Earlier this year, an article published in CAP Today, authored by Anne Paxton* described how the recent COVID pandemic had not only pushed healthcare workers to their limit and beyond, but exacerbated an already existing chronic labor shortage of laboratory personnel, especially medical technologists and histotechnologists. While the worst of the pandemic is behind us, the laboratory workforce shortage continues, and due to well-established demographics of an aging workforce population, the shrinking number of school-based training programs, and the relative invisibility of our profession (though briefly improved during the pandemic news coverage), we know that this will only worsen if nothing basic changes.
In the 1970s, there were about 800 accredited medical technology programs in the U.S., compared with fewer than 300 today. However, despite the chronic need for trained technologists, programs today typically are filled at only 80 percent capacity.
It is important to note that this tech shortage is not uniform; the proportion of laboratory personnel per 100,000 people varies widely among there states. Florida, Michigan, and Ohio, for example, have more than 100 licensed medical technologists per 100,000, in contrast with states experiencing the most severe shortages of medical technologists, including New York with only 67 per 100,000.
Why is the staffing situation worse in New York?
New York State has been in a particularly difficult position, due to its multilayered licensing requirements that have not taken into account alternative pathways for training and experience that are now possible through the use of online technology. This is not to criticize the intent and validity of these state regulations that were last codified several years ago, but more and more voices are being raised to re-examine and update these pathways to licensure in New York State and help address the severe shortage of professional personnel.
In 2020, to handle the huge demand for COVID testing, laboratory leaders from 12 of the 13 New York state academic medical institutions formed the New York SARS-CoV-2 Testing Consortium led by Dr. James Crawford, MD, PhD, professor and chair, Department of Pathology and Laboratory Medicine, and senior vice president of laboratory services, Northwell Health, New York. This group’s focus expanded beyond the pandemic testing in 2021 because of the increasingly critical and growing shortage of laboratory staff positions.
A survey in May of 2021 showed that vacant positions had increased to 12 percent while the number of qualified candidates remained below needs.
In fact, the actual situation was even more dire: many of those working in the laboratory under already stressed conditions were also working part-time in other labs testifying to the reality of inadequate salaries paid to lab professionals compared with other healthcare professions.
Thus, the true picture emerges of a real staffing level in New York of 70 percent based on real worker numbers.
According to Dr. Crawford: “add to that that half of the workforce is older than 55 and approaching retirement, and that the histologic technician workforce is particularly challenged: at the close of 2020 there were only 339 certified histologic technicians in New York, and laboratories find themselves faced with heavy constraints on hiring.” He added: for our consortium and for New York State, “advocacy for statutory and regulatory remedies is the top agenda item, bar none,” Dr. Crawford says.
New York’s licensing requirement is very prescriptive, according to Eloise Aita, PhD, president of the New York State Clinical Laboratory Association (NYSCLA). “In 2006, the legislature looked at the requirements for medical technology programs throughout the U.S. and unfortunately wrote those requirements into law and regulation. And they haven’t changed since then, although the national standards have changed.”
Licensure thus becomes a significant factor when laboratories want to hire people with experience, Dr. Aita contends. “Someone with 10 years’ experience in another state” may take online courses to fill some of New York’s extra requirements, “but they’re not going to do a clinical rotation for no pay when they have 10 years of laboratory experience under their belt.”
This means that “you can’t hire a person until you know they are able to get a license,” Dr. Aita adds. “So if you have a good candidate in front of you and that candidate is interviewing in New York but also in New Jersey or Pennsylvania, they’ll get a job offer from a state without a licensure requirement much sooner than from a New York lab, because we don’t know if they’re going to qualify.”
Pushing for Licensing Changes to Ease the Staffing Shortages While Maintaining a Quality Workforce
At the time this article was written (April 2022), the New York State Clinical Laboratory Association was supporting what it called a “laboratory cleanup bill,” which would allow licensees with a degree from a national accredited program and a passing grade on the ASCP medical technologist exam to qualify for a New York State license.
Success!
These efforts to update New York State’s Clinical Laboratory Licensure were successful, and the amended regulations for Clinical Laboratory Technologists, published October 20, 2022, are below. These go into effect December 28, 2022.
FUTURE LICENSURE REQUIREMENTS – Clinical Laboratory Technologists
Effective 12/28/2022*, to be licensed as a Clinical Laboratory Technologist in New York State, you must:
• be of good moral character;
• be at least 18 years of age;
• meet ONE of the education or “alternative” requirements listed in items 1-6 below;
1. Graduate from a NYSED registered clinical laboratory technology program or a substantially equivalent program (as determined by NYSED).
2. Graduate from a bachelor’s or higher degree program in biology, chemistry, or physical sciences with coursework acceptable to NYSED – and – graduate from a credit bearing clinical laboratory technology certificate program registered by NYSED or the “substantial equivalent” or a clinical laboratory technology program accredited by a national accrediting organization acceptable to NYSED.
3. Current ASCP MLS certification.
4. Clinical laboratory technology licensure in a jurisdiction acceptable to NYSED.
5. Graduate from a bachelor’s degree in a natural science or a clinical laboratory science with coursework acceptable to NYSED and 2 years of experience in a clinical laboratory while licensed as a clinical laboratory technician in New York or another jurisdiction acceptable to NYSED or while certified as a clinical laboratory technician by a national certification organization acceptable to NYSED.
• pass license exam – ASCPi (MLS) after 1/1 2015 or ASCP (MLS); and,
• submit to NYSED a license application and required fees.
* Chapter 466 of the Laws of 2022, effective December 28,2022
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FUTURE LICENSURE REQUIREMENTS – Clinical Laboratory Technicians
Effective 12/28/2022*, to be licensed as a Clinical Laboratory Technician in New York State, you must:
• be of good moral character;
• be at least 18 years of age;
• meet ONE of the education or “alternative” requirements listed in items 1-3 below;
1. Graduate from a NYSED registered clinical laboratory technician program or a substantially equivalent program (as determined by NYSED).
2. Current clinical laboratory technician certification by a national certification organization acceptable to NYSED
3. Clinical laboratory technician licensure in a jurisdiction acceptable to NYSED.
• pass license exam – ASCPi (MLT) after 10 /1 /2014 or ASCP (MLT); and
• submit to NYSED a license application and required fees.
* Chapter 466 of the Laws of 2022, effective December 28,2022
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FUTURE LICENSE REQUIREMENTS – Histotechnicians (formerly Histological Technicians)
Effective 12/28/2022*, to be licensed as a Histotechnician in New York State, you must:
• be of good moral character;
• be at least 18 years of age;
• meet ONE of the education or “alternative” requirements listed in items 1-3 below;
1. Graduate from a NYSED registered histotechnician program or a substantially equivalent program (as determined by NYSED) or a histotechnician program accredited by a national accrediting organization acceptable to NYSED
2. Current histotechnician certification by a national certification organization acceptable to NYSED
3. Histotechnician licensure in a jurisdiction acceptable to NYSED.
• pass license exam – ASCPi (HT) after 4 /1 /2015 or ASCPi (HTL) after 10/1/2014; or ASCP
(HLT) and,
• submit to NYSED a license application and required fees.
* Chapter 466 of the Laws of 2022, effective December 28,2022
The New York State Education Department (NYSED) Regulation of Professions has listened to the voices of concern by laboratory professionals and updated the requirements permitting work by laboratory professionals that are more in line with other states. This includes accepting ASCP certification alone, and recognizing licensure already granted by other states that meet NYSED standards.
There is increased optimism that this will help recruitment of additional laboratory professionals, but it is by no means the total answer to the nationwide shortage. Long-term solutions must be on the national as well as local and state levels and include efforts at increased visibility for our profession; increased training programs, financial incentives for hospitals to act as training sites, and competitive salaries. However, this is a great start for New York State!
NOTE:
*The introductory content and main body of information is directly derived from the CAP Today article “Lab Workforce Crisis Takes Top Spot” authored by Anne Paxton. Published April 2022. The NYSED Revised Licensure Requirements were published on October 20, 2022.