Last updated 12 April 2012
For a slightly different slant, see
I've been everywhere, man (Musings on fast-tracking those with foreign credentials)
Dark Daily reports, "Medical laboratory technologists with foreign credentials to get fast-track acceptance in Canada."
Unfortunately, this headline and accompanying article are misleading, at least so far as medical laboratory technologists are concerned (cannot speak to the situation for other health professionals).
If I were asked about foreign-trained technologists from the USA, UK, Australia, and New Zealand, where English as a second language is a non-issue, and where education and training are world class, here's what I'd say:
All the fast-tracking in the world won't help.
USA GRADS
First, besides clinical chemistry, hematology, clinical microbiology, and transfusion science, Canada's general certification exam requires education and a clinical rotation in histotechnology. Thus USA grads do not qualify.
Second, subject certification for USA grads in the other 4 main disciplines is out because Canada offers
subject certification only in clinical genetics and diagnostic cytology.
Reasons that
CSMLS does not offer subject certification in other disciplines include
- Cost (subject exams are costly to maintain)
- Employer need for flexible grads who can work in all disciplines
- Fear that employers may use those with subject certification to work in lab sections for which they are untrained
Accordingly, the path to employment in a clinical laboratory for a US-educated and trained medical technologist / clinical laboratory scientist is onerous:
- Step 1: Attend an educational institution (Canada or US) and take a course equivalent to an histotechnology course taught at Canadian institutions. For example, see MLS 250 at the University of Alberta.
- Step 2: Convince a potential employer to provide a clinical rotation in histotechnology. In Canada this is ~4 weeks. And it's next to impossible because employers can barely offer clinical rotations to Canadian-trained students.
- Step 3: Apply to CSMLS for a 'Prior Learning Assessment'
- Step 4: If eligible, arrange to write the CSMLS general certification exam covering the five disciplines specified on the CSMLS website (link above).
Be aware that the CSMLS exam is based on a
competency profile.
UK, AUSTRALIA, NEW ZEALAND
Background
In my experience, education and training in the UK and 'Down Under' exceeds that of the typical Canadian graduate, since Canada rejected the BSc as entry-level several years ago.
People who did not support the BSc were employers (private labs and public hospital labs, both govt-funded) and bureaucrats in provincial government departments of health.
Reasons for rejecting the BSc varied. But in my opinion, employer and bureaucrat rationales were biased: they perceived making the BSc entry level for nurses as being credential inflation leading to increased salaries without sufficient return on investment. They were determined to stop this happening in the case of medical laboratory technologists.
Accordingly, employers wanted the cheapest possible medical laboratory technologists, those who could be 'turned out' as quickly as possible and paid as little as possible. In their short-sighted view, with the move to increased laboratory automation and centralized testing, who needed a highly educated technologist whose education and training took 4 years?
Exception
For interest, the only (see correction below) Canadian program that provides both a BSc and professional certification by the CSMLS is the MLS program at the University of Alberta (UA). The first BSc (MLS) degrees were awarded in 1961. MLS also offers a post-diploma BSc.
Correction (9 May, 2012): The University of Ontario Institute of Technology (UOIT), which opened in 2003, offers a Bachelor of Health Science (Hons) in MLS that also provides both a BSc and professional certification by the CSMLS.
All other Canadian programs are 2- or 3-yr diploma programs at technical institutes or community colleges (equivalent of USA 'associate degrees').
Focusing on the UA program where I taught for many years, UA MLS grads are eligible to write the American MT(ASCP)* exams and many have upon completing their degree. [*To change once the ASCP's Board of Registry and NCA merge to form a single US certification agency.]
This allows MLS grads from UA to work in the USA and many did during the mid-90s when laboratory jobs greatly decreased in Canada and many educational programs closed.
As well MLS is the only Canadian program whose grads are eligible to work in NZ without writing exams. They have extensive international mobility, which is how it should be.
NOTES:
1. Although many Canadian diploma holders have a BSc and later obtain a med lab tech diploma (to gain employment more easily), their initial BSc is seldom the equivalent of a BSc in MLS. As one example, few non-MLS BSc degrees inculcate quality assurance and quality system concepts the way that MLS degrees do. And it's tough to grasp quality concepts in short diploma program, especially when introducing so much new knowledge related to transfusion, hematology, etc.
2.
An addendum stimulated by one of the blog's comments below ("the trend in Canada to "dumb down" medical science"):
Personal reflections on Canada's med lab technology / science scene:
Discussing this topic is cringeworthy but I think it's necessary. Having taught 100s of medical technologists who obtained diplomas or bachelor degrees over the years and worked with dozens more, I must comment on the view that Canada has a 'dumbed down' system, particularly if it is misinterpreted to imply that Canadian clinical labs and all their staff are not world class. They are.
Because the norm in Canada has always been been diploma programs, those wanting to work as medical laboratory technologists attended 2- and 3-yr technical institutes and community colleges.
The professional society (now CSMLS) developed an internal route for laboratory technologists to progress in their careers, certification as 'Advanced Registered Technologists' (ARTs). Because subject certification was then possible in all 5 disciplines, technologists could obtain subject ARTs, as well as a general ART (encompassing 3 disciplines).
Initially, the ART was obtained by a combination of continuing education credits, writing a literature review followed by a research project, writing the paper, and defending it in a oral examination. Latterly, written examination was an option to the research project. In many ways the ART simulated a masters degree.
By tradition, supervisors, managers, and other senior personnel were ideally required to have an ART. However, one big problem existed: Sadly, no one outside the clinical laboratory recognized the ART. Eventually, fewer and fewer candidates applied for ART certification and in 2011 CSMLS began to phase them out, with the last certifications by the end of 2014.
Another issue is how medical laboratory technologists are viewed by other health professionals. Many members of the health care team have bachelor degrees, including nurses (RNs), pharmacists, physiotherapists (where entry level is now a MSc). Since qualification prejudice continues to exist (consider how many physicians think of PhD holders), this affects how some view the credibility of diploma-holding medical laboratory technologists to be full partners on the health team.
Canada's clinical laboratories staffed by a combination of diploma-holding technologists (some with non-MLS degrees), technologists with a BSc in MLS (e.g., UA grads), ART holders, MSc and PhD level scientists, and directed by physicians, are some of the best in the world. Examples:
So, are Canada's labs 'dumbed down'? No.
Would Canadian labs be improved by a stronger mix of more medical technologists with a BSc in MLS and diploma holders? I believe Yes.
Would grads be better served by a BSc than a diploma, a resounding YES. They'd have more career mobility, more international mobility, and be better respected as a profession by other health care workers.
What about job mobility for technologists trained in other English speaking countries besides the USA? Can university educated and trained UK, Oz, and NZ grads easily work in Canada as med lab techs?
Unfortunately, no. The main reason is that programs in these countries, while providing education in the 5 basic disciplines, do not require clinical rotations in all 5 disciplines.
For example,
NZ graduates of university programs are ineligible to work in Canada because they may do a year's rotation in only 2 disciplines, e.g., 6 mth clinical rotations in their 4th year in each of 2 disciplines (e.g., hematology and transfusion science or clinical chemistry and hematology, etc.), as in the
Massey University program.
In contrast, a typical Canadian grad may spend 3 mths in a hematology lab and one month in a transfusion service lab, only one-third of the total time spent by NZ grads in these labs, and in the case of transfusion science, one-sixth as much. But NZ MLS grads are not eligible to write the CSMLS general certification exam without obtaining equivalent clinical rotations in all 5 disciplines.
Is this not nuts, given that NZ MLS grads clearly have more extensive basic education than most Canadian grads (diploma holders), as well as more practical experience in at least 2 clinical laboratories?
OZ and UK grads are similarly stymied if they want to work in Canada because graduates of Australia and UK's university programs can specialize. Examples:
Why do these medical laboratory technologists face significant barriers to working in Canada? Is it all about protecting public safety by ensuring medical laboratory professionals meet Canadian standards of education and training? Yes, but it's also about protecting Canadian jobs for Canadians.
If you graduated from one of the above foreign programs and are certified by your county's professional body and have worked in one or more areas of a clinical laboratory (perhaps for for 5-15 years), why do you need to write the CSMLS general certification examination covering all 5 disciplines to work in Canada?
CSMLS CERTIFICATION
For interest, if the educational programs of any foreign-trained technologists include the 5 basic diciplines and rotations in all 5, i.e., are otherwise equivalent to Canadian programs (or better), foreign-trained candidates must write the CSMLS general certification exam to work in almost all Canadian medical laboratories.
Most Canadian provinces (not all) have regulatory bodies that de facto require that medical laboratory technologists be certified by the CSMLS as a condition of employment in a clinical lab that performs diagnostic tests on patients.
For lab professionals with experience (e.g., those who trained 10-15 yrs ago), and who have likely worked in one discipline (perhaps two) for years, writing an exam covering knowledge and competencies in 5 disciplines is not easy. And getting clinical rotations in Canadian labs is pretty much impossible.
MUSINGS
I personally know NZ-, UK-, and USA-trained lab professionals who are better educated and trained than many Canadian grads, have ample current experience, and would make valuable contributions to Canadian labs and be exemplary employees. But they cannot work here, despite the fast-track BS of our governments.
True fast-tracking would allow
- Different routes that don't require candidates to re-learn specific disciplines (e.g., histotechnology), which they never will work in;
- Restricted licenses to practice and work only in the area or areas for which you are well qualified.
The situation for those for whom
English is a second language:
Besides becoming fluent in English, these technologists often need to upgrade their education and training to Canadian equivalency. As but one example, in transfusion science, the association of the Rh blood group system with severe hemolytic disease of the fetus and newborn would not have been taught in Asian countries where almost everyone is Rh positive.
Upgrading programs are rare but exist. If candidates pass required English language competency tests, successfully complete whatever minimal upgrading is deemed necessary, write and pass the CSMLS general certification exam, they still may not be hired if their English remains weak. That's the reality of today's clinical laboratories where staff are stressed to the max, mainly due to under-staffing.
If asked, I often advise foreign-trained grads to enroll in a Canadian medical laboratory technology program. It's a tough sell because they have to support themselves and their families. But in the end, this route can prevent much grief and frustration.
In total, not a pretty picture, but there it is.
Talk of fast-tracking foreign-trained medical laboratory technologists / medical lab scientists / biomedical scientists is largely smoke and mirrors.
As always, comments are most welcome.
