Histotechnology Certifications from the American Society for Clinical Pathology (ASCP) - HT, HTL

While no one wants the responsibility of delivering a disease diagnosis, early detection can help healthcare providers determine treatment plans to restore patients’ health and wellness. After a biological specimen is biopsied, patients may wonder: who is examining and testing their tissues for possible abnormalities? The answer is histotechnicians and histotechnologists.

The Greek word root “histo” means “organic tissue” and histotechnicians prepare living tissue samples for evaluation by using laboratory instruments to cut thin slices of tissue, place them on a microscope slide, and apply dyes to determine if there are abnormalities present. Histotechnicians and histotechnologists aide pathologists in determining disease diagnoses in medical or research laboratory roles. The information gathered from the biopsied tissue samples informs the appropriate treatment for specific patients and for future medical research.

As the healthcare sector continues to expand, so too are careers in histotechnology predicted to increase. The U.S. Bureau of Labor Statistics (BLS) shows that careers in clinical laboratory technology—a closely-related career to histotechnicians—are growing at a rate of 11 percent (2018-2028), which is much faster than the national average compared to all other occupations (BLS 2020). Most entry-level positions require a bachelor’s degree and while licensure and certification requirements vary by state, most employers prefer to hire certified laboratory technicians (BLS 2020).

The American Society for Clinical Pathology (ASCP) Board of Certification (BOC) offers global certification for medical laboratory professionals. Since 1928, the ASCP has set high standards for professional competency and has certified more than 560,000 laboratory professionals.

While the National Society for Histotechnology (HST), a participating society with ASCP, strongly recommends certification, it’s worth noting that not all medical laboratory positions require histology certification. A study released by the ASCP in 2017 shows that laboratory positions in specimen processing and phlebotomy are less likely to require histology certification, while positions with blood banks and hematology/coagulation are more likely to require certification (HST 2018).

Despite certification being optional for some positions, the same study, which was published in the American Journal of Clinical Pathology (AJCP), goes on to say that the increasing rates of people retiring from histotechnician careers—combined with an increased number of certification requirements and low rates of occupational vacancy—means laboratory professionals would be well-served to pursue certification in order to prove their professional competency in a competitive job market.

Careers in histotechnology are about more than doing experiments in a laboratory; most histotechnician teams work collaboratively for a shared mission of providing quality patient care. In a video titled Preparing for a Histotechnology Career in the US by HST, histologist Lisa Paez-Ryan describes the career in detail:

Histologists have an interest in science and enjoy hands-on work. They like to work as part of a committed team of healthcare professionals. They provide information that can help doctors determine the best patient treatment. Just think: that person could be you.

Read on to learn more about the two main histotechnology certifications: histotechnician (HT) and histotechnologist (HTL), which are both available through the American Society for Clinical Pathology (ASCP).

Preparation for Histotechnology Certification

High school students aspiring to pursue histotechnology careers are advised to take as many courses as possible in chemistry, biology, and mathematics to prepare them for coursework in post-secondary science degree programs. Coursework in computers and typing is also recommended since histologists are required to keep accurate laboratory notes.

Engaging in extracurricular activities related to science, math, and after-school team-building and activities in the arts or athletics could also be beneficial. Students are advised to keep their grades as high as possible to get into a reputable and accredited associate or bachelor’s degree program to prepare for histotechnology careers.

A list of schools with national and regional accreditation can be found at the U.S. Department of Education and a list of histology programs with programmatic accreditation can be found at the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS) and on the main histotechnology education page.

The ASCP Board of Certification (BOC) offers two certifications in histology: histotechnician (HT) certification and histotechnologist (HTL) certification. Prospective applicants can check their eligibility status using the ASCP examination eligibility assistant.

Histotechnician (HT) ASCP Certification: Associate’s Degree

To be eligible to sit for the histotechnician (HT) exam, applicants must have:

  • A two-year associate of science degree in a NAACLS-accredited histotechnician program or a two-year associate of science degree from a regionally accredited college or university, including 12 semester-hours (or 18 quarter-hours) of chemistry and biology, plus a year of clinical experience in a hospital or healthcare clinic
  • A year of full-time work experience in a histopathology laboratory
  • $215 application fee

If an applicant’s associate degree program did not include clinical experience, there are post-associate degree certificate programs available to meet this requirement. An example of a post-associate degree histology technician certificate program is available at the Mayo Clinic’s College of Medicine and Science. Graduates from this program boast a 97 percent graduation rate and a 100 percent first-time board exam pass rate, as well as a 100 percent job placement rate.

In this nine-month hybrid program, students learn how to embed, cut, stain, and prepare a tissue sample for review under a microscope. The program is divided into three parts with 50 percent of the time spent in clinical settings, 25 percent of the time spent in laboratories, and 25 percent of the time spent in the classroom.

Students are taught by Mayo Clinic’s histology teaching faculty in laboratories specifically designed for training students. Although graduates are fully prepared to work in any histology laboratory, many graduates go on to work at one of the Mayo Clinic’s three national campuses in Phoenix/Scottsdale, AZ, Jacksonville, FL, and Rochester, NY.

Histotechnologist (HLT) ASCP Certification: Bachelor’s Degree

For bachelor of science (BS) degree holders wanting to build on their histotechnician skills and explore future career options in laboratory leadership, becoming eligible to take the histotechnologist (HTL) certification exam requires:

  • A bachelor’s degree from a NAACLS-accredited histotechnician or histotechnology program or a bachelor’s degree from a regionally accredited college or university
  • A valid HT credential
  • Six months of full-time experience in a histopathology laboratory an additional post-baccalaureate certificate program
  • $240 application fee

Bachelor of science (BS) graduates who want to fulfill the clinical requirement can apply to post-baccalaureate programs in histotechnology. The University of Tennessee Health Science Center (UTHSC) in Memphis, Tennessee offers a hybrid 22-credit certificate program for bachelor’s degree holders to prepare students for laboratory work as histotechnologists. This part-time one-year program runs from January to December and prepares graduates to take the histotechnologist (HTL) exam through the ASCP.

Students in this program take courses in biology, chemistry, and college algebra or statistics, in addition to clinical practicums in accredited laboratory settings. Applicants to this program must meet minimum requirements for admission to this UTHSC program including a 2.8 GPA, two letters of recommendation from college instructors or employers, and proof of abilities such as the ability to analyze data, visual acuity, physical and motor skills, effective communication, safety, and clinical judgment in a laboratory setting.

It’s worth mentioning that in order to qualify for histotechnician or histotechnology certification, eligible applicants should expect to demonstrate equivalent knowledge and skill to a graduate of an accredited histotechnology program in the following areas of experience as set forth by the ASCP:

  • Fixation: tissue identification (15 to 25 percent)
  • Processing: selection and preparation methods for histology (10 to 20 percent)
  • Embedding/microtomy: using paraffin, water baths, or freezing methods on specimens (15 to 25 percent)
  • Staining: routine: staining (30 to 40 percent)
  • Laboratory operations: preventative maintenance and corrective troubleshooting (10 to 15 percent)

HT & HTL Certification Exam Preparation

The NSH offers HT and HTL certification exam preparation materials for student members of the organization. One year memberships cost $40 and students can remain at student status for up to two years. Student members are also eligible for discounts on the following exam preparation resources:

  • Histology Exam Simulator – This is an online practice resource for the HT and HTL ASCP Board of Certification exams. Over 2,000 questions with images and feedback are updated regularly so students can be assured that the information is up-to-date. Students can take mock exams or focus on specific subject areas for targeted review and can access the material anytime from any Internet-connected computer or mobile device. The cost is $99 and NHS student members can receive a $20 discount on the exam simulator.
  • HT Prep Course – This 8.25-hour prep course is designed for students studying for the HT certification exam who are taking the exam through the on-the-job training career pathway. The course is divided into seven modules and contains several hours of lectures, short knowledge check quizzes, and a final examination consisting of 20 questions. To earn a certification of completion for this course, students must earn a 70 percent or higher on the final exam. The cost is $349 and eligible members save $100.

In addition to the two aforementioned exam preparation resources, student NHS members have access to archived webinars and an image bank of over 200 unique tissue and stain samples to fill in gaps in knowledge and give students practice with diagnosis and treatment.

HT & HTL ASCP Certification Renewal Requirements

HT and HTL certificate holders will receive three-year renewal notification from ASCP Credential Maintenance Program of their credentials and must earn 36 hours of credential maintenance program credits to be eligible for recertification.

A minimum of one point must be earned in laboratory, patient safety, or quality control, and a minimum of two points must be in histology. The remaining points must be earned in areas such as lab specialty, management, education, or other related laboratory areas of interest. The non-refundable application fee for recertification is $95 every three years with a $15 reduced fee schedule for multiple certification holders.

State Licensure Requirements in Histotechnology

The ASCP keeps a list of specific state licensure requirements for histotechnicians. State licensure requirements vary widely for histotechnicians, with some states requiring a state-specific licensure exam or a combination of a state-specific licensure exam and an ASCP certification exam.

Additional requirements may exist for previously certified or licensed histotechnicians, depending on their last date of certification. For example, the state of New York has three licensing pathways: 1) a New York state license only, 2) ASCP certification and New York state licensure, and 3) a licensure pathway for those who are already ASCP-certified.

Applicants are strongly recommended to research the licensing requirements unique to the states in which they will work.

Rachel Drummond
Rachel Drummond Writer

Rachel Drummond is a freelance writer, educator, and yogini from Oregon. She’s taught English to international university students in the United States and Japan for more than a decade and has a master’s degree in education from the University of Oregon. A dedicated Ashtanga yoga practitioner, Rachel is interested in exploring the nuanced philosophical aspects of contemplative physical practices and how they apply in daily life. She writes about this topic among others on her blog (Instagram: @oregon_yogini).