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The American Society for Clinical Pathology's 2012 Vacancy Survey of Clinical Laboratories in the United States

Edna Garcia MPH, Asma Ali MA, Shahid Choudhry PhD
DOI: http://dx.doi.org/10.1309/LMZK40NMGLFLW9SX e1-e18 First published online: 1 February 2013

Since 1988, the American Society for Clinical Pathology (ASCP) has conducted its Vacancy Survey to determine the extent and distribution of workforce shortages within the nation's clinical laboratories. This confidential survey has been administered every 2 years and has served as the primary source of information for academic, government, and industry labor analysts. Results from past surveys show that laboratory medicine is a rapidly evolving field. Although ASCP recognizes the importance of continuity, each administration of the Wage and Vacancy Survey represents an opportunity to improve its methodology to collect the most current relevant data while maximizing survey participation. The Survey has evolved in response to changes within the profession; new questions were added to the 2012 Survey to examine some of the factors affecting wage and vacancy rates. The ASCP continues to gather questions, comments, and suggestions from our members regarding the profession with the goal of addressing them through this important survey.

Methodology

The 2012 Vacancy Survey was conducted through collaboration between ASCP's Institute of Science, Technology, & Policy in Washington, DC and its Educational Design and Technology division and Board of Certification in Chicago, IL. Select ASCP members who work in the field of laboratory medicine were recruited to review the survey questions and to critique the report. Partner organizations were also invited to participate in completing the survey to get a larger scope of the current issues faced by the laboratory workforce. Electronic survey invitations were sent on July 25, 2012, via Survey Gizmo (an online survey vendor). The survey was closed on August 31, 2012. To maximize response, this survey used snowball sampling, in which respondents were asked to forward the invitation e-mail message to other individuals currently practicing in the field. This year, ASCP also used social media (ie, Facebook and LinkedIn) to disseminate the Vacancy Survey to help augment response rates.

The main goals of this year's Vacancy Survey were to address the following:

  • Vacancy rates by laboratory department

  • Anticipated vacancies in the next 6 months by laboratory department

  • Rates of vacant positions left open for longer than 6 months

  • Retirement rates in the next 24 months by laboratory department

Most of the names on the initial e-mail recipient list were derived from the ASCP database and included:

  • Individuals who self-identified on the 2012 Wage survey as a supervisor, manager, lead, educator, educational program director, or director who have direct reports and can report on vacancies, anticipated vacancies, and certifications of staff

  • Individuals who have current certification through ASCP and can report on vacancies, anticipated vacancies, and certifications of staff

    • Individuals with lifetime certification

    • Individuals who are lifetime certified and who voluntarily maintain Certificate Maintenance Program (CMP) credits

    • Individuals who voluntarily maintain a National Credentialing Agency (NCA) component of their certification

  • Individuals who have taken relevant continuing medical education (CME) coursework through ASCP and can report on vacancies, anticipated vacancies, and certifications of staff

    • Individuals who have participated in relevant CME courses but are not ASCP certified

  • Individuals who completed the Wage or Vacancy Survey and can report on vacancies, anticipated vacancies, and certifications of staff from 2010

ASCP also requested participation from the following partnering entities:

  • AABB (formerly the American Association of Blood Banks)

  • American Society for Clinical Laboratory Science (ASCLS)

  • American Association for Clinical Chemistry (AACC)

  • American Medical Technologists (AMT)

  • American Society of Cytopathology (ASC)

  • American Society for Cytotechnology (ASCT)

  • American Society for Microbiology (ASM)

  • Clinical Laboratory Management Association (CLMA)

  • Associated Regional and University Pathologists (ARUP) Laboratories

  • Laboratory Corporation of America (LabCorp)

  • Quest Diagnostics

  • 1199 SEIU (Service Employees International Union)

The 2012 Vacancy Survey sought to collect staff- and supervisory-level data for the following laboratory areas:

  • Anatomic pathology (including non-MD professionals)

  • Blood bank (immunohematology)

  • Chemistry/toxicology

  • Core laboratory (new laboratory area surveyed this year)

  • Cytogenetics

  • Cytology

  • Hematology/coagulation

  • Histology

  • Immunology

  • Laboratory safety (new laboratory area surveyed this year)

  • Microbiology

  • Molecular biology/diagnostics (new laboratory area surveyed this year)

  • Phlebotomy

  • Reproductive medicine and genetics (new laboratory area surveyed this year; sample sides did not allow for statistically significant comparisons)

  • Specimen processing (new laboratory areas surveyed this year)

  • Tissue typing/histocompatibility (new laboratory area surveyed this year; sample sizes did not allow for statistically significant comparisons)

  • Administration (new laboratory area surveyed this year)

ASCP survey administrators recognize that there is no standard approach for how laboratories are organized and that laboratory areas may hire staff with a variety of certifications. The ASCP provided survey participants with the opportunity to report on the certifications that exist or are sought after for the laboratory area under their supervision.

Key Findings

The primary objective of this research was to estimate the rate of shortages within clinical laboratory departments. Overall, this survey presents data from 935 respondents responding for 22,842 employees across the United States. Of all the departments surveyed, phlebotomy, blood bank, core laboratory, hematology/coagulation, microbiology, chemistry, histology, and specimen processing departments employ most clinical laboratory personnel (Figure 1). By region, the Far West had the highest number of respondents, at 22.2%, and the Central North West had the least number of respondents, at 9.7% (Figure 2).

Figure 1

Overall total number of employees by laboratory department.

Figure 2

Percentage of responses by region.

Across the nation, the vacancy rate was highest for phlebotomy departments (8.0%) and lowest for the cytogenetics, histology, and immunology departments, as well as laboratory safety personnel (4.0% each) (Figure 3). According to the survey results, phlebotomy (8.0%) has the highest overall staff (nonsupervisor) vacancy rate in the nation while specimen processing (14.0%) has the highest overall supervisor vacancy rate (Figure 4 and Figure 5). The lowest staff (nonsupervisor) vacancy rates occurred in the departments of cytogenetics, laboratory safety, and specimen processing (4.0% each); the lowest supervisor vacancy rate occurred in the immunology department (1.0%) (Figures 4 and 5).

Figure 3

Overall vacancy rates by laboratory department. Note: sample sizes for Reproductive Medicine and Genetics and Tissue Typing/Histocompatibility did not allow for statistically significant comparison.

Figure 4

Staff (non-supervisory) vacancy rates by laboratory department. Note: sample sizes for Reproductive Medicine and Genetics and Tissue Typing/Histocompatibility did not allow for statistically significant comparison.

Figure 5

Supervisory vacancy rates by laboratory department. Note: sample sizes for Reproductive Medicine and Genetics and Tissue Typing/Histocompatibility did not allow for statistically significant comparison.

According to the survey findings, immunology and chemistry/toxicology departments have the highest overall percentage (10.0%) of employees anticipated to retire in the next 24 months. Cytogenetics and phlebotomy have the lowest rate of employees expected to retire in the next 24 months, at 4.0% each (Figure 6). The staff retirement rate is highest in the immunology department (10.0%) and lowest in the phlebotomy department (3.0%) (Figure 7). The supervisor retirement rate is highest in the hematology/coagulation department (24.0%) and lowest in the histology and molecular biology/diagnostics departments (4.0% each) (Figure 8).

Figure 6

Overall retirement rate by laboratory department.

Figure 7

Staff retirement rate by laboratory department.

Figure 8

Supervisory retirement rate by laboratory department.

Overall, survey results show that molecular biology/diagnostics and phlebotomy departments have the highest percentage (8.0%) of positions anticipated to become open by December 2012 while chemistry/toxicology has the lowest rate (0.4%) of anticipated positions by that time (Figure 9). Data also reveal that the chemistry/toxicology department has the highest percentage of vacancies that remained open for longer than 6 months (6.0%) (Figure 10).

Figure 9

Overall percentage of positions anticipated in the next 6 months (by December 2012).

Figure 10

Overall percentage of positions left open for more than 6 months.

The regional distribution of states is shown in Table 1. The Central South West and Far West regions reported higher vacancy rates than other regions; the Central North East had the lowest vacancy rates (Table 2).

View this table:
Table 1 Regional Distribution by States
RegionStates
Far WestAlaska (AK), Arizona (AZ), California (CA), Colorado (CO), Hawaii (HI), Idaho (ID), Montana (MT), Nevada (NV), New Mexico (NM), Oregon (OR), Utah (UT), Washington (WA), Wyoming (WY)
Central NorthwestIowa (IA), Kansas (KS), Minnesota (MN), Missouri (MO), Nebraska (NE), North Dakota (ND), South Dakota (SD)
Central SouthwestArkansas (AR), Louisiana (LA), Oklahoma (OK), Texas (TX)
Central NortheastIllinois (IL), Indiana (IN), Michigan (MI), Ohio (OH), Wisconsin (WI)
South Central AtlanticAlabama (AL), Delaware (DE), District of Columbia (DC), Florida (FL), Georgia (GA), Kentucky (KY), Maryland (MD), Mississippi (MS), North Carolina (NC), South Carolina (SC), Tennessee (TN), Virginia (VA), West Virginia (WV)
NortheastConnecticut (CT), Maine (ME), Massachusetts (MA), New Hampshire (NH), New Jersey (NJ), New York (NY), Pennsylvania (PA), Rhode Island (RI), Vermont (VT)
View this table:
Table 2 Vacancy Rates by Region
Laboratory DepartmentFar West (%)Central Northwest (%)Central Southwest (%)Central Northeast (%)South Central Atlantic (%)Northeast (%)
Administration615338
Anatomic Pathology634467
Blood Bank649475
Chemistry/Toxicology656443
Core Lab646454
Cytogenetics304244
Cytology252454
Hematology/Coagulation569335
Histology453155
Immunology866332
Laboratory Safety851070
Microbiology514543
Molecular Biology/Diagnostics538644
Phlebotomy5795710
Specimen Processing568759

Anatomic Pathology (AP), Including Non-MD Professionals

The total vacancy rate for AP is 7.0% (Figure 3). The staff (nonsupervisor) vacancy rate is 7.0%; the supervisory vacancy rate is 2.0% (Figures 4 and 5). Results also reveal that 8.0% of all AP employees are expected to retire in the next 24 months. Staff (nonsupervisor) and supervisor retirement rates for AP are each 9.0% (Figures 6, 7, and 8).

Compared with other departments in the survey, AP has a low percentage (2.0%) of positions anticipated to become open by December 2012 (Figure 9). The rate of vacancies expected by that time for staff is 1.0%; for supervisors, it is 6.0% (Figure 11 and Figure 12). Survey results also show that 3.0% of vacant positions remained open in the AP department for longer than 6 months (Figure 10). The rate of open positions that remained open for longer than 6 months is 2.0% for staff and 9.0% for supervisors (Figure 13 and Figure 14).

Figure 11

Percentage of staff positions anticipated in the next 6 months (by December 2012).

Figure 12

Percentage of supervisor positions anticipated in the next 6 months (by December 2012).

Figure 13

Percentage of staff positions by department open for more than 6 months.

Figure 14

Percentage of supervisor positions by department open for more than 6 months.

When hiring staff-level (nonsupervisor) employees in the AP department, most respondents report cytotechnologist (CT), histotechnician (HT), histotechnologist (HTL), and pathologist assistants (PA) as the preferred credential or certification. However, 53.5% of the respondents from the AP department indicated that they are not required to hire only certified individuals.

Within AP, data show that 100% of staff (nonsupervisors) and supervisors are certified (Figure 15 and Figure 16). The vacancy rate for the anatomic pathology department is highest in the Northeast region (7.0%) and lowest in the Central North West (5.0%) (Table 2).

Figure 15

Percentage of certified staff by department.

Figure 16

Percentage of certified supervisors by department.

Blood Bank (Immunohematology)

The vacancy rate for the blood bank department is 6.0% (Figure 3). This year's staff (nonsupervisor) and supervisor vacancy rates are each 7.0% (Figures 4 and 5). Survey respondents working at blood banks indicated that they anticipate a 7.0% overall retirement rate in the next 24 months. Staff (nonsupervisors) members have an anticipated retirement rate of 7.0%, compared with 8.0% for supervisors (Figures 6-8).

Blood banks also have a lower rate of expected available positions by December 2012, at 1.0% (Figure 9). This rate is almost nonexistent for staff (0.3%) but in the high range for supervisors (5.0%) (Figures 11 and 12). Blood banks also have the highest rate of overall and supervisor vacancies that remained open for longer than 6 months, at 5.0% and 25.0%, respectively (Figures 10 and 14). The rate of staff positions that remained open for longer than 6 months is 3.0% (Figure 13).

Respondents from blood banks prefer technologist in blood banking (BB), medical laboratory scientist (MLS)/medical technologist (MT), medical laboratory technician (MLT), and specialist in blood banking (SBB) certifications when hiring staff (nonsupervisor) employees. In this department, 75.5% of the respondents reported that certification is required of candidates for staff positions. According to the survey results, 81.0% of staff and 85.0% of supervisors working in blood banks are certified (Figures 15 and 16). The Central South West region has the highest vacancy rate (9.0%) and the Central North East and Central North West regions have the lowest vacancy (4.0% each) (Table 2).

Chemistry/Toxicology

The total vacancy rate for chemistry/toxicology is 6.0% (Figure 3). The staff (nonsupervisor) vacancy rate and that for supervisors is each 6.0% (Figures 4 and 5). Results also reveal that 10.0% of chemistry/toxicology employees are expected to retire in the next 24 months (Figure 6).

Compared with other departments in the survey, chemistry/toxicology has the lowest percentage of positions anticipated by December 2012 (0.4%) (Figure 9). This department also has the highest rate of vacancies that remained open for longer than 6 months, at 6.0% (Figure 10).

Most of the respondents from the chemistry/toxicology department prefer to hire employees with medical laboratory scientist (MLS)/medical technologist (MT) certification. Also, 62.3% of the supervisors indicated that certification is a prerequisite for candidates for hire. The vacancy rate for the chemistry/toxicology department is highest in the Central South West and Far West regions (6.0% each) and lowest in the North East (3.0%) (Table 2).

Further analysis of the staff and supervisor retirement rate, anticipated vacancies by December 2012, the rate of vacant positions that remained open for longer than 6 months, and percent of certified respondents could not be performed because the results would be rendered statistically insignificant.

Core Laboratory

ASCP collected data on core laboratories for the first time with this survey. Laboratory workflow models using core laboratory organizational methods have gained wide popularity in the past 20 years. Although specific test menus for core laboratories vary from facility to facility, those facilities generally handle hematology, chemistry, and, in many cases, microbiology. Core laboratories may serve 1 or more hospitals, physician offices, and nursing homes.

The vacancy rate for the core laboratory is 6.0% (Figure 3). The total vacancy rate for staff (nonsupervisors) is 7.0% and the supervisor vacancy rate is 4.0% (Figures 4 and 5). Results also reveal that 9.0% of the total core laboratory department employees are expected to retire in the next 24 months (Figure 6).

According to survey results, the rate for expected vacancies by December 2012 in the core laboratory is 6.0% (Figure 9). Data also show that 4.0% of the overall vacant positions remained open in the core laboratory for longer than 6 months (Figure 10).

When hiring staff-level (nonsupervisor) employees for core laboratories, most respondents report medical laboratory scientist (MLS)/medical technologist (MT), and medical laboratory technician (MLT) as the preferred credential or certification. In this department, 63.4% of the survey participants reported that certification is a prerequisite for candidates for hire. The Central South West and Far West regions have the highest vacancy rates (6.0% each), and Central North East, Central North West, and Northeast states have the lowest vacancy rates (4.0% each) (Table 2).

Further analysis of the staff and supervisor retirement rates, anticipated vacancies by December 2012, rate of vacant positions that remained open for longer than 6 months, and percent of certified respondents could not be performed because the results would be rendered statistically insignificant.

Cytogenetics

The vacancy rate for cytogenetics is 4.0% (Figure 3). The staff (nonsupervisor) vacancy rate is 4.0% and the supervisor vacancy rate is 3.0% (Figures 4 and 5). Survey respondents from the cytogenetics department indicated that they anticipate a 4.0% retirement rate within the next 24 months (Figure 6).

The overall percentage of positions anticipated by December 2012 for cytogenetics is 3.0% (Figure 9). The rate of positions remaining open in the cytogenetics laboratory for longer than 6 months is 3.0% (Figure 10).

The certification of choice when hiring staff-level (nonsupervisor) employees in the cytogenetics department is technologist in cytogenetics (CG). Although CG is the certification of choice, 61.1% of the respondents from this department indicated that certification is not a prerequisite for candidates for hire. Despite this, survey results show that 79.0% of staff and 100% of supervisors are certified (Figure 15 and Figure 16). The vacancy rate for the cytogenetics department is highest in the Central South West, South Central Atlantic, and Northeast regions (4.0% each) and lowest in the Central North West (0%) (Table 2).

Further analysis of the staff and supervisor retirement rates, anticipated vacancies by December 2012, and rate of vacant positions that remained open for longer than 6 months could not be performed because the results would be rendered statistically insignificant.

Cytology

The vacancy rate for the cytology department is 5.0% (Figure 3). Total staff (nonsupervisor) and supervisor vacancy rates are each 5.0% (Figures 4 and 5). Survey results show that 8.0% of cytology personnel are expected to retire in the next 24 months. The staff (nonsupervisor) retirement rate is 8.0% and the rate for supervisors is 11.0% (Figures 6-8).

The rate of anticipated positions by December 2012 for the cytology department is 1.0% (Figure 9). The percentage for staff-level positions is also almost nonexistent, at 0.4%. The anticipated percentage of new positions by December 2012 for supervisors, however, is the highest among all the departments surveyed, at 7.0% (Figures 11 and 12). Cytology has the lowest percentage of vacant positions that remained open for longer than 6 months, at 2.0% (Figure 10). The rate of positions remaining open for 6 months are 3.0% for staff and 1.0% for supervisors (Figures 13 and 14).

Respondents from the cytology department prefer cytotechnologist (CT) and specialist in cytotechnology (SCT) certifications when hiring staff-level (nonsupervisor) employees. Also, 79.1% of the supervisors indicated that certification is a prerequisite for candidates for hire. Survey results show that 100% of staff and supervisors are certified (Figures 15 and 16). By region, the vacancy rate for cytology is highest in the Central North West and South Central Atlantic regions (5.0% each) and lower in the Far West and Central South West (2.0% each) (Table 2).

Hematology/Coagulation

The vacancy rate for the hematology/coagulation department is 6.0% (Figure 3). Total staff (nonsupervisor) and supervisor vacancy rates are also each 6.00 (Figures 4 and 5). Survey respondents from the hematology/coagulation department indicated that they anticipate a 7.0% overall retirement rate in the next 24 months. Staff (nonsupervisors) members have a retirement rate of 6.0% compared with 24.0% for supervisors (Figures 6-8).

The overall percentage of positions anticipated by December 2012 for hematology/coagulation is 5.0% (Figure 9). The rate of vacancies expected by that time for staff is 5.0%; for supervisors, it is 6.0% (Figures 11 and 12). The total rate of positions that remained open in the hematology/coagulation laboratory for longer than 6 months is 4.0% (Figure 10). The percentage of open positions that remained open for longer than 6 months is 4.0% for staff and 7.0% for supervisors (Figures 13 and 14).

Most of the respondents from the hematology/coagulation department prefer to hire employees with medical laboratory scientist (MLS)/medical technologist (MT) certification. In this department, 68.3% of the respondents reported that certification is required when hiring staff. According to survey results, 90.0% of staff and 100% of supervisors are certified (Figures 15 and 16). The Central South West region has the highest vacancy rate, at 9.0%, and the South Central Atlantic and Central North East had the lowest vacancy rate, at 3.0%.

Histology

The total vacancy rate for histology is 4.0% (Figure 3). The staff (nonsupervisory) vacancy rate is 5.0% and the supervisory vacancy rate is 4.0% (Figures 4 and 5). Results show that in the next 24 months, the department anticipates a retirement rate of 6.0%. Staff (nonsupervisor) members have a higher retirement rate of 6.0%, compared with that of supervisors, which is at 4.0% (Figures 6-8).

According to survey results, the rate of anticipated positions by December 2012 in histology is 4.00% (Figure 9). The percentage of positions anticipated to become open by that time is higher for staff (5.0%) than supervisors (3.0%) (Figures 11 and 12). Overall, 3.0% of positions in histology have been available for longer than 6 months (Figure 10). The rates of vacancies left open for longer than 6 months is 4.0% for staff and 2.0% for supervisors (Figures 13 and 14).

When hiring staff-level (nonsupervisor) employees in the histology department, most respondents report histotechnician (HT), histotechnologist (HTL), and qualification in immunohistochemistry (QIHC) as the preferred credential or certification. However, 57.1% of the respondents from this department indicated that certification is not a prerequisite for candidates for hire. Survey results show that 63.0% of staff and 82.0% of supervisors in the histology department are certified (Figures 15 and 16). The Central North West and South Central Atlantic regions have the highest vacancy rates (5.0% each); the lowest rates are observed in the Central South West (3.0%).

Immunology

The vacancy rate for the immunology department is 4.0% (Figure 3). The total vacancy rate for staff (nonsupervisors) is 5.0% and for supervisors is 1.0% (Figures 4 and 5). Results show that in the next 24 months, the department anticipates an overall retirement rate of 10.0%, the highest in all the departments surveyed. The staff (nonsupervisor) retirement rate is 10.0%, which is also the highest among all departments surveyed; the supervisor retirement rate is 15.0% (Figures 6-8).

The overall percentage of positions anticipated by December 2012 for immunology is 5.0%. The rate of vacant positions expected during that time for staff is 6.0%; for supervisors, the rate is 2.0% (Figures 11 and 12). The rate of vacant positions in immunology that remained open for longer than 6 months is 4.0% (Figure 10). The rates of staff and supervisor positions that remained open for 6 months are 4.0% and 3.0%, respectively (Figures 13 and 14).

The certifications of choice when hiring staff-level (nonsupervisor) employees in the immunology department are medical laboratory scientist (MLS)/medical technologist (MT) and medical laboratory technician (MLT). In this department, 68.8% of the survey participants reported that certification is a prerequisite for hire. According to survey results, 100% of staff and supervisors are certified (Figures 15 and 16). The vacancy rate for the immunology department is highest in the Far West region (8.0%) and lowest in the North East (2.0%).

Laboratory Safety

In recent years, many facilities have added 1 or more full- or part-time safety officers to administer laboratory safety programs. Specific responsibilities for this position vary by institution; however, they generally include all or a combination of the following: oversight of lab safety policies and procedures, management of employee injuries and exposures, regular safety audits, staff education, and chemical hygiene.

The vacancy rate for the laboratory safety department is 4.0% (Figure 3). The staff (nonsupervisor) vacancy rate is 4.0% and the overall supervisory vacancy rate is 2.0% (Figures 4 and 5). Survey respondents from the laboratory safety department indicated that they anticipate a 7.0% retirement rate in the next 24 months. Staff (nonsupervisors) members have a lower retirement rate of 6.0%, compared with 14.0% for supervisors (Figures 6-8).

The rate of anticipated positions by December 2012 for the laboratory safety department is 3.0%. The rate of anticipated positions during that time for staff is 4.0% and nonexistent for supervisors (0%) (Figures 11 and 12). Overall, 3.0% of positions remain open in the laboratory safety department for longer than 6 months (Figure 10). The rate of open positions that remained open for longer than 6 months is 3.0% for staff and 3.0% for supervisors (Figures 13 and 14).

Respondents from the laboratory safety department prefer medical laboratory scientist (MLS)/medical technologist (MT), and medical laboratory technician (MLT) certifications when hiring staff-level (nonsupervisor) employees. Although MLS/MT and MLT are the certifications of choice, 51.3% of the respondents from this department indicated that certification is not a prerequisite for candidates for hire. Survey results show that 79.0% of staff and 100% of supervisors are certified (Figures 15 and 16). The Far West region has the highest vacancy rate (8.0%) and the Central North East has the lowest (0%).

Microbiology

The total vacancy rate for microbiology is 5.0% (Figure 3). The staff (nonsupervisor) vacancy rate is 5.0% and the supervisor vacancy rate is 2.0% (Figures 4 and 5). Results also reveal that 9.0% of microbiology-department employees are expected to retire in the next 24 months. The staff (nonsupervisor) retirement rate is 9.0%; for supervisors, it is 10.0% (Figures 6-8).

According to the survey, the rate of anticipated positions by December 2012 in microbiology is 3.0%. The rate of positions anticipated to open during that time is lower for staff (3.0%) than for supervisors (4.0%) (Figures 11 and 12). Results also show that 3.0% of the vacant positions that remained open in the microbiology department for longer than 6 months (Figure 10). The rate of open positions that remained open for longer than 6 months is 3.0% for staff and 2.0% for supervisors (Figures 13 and 14).

When hiring staff-level (nonsupervisor) employees in the microbiology department, most respondents report medical laboratory scientist (MLS)/medical technologist (MT), medical laboratory technician (MLT), technologist in microbiology (M), or specialist in microbiology (SM) as the preferred credential or certification. Also, 68.3% of the supervisors indicated that certification is a prerequisite for candidates for hire. Survey results show that 83.0% of staff and 90.0% of supervisors in the microbiology department are certified (Figures 15 and 16). The vacancy rate is highest in the Far West and Central North East regions (5.0% each) and lowest in the Central North West (1.0%) (Table 2).

Molecular Biology/Diagnostics

The vacancy rate for the molecular biology/diagnostics department is 5.0% (Figure 3). The vacancy rate for staff (nonsupervisor) positions is 6.0%; for supervisors, 3.0% (Figures 4 and 5). Survey respondents from the molecular biology/diagnostics department indicated that they anticipate a 5.0% retirement rate in the next 24 months. Staff (nonsupervisors) members have a retirement rate of 6.0%, which is slightly higher than that of supervisors, at 4.0% (Figures 6-8).

Compared with other departments in the survey, molecular biology/diagnostics has the highest overall percentage (8.0%) of open positions anticipated by December 2012 (Figure 9). Vacancies expected during that time for staff are also the highest among all departments, at 10.0%, but very low for supervisors, at 1.0% (Figures 11 and 12). This department also has the highest rate of overall and staff vacancies that remained open for longer than 6 months, at 5.0% each. The rate of supervisory positions that remained open is 1.0% (Figures 10, 13, and 14).

Most of the respondents from the molecular biology/diagnostics department prefer to hire employees with medical laboratory scientist (MLS)/medical technologist (MT) and technologist in molecular biology (MB)/molecular pathology (MP) certifications. However, 51.7% of the respondents from this department indicated that certification is not a prerequisite for candidates for hire. Survey results show that 77.0% of staff and 80.0% of supervisors in the molecular biology/diagnostics department are certified (Figures 15 and 16). The Central South West has the highest vacancy rate, at 8.0%, and the Central North West has the lowest vacancy rate, at 3.0% (Table 2).

Phlebotomy

The vacancy rate for the phlebotomy department is 8.0% (Figure 3). This department also has the highest staff (nonsupervisor) vacancy rate, at 8.0%, of all the departments surveyed. The supervisor vacancy rate is 3.0% (Figures 4 and 5). Results show that 4.0% of employees in phlebotomy are anticipated to retire in the next 24 months. The staff (nonsupervisor) retirement rate is 3.0%; the rate for supervisors is 5.0% (Figures 6-8).

Phlebotomy, like molecular biology/diagnostics, has the highest rate of positions expected to open by December 2012, at 8.0% (Figure 9). Expected vacancies during that time for staff are also the higher among all departments, at 9.0%, but low for supervisors, at 4.0% (Figures 11 and 12). Data show that 4.0% of the overall vacant positions remain open in the phlebotomy department for longer than 6 months (Figure 10). The rate of open positions that remain open for longer than 6 months for staff is 3.0% and is 7.0% for supervisors (Figures 13 and 14).

The certifications of choice for new staff-level employees in the phlebotomy department are clinical laboratory assistant (CLA), medical laboratory technician (MLT), and phlebotomy technician (PBT). Respondents also reported hiring noncertified staff to work in the phlebotomy department. In fact, 74.0% of the survey participants indicated that certification is not a prerequisite for candidates for hire. Results show that 50.0% of staff and 85.0% of supervisors in the phlebotomy department are certified (Figures 15 and 16). The North East region has the highest vacancy rate (10.0%) and the Far West and Central North East have the lowest (5.0% each) (Table 2).

Specimen Processing

The vacancy rate for the specimen processing department is 5.0% (Figure 3). The staff (nonsupervisor) vacancy rate is 4.0%; the rate for supervisors is the highest of all the departments surveyed, at 14.0% (Figures 4 and 5). Survey results show that 5.0% of personnel in specimen processing are expected to retire in the next 24 months. The staff (nonsupervisor) retirement rate is 5.0%; for supervisors, it is 8.0% (Figures 6-8).

The overall percentage of positions anticipated by December 2012 for specimen processing is 7.0% (Figure 9). The rate of vacancies expected during that time for staff is 8.0%; for supervisors, it is 2.0% (Figures 11 and 12). Data also show that 4.0% of vacant positions remain open in the specimen processing department for longer than 6 months (Figure 10). The rate of open positions that remain open for longer than 6 months is 4.0% each for staff and supervisors (Figures 13 and 14).

Respondents from the specimen processing department prefer clinical laboratory assistant (CLA), medical laboratory scientist (MLS)/medical technologist (MT), medical laboratory technician (MLT) and phlebotomy technician (PBT) certifications when hiring staff-level employees. Noncertified staff was also hired to perform specimen processing in this department. In fact, 81.5% of the survey participants indicated that certification is not a prerequisite for candidates for hire. Survey results show that 50.0% of staff and 88.0% of supervisors in the specimen processing department are certified (Figures 15 and 16). The North East region has the highest vacancy rate (9.0%) and the Far West and South Central Atlantic have the lowest vacancy rates (5.0% each) (Table 2).

Administration

Many facilities have 1 or more full- or part-time positions devoted to laboratory administration. Although the specific responsibilities for these positions vary greatly by institution, they generally require clinical-laboratory technical expertise and are therefore staffed with trained laboratory professionals. The vacancy rate for the administration department is 6.0% (Figure 3). The vacancy rate for staff (nonsupervisors) is 5.0%; for supervisors, it is 4.0% (Figures 4 and 5). Results also reveal that 8.0% of administration-department employees are expected to retire in the next 24 months. The staff retirement rate is 6.0%; for supervisors, it is 7.0% (Figures 6-8).

According to survey results, the rate of anticipated open positions by December 2012 in the administration department is 2.0% (Figure 9). The percentage of positions anticipated to open during that time is lower for staff (1.0%) than for supervisors (4.0%) (Figures 11 and 12). The rate of administration vacancies that remain open for longer than 6 months is 3.0% (Figure 10). The rates for staff and supervisor positions that remain open for 6 months are 4.0% and 3.0%, respectively (Figures 13 and 14).

When hiring staff-level employees in the administration department, most respondents report medical laboratory scientist (MLS)/medical technologist (MT) as the preferred credential or certification. Also, 51.1% of supervisors indicated that certification is a prerequisite for candidates for hire. According to survey results, 66.0% of staff and 93.0% of supervisors are certified (Figures 15 and 16). The vacancy rate is highest in the North East region (8.0%) and lowest in the Central North West (1.0%) (Table 2).

The Current Laboratory Workforce

Compared with those of ASCP's 2010 Vacancy survey, this year's results reveal decreased overall vacancy rates for the blood bank and the cytology, hematology/coagulation, histology, immunology, and microbiology departments. Data also show a slight decrease in staff (nonsupervisor) and supervisor vacancy rates by department except for the cytology department, whose staff vacancy rate has doubled since 2010. Overall, the rate of certified laboratory professionals is higher this year. Hematology/coagulation and histology departments reported a slight decrease in the rate of certified staff; the number of certified staff and supervisors decreased this year for microbiology compared with the most recent Vacancy Survey.

This year, the Vacancy Survey asked about the total positions anticipated to open in the next 24 months due to the retirement of personnel. Results show that the projected retirement rate for supervisors is higher than that for staff (Figures 7 and 8). In comparing the anticipated rate of vacancies by December 2012 among all the departments surveyed, staff rates are generally higher than supervisory rates (Figures 11 and 12). The rate of staff positions that take longer to fill (ie, those that remain open for longer than 6 months) is highest for the molecular biology/diagnostics department and the rate for the corresponding supervisor positions is highest for blood banks. The cytology department has the lowest rate of positions that remain open for longer than 6 months.

The 2010 ASCP Vacancy Survey report showed that overall, the most difficult work shift to fill was the night shift. In addition to challenges in staffing the night shift, the previous report had also pointed out that the immunology and phlebotomy departments also had difficulties in hiring for the day shift. This year's survey results, however, reveal that overall, laboratory departments are not experiencing difficulties in hiring staff for any work-shift. At the staff level, most laboratories filled most positions within 3 months of posting (Figure 17). Supervisor positions were usually filled within 3 to 6 months after posting (Figure 18).

Figure 17

Time to fill empty staff positions.

Figure 18

Time to fill empty supervisory positions.

The rise of new technologies in the field of laboratory medicine prompted ASCP to ask whether this has affected staffing in laboratories. Approximately 72.8% of participants indicated that new technologies have not caused changes to their staffing needs. Those who are affected by new laboratory technologies, however, reported that although new technologies potentially decreased the need for as large a staff, the number of tests and the workload have increased. Some of the new technologies mentioned were molecular testing, automation, flow cytometry, genetic testing, and immunohistochemistry (IHC).

Summary

This year, the ASCP Vacancy Survey included information on 7 new departments (administration, core laboratory, laboratory safety, molecular biology/diagnostics, reproductive medicine and genetics, and tissue typing/histocompatibility) in addition to the 10 laboratory areas surveyed in 2010. Vacancy rates are at least 2% lower for staff (nonsupervisor) and supervisor positions this year, compared with 2 years ago. The economy, the aging workforce, innovations in science and technology, and laboratory program closures appear to be contributing factors in the current status of the laboratory workforce.

The current state of the economy poses a challenge in the clinical laboratory field. The ease in staffing observed regardless of work shift suggests that laboratorians are accepting shifts that used to be difficult to fill to provide additional income or that facilities are asking their employees to work additional shifts to cut costs.

Higher retirement rates for supervisors compared with staff suggest that managers tend to be older compared with the staff they oversee. Further, the current Vacancy Survey results indicate that there is a higher rate of anticipated vacancies by December 2012 for staff compared with supervisors. The assumption has been that retirement among Baby Boomers will lead to an increase in vacancies for younger workers; however, this has not happened yet due to variations in the labor market. A report published by the Robert Wood Johnson Foundation1 stated that the economic downturn has “created pressure on healthcare professionals to revise their career and retirement plans.” Even with a current unemployment rate of 7.7% as of November 2012,2 the lowest it has been since 2009, it appears that many laboratory professionals nearing retirement age now tend to stay longer in their employed positions due to economic uncertainties.3

The growing demand for medical care due to an aging population is driving the fast-paced advances in medical technology and the explosion of higher laboratory test volume (data results show that the highest percentage of laboratories across the nation have an annual testing volume of 100,001 to 1 million tests) (Figure 19). Although these factors may redefine the workforce skills necessary to meet the demands of the laboratory of tomorrow, they have not reduced the need for qualified laboratory professionals. Many of this year's survey respondents indicated that program closures and limited programs available in colleges and universities have led to difficulty in finding qualified laboratorians.

Figure 19

Overall annual laboratory testing volume.

Lack of laboratory expertise in new graduates, lack of recognition for health professionals in the field of allied health, and inferior monetary compensation compared with other health care professions appear to be contributing factors in the current shortage of well-trained and qualified laboratory personnel. Planning a systematic strategy to address these issues is needed to ensure that the profession can achieve increased visibility and yield opportunities for advancement in the future.

Contributors

Andrea Bennett, MPH, MT(ASCP)—ASCP Institute of Science, Technology, & Policy, Washington, DC

Matthew Schulze—ASCP Institute of Science, Technology, & Policy, Washington, DC

Patricia Tanabe, MPA, MLS(ASCP)CM—ASCP Board of Certification, Chicago, IL

Reviewers

Mark Bailey, MA, HTL(ASCP)CM—The University of Texas MD Anderson Cancer Center, Houston

Barbara Caldwell, MS, MT(ASCP)SH—Clinical Laborator Services, MedStar Montgomery Medical Center, Olney, MD

JoAnne Edwards, MEd, M(ASCP), MLS(ASCP)CM—Consultant, Joint Commission

Phyllis Walker, MS, MT(ASCP) SBB, Consultant

James Wisecarver, MD, PhD, FASCP—Clinical Labor tory and Molecular Diagnostics, Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha

Sue Zaleski, MA, SCT(ASCP)HT— Department of Pathology, University of Iowa, Iowa City

Abbreviations

ASCP
American Society for Clinical Pathology
CMP
Certificate Maintenance Program
NCA
National Credentialing Agency
CME
continuing medical education
ASCLS
American Society for Clinical Laboratory Science
AACC
American Association for Clinical Chemistry
AMT
American Medical Technologists
ASC
American Society of Cytopathology
ASCT
American Society for Cytotechnology
ASM
American Society for Microbiology
CLMA
Clinical Laboratory Management Association
ARUP
Associated Regional and University Pathologists
LabCorp
Laboratory Corporation of America
SEIU
Service Employees International Union
AP
anatomic pathology
CT
cytotechnologist
HT
histotechnician
HTL
histotechnologist
PA
pathologist assistant
BB
technologist in blood banking
MLS
medical laboratory scientist
MT
medical technologist
MLT
medical laboratory technician
SBB
specialist in blood banking
CG
technologist in cytogenetics
SCT
specialist in cytotechnology
QIHC
qualification in immunohistochemistry
M
technologist in microbiology
SM
specialist in microbiology
MB
technologist in molecular biology
MP
molecular pathology
CLA
clinical laboratory assistant
PBT
phlebotomy technician
IHC
immunohistochemistry

References

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