Dr Caitlin Keighley is a Microbiologist and Infectious Diseases physician at Southern IML Pathology in Wollongong. As part of the RCPA’s Microwaves podcast series, Dr Keighley provides an insight into her day-to-day role in the laboratory and explains how microbiology and infectious disease are inextricably linked to other specialties across medicine.

“Pathology is the scientific basis of medicine. It is the basis of diagnosis. It facilitates treatment, determines outcomes, and in terms of infection, facilitates the prevention of transmission and outbreaks. For me, pathology encompasses the best bits of clinical medicine and I love the problem solving that is required to make a diagnosis. Microbiology and infectious diseases are the reasons I went into medicine. I’ve always had an interest in why people get sick; why people get an infection and what you do about that infection.

“Microbiology is the diagnosis of any infection. It is essential for the diagnosis of viruses such as COVID-19; bacteria such as Staphylococcus aureus; fungi such as Candida; and parasites such as malaria. It is important because it allows you to find out if something is harmless, or if it could kill you in the next 24 hours. If you realise, for example, that bacteraemia (presence of viable bacteria in the circulating blood) is more lethal at 30 days than a myocardial infarction then you can see how important the results from microbiology can be. With microbiology, when you find an answer, you are really finding the cure because you know what to treat that person with.

“Microbiology and infectious diseases provide a unique window into patients’ lives because infections can be acquired in so many different ways. For example, a patient may acquire an infection because their immune system isn’t optimal or because they have a prosthetic valve or joint. Infections may also be linked to where someone has been, what they have been around or who they have been with. It is in this way that microbiology is inextricably linked to other disciplines.

“In Australia, we have one of the best laboratory systems in the world and this is because we have constantly evolving standards, quality systems and every laboratory must have a medically qualified pathologist within each discipline. In the microbiology laboratory, my day is extremely varied. We advise on processing samples, handling results, explaining these results to clinicians, and providing clinical advice on further steps. We are also involved in improving quality processes, reviewing policy (including testing strategy for different kinds of infections), updates on new pandemics and other circulating infections, answering questions from clinicians, developing new tests, antimicrobial stewardship and infection control in hospitals, teaching students, and research.

“I think there are probably three important traits for a microbiologist. Number one is communication; you need to have excellent and collaborative communication in order to relay the urgency of results and what to do next. Secondly, and because microbiology is an area that is always changing, a thirst for knowledge is important; there is always something new, so an eternal curiosity is always good to have. Finally, I would say good organisational skills are essential because the role is so varied in terms of what you need to do and what you’re involved with.

“Microbiology can be studied as a specialty on its own or can be done as a dual specialty combined with infectious diseases. Both pathways take five years, but the dual training involves two years doing infectious diseases and three years doing microbiology in the laboratory. I would recommend anyone interested in learning more to contact their nearest microbiologist as they might be able to spend some time with them to get some idea of what it is like.”

To learn more about a microbiology career, listen to the latest episode of the Micro Waves podcast.