Pathologists anxious at shortages

Annette King

Pathology is facing a "death spiral" in New Zealand because of a shortage of training places, says a medical training body.

But Health Minister Annette King says the blame does not lie with the Government.

Pathologists are the laboratory doctors who diagnose diseases from specimens such as blood and tissue samples. Their short supply, which is worldwide, can delay diagnosis of diseases such as breast cancer and is disrupting surgery.

The Royal College of Pathologists of Australasia says 206 pathologists are working in the equivalent of 156 fulltime jobs. This is a reduction from 210 in 2003 - at a time when an increase of at least 63 is needed.

Even more will be required in future because of population ageing and increases in diabetes and other diseases.

A specialist pathologist usually requires five years' training after the eight needed to finish training as a junior doctor.

"We are going to be in a death spiral unless we start training people now," college chief executive Debra Graves said yesterday. "It's just going to go downwards; that's what we've been warning.

"Three years ago there were just enough pathologists to provide training."

She said it would get to the level where the few left would be so busy doing their work they would not have the time to train others.

The number of training positions rose by seven in 2002 and now fluctuates at around 58. Dr Graves said it needed to rise by 25, but an increase of 10 was all that could be sustained immediately.

Ms King said the Government had an unallocated $800,000 for pathologist training, enough for up to 13 placements. The hold-ups were in attracting more junior doctors into pathology and having enough positions at district health boards approved by the college.

But Dr Graves said that was rubbish. "We could accredit positions tomorrow. I have trainees coming to me saying I want to do pathology. I spoke to one in Christchurch last year who left New Zealand because she couldn't find a training position."

The clinical director of the Counties Manukau board's laboratory services, Dr Ross Boswell, said they were short of 2.5 fulltime equivalent pathologists, vacancies he hoped to fill this year.

The shortage had led to operations being rescheduled from the Manukau Surgical Centre to Middlemore Hospital.

"We're not able to provide the services we would normally provide."

Dr Graves said some pathologists were attracted overseas by higher pay. They earn from about $125,000 to more than $200,000 a year in New Zealand, compared with up to A$350,000 ($379,032) in Australia and 350,000 ($903,020) in Britain.

But the clinical director of the Auckland board's laboratory services, Dr Tony Barker, said pay was not a big issue driving people overseas.

He blamed excessive workloads caused by the shortages.