Dr Bernie Croal will become our 21st President on 16 November at our 2023 Annual General Meeting. In this interview, Bulletin Editor Shubha Allard asks Bernie what attracted him to pathology and what his aspirations are as he steers the College through current and evolving challenges. Bernie previously served the College as Scotland Regional Council Chair and Vice President from 2011 to 2014. He recently completed his term as President of the Association for Clinical Biochemistry and Laboratory Medicine.

Tell me about your career so far. What attracted you to pathology?

I first went to university in Glasgow (my home town) before moving to Aberdeen in 1996 to continue training in general medicine, chemical pathology and health services research. I ended up in pathology quite by chance, taking up an SHO post in clinical chemistry with no real knowledge of what this was. I soon realised this enabled me to combine my passions for science, medicine and research, and provided a good work/life balance that I was not used to in general medicine.

I obtained FRCP and FRCPath qualifications and completed an MD in health services and public health research around the topic of appropriate lab testing in primary care. Over the years, I have been an Academic Senior Lecturer, NHS consultant and Clinical Director for Pathology where I was responsible for leading the Scottish demand optimisation programme and had clinical oversight of various key patient groups, with my main specialist area being intravenous nutritional support.

I’ve held roles at other professional societies, networks and, of course, the College (since 2008). This has given me an outlet to try and make a difference. Going into my 15th year as a College Trustee I am honoured to be elected President – this is a huge privilege and an amazing opportunity that I will not waste.

What do you think are the main challenges for pathology and therefore for the College?

The College faces many challenges, further escalated by the pandemic and the economic downturn. Major objectives include ensuring that pathologists and scientists continue to enrol as fellows and that individuals continue to step forward to provide College input and leadership. The College is its members and without them it cannot survive. The same goes for College staff, who are integral to the functioning of the College – creating an attractive, welcoming and rewarding workplace environment needs to be enshrined in our objectives.

The main challenge for pathology across the UK is providing adequate services against a backdrop of inadequate numbers of staff and limited funding to support delivery. It is vital that substantive posts significantly increase, matched by increasing training numbers to fill such posts. The College needs to work with its fellows and other stakeholders to ensure relevant metrics are derived and used to explicitly inform future workforce plans.

Public engagement is more important than ever before, but we need to review our main objectives in relation to this. Patients are becoming more involved in their own healthcare, with increasing uptake of self-testing and results being sent directly back to patients. The College needs to re-align its focus and work with other organisations to ensure patients are equipped with the tools and knowledge that helps them understand not just their own test results, but also when testing is appropriate.

What are your main priorities as President over the next 3 years? 

1. Ensuring the financial viability of the College. Given the challenges, this will always be top of the list. We need to explore new ways of developing income for the College and examining how we currently operate will be part of this process.
2. Delivering a focused member engagement strategy. We need to attract and retain fellows and to encourage them to get involved and contribute to the work of the College. We need to emphasise the very strong case for collective responsibility to ensure we can meet the challenges pathology faces both now and in the future. We need to strongly promote the value of fellowship, with essential contribution to a collective voice, setting professional standards and taking leadership roles at the College. Above all, we need to ensure that the work of the College is aligned with what is important to members and what will best serve the needs of patients.
3. Collecting high-quality workforce intelligence to inform decision-making. This is difficult to get but is essential to allow informed workforce planning. The delivery of competent, adequately staffed pathology services needs adequate funding – the argument for, and the mechanics of doing this, require that relevant workforce/workload metrics are collected. The College cannot do this on its own and will work with our members and other stakeholders.
4. Investing in patient engagement. Patients are ultimately the focus of healthcare, therefore everything the College does to support pathology will benefit patients. We need to educate patients so they understand the central role of pathology in diagnosis, treatment and disease prevention. They need to be given the knowledge and tools to understand their own test results. We will work with other royal colleges, societies and stakeholders to help patients in this respect.

How do we ensure all specialties, together with those from a medical and scientist background, are represented by the College, across all levels of our work?

How can we get more fellows engaged and involved in College work?

I want pathologists from all specialties and backgrounds to feel engaged with the College. By working closely with other royal colleges and specialist societies, we can further increase the critical mass of expertise to make a difference. This collaborative approach is vital given the difficulty many fellows have in getting time to devote to College activity. It will also provide a stronger voice in advocacy matters. I plan to strengthen initiatives such as the Pathology Alliance, to enable this aim.

What are you plans for addressing greater diversity and inclusion across all strands of our College activities?

Equality, diversity and inclusion (EDI) principles need to be embedded into everything the College does. While there has been much welcomed change in recent years and the College has made progress with its action plan to embed EDI principles in all areas of its work, there is still a way to go. As President I will ensure this work progresses. 

The College’s EDI Network has set out its vision for shaping the College and pathology practice. You can read more about its achievements, new initiatives and the challenges that need to be addressed on the next pages. Gathering EDI data and engaging our members has been a challenge and the lack of data limits our capacity to address the needs of our members. We need to look at how we can gather this information in the future and ensure members feel engaged with this work. Over the next year we will be asking members for their input into our EDI strategy and guidance documents, and I encourage members to share their views and opinions.

How do you plan to keep in regular touch with members?

I aim to regularly communicate with members at a local, national and international level via our very well-established communication channels. We need to ensure that the content of this communication is relevant and timely. I plan to meet many trainees and members over the next 3 years to hear their views and ideas directly, and further discuss what the College does, why we do it and how they can help and contribute further.

Do you have any particular messages for our trainees and how the College can support them?

We have excellent trainees across all our specialties, and we must nurture and support them.

Our Trainees’ Advisory Committee (TAC) ensures that our trainees have a strong voice and I would encourage trainees to get involved with the TAC. There is understandably much focus on examinations and while this is achieved on a modest budget, this still equates to hefty fees for our trainees. We will continue to look at ways to minimise this impact and explore alternate funding models with training programmes and government.

The College is committed to expanding its online training resources. This includes adding to the highly successful Pathology Portal, but there is also scope to work with other specialist groups, both in the UK and internationally, to deliver further training materials. 

Can we further optimise use of our College building?

The College building is a fantastic resource, but the pandemic affected how the space is used. There needs to be adequate space for committee meetings, educational meetings, formal events, examinations and College staff. However, renting out surplus space to other societies, commercial organisations and social event clients provides us with a significant income that helps offset College expenditure.

Can you describe your vision for pathology’s place within healthcare, among policymakers and the public?

There is a major focus on the current state of the NHS and the economy. With a general election round the corner, in my opinion, there is a risk of much posturing, smoke and mirrors, and spin. We need to engage with the government and policymakers using robust arguments and evidence that highlight the importance of pathology in healthcare and stake a claim for the limited attention and budget available. We must advise, inform and develop appropriate strategies that are in the best interests of our specialties and members and, above all, essential for patient care.

Finally, how do you try and maintain a work–life balance?

I have always enjoyed my work, so maintaining a balance has been easy. However, I am sure my new granddaughter in London will have a say in that...