My introduction to prenatal pathology came, when as a registrar, it fell to me to 'do the babies' after I had done my share of adult post mortem examinations. What surprised me was how interested the clinicians were in my findings - woefully inadequate as they were.

By chance, my next appointment was at a large children's hospital. Well informed colleagues, plenty of books, and regular visits from clinicians, promoted a feeling of active involvement in patient care. Demonstrating cardiac malformations to world class surgeons does much to improve one's technique and speed. It wasn't until my next job that I really appreciated the importance and complexity of perinatal pathology.

The rapid development of prenatal diagnosis has led to fruitful collaborations with geneticists, radiologists, and fetal medicine specialists. And the advent of molecular genetics offers many new opportunities for diagnosis, research and, ultimately, therapy. All of which means there are opportunities to begin to understand aspects of both normal and abnormal development, rather than being limited by descriptive morphology.

The speciality of paediatric and perinatal pathology offers a range of career options. There are general histopathology posts in district general hospitals, with sessions in perinatal pathology; predominantly fetal and perinatal pathology posts at senior lecturer or consultant grade in academic departments of pathology; and equivalent posts in maternity hospitals. Most of our children's hospitals have pathology departments with two or more senior posts. Some of these units provide a regional fetal and neonatal pathology service, as well as specialist pathology services for the children's hospital.

There are also opportunities for teaching. Most paediatric/perinatal pathologists have an active teaching role at both undergraduate and postgraduate levels. And the development of the new curriculum offers opportunities for project-based small group teaching in both the pre-clinical and clinical course.

What makes perinatal/paediatric pathology so rewarding is the close collaboration with a range of very committed clinicians. Important and regular contacts are made with neonatologists and other specialist paediatricians and paediatric surgeons. Working with children seems to promote a spirit of accessibility, cooperativeness, and openness and the knowledge that what you find will be used for that child, for that mother, for the extended family, and for the implementation of optimal clinical practice, is the best stimulus of all. Paediatric pathology is not about reflecting on what's really happened; it's about laying foundations for a better future.

For further information on training programmes, please contact the Training & Educational Standards Department on 020 7451 6741 or email education@rcpath.org

Jean Keeling

The College Specialty Advisory Committee on Prenatal, Perinatal and Paediatric Pathology