Bacteria to the future

Lab manager Ian Sturdgess gives Catherine Nixey the low-down on a fast-changing profession

The rash of TV medical dramas such as No Angels has given us all insight into the medical professions. We all feel we know now what surgeons, doctors, nurses and porters get up to in their jobs, in their wards and in their linen cupboards. But not biomedical scientists.

The rash of TV medical dramas such as No Angels has given us all insight into the medical professions. We all feel we know now what surgeons, doctors, nurses and porters get up to in their jobs, in their wards and in their linen cupboards. But not biomedical scientists.

"You might hear someone on Casualty saying, 'Oh, take these off to the lab,' but that'll be pretty much the last you hear of us," says Ian Sturdgess, lab manager at the John Radcliffe Hospital in Oxford.

But though their dramatic role may be limited their medical one is not. Biomedical scientists are crucial to almost every area of medicine. "If you go for a blood test, a cervical smear, a urine test, or if you have a lump on your breast and have to have it analysed, then that will be us," says Sturdgess.

Sturdgess always knew that pathology was what he wanted to be involved in. "When I was at school I wanted to help people in one way or another. I also enjoyed the hands-on practical side of laboratory work. Working as a biomedical scientist lets me do both."

He was nearly thwarted in his ambition when his A-levels didn't go according to plan. Presuming that he wouldn't be able to be a biomedical scientist with his grades, Sturdgess started looking for another job. "I went to the careers officer who asked me what I wanted to do. I told him I wanted to be a nurse. He said, 'Do you really? You don't sound convincing.'"

Sturdgess admitted that his real hope was to work in pathology. He was told that as all he needed was four O-levels; he would be fine. Sturdgess applied to the Department of Pathology at Northampton General Hospital as a trainee. He was accepted, and remained there for 23 years, until last year when he moved to Oxford.

"And in 24 years I've never felt that I didn't want to go in in the morning. It is always interesting, and it is always changing. When I started it was all very simple. Now we are starting to see molecular techniques starting to come into some labs as routine, where we study the DNA of tumours to identify them. Of course there is a mundanity about it sometimes, but there is always something promising on the horizon."

The techniques used in pathology and the medical knowledge underlying them have improved immeasurably over recent years. "Ten or 15 years ago, if you had a lymph node tumour we would class it into one of two different groups: B-cell and T-cell. Five years ago, there were maybe five different types. Now there are 10 or 15."

And the more accurately a tumour can be identified, the more accurately it can be targeted. "Knowing exactly what type of tumour someone has means we know what type of treatment it will respond best to; so chemotherapy, radiotherapy or even surgery. And correctly identifying a tumour can make the difference between life and death."

The route to becoming a biomedical scientist is through taking a degree approved by the Institute of Biomedical Science. There is an option to do a day-release degree course. This route is somewhat slower than the full-time option, usually taking about four years as opposed to three. But there are advantages to this approach. "For four days a week you come to the hospital to work, and are paid for that. Then on one or two days a week you go to university. That has the wonderful advantage that you don't run up massive student debts."

Once in the job you can continue your training. "There is a definite career structure. You come in on day one on a low salary and work your way up. If you want to pass on to the next stage in terms of seniority or salary you take the exam and then you will jump up to another pay scale. The more you learn the more interesting it becomes - and the more you get paid."

And the discipline has gone to great lengths to get people in as there is something of a staffing shortage at the moment. "Mainly because we are notoriously badly paid in relation to other disciplines. We wanted people who had degrees, but the starting salary was £12,000."

Things are looking up. The starting salary is now around £15,000 and is hoped to rise again by the end of this year.

But it can be demanding. "A lot of pathology labs run a 24-hour service, 365 days a year," says Sturdgess. "You've always got patients coming into the hospital. And someone who has been in a road traffic accident needs blood, whether it is at four in the afternoon or two in the morning."

It does depend on where you work. In histology (the study of tissue) where Sturdgess works it is less common to be called in at odd hours. "Though if you're working in a renal centre you can be. If someone is waiting for a transplant and a kidney comes up, you have to go in immediately. Before the transplant can proceed you have to check the organ to make sure that it doesn't contain any disease that could be passed on to the next patient. So even histologists get called out in the middle of the night occasionally."

And although they are somewhat out of the main fray, histologists do interact with staff from all parts of the hospital. "Surgeons often want to watch the specimens being cut up so they will come in to the lab quite a lot. Or if there's a patient on the operating table, and we need to produce a specimen quickly, then theatre staff or junior doctors will come to watch the specimen being cut up."

Sturdgess has also had the chance to further his career outside of the lab. "After passing my fellowship exam I felt it was time to put something back into the profession," he says. "So I did a couple of management qualifications and got involved in teaching other members of staff."

He also helps on a pathology advisory panel which looks at documents from the department of health. One investigation that he advised on was called "Human Bodies, Human Choices". It was commissioned after the Alder Hey scandal in 1999 and looked at the medical and moral issues around the keeping and testing of human tissues and body parts.

So it's not just Sturdgess alone in a lab with his microscope all day. "In my laboratory there are currently 21 of us," he says. "We all go out for meals and drinks together. It's terribly friendly. I think its great in hospitals, I enjoy the environment. You have to get on with people, and so you do."

So is it anything like No Angels?

"Oh no. No. We're all very busy... And we do have to concentrate."

For more information on careers in pathology, contact the Institute of Biomedical Science on 020 7713 0214 or www.ibms.org; visit NHS careers at www.nhscareers.nhs.uk or 0845 60 60 655, or contact your local hospital