Training in ROSE and Completing the IBMS ROSE Portfolio - webinar report
This BAC lunchtime webinar offered a detailed, experience-led insight into Rapid On-Site Evaluation (ROSE) and completion of the IBMS ROSE portfolio.
The session was delivered by Tania White, Specialist Biomedical Scientist in Diagnostic Cytopathology at the Royal Devon University Healthcare NHS Foundation Trust, who shared practical guidance and candid reflections from her own ROSE training journey.
What is ROSE and Why It Matters
ROSE (Rapid On-Site Evaluation) involves the immediate microscopic assessment of cytology samples within clinic settings such as head and neck, thyroid, EBUS, and EUS procedures. The Biomedical Scientist’s role is to determine whether a sample is inadequate, adequate, or diagnostic, and to triage material appropriately for downstream testing.
“ROSE is not just about making slides – it’s about understanding the whole patient pathway.”
Tania emphasised that effective ROSE reduces inadequate sampling, increases diagnostic yield, and can prevent patients from undergoing repeat or more invasive procedures. From a service perspective, it improves clinic efficiency, reduces costs, and supports more effective use of pathologist time.
A Biomedical Scientist–Led ROSE Service in Practice
Drawing on experience from a fully Biomedical Scientist–led ROSE service, Tania described how her team supports up to ten clinics per week across multiple specialities, including ad hoc FNAs. She highlighted the flexibility of Biomedical Scientist–led models and their ability to respond quickly to clinical demand.
“We are more flexible as a Biomedical Scientist team, and that makes a real difference to clinic capacity.”
The Reality of Training for ROSE
Training for ROSE is intensive and typically takes between 12 and 18 months. Tania was open about the challenges of developing confidence in high-pressure clinic environments, particularly during fast-paced EBUS clinics.
“Speed in clinic was one of the most challenging parts, especially during EBUS.”
She stressed the importance of mastering slide preparation before entering clinic, describing this as one of the most effective ways to reduce pressure and minimise errors.
Inside the IBMS ROSE Portfolio
The IBMS ROSE portfolio consists of ten modules covering theory, clinical practice, and specialist knowledge across different ROSE settings. Tania explained that the portfolio suited her learning style by encouraging deep engagement with anatomy, pathology, and clinical context.
“Writing things down and working through case studies really helped consolidate my knowledge.”
Communication, Confidence, and Professional Boundaries
A recurring theme throughout the webinar was communication. Moving from a laboratory-based role into direct patient and clinician interaction requires confidence, clarity, and strong professional boundaries.
“You have to be confident enough to ask clinicians to slow down or change technique.”
Maintaining Quality and Competence
Maintaining competence following completion of the ROSE portfolio is essential. Tania described how she monitors her performance through correlation of ROSE opinions with final reports, feedback from clinic staff, and regular competency review.
Was It Worth It?
When asked whether completing the ROSE portfolio was worthwhile, Tania’s response was unequivocal.
“It was definitely worth it – it forced me to learn more and made me a better Biomedical Scientist in clinic.”
Conclusion
This webinar provided a grounded, practical account of ROSE training and the IBMS ROSE portfolio, enriched by real-world experience from a practising Specialist Biomedical Scientist. It offered valuable insight for laboratories developing ROSE services and for individuals considering undertaking the portfolio.