At the end of her junior year of college, a chance encounter with a friend’s father put Erika Figueroa on a career path she never imagined. Her friend’s dad, John Baci, is the Executive Director of Pathology at Boston Children’s Hospital. He asked Erika, a biology major, about her career plans.
At the time, Ms. Figueroa was not sure what she wanted to do. Mr. Baci invited her to do a month-long summer internship at the hospital. She accepted, and loved every bit of this eye-opening experience during her internship.
“I shadowed a pathologists’ assistant and histotechs, who walked me through their cases, and I got to see them gross specimens,” says Ms. Figueroa, who is now completing her second year of Quinnipiac University training to become a pathologists’ assistant.
“I am a visual learner,” she adds. “Having an organ or specimen in front of me, and working with the anatomy and being able to understand the structures, was amazing. When we think of medicine, we think of doctors and nurses. Pathology is a field we might not hear about often. An internship is extremely beneficial for anyone who is curious about a field, but might not have a direction yet. It’s important to get a foot in the door.”
The internship in the Pathology Laboratory at Boston Children’s Hospital experience certainly influenced Ms. Figueroa’s decision to apply to a pathologists’ assistant program. When she completes this spring semester of school at Quinnipiac University in Hamden, CT, she will start her clinical rotations in the laboratory.
Ms. Figueroa is among many young adults who participated in the Pathology Department’s internship program at Boston Children’s Hospital who have gone on to pursue careers in pathology, laboratory medicine, administration, or other areas of healthcare.
Boston Children’s Hospital: Creating its own ‘Farm Team’
“We are creating our own farm team,” jokes Mr. Baci, who launched the internship program for Boston Children’s Pathology Department more than a decade ago. “For most of these interns, they did not know these careers in pathology and laboratory medicine existed when they came here,” he says.
Cultivating the medical laboratory workforce of the future is on everyone’s minds these days, regardless of industry. Baby boomers are retiring in droves. The COVID-19 pandemic has pushed many healthcare workers to the brink of exhaustion, and many boomers are now retiring sooner than anticipated.
Raising the visibility of the medical laboratory profession and expanding the pipeline of future pathology and laboratory professionals has always been a high priority for ASCP. This year, ASCP is putting an even greater effort on revitalizing the field. It recently launched a Workforce Steering Committee, which will develop innovative solutions to promote pathways to careers in pathology and laboratory medicine.
These concerns have been reinforced by the results of the ASCP 2020 Vacancy Survey, which was published in December 2021. Perhaps one of the biggest takeaways from the report is that it will require a concerted effort on the part of numerous groups of stakeholders at all levels, including the laboratory employers, laboratory training programs, healthcare executives and hospital administrators, and professional organizations to address the workforce shortage. ASCP, for instance, has recently convened a Workforce Steering Committee to examine innovative ways to focus on recruitment, retention and expanding the diversity of the workforce.
Meanwhile, Boston Children’s is one of several health systems that have various programs to encourage young people to explore careers in health care. ASCP has invited Mr. Baci and several of his Boston Children’s colleagues to speak about their internship program and other workforce initiatives on June 12 in Boston, during the keynote session of KnowledgeLab 2022, presented by ASCP.
“John is an unsung hometown hero of sorts,” says Peter Jordan, who interned in the Pathology Department at Boston Children’s during high school several years ago. He is now completing medical school this spring at the University of Massachusetts Chan Medical School in Worcester, MA. “John started this out of the goodness of his heart, and he started connecting kids to a world-class healthcare institution,” Mr. Jordan says.
Mr. Baci downplays his role in establishing the program, but emphasizes the importance of getting laboratory and medical staff, as well as senior leadership at an institution on board. “We send emails to the department staff in the spring and ask if they need any work done that the student interns could perform,” he explains. “A lot of it is filing slides, organizing, or clerical work. But our interns also get to spend face-to-face time with our department industry experts. Our interns spend time in every pathology subspecialty and get hands-on work exposure to employment opportunities that they were likely previously unaware of.”
“We let the students attend department lectures when physicians are presenting, and they get to interact with Harvard faculty. We immerse them in our culture for as long as they are here,” Mr. Baci says.
Mr. Jordan recalls the first day of his internship, when he and other interns were led through the hospital’s Pathology Department and got to observe a gross dissection of a brain and heart in the teaching lab. “That was first time I saw and held a human brain and heart!” he exclaims. “It triggered deep thoughts that someone’s life was captured in these organs. My passion for the human connection part of medicine was ignited.”
Mr. Baci also used his influence and ability to connect young people who would not necessarily get their foot in the door of one of the finest children’s hospitals in America. After Mr. Jordan completed his two-week internship, he said Mr. Baci told him to reach out if he ever needed anything. Mr. Jordan took him up on that offer. After his first undergraduate year at Boston College, he reached out to see if Mr. Baci knew of any summer jobs in the area. Mr. Baci connected him with a few departments at Boston Children’s, but ended up keeping Mr. Jordan in the department family for several consecutive summer per-diem positions.
Geisinger School of Phlebotomy
Another example of a health system that is seeking to develop its own future laboratory professionals is Geisinger Medical Center, in Danville, PA. In addition to taking part in twice-yearly career fairs at area high schools, it has also established the Geisinger School of Phlebotomy.
“For the career fairs, we have multiple classrooms set up here at Geisinger,” says Terri McElhattan, MHA, MT(HEW), CLA(ASCP), PBT(ASCP), CPI(ACA), program director and instructor of the Geisinger School of Phlebotomy. “Students see us in the laboratory, and they attend the nursing, respiratory therapy, Cath Lab, or radiology sessions during Career Day at our hospital. A variety of our staff from across the system give 30 minute presentations on what they do. The students get to see where the Lifeline helicopter lands at the medical center.”
The phlebotomy program began in 2009 with two 15-week classes, one at Geisinger’s facility in the northeast part of Pennsylvania and the other at its Danville campus. “The idea was to fill the vacancies we were seeing in our phlebotomists at Geisinger,” Ms. McElhattan says.
She began the program with Dave Gingrich, PBT(ASCP), associate vice president of operations for the customer support team in Geisinger’s laboratory. They created a structured program where participants not only learned the art of blood collection, but also laboratory regulations and other aspects of how the laboratory operates.
“We had discovered that, in our area, other phlebotomy programs might not provide the depth of training in blood collection practices or safety practices that we wanted,” Mr. Gingrich says. “When (graduates of outside programs) come to Geisinger for jobs, we ask if they know the practices of the Clinical and Laboratory Standards Institute or Clinical Laboratory Improvement Amendments. One person did not know what a blood culture is.”
The Geisinger School of Phlebotomy’s 18-chapter curriculum is so detailed that it also includes a section on customer service. “We bring in someone from our patient experience team to talk about how the phlebotomist often creates the first impression with a patient and their experience in the hospital,” Ms. McElhattan says.
Gradually, Geisinger’s phlebotomy program has been expanded to several other hospital sites within its overall system. When the COVID-19 pandemic began, Geisinger lost many of its staff phlebotomists. It cut the program back from 15 weeks to 12 weeks, in order to squeeze in a series of four courses during the course of a year. The program’s graduation rate is usually about 99 percent and it has between a 95 to 96 percent placement rate. During the pandemic, its placement rate of phlebotomy graduates dropped to about 86 percent.
On April 1, it graduated 17 students from the phlebotomy program and 13 had already accepted positions. Some will take receiving and processing positions, and almost all have accepted jobs within the Geisinger system. “We grow our own team,” Ms. McElhattan says. “We train them properly under CSLI and our standard operating procedures, but also to our Geisinger system—our clinics, the different types of phlebotomy, our computer systems, and our lab systems.”
When the newest graduates began their job that following Monday morning, they had already undergone three weeks of onboard training in their clinical rotations. It greatly reduces the new hires’ acclimation time to their work environment.
The phlebotomy program is so successful that Geisinger receives more than 100 applications for every course and has to narrow the acceptances to 35, with 20 at its Danville campus and 15 at its South Wilkes-Barre campus. The program now has two instructors, Ms. McElhattan who lectures for all students, and a co-instructor.
The hook that helps attract students to the program is that Geisinger advertises it as student phlebotomy positions and the students are then paid at a lower rate than Geisinger’s regular full-time employees. Once someone is officially accepted into the program, they need to immediately go through “clearance” through the human resources department before they are hired. In this way, tuition is free and Geisinger pays the participants. Ms. McElhattan recently attended a clinical educators conference where she learned from other colleagues about the difficulty their schools have in recruiting students to their phlebotomy programs.
“A lot of colleges don’t seem to have large numbers for phlebotomy students,” she says. “Many people say they cannot afford to quit their jobs to go to phlebotomy school. In our program, they are getting paid, so it’s a win-win for everyone.”
Commitment, manpower, motivation
A health system does not need a lot of money to build a program like Boston Children’s, but it does need motivation, manpower, and commitment from the senior leadership on down to the department chairs and mentors within the department, says Anthony Calderone, Boston Children’s Administrative Manager to Pathology and Internship Coordinator.
When Boston Children’s Hospital first launched the pathology department internship, it had no money to pay its interns. There was no federal grant money available to pay students or support the program. Any financial support had to come directly out of the department’s discretionary fund.
The upside, however, was that student interns were gaining exposure to the healthcare system, making important connections with staff, and getting their foot in the door. The students also had mentors willing to write letters of recommendation to college.
As industries eagerly vie to lure young people into their professions, it makes sense to reach out to the students when they are young and exploring various career opportunities. Is it worth the effort to establish these outreach programs? It is, if your health system wants to have employees in the future. “We have a very grassroots program,” Mr. Baci says. “If a department our size can generate 15 to 20 professional laboratory professionals over ten years, someone with a larger department can do even more.”