Pathology training positions in Australia are appointments to accredited laboratories, interviewed by the laboratory itself: the director of pathology, a senior pathologist in the discipline, and often the laboratory manager. There is no central college interview. Candidate reports are few, so this guide is built from the RCPA curriculum, laboratory position descriptions and the generic registrar pattern, and it says where the evidence is thin.
The format
A laboratory panel, criterion mapped under hospital or pathology service merit selection, about thirty minutes. Panels assess motivation for laboratory medicine, the choice of discipline, scientific reasoning, attention to detail, communication with clinicians and suitability for laboratory practice and the examination load.
Motivation and discipline
- Why pathology, and which discipline, and why?
- What do you know about the RCPA training programme and its examinations?
- What makes you suited to laboratory medicine, and what will you miss about clinical work?
- What experience have you had in a laboratory or with pathology beyond ordering tests?
- How do you see pathology changing with genomics and automation?
- How will you manage the study load alongside laboratory work?
Pathology panels are alert to candidates who are leaving clinical medicine rather than choosing the laboratory. Evidence of choice scores: time in the laboratory, a project, exposure to the discipline's work, an understanding of what a day in it involves. Be honest about what you will miss. Know the programme: the disciplines, the examinations, the supervised training requirements. Have a view on genomics and automation: that they are changing the work, that pathologists will interpret and govern them, and that you would want to be part of that.
The clinical scenarios
Laboratory scenarios, not ward ones:
- A full blood count shows a white cell count of 150 with blasts. What do you do, and who do you call?
- A blood culture grows a gram negative organism at 2 am. What happens next?
- A potassium of 7.5 comes through on a sample. How do you decide whether it is real, and what do you do?
- A biopsy shows an unexpected malignancy in a young patient. How is that result handled?
- A transfusion reaction is reported from the ward. What is the laboratory's role?
The structure: recognise the critical result, consider whether it is real (haemolysis, the sample, the timing), confirm if needed, phone the treating clinician directly with the result and a recommendation, document the call with the name and the time, and escalate to the pathologist. For the biopsy, the review by the pathologist, the report with its clarity and urgency, and the communication to the clinician who will tell the patient.
Communication
- A clinician phones about an unexpected critical result. How do you handle the call and what do you document?
- A surgeon wants a frozen section result faster than is safe. What do you say?
- Tell us about a time you explained a complex result to a clinician who disagreed with it.
- How would you contribute to a multidisciplinary cancer meeting?
Pathology is a consulting specialty, and the panel is scoring whether you can hold a scientific position under pressure from a clinician, explain it in terms of the patient, and escalate to the pathologist when the disagreement matters.
Ethics and governance
- You notice that a colleague's reporting error has gone out and may have changed a patient's treatment.
- A clinician asks you to add a test to a sample without the patient's consent.
- A specimen has been mislabelled and two patients may be affected.
- What is laboratory accreditation, and why does it matter?
The error: the patient first, the pathologist and the clinician told, the amended report, open disclosure through the treating team, and the incident process without blame. The mislabelled specimen: stop, identify both patients, the laboratory's procedure, the clinicians told, the incident reported. Accreditation: the standards, the inspection, and why it underpins every result the laboratory issues.
System questions
The pressures on public pathology, how Medicare funds it and how that shapes requesting, and how laboratories contribute to closing the gap in outcomes for Aboriginal patients.
What the panels score
A genuine choice of the laboratory with evidence, a discipline chosen for reasons, a safe approach to critical results, communication that holds its ground, honesty about errors, attention to detail, and a credible plan for the examinations.
Preparing
Spend time in the laboratory before applying and have the evidence ready. Learn the critical result process. Practise the surgeon and the disagreeing clinician conversations. Prepare a two minute answer to each question. The bank on this site is marked lower evidence for pathology; if you are interviewed, tell us what you were asked.