Ask an Expert: Top 10 Things to Know Before Starting a Career in Histotechnology

“Learn to network and collaborate with colleagues in all professional organizations, and volunteer at your state’s annual histology society meeting and at the national meetings as well. In order to advance in your career as a histotechnologist, you must be a self-advocate and recognize when an opportunity presents itself.”
Mark A. Bailey, Associate Professor and Program Director in the University of Texas School of Health Professions MD Anderson Cancer Center

Histology, which is the science of cell structure, isn’t at the front of most people’s thoughts. Histotechnology, which focuses on detecting tissue abnormalities and aiding in the diagnosis of disease, is even further removed from the mainstream conversation.

But these concepts play a critical behind-the-scenes role in the medical workflow, and they make for an in-demand and rewarding career. Job data from the Bureau of Labor Statistics (BLS 2019) suggests the field of histotechnology will grow at over double the national rate, pay over the average salary, and continue to offer entry-level jobs that sometimes require only an associate’s degree.

Histotechnology is a niche subject, to be sure. The tools of the trade are an unlikely cross-section of raw materials, technology, and science. Histotechnologists and histotechnicians use dyes, chemicals, waxes, and scalpels. They use immunological and molecular techniques to provide accurate tumor detection. As part of a larger laboratory team, they work closely with a pathologist to help decide the next course of treatment. They conduct research and instruct others. The stakes can, at times, be life and death.

This year’s Medical Laboratory Professionals Recognition Week takes place April 18-24, 2021. It marks a time to call attention to the vital contributions to healthcare made by the nation’s 300,000-plus lab professionals, including histotechnologists. It’s also a chance to raise awareness about what histology has to offer those who join the field.

According to Fixation on Histology, a blog run by the National Society for Histotechnology, histology jobs are still largely invisible to the usual supply routes of personnel (i.e., high schools and colleges), and many people end up in the profession by chance. The counterweight to this is that those who enter the profession clear-eyed, and with set goals in mind, can distinguish themselves early on.

To give yourself a head start on this important and growing career, read on.

Meet the Expert: Mark A. Bailey

Lisa Cremeans

Mark A. Bailey is an associate professor and program director in the School of Health Professions at the University of Texas MD Anderson Cancer Center in Houston. He earned his certificate in histotechnology at MD Anderson in 1988, and then went on to get his MA in education and humanities from Texas A&M.

A board-certified histotechnologist, Bailey is a member of numerous professional societies, including the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS), the American Society of Clinical Pathology (ASCP), and the National Society for Histotechnology (NSH), among others. Over the course of his career, he’s co-authored over a dozen academic papers and served on numerous institutional committees.

He graciously agreed to share his experience in the field and advice for aspiring histotechnology professionals.

“Before I started my career, I wish I’d had an awareness about the endless job opportunities throughout the United States for histotechnology trained personnel,” Bailey stated. “It was not until I completed my education in an accredited histotechnology program that I realized the number of jobs available in hospital clinical labs, medical school research labs, university basic science labs, US federal labs, and veterinary surgical labs.”

If Bailey had been aware of just how many opportunities there were, he might’ve reconsidered some of the positions he’d been offered in his hometown of Houston. Now, he advises those considering histotechnology careers to get out and explore living in different parts of the country. At the same time, he recommends staying in each position for at least three to five years before moving on.

“I also wish I had known about the role of each person who works in a clinical surgical pathology team—everyone from the receiving clerk to the attending pathologist,” Bailey says. “Having a thorough understanding of the process of working together as a team, to acquire a diagnosis for the patient, will assist students’ understanding of the pivotal role histotechnologists play in patient care.”

That understanding of the flow of information within a wider team is critical to clear communication, which Bailey also highlights as a key skill in histotechnology: “When you have the ability to clearly communicate to your colleagues, students, and intra- or inter-departmental peers, everyone feels more confident about the tasks they perform on a daily basis to excel in their job position and profession,” Bailey says.

To excel at a job in histotechnology requires a robust educational foundation. According to Bailey, it starts in high school, with a solid understanding of the sciences, particularly biology and chemistry. In college, aspiring histotechnologists will branch out into anatomy, physiology, and other hard sciences.

“When an applicant begins the admissions process, it’s a cliché, but honesty is the best policy,” Bailey says. “When submitting your application essay, include the following items: why are you interested in histotechnology; describe your academic journey to meet the program’s prerequisites; describe your participation in research or community activities; and, finally, make sure to address each item on the application essay instructions.”

Bailey also advises that students make themselves aware of specific educational requirements that can open up longer-term career goals. An associate degree might be enough for a histotechnician (HT) certification, but a bachelor’s degree can lead to a histotechnologist (HTL) certification and future leadership positions. Those who are interested in becoming an educator will need to look further, to graduate-level programs.

“If you can meet the preceding educational goals, the most rewarding parts of a histotechnology career are the opportunities that open up for you,” Bailey says. “However, you must be willing to accept the occasional job or professional organization assignment which may not be that interesting or exciting to perform. Never say no, because future opportunities may never be offered to you again.”

Bailey’s career has been one of constant learning, involvement, and advancement. He advises others in the histotechnology profession to continue to learn new procedures after they graduate. Once histotechnologists have worked for a year or two in a histology lab, they can (and should) approach their supervisor or lab manager to ask about learning advanced histotechniques such as biopsy grossing, immunohistochemistry, and cloud-based digital image analysis and management.

“Learn to network and collaborate with colleagues in all professional organizations, and volunteer at your state’s annual histology society meeting and at the national meetings as well,” Bailey says. “In order to advance in your career as a histotechnologist, you must be a self-advocate and recognize when an opportunity presents itself.”

What to Know Before Starting a Career in Histotechnology

1. Who’s Who in the Lab

Over 80 percent of all physician decisions are based on laboratory test results produced by a laboratory team. That team includes histotechnologists, histotechnicians, cytotechnologists, laboratory assistants, and pathologist assistants. This behind-the-scenes team works together to determine the presence or absence of disease, and evaluate the effectiveness of treatment.

  • Cytotechnologists evaluate various cell cultures (e.g., Pap smears) for diagnosis.
  • Laboratory assistants perform specimen processing and provide assistance to other laboratory personnel.
  • Pathologists (MDs or DOs) function as laboratory medical directors and consultants to a patient’s physician
  • Pathologist’s assistants perform the gross diagnosis of tissue specimens removed at autopsy or biopsy and identify material for microscopic diagnosis.
  • Histotechnologists and histotechnicians prepare, embed, cut, and stain tissue samples and biopsies for diagnosis.

2. Histotechnology Educational Requirements

The primary difference between histotechnologists and histotechnicians is their level of training: histotechnologists have a bachelor’s degree, while histotechnicians usually have an associate’s degree.

Histotechnologists have more experience and education in why specimens are collected and processed for testing. This means histotechnologists are more qualified to handle unexpected situations in the laboratory, such as solving technical problems, understanding underlying causes of unusual results, and evaluating new laboratory techniques.

Both roles require a strong didactic skillset. Those interested in a career in this field can get a head start by building a solid foundation in high school sciences, such as biology, chemistry, math, and computer science.

3. The ASCP Certification Process

Certification by the American Society for Clinical Pathology (ASCP) Board of Certification (BOC) establishes a histotechnologist or histotechnician as competent in safe and effective laboratory practices. While it’s not a national requirement for histotechnologists and histotechnicians to be certified, many employers make certification a requirement for those they hire. Laboratories hiring graduates straight out of histotech programs often grant a period of time after the hire date for the tech to become certified.

Eligibility requirements for certification as a histotechnician (HT) include either completion of a histotechnician program accredited by the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS), or an associate’s degree and one year of full-time laboratory experience.

Eligibility requirements for certification as a histotechnologist (HTL) include either completion of a bachelor’s degree and an NAACLS-accredited cytotechnology program, or a bachelor’s degree and one year of full-time histopathology experience.

Once deemed eligible, an applicant must pass a 150-minute, 100-question examination. Certified histotechnologists and histotechnicians will need to maintain their credential every three years by completing continuing education and professional development.

4. Helpful Non-Didactic Skills

Technical knowledge can only accomplish so much, and certain non-didactic skills can give a boost to your histotechnology career. Histotechnologists and histotechnicians need to be natural problem-solvers, and they should enjoy challenges and responsibility. Communication, both in writing and in speaking, is a critical skill. The work of a histotechnologist or histotechnician is often time-sensitive, pressurized, and with little margin for error. This is a career for those who have a passion for science and hunger for continual learning.

5. Histotechnology Education Scholarships

You don’t necessarily have to pay for your education all on your own. In addition to grants and scholarships for students of different backgrounds and majors, histology students can also apply for domain-specific scholarships.

The ASCP offers member-funded scholarships to qualified students enrolled in approved laboratory science education and training programs, including for histotechnologists. Scholarship selection criteria include academic achievement, leadership ability, community activities, professional goals, and endorsements from faculty and community leaders.

6. Job Outlook for Histotechnologists and Histotechnicians

According to the Bureau of Labor Statistics, clinical laboratory technologists and technicians, a category that includes histology, is set to grow 7 percent between 2019 and 2029. That’s more double the national average in the same timeframe and amounts to an added 24,700 jobs. Histology professionals are among these lab personnel.

Current salary data from the BLS (May 2020) finds clinical laboratory technologists and technicians earning an average of $55,990 per year, with the top 10 percent earning more than $83,700 per year. Experience, employer, setting, and geography can all influence a histotechnology salary. Histotechnologists and histotechnicians working in urban areas tend to earn more, particularly when working in medical and surgical hospitals.

7. Where Histology Professionals Work

You aren’t required to work in a hospital as a histotechnologist or histotechnician. In fact, you aren’t even required to work with human patients. While the majority of their work will be performed in a laboratory of some kind, histotechnologists and histotechnicians can work in a variety of different settings.

Possible work settings for histotechnologists and histotechnicians include:

  • Hospital laboratories
  • Reference laboratories
  • Physician office laboratories
  • State health departments
  • Fertility clinics
  • Marine biology laboratories
  • Pharmaceutical or biotech laboratories
  • Veterinary laboratories
  • Forensic laboratories

8. Daily Routines of Histotechnicians and Histotechnologists

While it varies from lab to lab, there are a few technical routines to histotechnology. One in particular centers around the freezing, sectioning, and staining of tissue samples from patients in the operating room. A histotechnologist or histotechnician will embed a patient’s tissue in a paraffin wax block. That block is then processed through various chemicals.

Next, the histotechnologist or histotechnician will cut paper-thin sections of the tissue using a microtome, and then place those sections on a microscope slide for drying and fixing. Finally, they will stain the paper-thin sections with one of several stains in order to highlight different tissue components or microorganisms.

Histotechnologists and histotechnicians also deal in immunochemistry methods, electron microscopy, molecular pathology, and muscle enzyme histochemistry. Their exact duties will vary depending on their employer, setting, and level of experience.

9. Opportunities for Career Advancement

Careers in histotechnology leave plenty of room for advancement. Histotechnicians may become histotechnologists. Senior technologists can advance to supervisory and managerial positions, where they’ll coordinate laboratory operations, staffing, and finances. They can also advance to teaching positions and become educators in the field. Additionally, some histotechnologists go on to become pathologist assistants.

10. Professional Networks and Advocacy in Histotechnology

In the beginning, the terminology, the educational requirements, and the certification process can all seem extremely intimidating; but you’re not alone. Professional associations and journals act as hubs for histotechnologists, histotechnicians, and other laboratory personnel. They offer educational resources, how-to guides, networking opportunities, and helpful links to the information you need to build your career from the ground up.

Professional networks are also an important resource in supporting advocacy efforts in histotechnology. These networks represent a unified voice both in promoting the profession and helping shape its future. Top advocacy issues in histotechnology include:

  • Federal Recognition: The Clinical Laboratory Improvement Amendments (CLIA) of 1988 do not recognize or address histology. This means that the tests histotechnologists perform are not classified as complex under federal regulations, despite the tests’ growing complexity. Misclassification inhibits histotechnologists’ ability to access higher pay, better training, and broader recognition.
  • Insurance Reimbursement: The fight for proper reimbursement by insurance providers is a constant struggle in the medical community, and no different for those in histotechnology. Groups like the National Society for Histotechnology (NSH) act as key advocates for the profession if and when cuts to reimbursement are proposed.
  • Workforce Shortages: As many seasoned histotechnology professionals begin to retire, an excess of open positions is becoming available in the field. But a lack of awareness around the profession, and a dearth of quality academic programs to support it, has made filling the gap a major point of concern.

Whether you want to get current on the histotechnology conversation, or just get a clear answer to your own specific question, check out some of the resources below:

  • American Medical Technologists (AMT): AMT has been certifying healthcare professionals since 1939, and boasts over 87,000 certified members. AMT also acts as a hub of continuing education and connects members to networking opportunities and career development resources.
  • American Society for Clinical Pathology (ASCP): ASCP includes over 100,000 members of the medical community, including pathologists, residents, fellows, students, and medical laboratory professionals. In addition to being major advocates for the profession, they also offer certifications for histotechnicians and histotechnologists.
  • National Society for Histotechnology (NSH): Founded over 40 years ago, NSH is the only professional society dedicated purely to the field of histotechnology. It brings together over 3,000 histotechnology professionals from across the globe and acts as the premier source of learning and research in the profession.
  • NSH Annual Symposium/Convention: The NSH Annual Symposium/Convention is the largest educational event in histology. Attendees can take advantage of over 60 sessions to advance their knowledge, earn continuing education units (CEUs), and connect with others from around the world.
Matt Zbrog
Matt Zbrog Writer

Matt Zbrog is a writer and freelancer who has been living abroad since 2016. His nonfiction has been published by Euromaidan Press, Cirrus Gallery, and Our Thursday. Both his writing and his experience abroad are shaped by seeking out alternative lifestyles and counterculture movements, especially in developing nations. You can follow his travels through Eastern Europe and Central Asia on Instagram at @weirdviewmirror. He’s recently finished his second novel, and is in no hurry to publish it.