Up to the test
In anticipation of lab worker shortages, Cal State L.A. teams up with local medical centers to restart training programs
Andrea Wu loads a laboratory centrifuge at Methodist Hospital. Wu was inspired to carry on the “family business” of working in medicine after hearing stories about her mother’s father, an herbal doctor in China.
It's 6:30 a.m. Tuesday and while many Southland workers are just starting their days, the laboratory crew of Methodist Hospital of Southern California in Arcadia has kicked it into high gear.
The clinical laboratory scientists (CLS), outfitted in white labs coats and blue medical gloves, prepare thousands of vials, plates and slides with red and yellow liquids, load machines and process body fluid samples from patients all to be ready for the doctors’ rounds at 8:30 a.m.
They perform the tests that will help doctors to diagnose cancers, infections and other illnesses and determine if a patient will be admitted.
And in a couple years, the life science industry will see a shortage of lab workers, which could lead to major delays in patient care.
But academic programs, like the Clinical Laboratory Science Training Program offered through the College of Extended Studies and International Programs, are stepping in to help meet industry demands.
The yearlong post-baccalaureate certificate training program, funded by a subcontract from San Jose State University with a $5 million grant from the American Recovery and Reinvestment Act, is designed to address the critical shortage of clinical laboratory scientists.
In the past couple decades, advancements in technology led to a rise of sophisticated automated testing machines while cost-cutting measures in health care reclassified the work of clinical laboratory scientists into low, moderate and high skill levels in the state of California. This allowed hospitals to hire non-licensed workers at a cheaper rate to perform low-level testing while more complex tests still required a licensed technologist. As a result, the perceived demand for clinical laboratory scientists was low and training programs at hospitals diminished as the costs became prohibitive.
Additionally, the explosion of biotechnology and pharmaceutical companies means that diagnostic firms have been luring CLS workers from the hospital to the research and development side.
“The problem now is that the average age of a CLS is late 50s, so everybody’s getting ready for retirement and there’s nobody to take their place,” said Nancy McQueen, director of the Clinical Lab Scientist Training Programs at Cal State L.A. “Once the economy picks up, the clinical laboratory scientists in their 60s and 70s will retire, there’s going to be a big void and we’re really going to be in trouble.”
Without people in the clinical lab, some hospitals are going to have a hard time satisfying the needs of the patient. The role of the CLS is absolutely critical because 50 to 70 percent of diagnoses are based on lab tests, McQueen said.
“Without the CLS, diagnosis will be based solely on patient’s looks, how they feel and what they can say about their symptoms,” she said. “So if you don’t have enough folks in the lab doing the diagnostic tests that’s going to slow down diagnosis, which is a huge problem because treatment is based upon diagnosis.”
The CLS program prepares students to take the American Society of Clinical Pathology licensing exam. Academic requirements are fulfilled through lectures one day each week on campus while partnerships with local hospitals provide hands-on training the other four days. As an incentive to restart training, the grant paid the hospitals $10,000 per student for the first year of the program.
The collaboration has been mutually beneficial for the University and the hospitals.
“When the opportunity came, I jumped on it,” said Sonia Maljian, director of Laboratory Services at Methodist Hospital of Southern California in Arcadia. “Now in the second year, we have a solid system in place and we’re really happy with it. They are treated like staff.”
Christian Uy, a student in the Clinical Laboratory Science Training Program, tests a sample for Mononucleosis in the lab at Methodist Hospital of Southern California.
At Methodist Hospital of Southern California, the students first observe laboratory scientists as they perform tests, then they are coached and work alongside trainers such as clinical laboratory scientist Jessie Apan and other laboratory staff.
“That’s what I particularly like about Methodist Hospital,” said student Christian Uy, who completed his bachelor’s degree in biological sciences at UC Irvine. “They split us up so we get even more one-on-one experience instead of having both of us learn from one person at the same time.”
The clinical training covers five disciplines: hematology, clinical chemistry, blood-banking, microbiology and immunology. Though much of the work has become automated in the past couple decades, the training goes beyond learning how to operate the machines. Students must also have a thorough knowledge of the tests being performed and the standard parameters for results so they can identify abnormalities and improve either the instrument or specimen as necessary to ensure accurate readings.
Andrea Wu, who received a bachelor’s degree in biotechnology from Cal Poly Pomona, said the training goes beyond basics.
“I really like the hands-on experience,” said Wu, who worked as an assistant in a medical laboratory during college. “We have more of a chance to deal with critical values and troubleshooting, those are really helpful for the future when we become clinical laboratory scientists.”
That thoroughness and attention to detail is what makes for a better clinical laboratory scientist, according to Dr. Roger Der, medical director of the laboratory at Methodist Hospital of Southern California.
“To learn some of the clinical aspects behind everything that we do here … it adds a slightly different dimension to the training,” Der said. “In my experience, there are medical technicians that just do their stuff, but if they go that extra mile they can have a more profound effect on patient care without even meeting the patients.”
The laboratory work is immense with many fine details to scrutinize. The labs at Methodist Hospital of Southern California, for example, process 1,600 to 1,900 tests per day, Maljian said.
The results for the 2011-12 academic year, the Cal State L.A. program’s first, proved effective with all 14 participants passing the licensing exam and several of the hospitals hiring their interns. As of December, the statewide effort funded by the San Jose State University grant has led to the employment of 161 new clinical laboratory scientists.
This year, 18 students are enrolled in the program and interning at White Memorial Medical Center, Los Angeles County+USC Medical Center, UCLA-Harbor Medical Center, Martin Luther King Jr. Multi-service Ambulatory Care Center, Olive View-UCLA Medical Center, Methodist Hospital of Southern California and Citrus Valley Health Partners. Already, the program has received 75 applications for the 2013-14 session.
Also in 2012, the College began its Clinical Genetic Molecular Biologist Scientist program for specialized molecular diagnostic tests. The six students enrolled in the program this year are being instructed in molecular testing for cancers, genetic disease markers, histocompatibility types, and some infectious diseases to prepare for the CGMBS licensing exam. The clinical affiliates for that program are City of Hope, Kaiser Regional Labs, U.S. Labs and Clarient Labs.
“The need for a trained clinical laboratory workforce is great. There’s a huge gap between what’s needed and the number of people being trained for the positions,” McQueen said. “If we can find more clinical affiliates we can increase the number of students admitted to the program.”