As I mentioned in previous posts, there are a number of criteria that must be met in order to attain registration as a biomedical scientist. Today I will be discussing the placement year. Details of what went on during my placement year, how I coped and what I felt like throughout the year.

I wont labour on the set up for placement which occurs during the second year of the degree as I’ve covered it in a previous post. Just a brief recap. There are seminars about the disciplines, laboratory tours and interviews. Once you’ve decided where you’d like to go, you submit this to your tutor and your interview marks, combined with your first semester exam marks go towards your ranking in the class which determines whether you get your first or second choice laboratory.

The Placement (Starting Out)

So here I was. I’d passed all of my exams and I’d gotten my first choice laboratory. I navigated the summer months with a tedious mixture of excitement and uncertainty. As September drew closer, I once again found myself questioning my choices and ability. Was I good enough for this? Would I be ready for it all? and one question maybe more specific to those of who had changed courses before. What if I didn’t enjoy this like i was so sure I would? Perhaps more to the point was a little niggling thought in the back of my head that if I decided to drop out of another course, my mother and father probably wouldn’t allow me live long enough to see another sunrise. But time waits for no man as they say, and the time arrived.

My first day in the labs was early September 2017. Upon arrival, most if my concerns were alleviated and I’d arrived eager to go and ready to tackle the placement head on. Day one consisted of an introduction day. We were given a number of trust policies to read over which legally had to be acknowledged before we could commence any work, and we were provided with logon details for the numerous IT systems. Namely the Laboratory Information Management System (LIMS) where the majority of work took place, Q-Pulse which was the laboratory’s Quality Management System (QMS) and of course a login for the computer system itself.

The First Two Weeks

In each laboratory, the first portion of placement was run differently. But the theme remains the same. Rotations. During your first while, the laboratory allows you time in each of the disciplines to get a feel for the environment the type of work being carried out. In some laboratories this was a week in each disciplines. For myself, it was a couple of days in each with my rotations finishing at the end of week two.

During my second year and throughout my laboratory tours and modules I had in the back of my mind, two disciplines that I felt would be best suited to me. Haematology/blood bank and cellular pathology. One because I was rather found of the blood and diseases associated with it, and the other because a more manual work environment seemed appealing to me. Lots of dissecting and getting a hands on look at things that used to actually be on the inside of someone’s body. Over the course of my two weeks in rotations I was able to get a look at clinical biochemistry, haematology, cellular pathology, blood bank and microbiology.

At the end of these two weeks it was time to select a discipline. There were five to choose from (those listed above) and five students. By this stage, cellular pathology had left my list of choices and I was firmly set on haematology/blood bank. That isn’t to say that I didn’t enjoy my cellular pathology rotation, I certainly did, but I realised that dealing with blood was definitely my thing (queue vampire based references)…

In all honesty, if I learnt one thing during those rotations, It was that there wasn’t a single discipline I could be put into and be unhappy. From my limited experience I had enjoyed all of the laboratories which only served to reinforce the foundation and prove to me that I was in the right place.

When it came to picking our disciplines, there were two of us who wanted to be placed in haematology/blood bank which was offered as one placement i.e. blood bank and haematology were considered a placement together. So would my hopes and dreams be smashed into a million pieces? Would I be going home to purchase a blood poster off amazon to hang on my wall so that I wouldn’t feel so far away from my beloved life sustaining, oxygen carrying, nutrient transporting bodily fluid? No.. they agreed to take two of us. We would rotate again, six months in one laboratory and six months in the next. Success!

The Rest of The Year

My first six months was to take place in the haematology side of life. I was going to be focusing on a number of haematological disorders. Anything that involved the blood and It’s associated cells and their parameters, I would be involved with. The laboratory was split into certain sections and it was my task to get involved with each of them, and learn as much as I could with regards to what disorders they dealt with.

Haematology

So I had begun my haematology rotation. First things first, I was introduced to my mentor. She was an extremely well qualified specialist biomedical scientist and the head of coagulation. That being said she was extremely approachable and friendly, as everyone I met was, thankfully. To be quite honest for the first while I felt like a lost puppy. Despite being keen to learn and ready to get involved, I understood that I basically knew nothing. Without a doubt I felt like I had forgotten the vast majority of what I had supposedly studied for my haematology exam. It was in there somewhere I thought, but it certainly wasn’t coming out when I wanted it to. Not only this, but the haematology module that I took, did its absolute best to cover what it could, but there is no way that twelve weeks is enough to provide you with a detailed knowledge base covering what one may require for a haematology pathology laboratory.  In summary, my first days involved following my mentor around not unlike being on a leash.

So I was assigned a section to start on after some deliberation. That’s when I discovered that being a biomedical scientist is as much about understanding your analysers, as it is understanding the human body. For some reason, no matter how well you treat your analysers and what you do for them. They’re sole desire is to break repeatedly and make complete use of their alarms. It’s like a cat returning a dead bird to your door. You don’t really want it, but you’re sure It’s because the cat believes It’s doing something nice for you so you let it go on.

The machines are complex systems. They require specialist engineers to fix the majority of their problems, but those engineers cover a whole trust at a time and they don’t live in our laboratory. So It’s important that we know how to deal with a good portion of the minor problems which occur the most often. We work with these machines every day and we have to keep them well maintained and clean.

The general outline of my placement remained the same throughout the year. Thankfully as time went on, I managed to remember things that I had learnt and was able to build upon my knowledge. I would start in a section, learn about the tests that happened and how they happened (known as the experimental method). I would focus on what was measured, the normal references for these and how certain pathological states would effect these. I would learn about the analyser and how to maintain it, work with it and carry out quality control. So I rotated around the laboratory learning each and every section. As the year progressed I was able to gain confidence in what I was doing and finally began to feel like part of the team. Although never working unsupervised, I was afforded the opportunity to have my input more and more often. What do you think of this? What would you do? What disease do you think this may be? Were the questions starting to come my way. I was really beginning to fit in and I thoroughly enjoyed the work. And that’s when it happened…

Blood Bank

Six months had come and gone like a flash. I was just falling into my stride in haematology and beginning to grasp the general ideas within the laboratory and now I had to move. I had to start all over again and learn new protocols and procedures, new tests, new conditions, everything. It was all new.

When I first started in blood bank I was once again the puppy on a leash. I hadn’t a clue how the process worked, I didn’t even know the path that the samples followed when they entered the laboratory, so quite frankly at this stage, I was as much use a waterproof teabag. But as with all situations, and armed with six months in another laboratory, I knew that it would just be a case of getting stuck in, asking as many questions as possible and accepting that I knew very little.

Blood bank is a laboratory that has a special relationship with many regulations. What I mean by that is that everything you do, has to be signed, countersigned by somebody else, scanned, uploaded and filed and then checked and signed again for good measure. I wish I was joking or even exaggerating. Transfusion of blood and blood products is a vital service and an emergency one. It can make the difference between life and death for a patient. However, receiving the wrong blood can also spell disaster for a patient. ABO incompatible transfusions are considered an NHS “never event”. It shouldn’t happen and there’s no reason it should. Rule #1 of blood bank, never mess up the ABO. In order to make sure that all is in order prior to transfusion, transfusion occurs as it should without an issue and the unit is returned and disposed of properly; there is a trail of paperwork which I can only describe by way of employing a quote from the eternal Douglas Adams…

“The reason why it was published in the form of a micro sub meson electronic component is that if it were printed in normal book form, an interstellar hitchhiker would require several inconveniently large buildings to carry it around in.” 

So my time in blood bank was spent learning a ridiculous amount of policy and guidelines, followed by a ridiculous amount of theory knowledge. Transfusion science was covered in a single lecture at the end of the haematology module. In all honesty I’m glad it was done this way because it would need to be a module all of its own. If there had been any real depth to that lecture in the time allowed, I can honestly say that It would only have served to confuse me and probably put me off transfusion science. The sheer amount of knowledge required to understand transfusion practice is astounding. It spans the realms of genetics, immunology and haematology and not in a “you should be aware of this” way, in a “you really need to understand this” way. I shan’t provide any depth here but suffice it to say, there’s a whole other universe in the blood bank, and It’s one of the most interesting places I’ve ever had the pleasure of sticking my intellectually curious mind.

Over time I was again able to fit in and work with some degree of confidence in the blood bank laboratory however there is even less a student biomedical scientist can do. The vast majority of testing must legally be carried out and signed off by a qualified and competency assessed biomedical scientist. Even still, without a doubt, I really enjoyed my time in this discipline.

The End

Time progressed and I gained confidence and scientific skills throughout the year. Coming towards the end I had my verification to focus on. This is when another biomedical scientist, who has undergone additional training which allows them to sign off a trainee’s registration portfolio, comes from another laboratory to assess you. You have to take them on a tour of the laboratory, explaining how everything works. You have to answer questions about your placement and what you’re showing the verifier and then finally you have to leave the verifier alone for a few hours while they assess all of your evidence to determine whether or not they will sign you off as a competent biomedical scientist. If you are signed off then you’re eligible to apply to the Health and Care Professions Council (HCPC) for registration and that is when you’ll officially be a biomedical scientist.

As my verification approached I was actually surprisingly confident. I felt that a year of work experience and all the evidence I had provided was to a good standard. More importantly I felt very supported by my mentor and those around me and that was what spurred me on the most. When the time came, I was absolutely elated to hear that I passed my verification. I was to be awarded the certificate of competence, subject to completion of my degree. Provided I don’t make a complete mess of my final year, I’ll be able to apply to the HCPC for my registration.

So there we have it. You’re up to date with where I am at this exact moment in time. I’ll still continue to write posts to elaborate on particular aspects of the process and I plan to write a more scientifically relevant account of the haematology laboratory in the future. If you’ve made it through this whole article, I applaud you. You should see how much I’d written before I realised it was far too much and split it down into two other blog posts for another day!