Solving the Clinical Laboratory Workforce Shortage

As the demand for health care services continues to increase as a result of an aging population, an increasing number of complex tests, and a global pandemic, the need for qualified laboratory professionals will continue to grow. But for the nation’s clinical laboratory training programs to meet the anticipated need requires additional financial support, along with innovative thinking. 

The laboratory workforce shortage is nothing new, but it seems to be a problem that is difficult to fix. In 2018, the most recent year for which data is available, there were an estimated 331,700 employed clinical laboratory technologists and technicians in the United States, according to the Bureau of Labor Statistics (BLS),¹ but the need is expected to grow 11 percent over the next eight years. BLS estimates that an additional 35,100 jobs will be added between 2018 and 2028, not counting the number of jobs that will be made available by workers who will retire during that period. 

While the demand for clinical laboratory personnel is growing, the number of training programs actually is declining, according to the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS).² Currently, there are 235 MLS and 240 MLT training programs in the United States, compared to 2000, when there were 263 MLS programs and 248 MLT programs, a decline of about 7 percent. 

Partly as a result of the decline in training programs, laboratory managers continue to report difficulty filling many positions. The American Society for Clinical Pathology (ASCP) conducts a vacancy survey every two years to gauge how well clinical laboratories are able to fill staff openings. Results of the 2018 vacancy survey³ showed increased vacancy rates for most laboratory positions across all departments compared to the 2016 survey. Vacancy rates ranged from about 6 percent in the Central Northwest to over 11 percent in the Central Northeast. One of the top concerns mentioned by respondents to the survey was staffing the laboratory with qualified laboratory personnel.

Funding needed to support training

A decrease in training programs coupled with an increased need for laboratory professionals could impact patient care if nothing is done to address the problem, notes Jim Flanigan, executive vice president of the American Society for Clinical Laboratory Science (ASCLS), which has published a position paper on the laboratory workforce shortage.⁴

“There are not federal programs supporting clinical education in the laboratory the same way there are for physicians and nurses,” he explains. “This is true for all allied health professionals.”

ASCLS is calling for expansion of the Title VII health professions program, which provides education and training opportunities in high-need disciplines and settings, to specifically include clinical laboratory science. The association also supports efforts to improve visibility of the profession by engaging in community outreach opportunities and by partnering with middle and high school STEM (science, technology, engineering, and math) programs to show young people that laboratory medicine is a viable career path. In addition, the ASCLS was instrumental in developing the Coordinating Council on the Clinical Laboratory Workforce, which provides resources for individuals interested in becoming a laboratory professional.

ASCLS also has signed on in support of a bill introduced in Congress by Rep. David Cicilline (D-RI), the Allied Health Personnel Shortage Act, which would establish a program of scholarships and loan repayments for individuals pursuing a degree in science relating to health care at a school of allied health.

“It’s a small first step,” says Flanigan. “We need more. Colleges tell us that it costs more to educate lab personnel than they receive in tuition. We really need funding for educational programs and to support the clinical sites,” where clinical laboratory scientists do their clinical rotations.

Federal and state financial support for allied health programs, including clinical laboratory science professional training programs, would allow those programs to accept and train more students, helping bridge the gap between the supply of trained lab professionals and the increasing demand, he adds.

Innovative solutions

To ease the strain on clinical sites providing training, some clinical laboratory training programs are employing innovative solutions. The University of Minnesota’s Medical Laboratory Science program, for example, has reduced the time MLS students spend on clinical rotations from 22 weeks to 12 weeks. The director of the program, Janice Conway-Klaassen, PhD, says the plan for next year (at least prior to the COVID-19 pandemic) was to reduce clinicals even further, to eight weeks.

“The whole purpose of clinicals was to get students comfortable working in the hospital or laboratory setting,” she explains. “But we found that most of our students achieved competency in much less time, usually in just a few weeks.”

The COVID-19 pandemic also is having an impact on clinicals since students are not allowed at the sites where they typically would finish their training. To ensure that students get hands-on training, the University of Minnesota program is planning two-week clinical simulations on campus this summer.

“We are going to bring the students back in small groups and do a concentrated training like we are in a hospital,” says Conway-Klaassen. “They will be processing specimens on their own and reporting out the results, just as if they were working at a small clinical lab or a doctor’s office. They also will rotate through different areas, from microbiology to blood bank to core lab for chemistry and hematology.”

If the simulations are successful, they might be used in the future, even after clinical sites have reopened for training, says Conway-Klaassen. “I think this could make it easier for us to shift to a shorter clinical rotation,” she says. “It’s time we re-examine everything we are doing. What is really necessary and what are we doing just out of habit?”

Finding a solution to the laboratory workforce shortage is complex, say both Flanigan and Conway-Klaassen, but now is the perfect time to take action to ensure that the country has enough trained lab professionals to meet the demands of the future.

References

1. Clinical Laboratory Technologists and Technicians: Occupational Outlook Handbook. US Bureau of Labor Statistics. 2018.

2. “2019 annual report.” National Accrediting Agency for Clinical Laboratory Sciences.

3. “2018 vacancy survey of medical laboratories in the United States.” The American Society for Clinical Pathology.

4. “Addressing the clinical laboratory workforce shortage.” The American Society for Clinical Laboratory Science. 2018