Medical Laboratory Profession Needs All Hands On Deck Approach to Build Future Workforce

Innovative solutions to build the medical laboratory workforce are emerging, and that may help mitigate the critical shortage of workers that hospitals and laboratories are experiencing.  

Hospitals are interested in developing ways to help individuals who have degrees in the sciences, but no specific education or training in the medical or public health laboratory, become competent laboratory professionals with education and experience that enables them to become certified for work in the clinical laboratory. One viable option appears to be online training programs like the one that Weber State University, through a partnership with the American Society for Microbiology (ASM), began offering last fall. The program prepares students who have a bachelor's degree in a qualifying field, such as biology or microbiology, to qualify for the Technologist in Microbiology M(ASCP) certification exam from the ASCP Board of Certification via eligibility Route 3. (Click here to find out more about what this and other Routes entail.) This pathway to certification requires applicants to complete a categorical content area of an accredited MLS program specific to the examination for which they are applying, in this case microbiology.  

“We are in our first year of piloting this program,” said Susan Harrington, PhD, D(ABMM), MASCP, MLS(ASCP)CM, medical director in the microbiology laboratory at the Cleveland Clinic, in Ohio, and a member of ASM and a former Chair of the ASCP Board of Certification (BOC) Board of Governors (BOG). “The program has been in the planning stages for quite some time but was delayed because of the pandemic.” This program is in direct response to ASM members lamenting they cannot get enough certified laboratory scientists to work in their laboratories, she added. 

Through the partnership, ASM promotes Weber State’s program on its website. The role of ASM is to encourage ASM members who work in clinical microbiology laboratories to open their laboratory to prospective online students who might later seek employment in their laboratory. Clinical laboratories might also encourage employees who perform pre-analytic tasks, but don’t have the specific training needed to perform the high complexity work of the testing benches to enroll in Weber State’s online certification program. 

Online programs for advancement  

Dr. Harrington believes that more people are also using online training programs as a career ladder to go from a certified medical laboratory technician (MLT) position to become certified as medical laboratory scientists (MLS). The latter requires a bachelor’s degree with sufficient coursework in biology, microbiology, and chemistry; and two years of full-time experience in blood banking, chemistry, hematology, microbiology, immunology, and urinalysis/body fluids. Some MLTs enroll in online NAACLS-accredited MLS programs. These programs require a clinical internship. With numerous laboratory certification programs now available online, some “MLT to MLS” students can use their current workplace to get their laboratory experience. Often, however, obtaining clinical experience in blood banking, microbiology, and molecular biology can be an issue as larger hospital systems frequently consolidate these services to a central laboratory, limiting opportunities for clinical rotations. 

While one can certainly peruse the internet and find a plethora of online programs for medical laboratory science, it is important that prospective students seek out accredited programs, an indicator that a program has met rigorous standards to ensure a quality curriculum and faculty, according to Karen Brown, MS, MASCP, MLS (ASCP)CM, an adjunct professor of medical laboratory sciences in the pathology department at the University of Utah and a former ASCP BOC BOG Chair and an ASCP BOC representative to the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS). “It’s important to look for a program that has online instruction where the faculty really interacts with the students,” says Ms. Brown, who currently serves on ASCP's Commission on Continuing Professional Development and co-chairs ASCP’s Curriculum Educational Resource and Scientific Advisory Group.  

A directory of accredited online programs in the areas of medical laboratory scientist, medical laboratory technician, and graduate programs in clinical laboratory science can be found on the American Society for Clinical Laboratory Science (ASCLS) website.  

The challenges of online programs  

While online programs may be more affordable and convenient, there can be challenges, such as matching online students with a clinical site for rotations. “It is hard to find clinical sites for students because the laboratories themselves are working really hard,” Dr. Harrington says. “It slows their testing personnel down when they have a student sitting next to them in the laboratory. I think hospitals are realizing, however, that they need to provide more clinical rotations to students to help build the medical laboratory personnel pipeline.”   

It is also challenging for universities, which provide academic education, to secure clinical sites for students to perform rotations in the required areas. Dr. Harrington noted that securing clinical sites did not used to be a problem, but it has become one given the current realities of how laboratory professionals are so strapped for time to accomplish their own work. Again, if it turned out that a clinical site decided to ultimately hire someone who went through one of the rotations, it would be a benefit to the laboratory. 

“People need to train students if they are going to keep up with staffing needs and help maintain the workforce,” Dr. Harrington says.  

At Weber State, students registering for the program must have a clinical site already determined before they are even allowed to begin the online program. This prevents students from completing challenging coursework only to be unable to finish the online program for lack of clinical rotation. 

Meanwhile, there is a different set of hurdles for some prospective employees who hope to receive on-the-job training once they are hired by a hospital. For one thing, 80 percent of the laboratory directors and supervisors in the laboratory departments responding to the ASCP 2020 Vacancy Survey said they require medical laboratory employees to be certified. That makes it difficult to do on-the-job training. 

In addition, there are challenges for individuals who are seeking certification in microbiology but still need on-the-job training. “If you have a bachelor’s degree in microbiology, chemistry, or biology, you can work in a laboratory, as allowed by CLIA standards,” Dr. Harrington says.  

“However, without coursework and training in medical laboratory science such employees still have not mastered the medical laboratory skills and relevant clinical theory behind the complex testing they are performing, so they need to get that education and become certified.   

For those individuals who do find a laboratory willing to hire them and provide on-the-job training, they can spend a year in a clinical laboratory to gain the necessary skills and then qualify to sit for the ASCP BOC certification exam by meeting the required experience criteria. 

In the Cleveland Clinic’s microbiology laboratory, where Dr. Harrington works, both on-the-job training and a formal MLS program are key to employee recruitment and retention. Some individuals who have a degree in biological science or chemistry start work in the specimen processing section. To provide a career ladder and promote retention, some of these employees can complete the microbiology portion of the Cleveland Clinic MLS program while they are working, like the Weber State-ASM approach. “It is not easy, but this way, we can help them advance from pre-analytic processing to a testing bench position,” she explains. In departments such as chemistry and hematology, employees can gain a year of high complexity testing experience to allow them to be eligible for the certification examination via the experience route (ASCP BOC Route 2), but the Cleveland Clinic also capitalizes on the content from their MLS program to help these individuals prepare for the certification examination. “Anecdotally, I hear of more and more hospitals taking similar approaches in an effort to recruit and retain medical laboratory professionals,” Dr. Harrington says. 

ASCP launches Workforce Steering Committee 

In an entirely separate approach, ASCP announced last month that it has established a Workforce Steering Committee to address the workforce pathway issues from a strategic approach. Dr. Harrington has been appointed to chair the Committee. 

The committee’s task is to examine the Blueprint for Action, which was the result of an in-depth medical laboratory workforce study conducted by the University of Washington Center for Health Workforce Studies and ASCP. The Blueprint for Action identifies 12 potential workforce initiatives ASCP can work on; each fall into one of three areas: building visibility of the medical laboratory profession; retention and recruitment; and diversity, equity, and inclusion. 

“The Workforce Steering Committee is still in its nascent stages. We will begin by looking at the Blueprint’s recommendations and, from there, select several that are the most urgent,” Dr. Harrington says. “During the ASCP Leadership Conference in early March, one idea that floated up during discussions was the need to further examine opportunities for on-the-job training. It was deemed as critical to mitigate the workforce shortage right away.” 

One thing became very clear during the workforce discussions held at the Leadership Forum: “No matter what initiative we focus on, we need everyone in the profession to be engaged in this effort,” Dr. Harrington says. “Laboratory professionals really must start advocating for the profession. We will need to mobilize many volunteers who can work with their hospitals, local universities, high schools, and colleges to engage both laboratory professionals and the broader community.” 

How can laboratory professionals play a role in this effort? Talk about careers in the medical laboratory profession with college students and high school students who cross your path. There are many would-be scientists out there who know nothing about the medical laboratory. Word of mouth is an easy way for you to spread the word—and your passion—about careers in the medical laboratory. Want to take it a step further? Become an ASCP Career Ambassador or an ASCP Pathology Ambassador. ASCP will give you the tools you need to get started. It truly does take a village to accomplish this undertaking. With your involvement, we can achieve this goal! 

To get involved, click here, or email ASCP Senior Membership Director Natalie Sherry at Natalie.sherry@ascp.org.