The Bulletin of the Royal College of Pathologists Number 194 April 2021 In this issue The integration of genomics into pathology The 100,000 Genomes Project: research and clinical legacy Genomic testing for haematological malignancies Pharmacogenomics in cancer management Pathology workforce and training in genomic medicine Incorporating genomics testing into clinical biochemistry services Also in this issue: The Royal College of Pathologists The all-Wales medical examiner service Pathology: the science behind the cure Our new Viruses and Vaccines resources Working together, continents apart The Royal College of Pathologists CONTENTS Pathology: the science behind the cure APRIL 2021 NUMBER 194 EDITORIALS 316 REGIONAL 348 From the Editor 316 The hub of the system: the all-Wales From the President 317 medical examiner service 348 GENOMICS 319 Regional representation in England: The integration of genomics into pathology: an update 350 our promising future 319 INTERNATIONAL 352 The 100,000 Genomes Project: research and Working together, continents apart 352 clinical legacy 320 TRAINING 354 Genomic testing for haematological Higher Specialist Scientist Training: malignancies: the next generation 324 first cohort graduates reflect 354 Pharmacogenomics in cancer Digital reporting of frozen sections for management 327 mock exams 355 Pathology workforce and training in genomic medicine 329 WORKING SMARTER 357 Incorporating genomics testing into Implementing digital pathology: lessons clinical biochemistry services 332 from digital health 357 COLLEGE NEWS 335 CLINICAL EFFECTIVENESS 360 Tiny test, huge impact 335 Audits of HER2 status in invasive Bringing pathology front and centre in carcinoma of the breast 360 healthcare 337 PEOPLE 362 Reshaping the pathology training Appreciation: Professor Sir Peter Lachmann 362 landscape 338 Appreciation: Professor Archie Malcolm 363 Championing teamwork and cohesion 339 Appreciation: Dr Norman Simmons 364 ON THE AGENDA 340 Appreciation: Donal O'Donoghue 365 Transfusion 2024: a five-year plan for Appreciation: Dr Irvin Lampert 366 clinical and laboratory transfusion 340 Consultants: new appointment offers 367 SHARING OUR SUBJECT 342 Deaths reported to Council 368 The most engaging Fellow 342 Atlas of Humanity 368 Choose your own pathology adventure 343 REVIEWS 370 The Royal College of Pathologists College Fellows contribute to sickle Book reviews 370 6 Alie Street, London E1 8QT cell heritage project 345 NOTICEBOARD 372 College launches Viruses and Vaccines to T: 020 7451 6700 Legacies 372 engage diverse audiences 346 E: [email protected] College conferences 373 www.rcpath.org CPD-accredited events 374 President Dr Mike Osborn Vice Presidents Professor Sarah Coupland Dr Angharad Davies On the cover: DNA sequence Professor Peter Johnston image. Emerging technologies Registrar Dr Lance Sandle will further lower the cost of Assistant Registrar Dr Esther Youd DNA sequencing and increase Treasurer Dr Andrew Boon the speed. CEO Daniel Ross Bulletin Editor Dr Shubha Allard Disclaimer: authors’ views are personal and are not indicative of College policy, except when College officers write in their official capacity. Errors or admissions are the responsibility of the authors Production Editor Jack Reader alone. Advertisements are paid for by external agencies and do not indicate endorsement or otherwise by the College. Editorial & Digital Manager Stacy Baxter www.rcpath.org Number 194 April 2021 315 EDITORIALS EDITORIALS From the President Hello and welcome to the April 2021 issue of the • planning for and promoting a series of aware- From the Editor Bulletin. This issue highlights genomics and has ness days, e.g. International Women’s Day, to a variety of illuminating articles exploring this make our diversity visible. important theme. Genomics is an exciting, rapidly Welcome to the April Bulletin. Spring is in the air The College continues to have a vibrant and We have a long way to go, but the journey has developing area and one which promises huge and so is optimism around the possibility of some essential role in reaching out and engaging the well and truly started with the Group advising the advances in diagnosis and, ultimately, in patient return to normal functioning in our work and wider public and thereby showcasing the skills Trustee Board on these recommendations. personal lives. I suspect I am not alone in facing the and efforts of our varied pathology disciplines. care. It will help us on the path to truly personalised medicine. paradox of feeling exhausted but with undertones The ability of our members to communicate their The Pathology Portal: a great resource of restless energy as we yearn for more certainty. expert knowledge effectively to educate families Another core area of College strategy is the devel- Pushing forward with advances in genomics I am delighted to return to the theme of and school and university students on pathology Dr Mike Osborn opment of the Pathology Portal. This is a new As a College, we are focusing on the development genomics after we were understandably waylaid in a fun and engaging way, even during a online platform that will enable members to of a high-quality, comprehensive, user-friendly by the pandemic. I am particularly grateful to lockdown, is truly impressive (pp343–344). New access image-based material to help and support genomics service as one of our core strategic Louise Jones as Chair of the College’s Genomics resources and accompanying events on Viruses learning and training. This exciting project is Dr Shubha Allard aims. With this in mind, Professor Sarah Coupland, SAC for rallying around authors for some great and Vaccines (pp346–347) are particularly timely, the brainchild of Professor Jo Martin, our former one of our Vice Presidents, is working very closely updates as part of the ongoing ‘genomics revo- reaching out to diverse groups and encouraging College president, who is the project lead. It is with Dr Louise Jones, our Genomics & Reproduc- lution’. We have made some extraordinary strides the public to explore virology and immunology. being very generously funded by Health Education tive Science SAC Chair to help us achieve this aim. (see pp319–320), but there is so much more that Some of our members contributed to the Sickle England (HEE) and we aim to launch it this summer Together they represent the College on a variety could be achieved with a clear and coherent vision Cell Heritage Project within the Black Cultural as part of the HEE Learning Hub, HEE’s new digital of high-level national genomics committees and and scope for clinical application of advances Archives with some really powerful testimonies platform. It will also be directly accessible from groups. They are working with College members to supported by an appropriately skilled workforce and experiences of people living with sickle cell College’s own website. ensure the voice of pathology and our members is (pp329–332). The article on DPYD testing (pp327– and how research has helped improve treatment For trainees, the material will be linked to the heard clearly. We share the aim that our national 329) strikes a particular chord with the still vivid and care over the years (p345). College curriculum and, in the future, the aim is genomics service becomes the world leader our memory of a close family member succumbing to The College Book Club is a new initiative to have material for consultants. Initially, the early members and our patients deserve. Thank you to unexpected fulminant pancytopenia after adju- and I was particularly pleased to chair a panel material will be morphology based and cover them, and to everyone involved in developing this vant chemotherapy for bowel cancer. So, it is good reviewing Nine Pints entailing a lively discussion cellular pathology (a prerequisite of continued HEE service, for all your hard work. to see the role of genomics testing in this context with the author Rose George. We explored many funding) and haematology. The content will be translating from research into practice, resulting taboo subjects in relation to blood donation and rapidly expanded to cover a variety of formats and Listening to and including all our members in more targeted and bespoke patient care. transfusion from a medical and patient perspec- all our pathology disciplines. Very soon, and with The College strategy for the next three years is in This issue of the Bulletin continues with an tive. This attracted over 120 participants from input and material from College members, the the final stages of development. Beyond genomics, update on various strands of the ‘digital revolution’. across the globe with really positive feedback. portal will become an internationally available plat- another core strategy area is to listen to members Dr Samar Betmouni’s thoughtful and informative Finally, I ask you to join me in taking a moment form for hosting videos, online presentations and and to deliver College activities that reflect your review (pp357–359) is a timely reminder of the to pause and reflect on our personal loss at the other teaching and learning formats. It will cover a feedback to us. We are reviewing the results of limited progress to date and the steps needed for anniversary of the pandemic and also remember wide spectrum of pathology training, quality assur- the recent member survey and I will report on planning and monitoring for appropriate deploy- others who have recently departed, including His ance schemes and other learning activities. Our this shortly. We are already working hard towards ment of digital pathology into clinical practice. Royal Highness The Prince Philip, Duke of Edin- ambition is that it will have something for everyone, becoming more diverse and inclusive and we As the use of digital pathology increases we, of burgh, and Professor Sir Peter Lachmann, our past including provision of subspecialist training mate- want all members to feel that they can and should course, need to address the challenges of how President (pp362–363). rial that is not widely available (e.g.