National Medical Lab Professionals Recognition Week 2022: An Expert's Advocacy Guide
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“There’s been a critical shortage [of medical laboratory scientists] for quite a while now. I would say within the last eight to ten years, there’s been a lot of people that are retiring.”
Dr. Deborah Josko, Director of the Medical Laboratory Science Program at Rutgers University
Since the beginning of the pandemic, more than 940 million Covid-19 tests have been administered in the U.S. (as of February 2022), and every day that number rises. But have you ever wondered who is responsible for performing this task?
The approximately 335,500 medical laboratory professionals in the U.S. are the unsung heroes administering these tests on top of their pre-existing duties in the lab. Up until recently, these professionals have gotten little recognition for the behind-the-scenes work that they do.
Medical laboratory scientists (MLSs), also known as medical technologists or clinical laboratory scientists, work to analyze a variety of biological specimens. It is estimated 60 to 70 percent of all decisions regarding a patient’s diagnosis, treatment, hospital admission, and discharge are based on the results of the tests these professionals perform.
Now that we’re in the midst of a global pandemic, their services are that much more crucial to our daily lives. In honor of National Medical Laboratory Professional Recognition Week (April 24-30, 2022), we asked a professor about how Covid-19 has impacted this role—and what to expect for the future.
The MLS Role During the Pandemic
The term “Covid-19 testing” may be used to refer to the drive-thru testing sites, which are strictly nasal swab collection sites, or it may refer to the actual laboratory tests. Lab tests include both the genetic test used to detect viral particles as well as the antibody test used to detect antibodies formed to the virus. MLSs perform both of these tests.
To conduct the most common form of testing for the virus, which is called a polymerase chain reaction or a PCR test, MLSs do much more than just administer nasal swabs and run them through a machine. They are responsible for conducting a meticulous process:
“The first step is to convert any RNA from the virus into DNA. Then, using a series of chemical reactions and specialized equipment, the DNA is replicated millions of times so that it is easier to detect. If genetic material from SARS-CoV-2 is detected, then the patient is infected with the coronavirus,” which Deborah Fox, the medical laboratory science program director at Franciscan Missionaries of Our Lady University, describes in an in-depth article.
According to Fox, the demands created by this high volume of testing are putting a massive burden on MLSs—a workforce that is already under strain due to a shortage of workers.
We talked to Dr. Deborah Josko, the director of the medical laboratory science program at Rutgers University—one of the top programs of its kind in the country—to learn more about how the pandemic has affected the community of laboratory scientists and the current state of the industry. Graciously, Dr. Josko spoke to us in 2021 and 2022 in anticipation of National Medical Lab Professionals Recognition Week.
Meet the Expert: Deborah Josko, PhD, Rutgers University
Dr. Deborah Josko has been the director of the medical laboratory science program at Rutgers University, School of Health Related Professions in New Jersey for the last eight years, and has been an associate professor at the university for 24 years.
Dr. Josko earned her master of science in molecular biology from Georgian Court University and her doctorate from the University of Medicine and Dentistry of New Jersey. She started out in the field as a medical laboratory technician and then became a clinical microbiologist at Riverview Medical Center in New Jersey before she started her career in education.
How the Pandemic Impacted MLS Students
When the pandemic hit back in March of 2020, the next graduating class of Rutgers medical laboratory science students was in its second-to-last semester, the time in which they would normally be completing their clinical rotations before graduation.
“At the time, a lot of the hospitals went into lockdown, and they wouldn’t take students anymore,” Dr. Josko said. “It hit us really hard.”
There were six students that were told they couldn’t finish their rotations, so the program had to make arrangements for them to finish their rotations later on. But miraculously, the program was able to graduate all 30 of its students on time. “And every single one of them that looked for a job found a job,” Dr. Josko added.
The ease with which the program’s students were able to secure employment speaks to the immediacy in which labs are currently hiring employees.
“There was a new biotech company that opened up that was doing Covid and PCR [testing]. They hired six of my grads, and they started right when they graduated. And they gave one a $25,000 sign-on bonus,” Dr. Josko said.
The Rising Demand for MLSs
So, how bad is the shortage of medical laboratory professionals, really? Prior to the pandemic, the workforce was facing vacancy rates of 3.9 to 12.7 percent in almost every region of the country.
“There’s been a critical shortage for quite a while now,” Dr. Josko said. “I would say within the last eight to ten years, there’s been a lot of people that are retiring.”
“Once the economy tanked a little bit, people stayed on because they were afraid to retire, but now, with Covid, several people have basically retired because they just say, ‘Okay, I’ve had enough. I don’t want to subject myself [to this], I’m 60 years old, or 75 years old.’”
The American Society for Clinical Pathology conducted a survey of laboratory professionals and reported that 85.3 percent felt burned out; 36.5 percent reported inadequate staffing; 31.5 percent complained of a heavy workload and pressure to complete all testing; and 14.9 percent cited a lack of recognition and respect.
And these responses are from last year. Since the onset of the pandemic, it’s probable that an even higher proportion of respondents would report burnout and heavy workload, although there is no data to support this theory yet.
While there is already a shortage of laboratory professionals, which has been exacerbated due to the pandemic, demand is only expected to increase further in coming years due to the aging population of Baby Boomers in the U.S., who will require a significant amount of tests due to diseases like cancer and Type 2 diabetes.
As a result, the overall employment of clinical laboratory technologists and technicians is projected to grow 11 percent nationally from 2020 to 2030, faster than the average for all occupations.
A Wave of School Closures
Part of the shortage has to do with the availability of medical laboratory science programs that potential students have access to.
“Unfortunately, several of the programs across the country have been closing down their medical lab science programs, including university-based programs and hospital-based programs. So we’re not supplying enough laboratorians to do the job,” Dr. Josko said.
Currently, there are about 243 medical laboratory science and 238 medical laboratory technician training programs in the U.S. This number has remained steady for the past few years but is has never rebounded to 2000 levels.
“It’s hard to say why schools are closing,” Dr. Josko said. “[Hospitals] can’t really take on a lot of students at a time because they have to train them, so think about it. If you have four departments, they can only put one student in each department every rotation. You can’t overburden the laboratorians and put five students to train in each department because it’s overwhelming.”
Rutgers’ program is affiliated with 27 clinical sites in New Jersey and New York. So, they are able to spread their students out. “Even with that being said, sometimes they won’t take our students because they say, ‘Oh, we’re too short staff, and we can’t train them,’” Dr. Josko added.
The unique problem presents a catch-22 in which hospitals will not take on new students because they are too short-staffed to train them, even though they need more workers, contributing to the perpetuation of the shortage.
Addressing the Medical Lab Professional Shortages
Many MLS programs had to get creative in order to compensate for the lack of availability of clinical rotation opportunities at the start of the pandemic.
The University of Minnesota’s medical laboratory science program, for example, reduced the time MLS students spend on clinicals from 22 weeks to 12 weeks—and may reduce clinicals even further, to eight weeks.
“The whole purpose of clinicals was to get students comfortable working in the hospital or laboratory setting,” the director of the program, Janice Conway-Klaassen explained in an article from CLM Trends. “But we found that most of our students achieved competency in much less time, usually in just a few weeks.”
Rutgers’ program temporarily changed, as well, due to limitations caused by Covid-19. All of its students completed ten days of clinical rotation followed by 15 days of lab simulation, in which they utilized lab simulation software.
“We had to be very creative. We redid our entire curriculum and had the students do lab simulations every single day to fulfill the competencies that they needed to graduate,” Dr. Josko said. “But now we’re back. There are no abbreviated rotations this year (2022).”
To address the shortage issue, the American Society for Clinical Laboratory Science (ASCLS) is calling for an expansion of the Title VII health professions program, which provides education and training opportunities in high-demand disciplines, to include medical laboratory science.
The ASCLS also advocates for educating the public about medical laboratory science by partnering with middle and high school STEM (science, technology, engineering, and math) programs to introduce the career path to the next generation earlier on in their educational paths, to increase awareness about the demand for new entrants.
The Good News for MLS Program Graduates
The only good news about the MLS staffing shortage is for students who are able to get accepted in programs like the one at Rutgers.
“My grads are getting supervisory positions two or three years out because people are retiring. And so they are going into management positions really pretty quickly, in just a couple of years,” Dr. Josko said.
The availability of jobs means that new graduates are able to get hired quickly, choose their positions more carefully, and even receive signing bonuses. The truly industrious graduates may even decide to take on more than one position at a time to take advantage of the demand for MLSs and earn some extra money. “I have a lot of my grads that are working two jobs right out of school. They have a full-time job with benefits, and then they’re working per diem somewhere else,” Dr. Josko shared.
“When I worked in the lab, we would have one group of people that worked at one lab from 7:00 to 3:00, and then they came over to our lab and worked from 4:00 to 12:00. And so they were working two full-time jobs,” Dr. Josko said. “There’s also a lot of overtime that’s available because you’d have to work double shifts if they’re short.”
For the incoming class of 2022, Dr. Josko notes that she has had more applicants than ever: “This year is booming with applications. I don’t know if it’s because of the hype that medical laboratory scientists got from Covid or just a fluke that everyone has applied, but I have so many students now I don’t even know what to do with, unfortunately. I don’t think I’m going to be able to accept them all, and it’s really sad because there’s such a critical shortage. We just don’t have the facilities on campus to accommodate all of these students,” she shared.
Graduates of Dr. Josko’s programs are in high demand: “They’re getting hired before they even finish my program. To finish our program, students have to complete a mock certification exam. Once they pass that, they are done and they can take the certification exam. The day they pass our exam, students are asking me to write their employer a letter saying that they fulfilled all requirements for graduation because they want to hire them right away,” said Dr. Josko.
Job offers are coming from all industries, so graduates can choose to work in various places, not just in hospitals. Dr. Josko encourages “once you have the laboratory skills, you can work in any laboratory, whether it’s research, environmental, public health, forensics, or veterinary. The State Department of Health just called the other day and wanted to know if we had anybody to fill the molecular laboratory positions they have open.”
National Medical Laboratory Professional Recognition Week
Medical laboratory professionals work outside of the public eye, making recognition week all the more critical. “If you go into the hospital, you won’t see them,” said Dr. Josko.
“All these health professionals are so overworked and burnt out, especially the front lines such as the nurses and the doctors. However, I don’t think the public has any idea how much the laboratory staff is stressed as well. In addition to The influx of Covid testing, they still have to cover all the other blood tests that are being ordered.”
The best way for the public to help recognize these professionals is simply to thank them: “If you are visiting a hospital, at the front desk you can say, ‘Can you let the laboratory staff you know we are really appreciative of all they’ve been doing and all their accuracy?’” shared Dr. Josko.
She further offers that administrative staff or supervisors can make an effort to make laboratory staff more visible by having the table in a high traffic area to share their work with passersby.