National Medical Lab Professionals Recognition Week: An Expert's Advocacy Guide

“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 413 million Covid-19 tests have been administered in the U.S. as of April 2021, and every day that number rises. But have you ever wondered who is responsible for performing this task?

The approximately 337,800 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 18-24, 2021), 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. MLS’s 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, MLS’s 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 FranU 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 a 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.

Meet the Expert: Deborah Josko, PhD, Rutgers University

Deborah Josko

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 in 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 each of them 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 7 to 11 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 7 percent nationally from 2019 to 2029, 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 235 medical laboratory science and 240 medical laboratory technician training programs in the U.S. This is a 7 percent decline from the year 2000. And in some states, there are no programs.

“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 are getting creative in order to compensate for the lack of availability of clinical rotation opportunities.

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.

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 Rugers.

“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 MLS’s and earn some extra money.

“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.”

So, if you are looking for a career that is in high demand and want to become a part of the backbone of our nation’s healthcare, a career in medical laboratory science might be for you.

Nina Chamlou
Nina Chamlou Writer

Nina Chamlou is an avid freelance writer from Portland, OR. She writes about economic trends, business, technology, digitization, supply chain, healthcare, education, aviation, and travel. You can find her floating around the Pacific Northwest in diners and coffee shops, or traveling abroad, studying the locale from behind her MacBook. Visit her website at www.ninachamlou.com.