Too few technologists: labs take inventive steps

“But we’ve been expanding at a fairly rapid rate, so it is not enough,” Dr. Pessin says. “We remain challenged. We always have openings, but I know for a fact that we are doing better at recruitment than most of the other New York City hospitals.”

The Laboratory Scholars Program itself is expanding. “For the 2019–2020 cohort,” Rittersbach says, “we will expand to 10 scholars in the program, collaborate with pathology, and include a molecular component to meet the pathology experience.” Dr. Pessin explains: “Anatomic pathology is completely separate from lab medicine here at MSK. We have been so successful that AP would like us to recruit for them as well and train for molecular technologists.”

Dr. Pessin has not overlooked the related challenge of retaining talent. “Something that has been a challenge in most institutions is there are very few places to promote medical technologists. Traditionally we have LT1, 2, and 3 positions. After LT3 you possibly could become a supervisor or a manager. But obviously there are not many supervisors or managers. Furthermore, not every great tech should, or wants to, supervise. So we came up with a lab technologist 4, or LT4, which is the same salary level as a supervisor and allows technologists to be experts in their area or other areas—for example, a quality expert, lab information system expert, or education expert.” It has provided opportunities to promote people so they do not feel they have to go to other institutions to advance. “This is a creative way to value people in each of our service areas.”

The HR department handles the program’s funding matters. “HR is accountable for financials; we are not involved,” Dr. Pessin says. “But they have done the numbers and found this is more cost efficient than other forms of recruitment. Based on how much it costs them for the level of recruiting they have to do for us, they felt this was a good investment. And because MSK is traditionally so supportive of advancing its own employees, they felt this was the right thing to do.”

Rittersbach adds, “That MSK is financially supporting the Lab Scholars Program—salaries, tuition, expenses—shows a commitment of administration, the lab management team, and technologists who all recognize the value of having highly trained and qualified employees working at the bench.”

When TriCore Reference Laboratories experienced a more than 20 percent vacancy rate in histotechnologist positions in its pathology department, it was clear it was time to take action.

“We just could not find experienced HTs to fill all the positions,” says Chris Goodwin, MBA, PA(ASCP), CT(ASCP), anatomic pathology core lab manager. “My director, Eric Carbonneau, and I sat down to do our staffing plan and knew we had to get creative. We came up with the Histology Apprenticeship Program.”

They crafted job descriptions, after consulting with their human capital management department, “and set the program up correctly, so we could fulfill the business need for TriCore as well as attract the right candidates for the lab,” Goodwin says.

The apprenticeship program was launched in 2017 to recruit candidates for histotechnology training from within and outside TriCore. When the apprentices complete the program and graduate, they are encouraged to apply to TriCore’s open HT1 positions and take the ASCP BOC exam.

“In our AP areas we employ many great individuals who have experience in pathology in terms of accessioning, processing, slide distribution, and all the other things that make AP work,” Goodwin says. “This program provides them with a defined career path. They can go from a lab assistant to a histotechnologist. In fact, we have been able to recruit great people into our AP lab assistant program, based on our having this apprenticeship program open to them. They see a future.”

Laura Enriquez, HT(ASCP), TriCore’s technical supervisor of histology, says program participants must have completed 60 semester hours of academic coursework from an accredited college or university, and it has to include 12 hours of biology and chemistry. “All lab assistants with that college coursework can apply for an apprentice position. They will then go through a routine interview process, and we make a selection.”

The program begins with basic embedding, which is a four- to six-week process during which participants do little else. At the end of that period they must demonstrate 50 percent productivity, which is 20 blocks per hour, with a variety of tissues. Once they achieve that benchmark, they move on to microtomy for six to eight weeks. “Again, they have a benchmark,” Enriquez says, “where they must meet a minimum of 10 blocks per hour of cutting. Once they master that, they spend the next 12 weeks rotating between embedding and cutting. They also learn to cut the recuts, to cut from a special stain, IHCs.” At the end of the six-month period, they are encouraged to apply—“I hold my breath and hope they do,” Enriquez says—for a full-time HT1 position. “That provides a pay increase for them.”

While the program is still in its infancy, “and evolving as we evolve,” she says, “we already have one apprentice who became an HT1 in July 2018, two who became HT1s in February, and two more who completed the program in March who also plan to jump into full-time positions.”

TriCore had been down seven histotechnologists, but with the recent apprentices added to the mix, it is now short two.

“There is a shortage of histotechnologists across the country, so basically we just had to grow our own,” Enriquez says. “The positions wouldn’t be filled otherwise. I feel great that we are drawing great people into the field. I am proud of my apprentices; they are all wonderful.”

Histotechnologists who are already on staff mentor the apprentices, Goodwin says. “We are taking full advantage of their experience and knowledge. At first there were a few people who were a tad reluctant to step in and help train the apprentices. They may have doubted their teaching ability, but that changed in a hurry,” he says. “Once they tried it and got adjusted to the idea, it improved their lives and job satisfaction.” Some now enjoy being a mentor. “I don’t think there is a single person in our lab who has not helped the apprentices along their journey. The program has increased overall engagement and has been great for morale.”

Apprentices receive a salary while they train. At the program’s end, they are not constrained in any way, nor must they make a time commitment to the lab.

Because the apprenticeship is open to everyone who meets the educational criteria, many have wanted to take advantage of it. “We post the apprenticeships as positions,” Enriquez says. “On my first two postings there were roughly 90 applicants. So while we were having trouble getting histotechnologists, we had no trouble getting apprentices.” TriCore’s human capital management recruitment team uses social media to spread the word.

Enrollment is on a rolling basis. “Whenever we have good candidates,” Goodwin says, “we bring them in, as long as we are ready for them. We don’t want too many at any given time because we have to have an experienced HT to provide one-on-one training for each apprentice.” After two apprentices complete the program, two more are brought in. “We just want to keep the cycle going—leveraging our knowledge and growing our own.”

Valerie Neff Newitt is a writer in Audubon, Pa.