UCSF MLT Report 2017 - Healthforce Center At UCSF
Research ReportThe State of theCalifornia MedicalLaboratory TechnicianWorkforceby Kristine A. Himmerick, Ginachukwu Amahand Susan Chapman, Healthforce Center atUCSFJanuary 2017Abstract / OverviewCalifornia faces laboratory workforce shortagesto meet the healthcare demands of thepopulation. This national study compares theCalifornia MLT workforce to the rest of thecountry. The California MLT supply is scarceand the scope of practice laws are morerestrictive than any other state. Laboratorypersonnel in other states that regulate MLTsgenerally support MLTs practicing to theirhighest level of training. 2017 Healthforce Center at UCSFContentsKey Findings2Background2Methods3Supply of Licensed MLTs4Scope of 6Acknowledgements23
The State of the California Medical Laboratory Technician WorkforceKey Findings California has a scarce MLT supply relative to thesize of the population. California has the most restrictive scope of practiceand supervision laws regulating MLTs compared toall other states. Laboratory directors in other states that regulateMLTs generally perceived MLTs as beneficial toproductivity and quality. Some concerns were raised about MLTs decisionmaking and troubleshooting abilities, and thevariability in individual MLT skills and knowledgebase.2California has historically employed far fewer clinicallaboratory workers per population compared to otherstates.6 Medical Laboratory Technicians (MLTs)became a licensed occupation in California in 2007after a long period of development of trainingcurriculum and regulations for practice.7 ClinicalLaboratory Scientists (CLSs) are Bachelor Degreetrained while MLTs are Associate Degree trainedlaboratory professionals. In California, thecomplexity of a test determines which level oflaboratory personnel can perform the test and underwhat level of supervision (Appendix 1). A surveyconducted by the California Hospital Association’sHealthcare Laboratory Workforce Initiative (HLWI) in2007 showed that 63% of hospitals plan to use MLTsto address projected shortages in the CLSworkforce.8BackgroundShortages in the healthcare workforce are wellknown in the fields of primary care, behavioralhealth, long-term care, and oral health. Workforceshortages of clinical laboratory professionals may beless well known because they are often less visibleto the public. However, clinical laboratoryprofessionals are critical to health care delivery andefficiency. Overall laboratory workforce vacancyrates have increased in nearly all specialty areas ofthe clinical laboratory and anticipated retirementrates are higher than two years ago.1 Laboratoryworkforce shortages are attributable to similar forcesas in other health workforce occupations, namely anaging population, a growing chronic disease burden,and an increasing number of newly insured patientsunder the Patient Protection and Affordable Care Act(ACA).2-4 To address healthcare workforceshortages, the National Adacemy of Medicinerecommends broadening the duties andresponsibilities of health workers at various levels oftraining.5 2017 Healthforce Center at UCSFA 2014 study of MLT utilization in California revealedchallenges to increasing the use of MLTs includingopposition by incumbent workers and administration,state legislative limitations to MLT scope of practice,limited number of MLT training programs, limitedclinical internship positions, and scarcity of MLT jobopenings.9 Drivers that facilitated the integration ofMLTs included an aging and shrinking CLSworkforce, increasing automation of laboratorytesting, and the expected cost benefits of hiring moreMLTs.9Expanding the scope of practice for MLTs inCalifornia may provide one solution to alleviatingCalifornia’s ongoing shortage of clinical laboratorypersonnel. The HWLI identified three possible areasfor expanding the MLT scope of practice inCalifornia: microscopic blood smear reviews(morphology and manual white blood celldifferential), microscopic urinalysis, andimmunohematologic blood typing (moderatelycomplex ABO/Rh testing). These tests wereselected by the HLWI committee after thoughtful
The State of the California Medical Laboratory Technician Workforcedeliberation for three reasons: they are high volumetests that would have a measurable impact onlaboratory efficiency and the current workforceshortage, they are categorized as moderatelycomplex under CLIA, and they are performed usinginstrumentation that is also categorized asmoderately complex.We conducted a national study of MLTs to betterunderstand national variability in supply; scope ofpractice; and impact. The study aims to:1. Describe state-level differences in the supplyof MLTs in California compared to otherstates that also regulate MLTs.2. Compare the scope of practice lawsregulating MLTs in California with other statesthat also regulate MLTs.3. Understand how the use of MLTs, particularlywith regard to the three areas identified apriori by the HLWI, might impact quality,safety, and productivity.MethodsTo address the first study objective, we examinedpublicly available national data to determine thesupply of MLTs in each of the 50 states andWashington DC. The Bureau of Labor Statistics(BLS) Occupational Employment Statistics (OES)produces national workforce estimates that are theindustry standard for comparing the US workforceacross states and occupations.10 Analysis of thesedate revealed that MLT counts in both regulated andunregulated states were drastically inflated due tothe inclusion of laboratory personnel that do notmeet the criteria for a licensed MLT. In the absenceof crediblenational data on only MLTs, we contactedindividual state licensing boards for the twelveregulated states to request data on the number oflicensed MLTs. Two thirds of regulated statesresponded to the request for information (8 of 12). 2017 Healthforce Center at UCSF3To quantify growth in the MLT supply, we obtaineddata from 2011-2015 from the American Society ofClinical Pathology (ASCP), which tracks certifiedMLTs by their mailing address. These data allowedus to describe state-level differences in the supply ofnew entrants into the MLT workforce.11 Cautionmust be exercised in interpreting these data becausemailing addresses may not represent theemployment location, certified MLTs may not beemployed as MLTs, and some states allowemployment of non-certified MLTs. Finally weassessed publicly available data from the NationalAccrediting Agency for Clinical Laboratory Sciencesto identify state-level differences in the number ofMLT education programs.12 To our knowledge, noother data sources exist to describe the number ofMLTs by state.To address the second objective, we searched statesponsored websites to obtain primary sourcedocuments of MLT legislation for the twelve statesthat license and regulate MLTs. Unregulated statesdefault to national regulations. The Centers forMedicare & Medicaid Services (CMS) regulates alllaboratory testing and personnel in the U.S. throughthe Clinical Laboratory Improvement Amendments(CLIA) of 1988.13,14 State regulations can be morerestrictive than the federal CLIA laws, but not less.We then analyzed the content of the legislation foreach state and developed a matrix to capture thediscrete components of the scope of practice laws.Specifically, we documented legislation pertaining toeducation requirements, licensing requirements,supervision requirements, and scope of practiceelements. We were interested in the level of CLIAcomplexity permitted and the three areas identified apriori by the HLWI: blood smear reviews, urinalysis,and blood typing. The matrix served as a basis foranalyzing state-level differences in the scope of workperformed by MLTs in California versus other states.
The State of the California Medical Laboratory Technician WorkforceTo address the third study objective, we conductedsemi-structured interviews with Clinical LaboratoryScientists, Medical Laboratory Technicians, anddirectors of laboratory services at laboratorieslocated in states that license and regulate MLTs.HLWI members, ASCP staff, and intervieweesassisted the research team in identifying potentialinterviewees. We contacted 42 potentialinterviewees via email and/or telephone: 15responded, and 10 agreed to be interviewed. Weconducted semi-structured interviews based on aninterview guide developed by the research team(Appendix 3). Thematic analysis of interviewtranscripts was conducted by a minimum of tworesearch team members and three when interreviewer agreement was not aligned.Supply of Licensed MLTsFor the purpose of this study we differentiateregulated states that license and regulate thepractice of MLTs at the state level, and unregulatedstates that do not have licensure requirements orlegislation to dictate MLT practice. As of 2016 themajority of states do not regulate MLT practice. Thetwelve states that regulated MLTs are Florida,Georgia, Hawaii, Louisiana, Montana, Nevada, NewYork, North Dakota, Rhode Island, Tennessee, andWest Virginia. Tennessee has more licensed MLTsthan any other regulated state with over 6,000.California ranks fifth with ten times fewer thanTennessee (Figure 1).4Figure 1: Number of LicensedMLTs in Regualted States, 2016Tennessee6,153New York1,869Florida1,382West Virginia726California640HawaiiNorth DakotaMontana434296122Data Source: Individual State Licensing Boards, Proprietarydata on number of licensed MLTs as of December 2016. Dataunavailable for Georgia, Nevada, Rhode Island, & Louisiana.Figure 2: Licensed MLTs perCapita* in Regulated States, 2016Tennessee93West Virginia39North Dakota39Hawaii30Montana12New YorkCalifornia is the most populous state with over 39million people.15 When we compare the number oflicensed MLTs relative to the size of the populationof each regulated state, California drops to last placewith 2 licensed MLTs per 100,000 people (Figure 2).The scarcity of MLTs relative to the populationrepresents an opportunity to expand the MLTworkforce to serve Californians. 2017 Healthforce Center at UCSF9FloridaCalifornia72* Per 100,000 populationData Source: Individual State Licensing Boards, Proprietarydata on number of licensed MLTs as of December 2016. Dataunavailable for Georgia, Nevada, Rhode Island, & Louisiana.
The State of the California Medical Laboratory Technician WorkforceMLT certification data from ASCP reveal that thenumber of newly certified MLTs increased every yearfrom 2011 to 2014. Slightly fewer new MLTs werecertified in 2015 compared to the previous fouryears. We further examined growth in the MLToccupation in regulated versus unregulated states.The rate of growth was similar in regulated andunregulated states at 55% and 53%, respectively(Figure 3).Number of Newly Certified MLTsFigure 3: National Growth inNewly Certified MLTs, 2011-20153,000Unregualted 20122013201420151,9611,0000Data Source: American Society for Clinical Pathology.Proprietary data on newly certified MLTs from 2011-2015.Includes 50 states and Washington, D.C. 2017 Healthforce Center at UCSFThe rate of growth of newly certified MLTs inCalifornia is 66% per year from 2011-2015, a fasterrate of growth than the national rate of 54% over thesame time period. In 2011, sixty new MLTs werecertified in California. The number increased everyyear through 2014 to a peak of 127 newly certifiedMLTs with a slight drop to 106 in 2015 (Figure 4).Figure 4: Growth in NewlyCertified MLTs in California, 20112015# of Newly Certified MLTsTo further describe growth in the supply of MLTs, weexamined data on newly certified MLTs across thecountry in the last five years. Certified MLTs havedemonstrated competency through a series ofqualifications and examinations administered by anational organization such as the American Societyfor Clinical Pathology (ASCP), and non-certifiedMLTs that may be working under the title MLTwithout completing the requirements to be nationallycertified. Not all states require national certificationto practice as an MLT, which adds complexity to thetask of counting and comparing MLTs by state.512710692726020112012201320142015Data Source: American Society for Clinical Pathology.Proprietary data on newly certified MLTs from 2011-2015.While the rate of growth is promising, the totalnumber of new MLTs per year is small. One reasonfor the relatively low number of newly certified MLTsin California may be the narrow educational pipeline.California has four accredited MLT training programsto supply MLTs for the entire state.12 Furtherinvestigation is needed to determine the percentageof California MLTs that train within California.On average, newly certified MLTs in California earna higher wage, are younger, and less likely to befemale compared to the national average (Figures5a-c, Appendix 2a & 2c). The incoming MLT
The State of the California Medical Laboratory Technician Workforceworkforce is young relative to the CLS workforce andless prone to attrition due to retirement.6Scope of PracticeWashington DC and 38 states do not license orregulate MLTs, and those states default to federalCLIA regulations. California and eleven other statesregulate MLT practice at the state level. In Figure 7and Figure 8, the test complexity and supervisionlaws are compared by state. States that do notregulate MLTs are represented by the entry “CLIA”.State regulations can be more restrictive than thefederal CLIA laws, but not less.Figure 5a: Mean Wage 24 22 20 18CaliforniaRegulated Unregulated All StatesStatesStatesFigure 5b: Mean Age34323028CaliforniaRegulated UnregulatedStatesStatesFigure 5c: GenderAll StatesMaleFemale100%50%0%CaliforniaRegulated Unregulated All StatesStatesStatesData Source: American Society for Clinical Pathology.Proprietary data on newly certified MLTs from 2011-2015. 2017 Healthforce Center at UCSFTest ComplexityLaboratory tests are classified by CLIA as simple(CLIA-waived), moderate complexity, highcomplexity, and not classified. CLIA permits MLTs toperform all simple and moderate complexity testing.(§ 493.1421 & §493.1423)14 CLIA permits MLTs toperform high complexity testing after conducting atleast 3 months of documented laboratory training ineach specialty in which the individual performs highcomplexity testing. (§ 493.1489)14 Among all states,regulated and unregulated, California has the mostrestrictive scope of practice (Figure 6). MLTs inCalifornia are permitted to perform all simple tests(CLIA waived). Moderate complexity testing islimited to the specialties of chemistry, hematology,immunology, and microbiology. However, MLTs inCalifornia are prohibited from performing moderatecomplexity tests in the specialties of microscopy andimmunohematology. High complexity testing is alsoprohibited for MLTs in California. All other statespermit MLTs to perform moderate and highcomplexity testing. Some states that regulate MLTslimit MLTs from performing tests with results thatrequire interpreting or include supervision provisionson moderate and high complexity tests.
The State of the California Medical Laboratory Technician WorkforceSupervisionCLIA does not specify supervision ratios, allowsMLTs to conduct moderate complexity testingwithout supervision, and requires on-site supervisionfor MLTs conducting high complexity testing. (§493.1425 & §493.1495)14 California law has themost restrictive supervision requirements of allstates, regulated and unregulated (Figure 7).California restricts MLTs to performing only simpletests without supervision. All other states allowMLTs to perform at least some moderate complexitytesting without supervision. California restricts MLTswith on-site supervision to moderate complexitytesting in the specialties of chemistry, hematology,immunology, and microbiology. California is the onlystate to specify a supervision ratio, limiting eachsupervisor to a maximum of four MLTs. WestVirginia law explicitly states that no supervision ratioexists for MLTs; all other states do not specify a ratioin the state law.Less restrictive state laws require that the degree ofMLT supervision be determined by the supervisorbased on the complexity of the procedure to beperformed, the training and capability of the MLT, 2017 Healthforce Center at UCSF7and the demonstrated competence of the technicianin the procedure being performed. This type of law,similar to the federal law, places control of MLTpractice at the practice level rather than the statelevel.Specific Tests of Interest to HLWIUnder California law, MLTs are explicitly prohibitedfrom performing moderate complexity microscopyand immunohematology. This provision restrictsMLTs from performing microscopic blood smearreviews, microscopic urinalysis, andimmunohematologic blood typing (ABO/Rh testing);these are the three tests that the HLWI has identifiedas potential scope of practice expansionopportunities for California MLTs. Our analysis ofstate regulations revealed that two states, Nevadaand North Dakota, explicitly permit MLTs to performmicroscopic urinalysis testing. Only Georgiaexplicitly permits blood typing. No states explicitlypermit blood smear reviews. The three tests werenot specified for MLT practice in the remaining statesthat regulate MLT practice or in CLIA regulations.
The State of the California Medical Laboratory Technician Workforce8Figure 6: Comparison of MLT Scope of Practice Regulations by State, ayesyes, prohibits microscopyor immunohematologynonononoFloridayesyesyes, with trainingyesyesyesGeorgiayesyesyes, with trainingyesyesyesHawaiiyesyesyes, prohibits if theresults need interpretingyesyesyesLouisianayesyesyes, with supervisionyesyesyesMontanayesyesyes, with trainingyesyesyesNevadayesyes prohibits if the resultsneed interpretingyes, prohibits if theresults need interpretingyesyesyesNew Yorkyesyesyes, with trainingyesyesyesNorth Dakotayesyesyes, with trainingyesyesyesRhode Islandyesyesyes, with trainingyesyesyesTennesseeyesyesyes, with trainingyesyesyesWest Virginiayesyesyes, with trainingyesyesyesUnregulatedStates(CLIA)yesyesyes, with trainingyesyesyesStateData Sources: Individual State websites, see References for details. Unregulated states default to federal CLIA regulation 2017 Healthforce Center at UCSF
The State of the California Medical Laboratory Technician Workforce9Figure 7: Comparison MLT Supervision Regulations by StateSupervision RatioMaximum test levelwithout supervisionMaximum test level withsupervisionOn site supervisionrequired?California4:1simplemoderate complexity testing inchemistry, hematology,immunology and microbiologyyes for all moderatecomplexity variedvariedHawaiinonehigh, if no interpretationand no interventionneededhighyes for onevariedvariedvariedNevadanonehigh, if no interpretationand no interventionneededhighyes for highcomplexityNew Yorknonemoderatehighyes for es for highcomplexityWestVirginianonemoderatehighyes for ighyes for highcomplexityStateData Sources: Individual State websites, see References for details. Unregulated states default to federal CLIA regulations 2017 Healthforce Center at UCSF
The State of the California Medical Laboratory Technician WorkforceImpactFor the final objective of the study, we interviewedlaboratory personnel located in states that regulateMLTs to better understand the use of MLTs. Weconducted interviews with laboratory personnel, mostof whom were physicians or PhDs, directing largeacademic medical center laboratories conductingmillions of laboratory tests per year. We also soughtout a few smaller hospitals, reference laboratories,an HMO, and a representative from the Departmentof Defense (DOD) medical operations to providedifferent perspectives on the impact of MLTs in thelaboratory. On average, MLTs comprised 20% of thelaboratory staff in the laboratories represented in oursample. The DOD and the reference laboratoriesemployed the highest percentage of MLTs in oursample at 30% and 60%, respectively. Severalinterviewees noted that they had experienced ahigher percentage of MLTs employed in theirlaboratories prior to licensing and regulation of MLTsin their states. This finding indicates that state-levellicensing and regulation may present a barrier to theemployment of MLTs.10microscopic urinalysis, blood smear reviews, andblood typing, the three tests of interest to the HLWI.Respondents were nearly unanimous in support oftraining MLTs and allowing them to performmicroscopic urinalysis testing. Microscopic urinalysisis “not so complex. It is fairly easy to train someoneto do urinalysis slide reviews.”Blood Smear ReviewsSupport was less strong for allowing MLTs toperform blood smear reviews. “Blood smear reviewis a sophisticated test that requires a technologist(CLS). In tertiary hospitals, lymphoma and otherunusual results are common and misclassifiedresults are egregious errors. Possibly a techniciancertificate and special training could be workable.”Another noted, “Even with CLSs, blood smearreviews can be problematic to interpret. It is acomplicated skill.” Another respondent thought thatMLTs would be capable of blood smear reviews withon-the-job training and recommended limiting earlycell identification along with thorough training andcompetency testing.Blood TypingCalifornia MLT lawsThe vast majority of interviewees opined that currentCalifornia MLT laws are too restrictive. Oneinterviewee remarked “California law is too narrow.[It] does not recognize MLT training by limitingcomplexity. According to CLIA, a high schoolgraduate can do moderately complex tests withtraining and competency testing.” Anotherinterviewee observed “Restrictive laws create asituation where the letter of the law is followed, butthe MLT is capable enough to actually have apositive impact on the productivity of the lab.”Microscopic UrinalysisWe asked laboratory personnel specifically aboutexpanding the scope of practice for MLTs to perform 2017 Healthforce Center at UCSFResponses were much less robust for allowing MLTsto perform blood typing. Most interviewees said thatMLTs do not conduct blood bank work in theirfacilities, even in states where it is legally permitted.“I have some reservation for MLTs to work in bloodbank due to high consequences of error. Manytechs don't even like to work in blood bank.” Anothersaid, “MLTs may not be qualified to do early cellidentification in blood smear reviews and advancedblood bank work ups like antibody workups, but theyare fine for ABO/Rh testing and cross matching.”
The State of the California Medical Laboratory Technician WorkforceProductivityMost interviewees noted that well-trained MLTs inthe right setting provide a good benefit toproductivity. One strong proponent of MLTsremarked, “If I could find more MLTs to hire, I wouldbe happy to use them.” Some laboratory directorsfelt “boxed in” by state practice laws that limit theirability to optimally use their staff. One intervieweenoted that “Overall, MLTs are less productive thanCLSs due to the scope of what they can do: training,experience, and regulations.” Another director notedconcern about potential pending legal changes in hisstate, which may decrease the scope of practice forMLTs, deterring him from hiring MLTs even thoughthey are a great benefit to productivity. Oneinterviewee divulged, “My hospital no longer hiresMLTs because they must be supervised to releaseresults and cannot operate independently. It’s justnot cost-effective to have employees that can’t workindependently.”Decision-Making SkillsWhen we asked about the quality of work performedby MLTs, a common theme that emerged was thedifference between CLS and MLT problem solving,decision-making, and troubleshooting. Manyinterviewees acknowledged that MLTs often needsupport to solve problems. “Lab testing is complex;many pre-analytic, analytic, and post-analyticproblems can arise. You need to be able torecognize and solve problems.” However, individualvariability likely exists. One interviewee noted,“Some CLSs have the degree to work withoutsupervision or conduct high complexity tests, butmay not be cognizant or capable.” The difference indecision-making skills may be due to the broaderknowledge base and more experience obtained byCLSs in the lengthier CLS education process. Alaboratory director mentioned, “When everything isworking smoothly, our quality control testing showsMLTs function just as well as CLSs. Troubleshooting 2017 Healthforce Center at UCSF11and decision making is where MLTs don't have theexpertise of CLSs due to training and knowledge.”AutomationMany respondents also pointed to the increasing rolefor MLTs with the increasing automation oflaboratory tests, which have quality assurance builtinto the machines. “MLTs are becoming increasinglymore productive in our laboratory as more testsbecome automated.”AccuracySeveral interviewees noted that properly trainedMLTs are as capable as CLSs. “It has a lot to dowith individual training and skill of [the] individual.”“We feel confident in their skills once they havecompleted our in-house vetting process.”Understanding the impact of MLTs on laboratorysafety is an important question in the debate aboutexpanding scope of practice. Do MLTs make moreerrors than CLSs? No one in our study was willing tocomment specifically on accuracy rates betweenMLTs and CLSs. Future studies are needed toexamine the relationship between employing ahigher proportion of MLTs and accuracy of testresults as measured by proficiency tests, similar toprevious studies comparing certified versusnoncertified CLSs.16,17Challenges and Facilitators to MLT HiringInterviewees identified several challenges associatedwith hiring MLTs, including lack of availableworkforce in the region, tension between CLSs andMLTs, variability in quality of individual MLTs,limitations to scope of practice by state laws, timeintensive supervision requirements, increasinglaboratory test volume, increasing laboratory testcomplexity, and fear of errors by a lesser trainedworkforce. Interviewees also identified facilitatorsthat have supported more MLT hiring, including
The State of the California Medical Laboratory Technician Workforceincreasing automation of laboratory tests that mayincrease the future role for MLTs, hospitals trainingor partnering with local schools to offer externships,training and competency testing in-house, expandingopportunities for MLTs in reference labs, andregulating the scope of practice at the practice level.Practice-Level versus State-LevelRegulationA common theme was a frustration with state levellimitations that prohibit laboratory directors frommaking practice level decisions about “who can dowhat” in the lab. “Labs are variable, the needs of thecommunity and the hospital are variable, and theavailable workforce is variable; I need to use everyperson maximally to keep up with the massivehospital laboratory test workload.” Anotherinterviewee echoed these sentiments, stating that“Training and competency testing at the practicelevel is ultimately safer than trying to regulatepractice at the state level.”ConclusionLicensed MLTs were recently introduced intoCalifornia to alleviate laboratory workforceshortages. Increasing the number of MLTsemployed as well as broadening the duties andresponsibilities of MLTs are two strategies toaddress the ongoing laboratory workforce shortagesin California. Our study reveals that California’s MLTpractice laws are the most restrictive in the country.The numbers of new MLTs entering the Californiaworkforce over the last five years are increasing,although the growth is small relative to thepopulation. Laboratory personnel in other states thatregulate MLTs generally support MLTs performingmoderately complex testing with adequate training,competency testing, and supervision. Given thesefindings and the laboratory workforce shortages thatpersist in California, it may be time to expand the 2017 Healthforce Center at UCSF12MLT education pipeline and reexamine the scope ofpractice laws that govern MLT practice in California.
The State of the California Medical Laboratory Technician Workforce13References1.2.3.4.5.6.7.8.Garcia E, Ali AM, Soles RM, Lewis DG. TheAmerican Society for Clinical Pathology's2014 vacancy survey of medical laboratoriesin the United States. Am J Clin Pathol.2015;144(3):432-443.111th Congress Public Law 148. The patientprotection and affordable care act. Stat.2010;119.Bodenheimer TS, Smith MD. Primary care:proposed solutions to the physician shortagewithout training more physicians. Health Aff(Millwood). 2013;32(11):1881-1886.Rosenblatt RA, Andrilla CH, Curtin T, HartLG. Shortages of medical personnel atcommunity health centers: implications forplanned expansion. JAMA.2006;295(9):1042-1049.Institue of Medicine of the NationalAdacemies. Retooling for an Aging America:Building the Health Care Workforce. 2008;https://www.ncbi.nlm.nih.gov/pubmed/25009893. Accessed October 2016.Chapman S, Lindler V. The ClinicalLaboratory Workforce in California. .ucsf.edu/files/publication-pdf/6. 200306 The Clinical Laboratory Workforce in California.pdf. Accessed October 2016.Centers of Excellence California CommunityColleges. Environmental Scan: MedicalLaboratory Technician: Bay Area 2009. 2009;http://www.coeccc.net/Environmental Scans/mlt scan sf-gsv 09.pdf. Accessed October2016.California Hospital Association: HealthcareLaboratory Workforce Initiative. California’sOther Healthcare Crisis: The ClinicalLaboratory Workforce Shortage. ileattachments/final laboratory workforce short
UCSF January 2017 Abstract / Overview California faces laboratory workforce shortages to meet the healthcare demands of the . shortages of clinical laboratory professionals may be less well known because they are often less visible to
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development that combines one-on-one coaching, knowing the bar of excellence for specific industries and roles, and real-world engagement with a network of one’s peers. While the data gathered found that MLT Fellows’ salary growth was slower than the control group, the non-MLT Fellows control group were hired at a lower starting
office labs. At career entry, the MLT will be able to perform routine clinical laboratory tests done in all major areas of the laboratory. Graduates will have gained basic laboratory skills required for entry-level positions in current and other emerging laboratory fields, such as molecular diagnostics. The responsibilities of the MLT include:
image as a guide. Fill in a few petals using satin stitch, and add . The secret is to hold the working thread taut while you pull it through. Come up at point 1, then wrap the thread around the needle twice. Holding the working thread with your non-dominant hand, bring the needle down at point 2 (close to point 1, but not the same hole) and pull slowly until the knot is formed. 01 01 01 .
