Profession of Cytotechnology

"No other test ever invented has been as successful as the Pap smear in eradicating cancer." 1

 

What is cytotechnology?

Cytotechnology is the study of cells. The cytotechnologist is solely responsible for the microscopic interpretation of Pap smears interpreted as normal. The cytotechnologist makes a judgmental decision as to what is normal and abnormal by analyzing cellular patterns and subtle changes in both the nucleus and cytoplasm of cells while correlating the patient's clinical history.

Cytotechnologists work independently doing meticulous microscopic work. They must be comfortable making decisions and assume a great deal of responsibility.  Cytotechnologists are also responsible for the preliminary interpretation of specimens from other sites such as lung, bladder, body cavities, central nervous system, gastrointestinal tract, liver, lymph nodes, thyroid, salivary glands and breast. Cytotechnologists work in collaboration with pathologists to diagnose benign and infectious processes, precancerous lesions and malignant disease. Providin
g a definitive diagnosis in a timely, safe and cost-effective manner helps save patient lives by allowing clinicians to provide necessary and appropriate treatment to patients as quickly as possible.
Cytotechnology as a Career - Focus on Cytology article from
Advance Magazine

The future of cytotechnology.

Since the inception of modern cytology in the 1950's (thanks to the work of Dr. George Papanicolaou), the field of cytology had seen little change. Only in the past 15 years have technological advances led to the integration of molecular diagnostics, immunocytochemistry, flow cytometry and automation in the field of cytology.

Automation has been one of the most significant changes in cytotechnology practice. Automation in cytopreparation and computer-assisted screening has contributed to an increase in the number of abnormal cases detected as compared to conventional practice and methods. Other benefits to automation include increased productivity, consistency and decreased turn-around time.
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The advent of molecular diagnostic testing has also improved the detection of clinically relevant infections common to cervical cancer. It also has the potential for tailored intervention of therapeutic modalities.3 Molecular diagnostics similarly utilizes microscopic analysis and interpretation. There are few cytotechnologists already directly involved in performing and analyzing molecular tests. The impact of these changes to the cytotechnologist's traditional scope of practice is unclear but surely one that will certainly have an impact. Many cytotechnologists have already enhanced their skills in molecular diagnostics. Cytotechnology training programs are also integrating molecular diagnostics in their curriculums. The American Society for Clinical Pathology (ASCP) currently offers certification in molecular biology for cytotechnologists as well as other medical laboratory scientists.

 

How does one become a cytotechnologist?

In order to become a cytotechnologist, interested individuals must attend an accredited program in cytotechnology.  Currently, there are 30 accredited programs in cytotechnology. Educational programs are either university or hospital-based and involve 1 or 2 years of instruction. All individuals must possess a baccalaureate degree upon completion of the program. Minimum academic requirements are 28 semester credits of combined biology and chemistry and 3 semester credits of mathematics or statistics. Additional pre-admission requirements may vary depending on each individual program. Upon successful completion of a program, graduates are eligible to take the ASCP Board of Registry certification exam. Individuals interested in becoming supervisors, lab managers and educators may also wish to pursue ASCP certification of Specialist in Cytotechnology.
A minimum requirement of a baccalaureate degree or higher and three years' experience is required.

Occupational Description

 

International Cytotechnologist’s Requirements for US Employment

As stipulated by law in CLIA’88 (Clinical Laboratory Improvement Act of 1988), to meet the qualifications of a cytotechnologist one must have graduated from a school of cytotechnology accredited by CAHEA whose role is now being fulfilled by CAAHEP (Commission on Accreditation of Allied Health Educational Programs). There are other pathways for cytotechnologists who are already employed within the United States to meet CLIA qualifications.

A listing of the CAAHEP accredited programs which are all located in the US and Puerto Rico is available on the ASCT website under the Student Forum and on the CAAHEP website.

ASCP Board of Certification: International Cytotechnologist

The ASCP now offers certification in Gyn cytology for international candidates. While obtaining the International Technologist in Gynecologic Cytology, CTgyn(ASCPi) certification demonstrates your commitment to the high standards that ASCP certification reflects; it is not a substitute for the US employment requirements as stated above.

ASCP BOC International Technologists

 

Job opportunities for the cytotechnologist

There are plenty of opportunities for current and aspiring cytotechnologists, despite the impact of automation. Staffing includes practicing cytotechnologists and the contributions of molecular diagnostics to pathology practice. Cytotechnologists need to keep themselves abreast of future changes, embrace technology and adapt appropriately. Being involved in professional organizations like the ASCT is one way to keep abreast of such change and opportunity. Membership benefits include continuing education opportunities online and in person.  Visit our Career Center for job opportunities.

 

References:

1. DeMay, R. The Art&Science of Cytopathology. American Society for Clinical Pathology, 1997.
2. Kropf, P. Microscopic Talents - Molecular testing and automation take a seat at the cytotechnology bench. Advance for Medical Laboratory Professionals. Jan 31 2005; Vol.17(3), pp.2A-3A.
3. Geils KB, Holladay EB. Cytotechnology Education: Setting a New Paradigm for Your Future. The ASC Bulletin. May 2005; Vol.42(3), pp.59-60.