Clinical scientist, histocompatibility and immunogenetics

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 £33,706.
• Once qualified, you're likely to be employed on Band 7 (£41,659 to £47,672).
• Salaries for senior H&I clinical scientists can range from £48,526 to £77,274 (Band 8a to 8c), depending on their experience, training and level of responsibility.
• Salaries for consultant clinical scientists range from £79,592 to £109,475 (Band 8d and Band 9). These roles are usually held by laboratory directors who have obtained Fellowship of the Royal College of Pathologists (FRCPath).

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

You'll usually work a 37.5 hour week, which may include work on an emergency out-of-hours, on-call rota undertaking work to support solid organ transplantation.

Opportunities for part-time work are available once qualified.

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, you will need to live in the place where you're working. Do your research before applying to ensure you are happy to spend three years living there. You will also need to travel to the university as part of your training, which may be some distance away, so check commuting distances. NHS trusts may have multiple sites and you may need to travel between sites or to other laboratories in the country.
• 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.
• Once qualified, you may need to travel between hospital sites or to other relevant places for training, 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.

Evidence of research experience through a relevant Masters or PhD is desirable for all applicants. Getting good academic results and relevant work experience is also helpful. 

Applications to the STP are made via Oriel, the online application portal for postgraduate medical, dental, public health, healthcare science and pre-registration pharmacy training programmes. Recruitment takes place annually, usually in January. There is only a short application window and late applications are not accepted.

You must pass all stages of the recruitment process, which includes an online situational judgement test (JST), online application and interviews with employers. Sample questions for the JST are available on the Pearson VUE website.

You can only apply to one specialty, so make sure you do your research before applying to ensure it's the right specialism for you. Not all specialties are recruited to each year and depend on NHS needs, so you should check before applying that your specialty is available.

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:

• a programme of workplace training
• fully-funded, part-time study for an approved and accredited Masters degree specialising in cardiac science
• a final assessment of competence.

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

On successful completion of the STP you will be issued with a Certificate of Completion for the Scientist Training Programme (CCSTP) by the NSHCS and can apply for 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 National School of Healthcare Science (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 training in Wales, Scotland and Northern Ireland, see:

• Wales - Health Education and Improvement Wales (HEIW)
• Scotland - NHS Scotland - clinical scientist, life sciences
• Northern Ireland - NI Direct Healthcare Scientist

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 and time management skills and the ability to plan and prioritise work
• a flexible approach to work
• the capacity to work well under pressure
• resilience and resourcefulness in order to cope with work and study
• emotional strength and good self-awareness.

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

For roles in the NHS, you will also need to demonstrate how you meet the NHS core values.

Work experience

Entry on to the STP is competitive and there are many more applicants than places available. You'll need to be familiar with the programme, the specialism you're applying to and what you'll be doing.

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. Also, try to speak to people on the programme to find out what it's like to be an STP trainee so you can show that you understand the role and the commitment involved.

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.

You may need to think outside the box - being active in a university society, having a part-time job or getting involved in youth groups, for example, can also provide you with transferable skills such as teamwork, communication and time management.

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.

For free mentoring resources and experiences designed to support aspiring healthcare and legal professionals - including virtual work experience that is accepted by medical schools, see Medic Mentor.

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:

• NHS Blood and Transplant (NHSBT)
• Northern Ireland Blood Transfusion Service
• Scottish National Blood Transfusion Service
• Welsh Blood Service

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:

• New Scientist Jobs
• NHS Jobs - for vacancies in England and Wales.
• NHSScotland Jobs
• Jobs.hscni.net - for vacancies in Northern Ireland.
• Oriel and the NSHCS - for STP trainee posts.

Professional development

Continuing professional development (CPD) is an essential part of continuing registration with the Health & Care Professions Council (HCPC). You must keep up to date with the ongoing developments in your area of expertise, as well as building on your management skills.

CPD activities can be any activity 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 in an area of histocompatibility and immunogenetics. 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.

You can also study for a traditional PhD and get involved in research. 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 training, 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. Progression to consultant involves further training via the HSST programme. Promotion to deputy head or head of department 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, working for a university or research institute, or to get involved in training and registration assessments.

You can further develop your career by getting involved with professional bodies, taking on external professional roles or moving into an advisory role. There are also some opportunities to move into general management roles within the NHS.