Cytologist Certification - CT (ASCP)
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Becoming a certified cytologist can prove an ideal career choice for laboratory science-minded professionals who want to work in healthcare. Cytologists (CTs) and other allied health professionals work behind the scenes of an examination room in laboratories to examine tissue samples for evidence of cancerous and precancerous cells and infectious diseases.
Using a microscope, CTs look for cell abnormalities and support physicians and pathologists in making patient diagnoses. Through diligent independent work and communicative teamwork, cytologists can help save lives by providing the timely diagnosis so a patient can begin treatment and increase their chances of survival.
Cytologists are in demand in a wide range of healthcare facilities including hospitals, clinics, and university research laboratories. The Bureau of Labor Statistics (BLS) reported that clinical laboratory technologist and technician jobs, a general occupation that includes cytologist specializations, are expected to swell 5 percent between 2023 and 2033—the addition of 18,200 fresh openings (BLS 2024). This rate is much faster than the national average for all occupations (4 percent) during the same time period.
The pathway to becoming a cytologist is fairly straightforward. Like many allied health professions, most employers prefer to hire applicants who have completed an accredited educational program and earned certification in their field. Given the importance of accuracy and the time-sensitive nature of this profession, cytology certification is highly valued by healthcare professionals and patients. An incorrect tissue sample diagnosis could cost someone their life or cause severe emotional distress, so it is imperative that CTs receive a high-quality education, including didactic coursework and hands-on training, and be able to demonstrate comprehensive knowledge.
While not all states require certification and licensure, aspiring cytologists are strongly encouraged to complete a bachelor’s degree program accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) to be eligible to take certification exams given by the American Society for Clinical Pathology (ASCP) Board of Certification (BOC).
The ASCP was formed nearly a century ago and has been issuing credentials to medical technicians (MTs) and laboratory technicians (LTs) since the 1930s. The specialist certification in cytotechnology (CT) was established in 1957, and the most recent certification added in 2018 was the specialist in molecular biology (SMB) 2018. Currently, there are more than 635,000 laboratory professionals who hold an ASCP certification.
Read on to learn more about how to earn ASCP certification as a cytologist (CT)—formerly known as a cytotechnologist.
Early Preparation to Become a Cytologist (or Cytotechnologist)
High school students who know they are bound for allied health careers should take as many math and science courses as possible in biology, chemistry, anatomy and physiology, advanced algebra, and calculus. Pursuing part-time work, internships, or volunteer work in a laboratory or medical office can give students real-world laboratory and microscope experience. Students are advised to keep their grades high in order to gain admission into a reputable and CAAHEP-accredited bachelor’s degree program.
Post-High School CT (ASCP) Certification Preparation
A four-year bachelor’s degree from a CAAHEP-accredited program is required for CT professionals who want to take the ASCP certification exam. Most CAAHEP-accredited programs are 12-month programs that culminate in a bachelor of science in cytology.
To be eligible to apply for these one-year undergraduate CT programs, students must complete a certain number of prerequisite courses in English, humanities, math, science, history, social sciences, and other general education requirements. Each CT program has its own unique prerequisites.
For example, the University of Arkansas for Medical Sciences offers a 12-month CAAHEP-accredited cytology program. To be considered for admission, students must complete 80 credits of general education courses at any regionally accredited college or university. A minimum of 20 credits is required in biology and eight credits in chemistry are required on a student’s official transcript.
Students in this program are prepared for entry-level cytology positions and are required to complete a clinical internship and demonstrate cytopathology skills. Graduates from this program are eligible to take the Board of Certificate examination in cytology from the ASCP to earn the CT(ASCP) credential.
CT (ASCP) Certification Exam Preparation
The CT (ASCP) certification exam includes 100 multiple-choice questions and must be completed within 2.5 hours. The questions are administered using computer adaptive testing, meaning the level of question difficulty continues to increase until a question is answered incorrectly. Students have time to review answers and changing an answer doesn’t affect the previously answered questions. The cost to apply to take the CT exam is $250 and $300 for the specialist in cytology (SCT) exam.
The exam includes questions covering the following content areas:
- Gynecological cytology: CT (40 to 45 percent); SCT (20 to 25 percent)
- Non-gynecological cytology: CT (25 to 35 percent); SCT (15 to 25 percent)
- Respiratory system: CT (8 to 12 percent); SCT (5 to 10 percent)
- Genitourinary system: CT (8 to 12 percent); SCT (5 to 10 percent)
- Body cavity fluids: CT (8 to 12 percent); SCT (5 to 10 percent)
- Fine needle aspiration and other: CT (10 to 15 percent); SCT (15 to 25 percent)
- Laboratory operations: CT (15 to 20 percent); SCT (35 to 40 percent)
Sample CT and SCT exam questions for the content areas above are provided by ASCP and study guides are available for purchase. Test takers are notified via email of their scores four days after completing the exam and will receive a paper certificate in the mail three to five weeks after the exam.
Credential holders must renew their certifications every three years and must earn 36 points via laboratory or patient safety education, cytology, lab specialty, management, education, or another related area of laboratory interest. CT credential holders are advised to keep track of their continuing education with opportunities through the ASCP online credential maintenance program (CMP).
State Licensure for Cytologists
The ASCP holds the opinion that all states should license laboratory personnel to “ensure that laboratory personnel possess appropriate academic and clinical training, pass competency-based examinations conducted by an approved national certifying organization, and participate in continuing education programs.”
A complete list of states that require ASCP licensure for cytologists includes the following:
- California
- Florida
- Hawaii
- Louisiana
- Montana
- Nevada
- New York
- North Dakota
- Puerto Rico
- Rhode Island
- Tennessee
- West Virginia
Some states have unique pathways to CT certification via state-specific licensure, ASCP certification, state licensure, or other requirements for those with expired CT(ASCP) certification.
For example, the California Department of Public Health requires that cytologists hold a license through the state Office of Laboratory and Field Services to perform examinations on cytology specimens. The following is a list of requirements, the state of California applicants need when applying for CT licensure:
- Earning a CAAHEP-accredited 12-month bachelor’s degree program or earning a bachelor’s degree with 20 semester units (or the equivalent) of biological science, eight semesters of chemistry, and three semesters of mathematics
- Completing a 12-month cytologist program accredited by CAAHEP (or equivalent) or five years of employer-verified full-time clinical laboratory experience in cytology with time-sensitive limitations
- Passing the CT exam offered by the ASCP
- Renewing the certificate every two years, which includes paying a fee and submitting documentation of continuing education
Since every state has unique licensure requirements, degree-seeking cytotechnologists are advised to research the state requirements where they live or plan on working in the future.
Cytologist Career and Salary
It’s not surprising that the Bureau of Labor Statistics (2024) predicted a 5 percent increase in openings for clinical laboratory technologists and technicians, a general occupation that includes cytologist specializations, between 2023 and 2033, much more than the average growth anticipated across all U.S. occupations during that same decade (4 percent).
As far as the salaries are concerned, here are the salary percentiles for clinical laboratory technologists and technicians in the US (BLS May 2023):
| United States | |
|---|---|
| Number of professionals employed | 334,380 |
| Annual mean wage | $62,870 |
| 10th percentile | $36,770 |
| 25th percentile | $45,080 |
| 50th percentile (median) | $60,780 |
| 75th percentile | $78,120 |
| 90th percentile | $93,900 |
Lastly, while the BLS doesn’t specifically track salaries for cytologists, PayScale.com (Dec. 2024)—a site that relies on self-reported data—found that the median annual salary for a cytologist was $80,921. Among the 356 cytologists reporting their annual salaries, Payscale.com found these percentiles:
- 10th percentile: $61,000
- 50th percentile (median): $80,921
- 90th percentile: $97,000
Entry-level cytologists with less than one year of experience earn 17 percent below the average, while experienced cytologists (10 to 19 years) earn 5 percent above the average, and late-career cytologists (20+ years) earn 6 percent above the average.
It is important to note that these figures also vary based on the source of data. For illustration, Indeed.com (Dec. 2024) found an average annual salary of $130,577 among United States cytologists.
