More (groan) on Routes to becoming a histotech

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From:"Tim Morken" <>
Date:Tue, 04 May 1999 22:17:20 EDT
Content-Type:text/plain; format=flowed;

Freida Carson wrote:

<In the past, today, and until 2005, a
high school graduate with no chemistry, biology, or math, can be 
on-the-job-trained and then sit for the certifying exam.  That is just not 
an adequate background for today's increasingly complex histopathology 

This is the crux of the whole situation, as I see it. Consider this:

In 1981, when I started in the histology lab, and for practically 50 years 
before that, everything was just cutting and special stains and practically 
anyone could be, and was, trained to do it.

When I started out in histology in 1981 imunochemistry was used only in big 
medical centers. We started up our immuno service in 1984, which was when I 
learned it. In the time since we have developed immunos and in situ's as 
routine procedures and they take up a large part of the testing time in 

Now, what's in the pipeline for the Histology lab?

Whereas before pathology was mainly confirmatory we are now moving into 
real-time treatment testing. The Hercep test from DAKO is only the first of 
a huge push to use tissue-based testing for tumor management rather than 
diagnosis. It will a big area in histology in five to ten years and may 
outstrip diagnostics immunos. It could also be a cash cow for histology. The 
need for immunochemistry is going to skyrocket.

Molecular biology is used in the big centers now but will be used extensivly 
in histolgy within 10 years. Here at the CDC we make our own RNA probes for 
in situ hybridization and primers for PCR. We make probes for viruses from 
the virus' own DNA or RNA and then use them to detect that virus in other 

Tissue-based tumor genetics testing will do away with the morphological 
criteria now used to classify tumors but morphology will still be necessary 
to see exactly where the tumor cells are. Guess who will be asked to do the 
in situ's on those tumors? It will be as big a load as immuno's are now.

We have three PhD molecular biologists working flat out to support our 
section. That will be routine in hospitals in ten years. Will high school 
graduates, no matter how motivated, be able to handle that sort of thing? If 
we don't start getting well trained people the work will go to other labs 
and histology will be left to the usual things. Indeed, if you haven't 
started learning molecular biology, you will be left out!

It is really unfortunate that histology was dropped from the medical 
technologist programs many years ago. The US was one of the few countries to 
do that and is now suffering for it. I hope schools will start realising the 
need for histology training again, because on-the-job training won't begin 
to cover the needs of the future.

I feel that requiring more education for certification will eventually make 
the profession more visable and will attract more people. 2005 will be 
barely adequate to get this started.


----Original Message Follows----
Subject: Routes to becoming a histotech
Date: Tue, 4 May 1999 21:30:42 EDT

The problem is that there are not enough accredited programs to train
histotechs.  I do not think that anyone would deny that the most desirable
way to become a histotech is through an accredited program.  There are less
than 30 in the US, so obviously that is not enough to train all of the
histotechs needed.  So the majority of histotechs are on the job trained, 
will continue to be trained that way.  In the past, today, and until 2005, a
high school graduate with no chemistry, biology, or math, can be on-the-job
trained and then sit for the certifying exam.  That is just not an adequate
background for today's increasingly complex histopathology laboratory, and 
is proven by the much higher failure rate of those coming to the exam 
the high school route. We need more NAACLS accredited programs desperately -
anyone interested in beginning one, preferably in association with a
community college?

Incidentally, 56% of the accredited programs now either require an AA degree
for entry into the program or award an AA degree upon completion of the
program.  All programs require a specified number of hours of math, biology,
and chemistry.  This is required by NAACLS.  I would anticipate that  some 
those that are certificate programs will now begin to think about becoming 

May I also address Karen's confusion.  You can have an AA degree that
includes a specific number of hours in chemistry, biology, and math before
you begin your on-the-job training or you can complete the degree during or
after training. But you must have it before you apply for the exam as of
2005.  The requirements of the NAACLS accredited programs vary with the
program as stated previously.

Hope this helps somewhat.

Freida Carson

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