Shining a light on Paediatric and Perinatal Pathology: A conversation with Dr Francesca McDowell.

Dr. Francesca McDowell, a Resident Doctor in paediatric and perinatal pathology at Alder Hey Children’s Hospital Trust, shares her journey and insights into the ever-evolving field of pathology.

Although born in Manchester, Francesca grew up in a quiet Sussex town nestled between London and Brighton. Her academic journey led her to the University of Oxford, where she completed both her medical degree and an intercalated bachelor’s degree.

Francesca completed her foundation training at Stockport NHS Foundation Trust, where she rotated through a variety of specialties. It was during these rotations that her early fascination with forensic science - fuelled by shows like CSI and Silent Witness - evolved into a genuine professional passion.

She recalls, “I did a placement at Alder Hey during my ST2 year, and it just clicked with me there. I thought, yes, I definitely want to do this.”

The diversity of paediatric pathology

Today, Francesca’s work covers a remarkable range of cases - from foetuses to children up to 16 years old. As an experienced resident doctor, she reports on routine surgical specimens and, for more complex cases, collaborates closely with her supervising consultants.

“I wouldn't be expected to handle those specimens independently,” she explains. “I would receive the slides, write a report, and then show the case to my supervising consultant. We’d come together and discuss it.”

Meaningful work that makes a difference

One of the most profound aspects of Francesca’s role is her involvement in cases where findings can provide families with vital answers.

“We often have cases where we find something that could potentially reoccur in another pregnancy. When you know you’ve got condition X, you can mitigate it,” Francesca explains. “Those moments really stand out - when you can provide a meaningful diagnosis that has real clinical implications for parents and families.”

Support and collaboration at Alder Hey

Francesca credits much of her progress to the strong mentorship and supportive environment around her.

“There’s a kind of parachute - and that’s definitely the way to teach pathology rather than throwing someone in at the deep end. That’s one of the joys of working at Alder Hey because we have a very well-staffed department.”

She says her experience of being employed through Lead Employer has been positive. “I’ve found Lead Employer very easy to communicate with, and when issues have occurred, they’ve been rectified quickly,” she adds. “They’re proactive and responsive - when we had the Southport incident, they were really quick to let people know where support was available. I was quite impressed with that!”

Looking to the future of pathology

Francesca is optimistic about what lies ahead, particularly with the rise of digital pathology.

“Digital systems will allow us to share cases instantly with specialists across the country, improving diagnostic speed and accuracy. It also means that hospitals without paediatric pathology services can still access expert opinions, which will make a huge difference.”

While the North West benefits from strong departments in both Liverpool and Manchester, Francesca acknowledges that many parts of the UK still face challenges in accessing these services. “Digital pathology will help bridge that gap. Ultimately, it’s about giving every family the best possible care, no matter where they live.”

Encouraging the next generation

Francesca has clear advice for medical students or colleagues-in-training considering paediatric pathology.

“There’s a real shortage of paediatric pathologists in the UK. If you’re curious about it - even just a little, reach out. The North West is one of the best places to get exposure, and we’re always happy to take on students for placements or projects.”

When speaking about her department, she says, “We’re very welcoming. We take people for placements and can set up projects or other opportunities to help with applications for any specialty. We even had someone interested in radiology, and we involved them in a post-mortem/radiology audit.”