Aims This is a qualitative study of the perceived learning needs of trainees for graded responsibility in histopathological training in the UK.

Methods A focus group with trainees and interviews with consultants was carried out. Participants were asked ‗What do you perceive are the learning needs of histopathology trainees to develop skills for safe and confident independent reporting in surgical histopathology?‘ Data was analysed using open coding content analysis for items relating to training content and structure.

Results Trainees and consultants perceived a need for a case load of around 100 specimens per week with a continuously variable case mix. It was thought necessary to be the principal presenter of cases at multidisciplinary team meetings. There was a perceived need for adequate amounts of supervision by consultants using double-headed microscopes and sufficient time to develop skills in microscopic visual perception through detailed feature discussion, not necessarily related to specific diagnoses. Being able to write clear histopathology reports, developing the ability to recognise normal histology and to be aware of diagnostic pitfalls were also thought to be important.

Conclusions Our findings may inform efficacious implementation of graded responsibility in histopathology departments and be used as a sound basis for further research.