Clinical Biochemistry – 2025 review results

View the outcomes of the 2025 curriculum content review for Clinical Biochemistry.

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Programme Scientist Training Programme
Specialty Clinical Biochemistry
Year of review 2025 – 2026
Curriculum Click link to access Clinical Biochemistry curriculum
Specialty Lead Editor Ellen Stephens, Hannah Fearon

Current priority areas

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Stakeholder feedback

Feedback collecting through the Curriculum Library survey collected between January 2024 and November 2025. All stakeholder feedback is presented verbatim.

Programme

  • Since the Clinical Biochemistry curriculum was revised, the year 1 training activities have become largely process-related and there is very little focus on the routine biochemistry tests. The old Y1 curriculum covered the key biochemistry profiles (renal, bone and liver), and it required trainees to gain a working knowledge of reference ranges, phoning limits, common causes of high and low results etc. as well as the analytical aspects of these tests. This held them in good stead for the year 2 specialist modules. The training activities in the new curriculum are mainly process-related, and they cover very little routine clinical biochemistry. This puts additional pressure on trainees to cover the basics as well as developing this knowledge when they enter their specialist training. There could be a better balance in this first year.
  • Curriculum should include sustainability, NHS net zero, social value and the importance of appropriate test utilisation/diagnostic stewardship. This applies to all STP curricula across programmes.

S-CB-R1 Introduction to Biochemistry

  • no feedback received

S-CB-S1 Endocrinology and Diabetes

  • no feedback received

S-CB-S2 Major Organs and Cancer

Training activities

  • 8 – Not always practical or easy for trainees to carry out faecal tests – often a sendaway test. We managed to cover the FIT testing as our Trust covers the bowel cancer screening programme for London but the other tests (calprotectin and elastase) are sendaways. Ideally tests that are often sendaways should not be included as core activities. Or the wording ‘perform’ should be changed to ‘interpret’ etc. to allow for an overall understanding rather than carrying out the activity itself.
  • 10 – In our Trust we do not offer biochemical analysis of cyst fluid, and I do not think it is common in other Trusts. Likewise we do not test for chylomicrons. However, we do routinely offer analysis, with interpretation, of ascitic fluid which is not included in this TA.

S-CB-S3 Paediatric Biochemistry and Inborn Errors of Metabolism

  • no feedback received

S-CB-S4 Pregnancy and Screening

Training activities

  • 9 – Sweat testing is rarely carried out anymore, even in specialist paediatric centres. Our trainees attend a specialist paediatric centre for newborn screening rotation, however even there they do not cover sweat testing in their department. This test has been superseded in many labs by genetics. I think this should be removed as an activity.

S-CB-S5 Vitamins, Trace Elements, Toxicology and Therapeutic Drug Monitoring

Training activities

  • 9 – Many of these drugs are sendaway tests not done in a routine lab making it difficult to get access to the assays themselves. I think the wording should be changed from ‘perform’ to just ‘interpret’ so that results can be discussed and any important aspects can be highlighted but removing the need to perform the test itself which can be difficult to witness.

Changes made

Module level changes

Change ID M1
Module code S-CB-R1
Module content Training Activity
Original Observe specimen reception, and reflect on the processes.
Change Follow the pathway for routine and urgent samples throughout the laboratory from specimen reception to result reporting and reflect on the process.
Change category Minor
Implementation cohort 2026

 

Change ID M2
Module code S-CB-R1
Module content Training Activity
Original Follow the pathway of an urgent sample from reception to reporting, and reflect on the journey.
Change Observe analyses involved in the detection of renal disease and reflect on the process.

Considerations:

  • Local SOPs and guidelines
  • Processing of urgent and routine samples
  • Appreciation of normal and abnormal results
  • Understand the roles and responsibilities of the different members of the laboratory team
Change category Minor
Implementation cohort 2026

 

Change ID M3
Module code S-CB-R1
Module content Training Activity
Original Review the impact of national, regional and local guidelines, and reflect on how this guides practice.
Change Review the national, regional and local guidelines for kidney function tests, and reflect on how this guides practice and their impact.

Considerations:

  • Different guidelines in place from different bodies
  • Reflect on the impact considering:
    • Adherence to best practice vs. deviation from best practice
    • Effect on the laboratory, service users, management, reference ranges, and workload
Change category Minor
Implementation cohort 2026

 

Change ID M4
Module code S-CB-R1
Module content Training Activity
Original Follow the pathway of multiple samples for one patient from reception to reporting, and reflect on the journey.
Change Observe the phoning of abnormal results and reflect on the process.

Considerations:

  • Impact of different requesting locations
  • Critical result phoning limits
  • Appropriate timescales for phoning results
Change category Minor
Implementation cohort 2026

 

Change ID M5
Module code S-CB-S1
Module content Training Activity
Original 3 – Perform and interpret the analyses to laboratory standard operating procedures on patients with:

  • Male hypo- and hypergonadism
  • Female hypo- and hypergonadism
  • Infertility and/or patients undergoing fertility treatment
  • Pubertal disorders
  • Intersex disorders
  • Gonadal malignancies
Change Perform and interpret the analyses to laboratory standard operating procedures on patients with:

  • Male and female hypogonadism
  • Infertility and/or patients undergoing fertility treatment
  • Pubertal disorders
  • Intersex disorders
  • Gonadal malignancies
  • Patients undergoing gender affirming hormone therapy
  • Menopause and hormonal replacement therapy
Change category Minor
Implementation cohort

 

Change ID M6
Module code S-CB-S1
Module content Training Activity
Original 7 – Perform and interpret the analyses to laboratory standard operating procedures on patients with endocrine causes of obesity, including:

  • Hypothyroidism
  • Type 2 diabetes
  • Cushing’s syndrome
  • Growth hormone deficiency

Learning outcomes: 1, 2

Change Interpret the analyses to laboratory standard operating procedures on patients with endocrine causes of obesity, including:

  • Hypothyroidism
  • Type 2 diabetes
  • Cushing’s syndrome
  • Growth hormone deficiency

Learning outcomes: 2, 4

Change category Minor
Implementation cohort

 

Change ID M7
Module code S-CB-S1
Module content Training Activity
Original 8 – Perform and interpret four of the following analyses to laboratory standard operating procedures on patients with:

  • Primary and secondary diabetes mellitus
  • Newly diagnosed type 1 and type 2 diabetes mellitus
  • Gestational diabetes mellitus
  • Stable diabetes mellitus on treatment
  • Acute diabetic complications
  • Chronic diabetic complications
  • Differential diagnosis and monitoring of diabetes using the following test(s):
    • HbA1c,  Fasting glucose test
    • Oral glucose tolerance test
    • Insulin and C-peptide
    • Urinary albumin

Learning outcomes: 1, 4

Change Perform and interpret the following analyses on patients for:

  • differential diagnosis
  • classification
  • monitoring, and
  • acute and chronic diabetic complications of diabetes

using the following test(s):

  • HbA1c
  • Fasting glucose test
  • Oral glucose tolerance test
  • Insulin and C-peptide
  • Urinary albumin

Learning outcomes: 1, 2, 4

Change category Minor
Implementation cohort

 

Change ID M8
Module code S-CB-S2
Module content Training Activity
Original 2 – Interpret and report on routine biochemical results in the detection of major organ disease and cancers to include:

  • Renal
  • Liver
  • Bone
  • GIT
  • Cardiac
  • Lipids
  • Cancer
Change Interpret and report on routine biochemical results in the detection of major organ disease and cancers to include:

  • Renal
  • Liver
  • Bone
  • pancreatitis markers
  • Cardiac
  • Lipids
Change category Minor
Implementation cohort

 

Change ID M9
Module code S-CB-S2
Module content Training Activity
Original 3 – Identify cases that require urgent action and offer clinical advice on follow-up and further management

To include six of:

  • DKA
  • MI
  • AKI
  • Pancreatitis
  • Hypo/hypernatraemia
  • Hypo/hyperkalaemia
  • Hypo/hypercalcaemia
  • Refeeding
Change Identify cases that require urgent action and offer clinical advice on follow-up and further management

To include:

  • DKA
  • MI
  • AKI
  • Pancreatitis
  • Hypo and hypernatraemia
  • Hypo and hyperkalaemia
  • Hypo and hypercalcaemia
  • Refeeding
Change category Minor
Implementation cohort

 

Change ID M10
Module code S-CB-S2
Module content Training Activity
Original Perform the faecal analyses involved in the detection of major organ disease and cancers to laboratory standard operating procedures to include:

  • Faecal elastase
  • FIT
  • Faecal calprotectin

Learning outcomes: 1, 2, 3

Change Interpret the results of faecal analyses involved in the detection of major organ disease and cancers to laboratory standard operating procedures to include:

  • Faecal elastase
  • FIT
  • Faecal calprotectin

Learning outcomes: 2, 3

Change category Minor
Implementation cohort

 

Change ID M11
Module code S-CB-S2
Module content Training Activity
Original 9 – Perform the tumour markers analyses involved in the detection of major organ disease and cancers to laboratory standard operating procedures to include:

  • CEA
  • PSA
  • Ca-125
  • Ca-153
  • Ca19-9
  • AFP
  • hCG

Learning outcomes: 1, 2, 3

Change Interpret tumour marker results to laboratory standard operating procedures to include:

  • CEA
  • PSA
  • Ca-125
  • Ca-153
  • Ca19-9
  • AFP
  • hCG

Learning outcomes: 2, 3

Change category Minor
Implementation cohort

 

Change ID M12
Module code S-CB-S2
Module content Training Activity
Original 10 – Perform the fluid analyses involved in the detection of major organ disease and cancers to laboratory standard operating procedures to include:

  • Cyst fluid
  • Chylomicrons
  • Pleural fluid
Change Perform the fluid analyses involved in the detection of major organ disease and cancers to laboratory standard operating procedures to include:

  • Pleural fluid chylothorax
  • Pleural fluid transudates vs exudates
  • ascitic fluid
Change category Minor
Implementation cohort

 

Change ID M13
Module code S-CB-S3
Module content Training Activity
Original 2 – Perform analysis of:

Glucose, Ammonia

Bilirubin (conjugated/unconjugated)

Creatinine, Lactate

Bicarb/blood gases

Uric acid (plasma/urine)

Change Remove
Change category Minor
Implementation cohort

 

Change ID M14
Module code S-CB-S3
Module content Training Activity
Original Perform under supervision point of care testing for ketones (ketometers/dipsticks) and glucose (glucometers).
Change Perform under supervision point of care testing for ketones (ketometers/dipsticks), glucose (glucometers) and blood gas instruments.
Change category Minor
Implementation cohort

 

Change ID M15
Module code S-CB-S3
Module content Training Activity
Original 7 – Write a plan of investigation for the diagnosis of one of the following disorders:

  • Congenital hypothyroidism
  • Disorders of sexual development e.g. CAH
  • MEN
  • Type 1 diabetes
  • Autoimmune polyglandular disorders (type 1 and 2)
Change Write a plan of investigation for the diagnosis of one of the following disorders:

  • Congenital hypothyroidism
  • Disorders of sexual development e.g. CAH
  • Autoimmune polyglandular disorders (type 1 and 2)
Change category Minor
Implementation cohort

 

Change ID M16
Module code S-CB-S3
Module content Training Activity
Original 8 – Write a plan of investigation for three of the following categories of IEM:

  • Peroxisomal Disorders
  • MPS Disorders
  • Lysosomal storage disorders (other than MPS)
  • Sterols e.g. Smith Lemli Opitz
  • Mitochondrial
  • Purines/pyrimidines
Change Write a plan of investigation for one of the following categories of IEM:

  • Peroxisomal Disorders
  • MPS Disorders
  • Lysosomal storage disorders (other than MPS)
  • Sterols e.g. Smith Lemli Opitz
  • Mitochondrial
  • Purines/pyrimidines
Change category Minor
Implementation cohort

 

Change ID M17
Module code S-CB-S3
Module content Training Activity
Original 10 – Write a plan of investigation for two of the following in the context of a suspected inborn error:

  • Hypoglycaemia
  • Hyperammonaemia
  • SUDI (sudden unexpected death in infancy)
  • HAGMA (high anion gap metabolic acidosis)
Change Write a brief plan of investigation for the following in the context of a suspected inborn error:

  • Hypoglycaemia
  • Hyperammonaemia
  • Hyperbilirubinaemia
  • SUDI (sudden unexpected death in infancy)
  • HAGMA (high anion gap metabolic acidosis)
Change category Minor
Implementation cohort

 

Change ID M18
Module code S-CB-S4
Module content Training Activity
Original 3 – Perform the analyses involved in the detection of pregnancy specific complications to laboratory standard operating procedures to include three of the following:

  • hCG (ectopic pregnancy)
  • oGTT
  • Thyroid function tests
  • Uric acid
  • Total bile acids
  • FBC
  • Liver function tests
  • ACR/PCR
Change Perform the analyses involved in the detection of pregnancy specific complications to laboratory standard operating procedures to include:

  • hCG (ectopic pregnancy)
  • oGTT
  • Thyroid function tests
  • Uric acid
  • Total bile acids
  • FBC
  • Liver function tests
  • ACR/PCR
Change category Minor
Implementation cohort

 

Change ID M19
Module code S-CB-S4
Module content Training Activity
Original 7 – Interpret the results of a trisomy EQA report
Change Remove
Change category Minor
Implementation cohort

 

Change ID M20
Module code S-CB-S4
Module content Training Activity
Original 8 – Interpret and report the results of newborn screens, including examples of both negative and positive cases for three of the following conditions:

  • Phenylketonuria (PKU)
  • Congenital hypothyroidism
  • MCADD
  • Cystic fibrosis (CF)
  • GA1
  • MSUD
  • IVA
  • Homocystinuria
Change Interpret and report the results of newborn screens, including examples of both negative and positive cases for three of the following conditions:

  • Phenylketonuria (PKU)
  • Congenital hypothyroidism, MCADD
  • Cystic fibrosis (CF)
  • GA1
  • MSUD
  • IVA
  • Homocystinuria, tyrosinaemia type 1
  • haemoglobinopathies
Change category Minor
Implementation cohort

 

Change ID M21
Module code S-CB-S5
Module content Training Activity
Original 1 – Select the appropriate diagnostic pathway for patients with a suspected diagnosis of the following conditions:

  • High anion gap metabolic acidosis
  • Paracetamol overdose
  • Drug overdose causing reduced level of consciousness
Change Select appropriate investigation protocols for patients with a suspected diagnosis of the following conditions:

  • High anion gap metabolic acidosis
  • Paracetamol overdose
  • Drug overdose causing reduced level of consciousness
Change category Minor
Implementation cohort

 

Change ID M22
Module code S-CB-S5
Module content Training Activity
Original 3 – Interpret results for one of the following pharmacogenetic tests:

  • Thiopurine methyltransferase (TPMT) activity and metabolites
  • Cholinesterase variants
Change Interpret the results for Thiopurine methyltransferase (TPMT) activity and metabolites.
Change category Minor
Implementation cohort

 

Change ID M23
Module code S-CB-S5
Module content Training Activity
Original 4 – Perform and interpret assays for the following metals:

  • Copper
  • Zinc
  • Selenium
  • Lead
  • Aluminium
  • Chromium and cobalt
Change Perform and interpret assays for the following metals:

  • Copper
  • Zinc
  • Selenium
  • Lead
  • Manganese
  • Chromium and cobalt
Change category Minor
Implementation cohort

 

Change ID M24
Module code S-CB-S5
Module content Training Activity
Original 5 – Perform and interpret assays for the measurement of including chromatographic analysis:

  • ethylene glycol
  • ethanol
  • methanol
Change Interpret the assays for:

  • ethylene glycol
  • methanol
  • ethanol
Change category Minor
Implementation cohort

 

Change ID M25
Module code S-CB-S5
Module content Training Activity
Original 8 – Perform and interpret assays for the analysis for three of the following:

  • Methotrexate
  • Phenytoin
  • Theophylline
  • Gentamicin
  • Vancomycin
  • Digoxin
Change Interpret assays for the analysis for Methotrexate, Digoxin and one of the following:

  • Phenytoin
  • Theophylline
  • Gentamicin
  • Vancomycin
Change category Minor
Implementation cohort

 

Change ID M26
Module code S-CB-S5
Module content Training Activity
Original 9 – Perform and Interpret assays for the measurement of four of the following:

  • Lamotrigine
  • Levetiracetam
  • Clozapine
  • Tacrolimus
  • Ciclosporin
  • Infliximab
Change Interpret assays for the measurement of four of the following:

  • Lamotrigine
  • Levetiracetam
  • Clozapine
  • Tacrolimus
  • Ciclosporin
  • Infliximab
Change category Minor
Implementation cohort

Programme level changes

  • no changes made
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Periodic review

This specialty curriculum requires significant change beyond the scope of an annual review.

Responseno

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Rationale

Please provide an overview of the rationale for why the proposed changes are needed or why changes were not needed, with reference to stakeholder feedback.

Response – no rationale provided by Lead Editor

I confirm I have reviewed the Reflective Practice Guidance for ETAs and DTAs and have made any changes necessary.

Specialty Lead Editor signature: Ellen Stephens
Date: 2 January 2026
Note: I have reviewed ETAs/DTAs for CB-S2, CB-S3 and CB-S4

Specialty Lead Editor signature: Hannah Fearon
Date: 4 January 2026
Note: I have reviewed ETAs/DTAs for CB-S1 and CB-S5

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Change control - completed by the school

Programme structure

Change ID Programme structure maintained Comments
M1 Yes
M2 Yes
M3 Yes
M4 Yes
M5 Yes
M6 Yes
M7 Yes
M8 Yes
M9 Yes
M10 Yes
M11 Yes
M12 Yes
M13 Yes
M14 Yes
M15 Yes
M16 Yes
M17 Yes
M18 Yes
M19 Yes
M20 Yes
M21 Yes
M22 Yes
M23 Yes
M24 Yes
M25 Yes
M26 Yes

Completed by: Chris Fisher
Date: 15 January 2026

Health and Care Professions Council (HCPC) mapping

  • No changes made to learning outcomes. HCPC mapping maintained.

Completed by: Chris Fisher
Date: 15 January 2026

Last updated on 29th January 2026