’s competence to take independent Consultant charge of a hospital Biochemistry Department.

During their in-service training, Clinical Biochemists will gain wide-ranging experience in all aspects of the provision of a Clinical Biochemistry service. They must become competent in the practice and understanding of a wide range of analytical techniques and in the practice of quality assurance including external quality assessment. During their training, they will also become skilled in the interpretation of test results and actively participate in liaison with clinical colleagues in providing advice on further relevant analysis. In addition, as a Clinical Biochemist progresses in their career, there is the opportunity to specialise in one of the many sub specialties and to engage actively in research projects either initiated within the laboratory or in collaboration with clinical colleagues.

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Career Pathway

There are four grades of Clinical Biochemist posts within the hospital career structure: Basic, Senior, Principal and Consultant.

The minimum qualification requirements currently laid down by the Department of Health and Children for progression beyond Basic Grade are as follows:

Senior  Clinical Biochemist
BSc degree in which Biochemistry was taken as a subject in the final examination, or equivalent PLUS at least three years satisfactory experience in clinical biochemistry and/or chemical pathology in the laboratory of a hospital or allied institution.

Principal Clinical Biochemist
As specified for Senior Grade PLUS an MSc in Biochemistry or Clinical Biochemistry, PLUS at least five years satisfactory experience in clinical biochemistry and/or chemical pathology in the laboratory of a hospital or allied institution.

Consultant Clinical Biochemist
A PhD in Biochemistry or FRCPath examination in Clinical Biochemistry, or a qualification in clinical biochemistry equivalent to either of these, PLUS at least eight years post graduate experience including not less than five years in Clinical Biochemistry.

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