Even as the need for qualified clinical laboratory scientists and clinical chemists in traditional jobs remains strong, innovations in information technology, care delivery, and automation are opening new career paths in laboratory medicine beyond the old categories. According to the Bureau of Labor Statistics, the job outlook for medical laboratory scientists and technicians is solid, with the field expected to grow 13% between 2016 and 2026, faster than the average for all occupations. The government attributes this growth in part to the aging population, leading to additional diagnostic testing.

A recent survey by the American Society for Clinical Pathology (ASCP), meanwhile, found that while lab personnel vacancy rates have decreased in recent years, this decline is due, in part, to managers being forced to hire less qualified individuals to fill open positions because the pool of more qualified applicants is small.

“Data from this survey strongly suggest the crucial need in the supply of qualified and certified laboratory personnel,” notes a report in the May 2018 issue of the American Journal of Clinical Pathology. “The uptick in the rate of noncertified individuals performing low- to high-complexity tests, high retention rates, high retirement rates, and increased rate of staff taking on more responsibilities support this need. For supervisors in rural areas and small community hospitals, vacancies have been open for many months, leaving their laboratories with heavier workloads.”

As one’s level of education rises, a career in lab medicine can be personally fulfilling and financially lucrative, a conclusion backed up by results of a recent salary survey by AACC’s Society of Young Clinical Laboratorians (SYCL), noted Joe El-Khoury, PhD, DABCC, FADLM, co-director of the clinical chemistry laboratory and fellowship program at Yale-New Haven Health and an assistant professor of laboratory medicine at Yale University in New Haven, Connecticut. Of the almost 200 respondents, the clear majority held doctoral degrees and were certified by the American Board of Clinical Chemistry as clinical chemists.

Respondents were almost evenly split between males and females and represented academic medical centers, community hospital labs, commercial reference labs, in vitro diagnostics (IVD) manufacturers, and government labs. They reported salaries ranging from $100,000 to $251,000, with most entry-level positions earning between $116,000 and $146,000. A few were as high as $205,000 in the states with the highest cost of living.

Not surprisingly, SYCL survey respondents with the most experience and working in the most expensive states tended to receive the greatest compensation. Two-thirds of respondents in the United States reported that they were either very or somewhat satisfied with their compensation. Clinical chemists often serve as lab directors, lab section heads, or directors of medical affairs for IVD manufacturers

“I think this survey shows that this is an attractive field to be in,” El-Khoury said. “Whether some-one is a clinical chemist or a technologist, there are opportunities in labs. I don’t think automation will eliminate the need for technologists, but their role is changing from performing highly repetitive functions like loading samples on an analyzer to being involved with troubleshooting, process improvement, and building rules and quality metrics. By freeing up their time to focus on more advanced informatics-type issues, we are able to offer technologists a more attractive and creative role.”

Beyond the Bench

For some clinical laboratory scientists, the next step in their career path might not involve benchwork at all. Andrew Brammeier, MT(ASCP), who has more than 10 years of experience working in hospital labs and in point-of-care testing, transitioned from performing benchwork at UW Northwest Hospital and Medical Center in Seattle to maintaining lab software and analyzers at the hospital to working for SCC Soft Computer, a lab software firm. “Being on the bench got very routine, very rote,” said Brammeier. “I didn’t see a lot of advancement opportunities at the time. I did lab IT [information technology] at the hospital for two to three years before joining the software company.” 

As laboratory automation increases, there will be a greater need for laboratorians who can support IT and lab information systems, Brammeier said. He pointed out that in countries such as Japan where lab systems are more highly automated, technologists already have more responsibility for IT and analyzer repairs. “We don’t see quite as much automation in the U.S., but we’ll get there when it becomes more cost- effective,” he said.

Laboratorians interested in getting involved in lab IT should start by volunteering with their organization’s validation team and taking more of an interest in how lab software works, Brammeier com-mented. “Some of it is curiosity . . . looking behind the curtains, asking questions.”

Individuals who work in lab IT might start on the bench and transition to IT, or they might start as programmers and learn the lab business as they go along. Both tracks are viable options, Brammeier noted. “It really depends on what role you want, such as an analyst or IT support,” he added.

While there is not a specific degree in lab information technology, AACC offers online certificate programs in laboratory information systems and other areas. Individuals interested in pursuing this career path could also follow Brammeier’s example: He received an associate degree in lab science and a bachelor’s in business management.

It’s also clear that as some employees seek opportunities outside the lab, others are forging non-traditional paths into it. For example, Steve Ceulemans, ScD, parlayed training in life sciences and business into a role as laboratory director for North Oaks Medical Center in New Orleans. After receiving advanced degrees in molecular biology, public health, and business, Ceulemans began working at a pharmaceutical company. He quickly picked up on the commonalities between drug discovery and clinical laboratories and transitioned from pharma to lab.

“The lines between different disciplines in life sciences are becoming more fluid,” he explained. “Many molecular technologies historically predominantly found in research labs have become common in the clinical laboratory setting, and the silos are shrinking. People can more easily move from one type of job to another because of significant technology overlap.”

With training in health outcomes and public health, Ceulemans' focus includes value-driven care, as well as overseeing the next generation of lab leaders through a administrative laboratory fellowship program at North Oaks. “Our goal is to give recent grads a segue into a successful career in lab medicine. I believe you get what you invest in,” he said. “We are actively involved in two training programs in our area. Ultimately, our return in human capital has far outweighed our investment.”

Clinical Laboratorians' Consultative Role

Another career path for a laboratorian looking to move beyond the bench is a relatively new degree option that’s offered so far by just two schools in the country. Rutgers University in Newark, New Jersey, now offers a doctorate in clinical laboratory science (DCLS) as a means of closing the gap between diagnostic testing, clinicians, and patients, according to Nadine Fydryszewski, PhD, MLS(ASCP)CM, a professor and director of the DCLS program.

“We saw a need for laboratorians to serve in a more consultative role. Typically, laboratorians are behind the scenes and not as visible,” she said. “Our program is preparing certified medical laboratory scientists for advanced practice—front-line roles—bringing their expertise directly to clinicians.” The program also prepares students for research on showing evidence for the impact of diagnostics on outcomes, she added.

Brandy Gunsolus, DCLS, MLS(ASCP)CM, the first graduate of Rutgers’ DCLS program, now works at Augusta University Medical Center in Georgia, where she rounds with physicians and offers consultations on appropriate testing. “I rotate every day to a different specialty,” she said. “My job is to make sure the right test is ordered at the right time and interpreted correctly. Most physicians welcome this input because, with an expanding test menu, they often are not sure of what test to order.”

Currently, Gunsolus holds three job titles: pathology utilization manager, immunology laboratory manager, and toxicology laboratory manager. Because an advanced degree in CLS is so new, there really is not an appropriate position title to describe all she does. “As a profession, we need to establish a position title for the DCLS related to their advanced practice responsibilities,” Fydryszewski emphasized. “One of my thoughts is ‘clinical laboratory consultant.’”

Whether someone entering the field of lab medicine chooses to become a traditional medical laboratory scientist, a clinical chemist, or to pursue one of the newer careers available, clearly the need for qualified laboratory personnel will only continue to grow. “As retirement rates continue to increase, the field needs to intensify its efforts on recruiting the next generation of laboratory personnel,” concludes the ASCP report. “This can be accomplished by enrolling more students in ac-credited training programs or getting more people involved in obtaining experience necessary to be-come certified. Retention of new graduates is critical, and the staffing needs of rural areas need to be highlighted.”

Kimberly Scott is a freelance writer who lives in Lewes, Delaware. +Email: kmscott2[at]verizon.net