The practice of medical laboratory scientists (MLS) is clearly integral to proper health care delivery given that the majority of medical decisions are based on laboratory findings. As the demand for MLS in the clinical setting is increasing, knowing the factors that best influence the job selection decisions of new professionals may help employers tailor their environments to increase both hiring appeal and retention of recent graduates as employees.1
The Need for Quality MLS
There are a significant number of vacancies in the MLS field nationwide, with the US Bureau of Labor Statistics projecting that the “US will need 81,000 additional MLS to replace retiring staff, and another 68,000 to fill newly created positions.”2 In addition, the American Society for Clinical Pathology (ASCP), a governing body of certified MLS programs and workers, performed a study on vacancies in the MLS profession. In this study, ASCP surveyed 1353 lab management and human resource professionals who represented 33,162 laboratory employees from a wide range of hospital types and sizes. The results indicated that the western half of the US has a vacancy rate of 10.7% for MLS jobs.3 The Bureau of Labor Statistics estimates that there are 328,000 MLS jobs in the US and the field is expected to grow by 16% between 2014 and 2024. This is considered higher than average when compared to other occupations (2015).3
Downsized Pool of Candidates
This MLS workforce crisis is further compounded by the fact that many MLS academic programs across the country have closed or consolidated due to economic and resource concerns, resulting in fewer opportunities for the new workforce to get trained and enter the field.4 Consequently, the number of students graduating from current MLS programs is insufficient to fill the projected workforce shortages. Due to the desperate need to fill the increasing number of MLS vacancies, employers could greatly benefit from understanding the employment characteristics most valued by recent MLS graduates.
Value of Clinical Rotations
Clinical rotations, which can be mutually beneficial for students and future employers, have become a staple of accredited MLS academic programs throughout the nation. For students, participation in clinical rotations offers a real-world setting to practice and refine those skills learned in the academic environment. Furthermore, it is common for students to accept employment opportunities that arise from clinical rotation experiences. For employers, having students participate in clinical rotations provides the opportunity to examine prospective employees without having to spend extra time and money on recruiting or hiring, in addition to their clinical contributions.
A recent survey sought to identify the career motivations of dental and nursing students, revealing that “features of the job” (job availability, reliability, flexibility, financial security) and “professional factors” (opportunity for future career progress) were the strongest job selection motivators.5 Unfortunately, little research has been done on what job selection criteria are most important to MLS students, specifically. In 2004, University of Utah faculty members Joann P. Fenn and J. Michele Stuart surveyed 21 students from their MLS program in an attempt to assess perceptions of clinical site rotations and subsequent job choice criteria.6 According to this study, the primary factors that influenced MLS students to accept laboratory employment included (in descending order of importance):
- Organizational climate-defined as positive professional interaction, trust extended to individuals, employee satisfaction with career environment
- Work environment-defined as good reputation, hospital environment, stat lab environment, proper scheduling
- Student participation-defined as participation in hands-on activities and direct application of skills for problem solving and critical thinking
- Employee benefits-defined as adequate wages, health and educational benefits
Despite the small sample size, these conclusions identify probable and intriguing factors MLS students value most when looking for a job.
Refreshing a Dated Study
To the best of our knowledge, there have been no follow-up studies to support or expand on the findings of Fenn and Stuart, although additional research has the potential to be of great value to the clinical laboratory field. Consequently, we chose to replicate the 2004 study to determine whether its findings still hold true across other MLS programs. We began by surveying a total of 58 participants (18 men and 40 women) from the two most recently graduating cohorts of the Idaho State University (ISU) MLS program. Of the participants, 43 completed their clinical rotations during the summer of 2017 and 15 participants completed their clinical rotations during the summer of 2016. FIGURE 1 details full participant demographic data, including age, gender, age range, highest degree achieved, and future education plans.
Is It All About the Money?
The nature of the ISU MLS program enables most students to rotate into more than one clinical site, creating diverse opportunities. This allows students to compare experiences when assessing future employment options. A total of 21 factors were surveyed on a five-point Likert scale; regarding clinical experiences, students considered both their most favorable and least favorable (see TABLE 1). The results of this recent survey indicate that the factor considered most favorable (and statistically significant), was I received hands on experience.
This statistic was consistent across clinical experiences when students considered both their most favorable and least favorable. The subsequently important factors were: Laboratory personnel were friendly and Cooperation among laboratory staff is common. Interestingly, of all of the statements comparing most favorable and least favorable clinical sites, all but two were considered statistically significant at p < 0.05. The two statements that were not found to have significant difference between most and least favorable clinical sites were I was able to use critical thinking skills learned in my MLS program and Employee benefits are reasonable. These results indicate that the effect clinical rotation experiences may have on a student can be dramatic. Only 20% of students surveyed would consider accepting a position at their least favorable clinical site, if it were an option.
Similar to the 2004 study, our survey further assessed motivations in job selection for recent MLS graduates. The following five criteria were assessed on a five-point Likert scale:
- Organizational climate
- Active student participation
- Work environment
- Employee benefits
According to the resulting data, work environment was considered most important when searching for a job, prioritized even above pay. In total, 50% of respondents rated work environment as “Extremely Important” and 41.1% of respondents rated it “Very Important.” Furthermore, work environment was the only job choice criterion for which the “Not Important”category was not selected by any participant, further reinforcing the idea that this factor is most highly regarded by study participants. Not unexpectedly, pay followed work environment as the second most important job choice criterion, with 33.9% of participants rating it “Extremely Important” and 48.2% of participants rating it “Very Important.”
Of interest, almost 26% of participants who took the ISU survey were over the age of 30, indicating that roughly a quarter are not traditional college-age students. However, when the data were broken down further into age groups, there were no statistical differences in responses between older and younger students in any category. FIGURE 2 contains the full breakdown of importance ratings of job selection criteria.
Standing the Test of Time
Coincidently, Stuart and Fenn’s 2004 survey also recognized that pay was secondary to work environment in the ranking of job choice criteria. However, that 2004 study found employee benefits were only rated as “Important” by 29% of respondents. In contrast, our current study found that 82.7% of recent MLS graduates felt that employee benefits were “Very Important” or “Extremely Important.” This may be a direct reflection of the drastic economic landscape changes between 2004 and 2017.7
It will become increasingly important for lab managers, supervisors, and directors to identify the job selection factors most important in recruiting recent MLS graduates and potential job seekers in order to maintain adequate staffing levels. Considering the vital impact medical laboratory scientists have on effective health care delivery, failure to take advantage of these factors could have negative consequences for patient care. Providing students with positive clinical rotation experiences that involve practical, hands-on interaction will certainly help attract quality MLS graduates and entice prospective employees across clinical laboratory disciplines.
While pay and overall compensation are certainly important, these factors may not offset a lack of a positive work environment or other employment benefits. That said, further study is recommended to strengthen this evidence across non-university MLS academic settings, and across other areas of the country.
Rachel Hulse, MS, MLS(ASCP)CM, is the program director for the medical laboratory sciences program at Idaho State University and has worked as a certified laboratory scientist for over a decade. Rachel earned a BS and MS from the University of Utah and holds an additional MS degree from Brigham Young University.
Matthew Jones, MS, MLS(ASCP)CM, is a generalist for a northwest regional reference laboratory. His professional laboratory interests include hematology and blood bank operations.