The medical detectives

"We are medical sleuths," says Nancy Vetrano, a clinical laboratory technologist at Mount Auburn Hospital in Cambridge. Samples of blood, urine, cells, and other tissues undergo batteries of tests in the clinical lab. Mostly, the results are normal. But when the amount of some important chemical is too high or too low, or an unusual microbe swims into the view of the microscope, lab technicians are often the first to know something's wrong. And in some cases, an offbeat result is the first sign of an unfolding medical mystery. "We help to solve those mysteries," says Vetrano, who calls her job "a great occupation."

When you have blood drawn for a routine checkup or are in search of a diagnosis, clinical laboratory technologists or technicians-mainly working behind the scenes-are the experts who perform the analyses and make certain that the results get reported as quickly as possible. "We always keep in mind that there's a patient on the other end of the test," Vetrano says.

Vetrano and some 50 or 60 members of the medical technology staff work at Mount Auburn's laboratories days, nights, and weekends. Among the activities of technologists here and elsewhere are running blood and urine tests, looking for bacteria and parasites in specimens, matching blood for transfusions, and testing for drug levels in blood to show how a patient is responding to treatment. Some workers hold highly specialized positions, such as carrying out the many assays required when a woman undergoes in-vitro fertilization.
Blood banker
Deb Bongiorno is a technologist in the hospital's blood bank, testing for blood types, antibodies, and ensuring the donor blood is compatible with that of recipients. "I've wanted to do this since I was a kid," she says. "When all my friends were asking for dolls, I was asking for a microscope." In her fifties, she's been at Mount Auburn full time for five years. The downsides to the job? "The hours, working on weekends and holidays, and times when it's really busy," she says. "But I find it very interesting; I don't think I could be doing anything else."

In 2002, according to the U.S. Department of Labor, labs, hospitals, doctor's offices, outpatient centers, and research programs employed about 297,000 clinical laboratory technologists and technicians. Despite a continuing trend toward automation of many routine tests, jobs are expected to grow on par with the average for all occupations through 2012, the labor department projects.

"There are a lot of unfilled vacancies in Massachusetts and nationwide," says Mary-Lou Turgeon, who heads the clinical medical technologist educational program at Northeastern University. For a variety of reasons, not enough new graduates have been entering the field in the past two decades, she explains, although in the past two or three years the program at Northeastern has seen renewed interest. The field is heavily dominated by women, whose career options have expanded dramatically in areas calling for scientific and technical background. In addition to the hospital-based and freestanding clinical laboratories, there are opportunities with biotech companies, sales and marketing divisions of manufacturers of diagnostics, instruments and other products, and in laboratories of state and federal agencies like the U.S. Food and Drug Administration. A significant number of students who undergo the rigorous clinical laboratory programs decide to go on to medical, dental, and veterinary schools, Turgeon says.

Good wages; flexible hours
Medical technologists receive a bachelor's degree from a four-year college, majoring in medical technology. Technicians are trained in a two-year associate's programs. In Massachusetts, there are three accredited medical technology programs: at Northeastern, the University of Massachusetts-Lowell, and UMass-Dartmouth. Students seeking technician training can find it at Bristol Community College in Fall River and Springfield Technical Community College.

A 2002 national salary survey by the U.S. Bureau of Labor Statistics showed that the median annual wage for medical technologists was $42,910; of course, salaries vary quite a bit from one region to another. The middle 50 percent earned between $36,400 and $50,820, while the highest 10 percent received more than $58,000 and the lowest 10 percent less than $30,530. In the Boston area, "No one is starting off at the base [salary] rate," says Deb Steward, who supervises the clinical laboratory staff at Mount Auburn. They can command higher pay because of the technologist shortage, she says. The situation may only become more acute when the baby-boom generation of lab technologists begins to retire in a few years.

Some aspects of the profession itself have deterred new entrants in the field, says Steward, including the need for night and weekend shifts and a fear of working with infected blood that turned some prospective technologists away when AIDS emerged in the mid-1980s. However, notes Steward, "We have a very good record and very strict safety policies."

And while it's true that many routine tests have been assumed by laboratory robots, what is left represents the most interesting work, Turgeon stresses. "The specialized testing, including the growing number of molecular and genetic tests, has to be done by the more highly trained technologists."

As more and more treatment and diagnostic decisions are being aided by these tests, which detect small but significant differences in individuals' medical problems, labs will be even busier, says Turgeon. "We see it exploding down the road."