Too few technologists: labs take inventive steps

Valerie Neff Newitt

April 2019—The tight supply of technologists to fill open positions is pushing laboratories to be creative in finding answers. Memorial Sloan Kettering Cancer Center and TriCore Reference Laboratories found their answers by looking not just outward but also—and largely—inward.

MSK has created an innovative Laboratory Scholars Program that draws employees from other parts of the cancer center, places them in an education program in coordination with a partnering college, and retrains them to become laboratory technologists.

TriCore Laboratories in Albuquerque, NM, designed a Histology Apprenticeship Program that recruits candidates from among TriCore employees to participate in targeted histotechnology training. Those who complete the training successfully can apply for an HT level-one position within the laboratory.

New York City proves to be a tough recruitment locale for laboratory technologists, says Melissa S. Pessin, MD, PhD, chair of the MSK Department of Laboratory Medicine. “It is worse than in other parts of the country for a few reasons. First, many clinical laboratory scientist training programs had closed in New York State. Second, it is very expensive to live in the New York City metro area, so many lab technologists have worked two jobs. Those reaching retirement age just can’t handle the strain of that anymore; as a result, many of the technologists are retiring,” she says.

In addition, anyone from outside the state has to take the full ASCP Board of Certification exam and undergo a transcript and clinical education review, in accordance with New York State licensure law. “So we can’t easily bring in a specialist—for example, someone who has been doing just micro for 20 years—because that person would have to pass the full board, which presents a challenge.”

Not unique to New York is the general lack of knowledge about the profession, “which certainly doesn’t help any of us.”

With a number of new sites opening over the next few years in the MSK network, Dr. Pessin and others worried there would be far too few laboratory technologists to staff them. In 2013 Dr. Pessin, working with the human resources department and Cynthia McCollum, senior vice president of hospital operations, started to explore solutions. Dr. Pessin suggested the creation of a scholars program that would include MSK employees, rather than students drawn strictly from outside, in hopes of attracting some of their own employees to the field.

“We don’t have our own medical laboratory technology school, and to create one would have been too difficult,” Dr. Pessin says. There was no place to house it, and an administrative structure and New York State approval would have been needed. “So we devised an option that no one else had considered. We partnered with another organization in an innovative way.”

Tomya Watt, MSK’s VP of talent acquisition, working with the nonprofit Council for Adult and Experiential Learning, identified several potential partners. Marist College in Poughkeepsie, NY, about two hours away by train, was the potential partner school with the greatest flexibility to create a customized program. “Together,” Dr. Pessin says, “we came up with a plan that would allow our students the shortest amount of time for retraining, and which in turn would allow us to fill these positions as fast as possible.”

The yearlong program, which got underway in 2014, runs from July to July. From July to December the scholars attend lectures at MSK two days a week and participate in study groups on a third day. On alternative days, twice weekly, they travel to Marist College for their student lab experience. From January to February they are in level-two didactic courses, and from March to July they are in clinical rotations.

“Scholars must rotate through all of the general labs. They do blood bank, chemistry, hematology which includes coagulation, urinary analysis and body fluids, and microbiology,” Dr. Pessin says. “We also give them extra experiences: phlebotomy, time in our outpatient site, time in our flow cytometry/cell immunology area, and time in cell therapy where we process stem cells for transplants.” Molecular pathology is being added to the program.

When the scholars complete the program, they sit for the ASCP BOC exam for the medical laboratory scientist. Successful completion of the exam, along with the degree from Marist College, is recognized by the state, qualifying scholars to apply for the New York State license.

Joann C. Rittersbach, BS, MT(ASCP), educational liaison manager for laboratory medicine at MSK, is confident there is no other program like this in the United States. “And I suspect there is not another program like this outside of the U.S. as well,” she says. Rittersbach meets with educators often and says she has yet to come across anyone who has developed a similar program. “There is a lot of interest in it because it’s the right thing for the right reasons.”

Recruitment for the program started in 2014 on MSK’s internet site where information about the program is available. Email, informational sessions, referrals, and posted notices help get the word out. Candidates must be full-time MSK employees in good standing and employed for at least a year by the time they apply for the program, and they must hold a bachelor’s degree or higher in a life science or a two-year MLT degree. They have to submit an essay about why they want to work in the lab, be interviewed, and complete prerequisite courses required by Marist College (general biology I and II, general chemistry I and II, introduction to organic chemistry or organic chemistry I and II, microbiology, all with labs; immunology, parasitology, statistics, and a computer class).

Ultimately, Marist College holds the curriculum for the program and grants the degree.

“Many of the people we get are working as research assistants, physician office assistants, or in animal tech jobs,” Dr. Pessin says. “Often they hope to get into medical school and then realize it may not work out for them. They want to stay in medicine and want to do something more patient-care-related than what they have been doing.”

“We also pay,” Dr. Pessin says. “By redirecting part of the tuition reimbursement budget, the HR department covers their salary while they are students in the program throughout the year, the cost of prerequisite courses, the tuition, their books, their train travels to Marist and back, review courses for them, and the cost of their exam. It’s a good deal.” If participants put in the effort, she says, “they don’t take a financial hit doing it.” It’s an opportunity for MSK employees to change careers at the cancer center’s expense. Scholars pay only for the resulting license, and graduates of the program must commit three years to laboratory medicine once they receive their New York State license and it can be verified by MSK.

Says Rittersbach: “Graduates are technically clinical laboratory technologists, and are considered LT1, our entry-level medical technologist position. Managers with open positions offer interviews to the graduates. The scholars and the managers rank their preferences, and then we do a matching system to find the best fit for both.”

Eight scholars have been accepted into the program each year from 2014 to 2019. Thirty have graduated.

Dr. Pessin says the program has been a success by all accounts. “We are very satisfied. The scholars have worked at various parts of the institution; they bring new perspectives from other departments. And they tend to be very motivated. We are at 100 percent exam pass rate, which is terrific, for our first four cohorts.” All are still employed at MSK.

The scholars now make up about 12 percent of the laboratory technologist/technician workforce.