Solving the Shortage of Medical Laboratory Technologists in Canada

The Canadian Alliance of Medical Laboratory Professionals Regulators (CAMLPR), the organization representing the provincial medical laboratory technology regulatory bodies, is planning a suite of innovative initiatives to address shortages of medical laboratory technologists (MLTs) through the Flexible Pathways to Registration for MLTs project.

Employment and Social Development Canada (ESDC) has modelled projections of the demand for medical laboratory workers from 2022 to 2031 by considering population growth, the growing demand for healthcare services, and the need to replace retirees. (The modeling includes the demand for medical laboratory assistants as well as MLTs; however, MLTs compose most of this combined group.) 

ESDC projects that, cumulatively, 25,600 new job openings will be needed, but that without taking into account immigration, the cumulative number of job seekers will be 20,400—fulfilling only 80 percent of job openings. 

Even if immigrant job seekers maintain historical patterns, there is still a projected shortfall of some 7 percent of needed workers. It is incumbent upon the regulators to create flexible and user-friendly pathways into the profession for both domestic and internationally educated applicants.

What factors are contributing to a potential MLT deficit?

An aging workforce

The MLT workforce in Canada is currently facing a demographic challenge, as a significant portion of its professionals are reaching or have surpassed the age of 50. This trend is a cause for concern as it signals a potential shortage of MLTs when seasoned professionals retire. Will enough new graduates be available to meet the upcoming demand?

The aging MLT workforce is not an isolated phenomenon but rather reflects the broader trend of the aging Canadian population. According to Statistics Canada, the proportion of seniors who are 65 and over in the population will increase from 18.5 percent in 2021 to between 21.6 percent and 29.8 percent in 2068, depending on whether there is slow or rapid population growth.

The aging Canadian population is a pressing issue for the healthcare system and a crucial factor contributing to the increased need for medical laboratory investigations. As people grow older, they become more susceptible to chronic diseases and require more frequent medical interventions. Individuals aged 65 years and older also account for a significant proportion of all hospital stays. 

These trends inevitably translate into a higher demand for medical laboratory technology services because diagnosis, treatment, and prevention of chronic diseases often rely on laboratory tests. Consequently, the increased demand for testing exerts pressure on the existing MLT workforce and contributes to the need to register additional MLTs.

A lack of awareness and representation

The MLT profession is not alone in experiencing shortages, as the healthcare sector is facing shortages in various areas. As a result, there may be competition among healthcare professions to attract potential candidates, with the MLT profession potentially losing out to more visible and better-known professions. 

Despite their importance, the role of MLTs is often underrepresented in public discourse and media coverage. As a result, many people exploring potential career paths may be unaware of the opportunities and rewards associated with a career as an MLT.

Insufficient funding for educational programs

The scarce healthcare dollars that fund education programs may not be sufficient to accommodate the growing need for new MLTs. This could lead to limited capacity in educational programs, making it difficult for potential students to access the necessary education to become qualified MLTs.

Even when new graduates do enter the MLT profession, labs may find it difficult to retain them long-term. Factors such as job satisfaction, working conditions, and opportunities for career advancement could influence the decision of MLTs to remain in the field or pursue alternative career paths.

Nontraditional graduates face barriers to registration

The global pandemic has underscored the critical role MLTs play in the healthcare system by performing and analyzing tests for infectious diseases. However, the additional pressures of COVID-19 (e.g., increased testing demands, illness-related staff shortages) may have exacerbated existing shortages by prompting early retirement or career change for those who became burned out.

Attracting internationally educated applicants and Canadian graduates with nontraditional education holds promise for meeting some of the shortage of qualified MLT personnel. But international applicants and nontraditional graduates face barriers to registration that include recognition of existing field-of-practice competencies (e.g., hematology and transfusion science), access to education opportunities to address competency gaps, and competition for resources in Canada's universal, publicly funded healthcare system.

The question remains: Will the existing MLT workforce be able to keep up with an increasing demand for practitioners?

Creating flexible pathways to registration for MLTs

Addressing the potential workforce shortages and ensuring the MLT workforce can keep up with the growing demand for laboratory testing requires a multifaceted approach and collaboration among government agencies, provincial regulatory bodies, educational institutions, professional organizations, and the healthcare industry.

With support from the Government of Canada, the CAMLPR is taking action to accelerate and enhance the registration of MLTs through the Flexible Pathways to Registration for MLTs project. Undertaken on behalf of the provincial regulatory bodies, the project will address an anticipated shortage of MLTs over the next 10 years, helping CAMLPR and the Government of Canada achieve one of their main objectives: increasing the supply of qualified health professionals in Canada.

Developing competency standards for a rapidly changing profession

CAMLPR is developing multiple entry pathways to practice for MLTs, regardless of their international or nontraditional education backgrounds. Such pathways depend upon the development of competency standards that practitioners need when they begin practice, the tools to assess those competencies, and the provision of supports to facilitate seamless integration into the Canadian MLT workforce.

A major first step is the production of competency standards that reflect the current demands of a rapidly changing profession. Seasoned practitioners with deep knowledge of the current demands of MLT work are identifying competencies common to all fields of practice as well as the specialized competencies required in each field.

Potentially adding registration in specialized fields

A second initiative of the Flexible Pathways project is a feasibility study exploring the possibility of introducing registration in specialized fields of practice within the MLT profession where those do not currently exist. This initiative aims to address workforce shortages by enabling MLTs to hone their expertise and practice in specific areas, such as clinical chemistry or microbiology.

Streamlining the registration process

The Flexible Pathways project also entails developing an online portal for internationally educated MLTs and Canadian-educated applicants whose education does not qualify them to register through existing processes. 

The portal is intended to streamline the registration process for individuals by allowing them to have one point of entry and learn about practicing as an MLT in Canada, connect them with the appropriate provincial regulator, undergo assessments of current education and competencies, access education options to address competency gaps, and access field-of-practice competency assessments. 

CAMLPR believes the portal will help simplify the application process and reduce wait-times for exams and assessments.

Upholding high standards for registration and practice

Healthcare regulatory bodies are committed to ensuring the public that practitioners possess the knowledge and abilities they need to do their jobs safely. This commitment is at the heart of the work underway by the provincial MLT regulatory bodies. This dedication extends to upholding high standards for registration and practice and continuing to implement rigorous quality assurance measures to ensure MLT competence and conduct.