My name is Behdad Shambayati and I'm consultant clinical cytologist
and I work at Ashford and St. Peters Hospital in Surrey.
When I was doing my A Levels, I, again, was very interested in microscopy,
looking at particularly plant cells at the time and that was when I,
talking to a career advisor and she mentioned, why don't I pursue a career
in laboratory science where I would be able to use microscopy all the time.
So initially I worked in histopathology and later on I moved into cytology.
That's how it came about.
Most of the, sort of interesting elements of the job is the fact that your interaction
with the microscope and the slide,
you're looking down the microscope, identifying cell,
identifying nuclear abnormality and this is a challenge.
Every slide is different and I still have, you know, that sort of,
when I look down a microscope I'm quite excited.
What am I going to find.
So, to me, that's been the, my interest, looking down a microscope in a way,
hunting, I'm hunting with my eyes, to find things, finding abnormality
and that's motivated me all these years to learn and you never stop learning.
It's one of those disciplines that there's always, you know,
opportunity to learn about a new entity combines pathology.
There's a lot of pathology involved in cytology.
So you learn, you just, you know,
really opportunity for continuing self-learning.
This is cytology lab, and cytology is a study of cells.
But this, the department has got two main functions,
it's sort of biggest workload is cervical screening for pre-cancer of the cervix.
So a lot of the work we do is based on that.
The other work we do is diagnostic cases, for hospital patients.
These are the patients who've something wrong with them,
they've attended the hospital, clinics or during the ward.
We look at various specimens, particularly to diagnose cancer.
So they suspect cancer and that's what we, we are here for, in that.
So two function, one is cervical screening, and the other function is diagnosis of cancer.
Well, I'm sort of a lead biomedical scientist, clinical cytologist.
So I've got a dual role of, management, leadership, and a diagnostic role.
So, and this is how I occupy my day. I would say mostly doing diagnosis,
looking down the microscope, assessing slides.
Related to that, there's some element of teaching
and some elements of management and leadership.
The fact that you really do not stop learning, you know, if you’re that kind of person
who likes to learn, even though I still pick up a textbook cytology
or come across a case I haven't seen before or is a rarity,
and that has never stopped and that was a surprise.
You know, in most jobs you learn the job and it becomes routine.
There's no doubt this job has got this routine element,
but, at the end of the day, this is what surprised me.
You still never, you have not seen enough, you've never seen enough.
You can't say you know it all.
So you've always got to study.
You always got to learn.
The highlights is, again, for me, the diagnosis, the fact that I'm really involved in diagnosis
and as technologies moved on we've seen different types of sampling,
samples we never used to see before in the past.
That to me has been the highlight, the fact that hasn't, it hasn't changed.
There is some root aspect, and I, I can't say, you know, there isn't a job really.
Most jobs, there's routine aspects of it, and to me, that is acceptable.
You know, there's enough interest to keep the, the law side of it, you know, acceptable.
Yeah, quite a bit.
I mean, there was for many years, maybe for ten, fifteen years
there was sort of no really major development, but suddenly there was a big leap,
that the first leap was development of monoclonal antibodies.
The fact that you could use markers to identify cell types origin of the cells
that really changed cytology.
At the beginning we used to just look down the microscope
and be able to say whether a cell, whether it was, is benign or malignant.
So the firstly what we could say, okay, it's benign or malignant,
but we could type it.
We could say whether it's from glandular tissue, whether it's from connected tissue,
lympho tissue that's our first step which came about.
These monoclonal antibodies that develops further, we could actually identify tissue specific.
We could say malignancy was arising from the lung,
it was arising from the prostate gland, ovary, et cetera.
So that’s really big… changed diagnostic cytology considerably.
In cervical cytology, we had a big change, not long ago, about six, seven years ago,
where the preparation method changed considerably.
We used to look at what they used to describe as conventional directly spread material,
with the introduction of liquid based cytology where the material is placed into a little pot,
and that pot is sent to the laboratory and using new technology
the cells are retrieved from a solution.
Now, that was a big advantage because it removed a lot of the stuff
which material which used to contaminate the sample.
So it, that improved the appearances of them. It's contributed considerably
to our diagnosis in cervical screening.
So that's one side of it and of course, molecular technology is coming about now.
Now, that's still we have to see how much we're use that.
So initial in cytology was in it years ago, was, is it been on malignant in diagnostic cytology.
Then the clinician wanted to know whether we could identify the tissue, where they come from.
But now we can use cytology maybe to predict prognosis
and this is the area which is in development now.
Again, what I would like is keep up with development in technology,
how we can introduce it to our routine practice to diagnosis.
Not going to be easy, particularly funding issues involved.
So we have to be realistic.
We can't have all the new technology which is available,
but once something's proven, is tested, is really
whether we can introduce that to routine practice in cervical cytology
and diagnostic cytology.
Very difficult.
The changes in the past few years been really quite, quite fast, particularly in the molecular side.
We've got to see whether, how that would reflect in cytology
and we've got to be very proactive as cytologists.
We've be up front of it and learn, you know, come away from maybe possibly just being so attached
to the microscope and get involved and use molecular cytology,
molecular techniques and apply them to cytology and again, be at the forefront.
And being, you know, being able to bring in the technology to routine practice is a challenge.
As I said, funding is an issue to be able to use a finite resource, and provide a diagnostic service.