Learning on the job while delivering essential services

March 17, 2025 by Liz Farquhar Leave a Comment

NSW Health Pathology is proud to be part of the NSW Government’s 1000 NSW Public Sector Apprentices and Trainees Program. For Matthew, it’s a chance to transition into a rewarding health career.

Matthew Youhanna began his traineeship at NSW Health Pathology in 2024 as a Technical Assistant at our Nepean laboratory.

The traineeships are part of a statewide program supporting apprenticeships and traineeships across the healthcare, automotive, building and construction, IT and administration sectors.

Trainees receive a nationally recognised qualification upon completion, giving their career a kickstart and allowing them to earn a wage while learning.

Matthew says he was looking for a career change when he decided to take up the pathology traineeship.

“I am overwhelmed with the opportunity I have been given,” he said.

“The level of support I have received is setting me up for a career in NSW Health. I would encourage anyone to pursue a career in health, as I have found it so rewarding.”

He said he would like to gain experience in different aspects of pathology, beyond phlebotomy (blood and sample collections).

“I can see myself having a career in Haematology – something I am very passionate about.”

NSW Health Pathology’s Deputy Director People and Culture Jess Lee says the traineeships are proving a game-changer for the organisation.

“It’s been such a positive experience across our organisation in both metropolitan and regional laboratories and offices.

“The traineeships provide meaningful, hands-on experience, and in some cases rewarding interactions with patients.

“Our staff are also enjoying mentoring and guiding the trainees through their training journey with us,” she said.

First wind, then rain. Next come the mozzies – here’s how to reduce your risk of bites and infections

March 13, 2025 by Liz Farquhar Leave a Comment

While some parts of southeast Queensland and northern New South Wales are still on alert for flooding, others are starting the difficult clean-up process as flood waters recede.

Stagnant water after floods provides the perfect breeding ground for mosquitoes. So as you clean up, remember to empty containers of water and other reservoirs around your house and yard such as water-filled boats, trailers and other large objects. Get rid of debris that may be collecting water too.

This year, mozzies are carrying the usual viruses we want to avoid, such as Ross River virus, but the potentially deadly Japanese encephalitis virus has also been detected in parts of New South Wales and Queensland.

Will more mozzies mean more disease?

In February 2020, floods in northern NSW boosted mosquito activity and increased cases of mosquito-borne diseases caused by Ross River and Barmah Forest viruses in subsequent months.

But while flood waters may boost mosquito numbers, outbreaks of disease don’t always follow. Hurricanes in North America have been associated with increased mosquito populations but few outbreaks of disease.

In Australia too, there are few examples of mosquito-borne disease outbreaks after cyclones – with a notable exception. After Tropical Cyclone Zoe made landfall in 1974, we had one of the one of the biggest outbreaks of Murray Valley encephalitis virus later in the year.

Warmer weather helps drive big mosquito populations, and the forecast predicts a warmer-than-normal autumn. So health authorities are on the lookout for outbreaks of disease.

Scientist inspecting a mosquito trap — Health authorities in Queensland and NSW are monitoring activity of mosquitoes and mosquito-borne pathogens.
A/Prof Cameron Webb (NSW Health Pathology)

Japanese encephalitis is already active

Somewhat dry conditions in the summer of 2024–25 have meant mosquito populations in many regions of eastern Australia have remained well below average.

But cases of Japanese encephalitis virus have been widely detected in Victoria, NSW and Queensland – in mosquitoes, piggeries and feral pigs.

Humans have also been infected. Cases are rare but the disease can be serious, with symptoms ranging from fever, headache, and vomiting through to disorientation, coma, seizure and brain swelling. One person has died of the virus this year.

Japanese encephalitis virus first arrived in southeastern Australia over the summer of 2021–2022. That followed extensive flooding across the Murray Darling Basin thanks to the arrival of La Niña. At the time, there were phenomenal numbers of mosquitoes that continued over subsequent years as the above average rainfall continued.

In the summer of 2022–23, a significant outbreak of Murray Valley encephalitis was also linked to ongoing flooding. This disease has similar symptoms to Japanese encephalitis and can also be fatal.

Mosquito numbers this summer have only been a fraction of what was recorded during those seasons influenced by La Niña. The activity of Japanese encephalitis in 2024–25 has scientists scratching their heads, as it goes against the commonly held theories that greater mosquito numbers combined with increased waterbird activity (typically following flooding) drive greater transmission of viruses such as Japanese and Murray Valley encephalitis.

Fortunately, there is no evidence of these viruses along the coast of southeast Queensland through to northern NSW.

But regions where the virus has already been active, such as Darling Downs in Queensland and Moree in NSW, may see substantial rainfall as a result of ex-Tropical Cyclone Alfred.

Predicting outbreaks is incredibly difficult and relies not just on mosquito activity but also on on the dynamics of the the wildlife hosts that carry these viruses

But unpredictable mosquito-borne disease combined with extreme weather is not a good mix.

Don’t forget about Ross River virus

While not life threatening, disease caused by Ross River virus can be severely debilitating with joint pain and fatigue lasting many weeks or months.

Thousands of cases of infection are reported across the country each year, including in urban areas of southeast Queensland and northern NSW.

Concerns about Ross River diseases were already raised with heavy rain and flooding in northern Australia this summer. Case numbers often peak at the end or summer and early autumn. So there is potential for greater activity in the coming months.

Other mosquito-borne pathogens, such as Barmah Forest virus, may also be circulating and may cause cases of mild disease but these occur far less commonly than those due to Ross River virus infection.

Protect yourself while cleaning up

If you’re out cleaning up after the storms, try to avoid mosquito bites.

Cover up with long-sleeved shirts, long pants and covered shoes for a physical barrier against mosquito bites.

Use topical insect repellents containing DEET, picaridin, or oil of lemon eucalyptus. Be sure to apply an even coat on all exposed areas of skin for the longest-lasting protection.

For those living or working in regions of Queensland, NSW and Victoria at risk of Japanese encephalitis, a safe and effective vaccine is available.

Cameron Webb, Clinical Associate Professor and Principal Hospital Scientist NSW Health Pathology and University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Congratulations to our newest pathology graduates!

March 6, 2025 by Liz Farquhar Leave a Comment

More than a dozen of NSW Health Pathology’s trainee pathologists have graduated at the Royal College of Pathologists of Australasia (RCPA) conference in Melbourne. They’ll now embark on their specialist pathology careers.

It was a big day for the graduating class of 2025 at the RCPA conference in Melbourne on 22 February.

“We are delighted to have been able to keep so many of the graduates here at NSW Health Pathology!” said Anatomical Pathology Training Coordinator Associate Professor Lisa Parker.

“It was so lovely to see the happy faces on our former trainees and to meet many of their families who are clearly just as delighted about the graduation as the new specialists.”

A/Prof Parker says the training program for pathologists is intense, with many exams, which can be hard on families as well as the trainees.

“Some are Specialist International Medical Graduates, who have previously trained as pathologists in other countries, and are required by the RCPA to do additional training here in Australia. We welcome them all into our specialist workforce.”

Here’s what some of the graduates had to say about their training and the prospect of working as specialist pathologists:

A woman wearing graduation robes holding a graduation certificate. — Dr Alice Ormandy, now working as a specialist Anatomical Pathologist at St George Hospital in Sydney.

Dr Alice Ormandy says she was drawn to Anatomical Pathology as it involves a wide range of body systems and presentations.

“After working in the hospitals for a few years I found AP to be one of the most diverse specialities, where you can be reporting cases from all different organs and medical conditions in one day – which is what I love about it.

“I was fortunate enough to know people who had gone into training before me, and spent some time in a few laboratories and felt like it would be a great fit for me.”

She admits the most challenging aspect of the training was the exams and balancing other work duties while studying.

“But I always felt well supported and had lots of opportunities to learn and do practice exams. I also remember it being challenging in my first years, questioning whether I was progressing or would I ever know ‘enough’. In retrospect, I definitely was. It is a steep learning curve to begin with but there are plenty of learning opportunities.”

Alice says now that the training program is over, she is most looking forward to the new challenges that working as a staff specialist provides.

“It is rewarding to work with my colleagues and other medical teams to provide patient care.”

She says she would encourage junior trainees to enjoy all aspects of their training (even cut-up!).

“It doesn’t always feel like it, but all the registrar tasks really do prepare you to handle anything that comes up in your work day.

“Seek out as much exposure as you can to cases and reporting styles to help develop your knowledge base and reporting ‘style’. I was fortunate to work across a number of different laboratories with many inspiring pathologists who all had something different to teach me.

“That experience in my training has hopefully shaped me into a well-rounded pathologist.”

A woman in graduation robes standing with a man and young boy to one side, and a woman on the other side. — Dr Geetika KC Shrestha with her family and A/Prof Lisa Parker.

Dr Geetika KC Shrestha says as a medical student she always enjoyed histology and microscopy.

“You get to see the entire spectrum of disease, it’s almost like all of internal medicine in a slide. And you can get to the bottom of the cause of disease,” she said.

Geetika worked as an Anatomical Pathologist in Nepal for over 6 years before coming to Australia and said the training has been challenging but worthwhile.

“The level of complexity and volume of cases is much more here. There is more neoplastic work here, particularly more skin cancers including melanomas, compared to more infectious diseases in Nepal. There are also more special stains and ancillary tests here than what we used to do in Nepal.”

Geetika still hasn’t decided where her career will take her.

“After a few years I might think about sub-specialising, I’ll see where it goes. I’d like to spend more time with my family, especially my son. I’m looking forward to being more settled and having more stability.”

She says her advice to junior trainees would be that pathology is a vast discipline and there are lots of new skills to learn including cut up and microscopy.

“It’s not easy, but it’s better to start early and try to learn as much as possible and report as many cases as possible,” she said.

Two women, one in graduation robes, smiling in a roomful of people. — A/Prof Lisa Parker with Dr Abeer Hagelamin.

For Dr Abeer Hagelamin, joining Anatomical Pathology training was all about the challenge.

“For me each case is a chance to challenge myself and my way of thinking,” she said.

“AP also gives us the chance to participate in research and new developments that help in improving patient’s outcome. In addition, anatomical pathology is specialty that gives me the opportunity to continue learning and advancing my knowledge.”

She says the most challenging aspects of the training involved handling the conflicting duties as a parent and a trainee.

“For example, the need to prepare for exams and provide care for my children. It can be difficult to manage finding an hour or two to study on daily basis.

“What has helped me during those times is the structured day and the support of the people around me.”

Abeer says she would encourage junior trainees to consider each day as a new learning opportunity and go to work with the mindset that you are there to learn at the same time to share your knowledge with others.

“An important thing also, is to be supportive for your colleagues especially around exam time,” she said.

“Anatomical pathology can be challenging and intimidating especially in the first few months as a trainee, but giving yourself a chance and trying to engage with your colleagues and participating in educational activities will help you through the early days.

“It is good to ask questions, and there is never a silly question. Each question you ask adds to your knowledge and experience. At the same time, each question you are asked and unable to answer will be one of your strengths as a trainee and as a pathologist in the future as you will always remember that question and how you reached the answer.”

Some excellent advice from our newest pathologists!

All three are now working as specialist Anatomical Pathologists with NSW Health Pathology; Dr Ormandy based at St George Hospital, Dr KC Shrestha at Wollongong Hospital and Dr Hagelamin at Liverpool Hospital.

Meet trainee clinical scientist, Fakhria Kakar

March 5, 2025 by Liz Farquhar Leave a Comment

Fakhria Kakar, or Hila as she’s better known, is a hospital scientist and trainee clinical scientist at NSW Health Pathology’s Immunopathology Laboratory at Westmead Hospital. She was recently awarded a grant from the Royal College of Pathologists of Australasia (RCPA) to further her studies.

Hila is the lead scientist on a ground-breaking project at NSW Health Pathology that has seen the organisation develop Australia’s first NATA-accredited blood test, serum Neurofilament light (NfL), to monitor neurodegenerative diseases like multiple sclerosis.

In late 2024, the RCPA selected Hila as the inaugural recipient of its Faculty of Science Financial Support Grant, designed to assist those currently studying the RCPA Faculty of Science (FSc) Fellowship training program.

Hila says she’s grateful for the financial assistance as she enters the final year of the five-year training program.

In addition to her studies, Hila serves as an RCPA FSc trainee representative. One of her biggest achievements as a trainee representative was advocating for a reduction in exam and registration fees for RCPA FSc trainees. This achievement was celebrated by over 50 RCPA FSc trainees across Australia and New Zealand.

A woman wearing a white lab coat and protective eyewear working in a laboratory. — As a trainee clinical scientist, Hila’s day can involve laboratory work, training and research.

Hila says that working as a trainee clinical scientist means actively participating in and learning about various aspects of the Immunopathology discipline.

“Some days, I’ll be working on the bench, testing and analysing samples. Other days, I could be training registrars, writing Standard Operating Procedures (SOPs) for laboratory equipment, participating in study groups, writing my own notes, preparing for exams, working on research projects, or developing new assays,” she said.

“It is most rewarding knowing that my work is an important part of the bigger picture of patient care.”

One of Hila’s career highlights during her RCPA FSc training has been her work on what’s known as serum Neurofilament light (NfL) testing.

“We are now the first laboratory in Australasia to have a serum NfL assay accredited by NATA, the National Association of Testing Authorities,” she says.

“This means patients can avoid having a lumbar puncture and instead just do a blood test for NfL to monitor neurodegenerative diseases like multiple sclerosis.”

“This is a game-changer for patients, as blood collection is a much less invasive procedure. It’s quick and reduces overall risks to the patients.”

Hila says the next stage of her work will be expanding the testing to include Alzheimer’s Disease plasma biomarkers.

A woman working in a laboratory — Hila says the new serum Neurofilament light test will bring significant benefits to patients.

Her laboratory supervisor, A/Prof Ming Wei Lin, describes Hila as an outstanding scientist.

“She is an exceptional trainee, and the RCPA should be very proud of her contributions,” she says.

“She is the scientific face of Immunopathology and an asset to our laboratory here at Westmead.”

Immunology Laboratory Manager at Westmead, David McDonald also praised Hila for her hard work and dedication.

“While studying for the Faculty of Science fellowship, Hila has not only improved her own skills and knowledge, but she has applied those to projects such as NfL, to also benefit the organisation and patients.”

Head lice are getting harder to kill. Here’s how to break the nit cycle

March 3, 2025 by Liz Farquhar Leave a Comment

Wrangling head lice, and the children they infest, must be up there with the most challenging duties a parent or carer has to face. And the job is getting harder.

Commonly used chemical products aren’t working as well as they once did, meaning head lice are harder to kill.

You can still rid your children of lice – but it’s likely to take some patience and persistence.

Remind me, what are head lice? And nits?

Head lice are tiny six-legged insects that are only found in the hair on a human’s head – most commonly in the hair of primary school-aged children.

Head lice have been a constant companion for humans throughout their millions of years of evolution.

Lice love living in our hair. But they scoot down to our scalp up to a half dozen times a day to drink our blood.

Their claws are perfectly designed to scuttle up and down shafts of hair. But while they’re nimble on our hair, once they’re off, they don’t last long –they’re clumsy, uncoordinated and die quickly.

The term “nits” actually describes the eggs of head lice. They’re often the first sign of an infestation. And with one louse laying more than 100 in their month-long lifespan, there can be a lot of them.

file 20250226 32 h6at8z.jpg?ixlib=rb 4.1 — Head lice live for around a month.
logika600/Shutterstock

Can they spread diseases?

No. Head lice are annoying and their bites may cause skin reactions. But Australian health authorities don’t consider lice a health risk. There is no evidence that head lice can spread pathogens that cause disease.

The stigma of head lice infestations can be greater than any direct health consequences for infested children.

Why do my children always pick up lice?

From child care through to primary school, it’s likely your child has had a head lice infestation at least once. One Australian study found the infestation rate in Australian classrooms ranged from no cases to 72% of children affected.

Girls are more likely to be carry head lice than boys. Long hair means it’s easier for the head lice to hitch a ride.

Children work in class — One study found that in some classrooms, almost three in four children had head lice.
CDC/Unsplash

Head lice don’t jump or fly, they move from head to head via direct contact.

Head lice come home with your children because they spend time in close contact with other children, hugging, playing or crowding around books or screens. Any head-to-head contact is a pathway of infections.

Rules differ slightly between states but in New South Wales and Queensland, children don’t need to be kept home from school because of head lice.

How can I keep my home free of head lice?

Keeping the house clean and tidy won’t keep head lice away. They don’t care how clean your bed sheets and towels are, or how frequently you vacuum carpets and rugs.

There may be a risk of head lice transfer on shared pillows, but even that risk is low.

There’s no need to change the child’s or other family member’s bedding when you find lice in a child’s hair. Research-based recommendations from NSW Health are that “bed linen, hats, clothing and furniture do not harbour or transmit lice or nits and that there is no benefit in washing them as a treatment option”.

I’ve used nit solution. Why isn’t it working?

A wide range of products are available at your local pharmacy to treat head lice. Australia’s Therapeutic Goods Administration assesses products to ensure that they are both safe and effective.

The problem is that most of these products are insecticides that kill the lice on contact but may not kill the eggs.

Also, if treatments aren’t completed as directed on product labels, some head lice won’t be killed.

Head lice also seem to be fighting back against the chemicals we’ve been using against them and it’s getting harder to clear children of infestations.

So how can you get rid of them?

Mum combs child's hair — You’ll need conditioner and a nit comb.
riopatuca/Shutterstock

Don’t expect any miracle cures but health authorities in Australia generally recommend the “conditioner and comb” or “wet comb” method. This means you physically remove the lice without the need for chemical applications.

There are three key steps:

immobilise the lice by applying hair conditioner to the child’s damp hair and leaving it there for around 20 minutes
systematically comb through the hair using a fine toothed “lice comb”. The conditioner and lice can be wiped off on paper towels or tissues. Only adult lice will be collected but don’t worry, we’ll deal with the eggs later
repeat the process twice, about a week apart, to break the life cycle of the head lice.

Repeating the process after a week allows the remaining eggs to hatch. It sounds counter-intuitive but by letting them hatch, the young lice are easier to remove than the eggs. You just need to remove them before they start laying a fresh batch of eggs and the infestation continues.

While children are much more likely to have head lice, the reality is that everyone in the household is just as likely to host a head louse or two. You don’t necessarily need everyone to have a treatment but “grown ups” should be on the lookout for lice too.

Cameron Webb, Clinical Associate Professor and Principal Hospital Scientist at NSW Health Pathology and University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Fond memories of 46 years in healthcare

February 26, 2025 by Liz Farquhar Leave a Comment

Lynne Coleman began work as a clerical cadet in the late 1970s at Royal Newcastle Hospital. As retirement beckons, she looks back on an incredible career that included an earthquake, a royal visit and the start of our statewide pathology service.

On 6 February 1979, at barely 17 years of age, Lynne began her career as a Clerical Cadet at Royal Newcastle Hospital – a hotly contested job at the time.

“I was one of 12 candidates selected from 720 applications after an entrance exam and two rounds of interviews,” she remembers.

“We were drilled in spelling, English, maths, typewriting, basic physiology and medical terminology and made to recognise every form in use in the hospital.

“We learned phone numbers by rote and were given photographs of key personnel.

“When I graduated from the Clerical Training School I was assigned to the Personnel Department before commencing in Clinical Chemistry at Royal Newcastle Hospital in March 1983.”

Lynne recalls that it was around that time she first met NSW Health Pathology’s Judy Kempton-Webb and Scott Jansson who were both working in the Haematology Department.

“They were great times, a fierce but friendly rivalry existed between the two departments. The Biochem Boomers (Chemistry) and the RNH Clots (Haem) competed against each other at the annual Mattara Festival Corporate Games.”

At the end of 1989 came the Newcastle earthquake, and Lynne remembers unprecedented administrative challenges for staff as patients were relocated to surrounding hospitals with very little in the way of electronic records.

“It was an incredible time. In the aftermath, when the city was coming to terms with the destruction, a 27-year-old me was chosen to meet HRH Prince Edward when he visited RNH as the Queen’s representative.”

A black and white photo of a group of women smiling at HRH Prince Edward. — HRH Prince Edward meeting health workers in Newcastle including Lynne (centre). (photo courtesy of the Newcastle Herald)

In 1990, Lynne became the Clerical Services Manager for what was then HAPS (Hunter Area Pathology Service which later became known as Pathology North) and worked with some of the original leadership team at NSW Health Pathology, including founding Chief Executive Tracey McCosker, former Chief Medical Information Officer Dr Stephen Braye and Maree Gleeson (former NSWHP Board member)

In 2012 she was appointed as Dr Braye’s Executive Assistant when he was the Network Director of Pathology North. Lynne moved to the Newcastle Office of NSWHP in 2017 when Stephen took on the role of Executive Director Statewide Clinical Service and later CMIO.

“That move took me back to the grounds of the old Royal Newcastle, so I had come full circle,” she said.

“In 2018 I joined Judy Kempton-Webb and her team in Pre and Post Analytical and Collections.

“In 2020 during COVID I found myself coordinating the packing and distribution of test kits, posters and request forms to support our many collection sites statewide.

“Collectively there was something in the order of 100,000 kits packed and sent from the Newcastle office.”

Two women in an office surrounded by packaging. — The ‘Swab Squad’: Lynne (right) and Aunty Joy packing test kits in the Newcastle office.

“I’ve lived through the transition from manual office procedures to the technologies of today and seen the transformation of pathology from individual hospital departments into what is now a statewide pathology service.

“I am fortunate to have spent my life working in Health, and particularly with NSW Health Pathology. It has afforded me the opportunity to live my life well, provide for my family and secure my future in retirement.

“It has been an incredible journey, with twists and turns along the way but one with many fond memories made and friendships formed. The people are the backbone of our organisation and I am proud to say I have been part of such a committed and professional team.

“Not bad for a kid who turned up on the wrong day for the entrance exam!”

Lynne tells us she will enjoy some much needed down-time as she begins her retirement but has plans to travel with a cruise or two and a trip to the Antarctic on her bucket list.

Happy retirement Lynne – you will be missed!