So You Want To be a Medical Technologist - Practicum Tips

So you have entered the medical technologist program, and are about to embark on your first practicum, away from your classmates and familiar environs. You've arranged a new place to live for the quarter (as most practicums at BCIT and NAIT are speckled throughout B.C and Alberta), and are armed with your Blue Book of Learning Requirements. For some of you, this will be your first foray into a workplace.

Welcome.

Some things to remember though about your soon to be teachers.

Teaching technologists are a thing of the past.

All technologists showing you the ropes will be expected to do so on top of holding their regularly scheduled benchwork. The majority of us will not be paid for teaching you during your practicum. Those that will, will be paid at most an extra three dollars a day (oh, wonderful 0.30/hr differential). If they are to do a through and useful job teaching you, you can bet they have put in time at home to prepare lesson plans, review sheets, and to dust off the hows and whys to explain things they know bone deep. They will have shown up five or ten minutes early to plan out the day's work, pull some interesting cases for you, and figure out how to fit giving you the most experience as well as the odd rare test (oh, fecal meat fibres) into the schedule. In return for this, they expect three things.

1) Respect for the fact that they are taking the time to do so.
2) That you listen, learn, and review pertinent theory before time if asked.
3) That you follow instructions.

They are, for the most part, not millenials. The style of discourse you may be used to among your peers (and to your parents) is not found in this particular work environment. Talk-back, whining, or arguement when your instructor or section head asks you to do something is both unappreciated and will frankly prejudice against your hiring (and your school's students being accepted back) for in the future.

After putting in said thought, it highly irks to give instructions for a student to help out for a few minutes with a skill they have already mastered, and be met with talk-back and stated entitlement of Learning All Teh Time. Simple logic states that if you want more of your teacher's time to help walk you through doing new things, the workload must be met too. Loading samples onto machines, or aliquoting tubes under supervision can help make that twenty minutes to talk about fluid pH theory, or to learn how to troubleshoot an osmometer. What is helpful is having two or three topics you want to cover in your head, so if we have a spare ten minutes, you can bring that up and we can plan that into the day.

Your Blue Book:

Yes, we are aware you have one. Every program sends their students with some version of competency requirements. We absolutely do not want you to bring the book to every bench day. As it must be returned to your practicum supervisor at the end of the three years, we want to keep it non-biohazardous. ^^ Ideally, you would bring it on your second to last day on each area, so we can then zero in on anything not covered during the usual process.

Appropriate Dress:

In general, scrubs are safe. Some labs allow street clothing, if gowns are worn overtop, and others prefer business casual. All of these work.

Do not wear shirts with obscenities on them, revealing clothing such as tube tops or shortie-shorts, or flip flops. You may think that an obvious statement, but we've had to memo two separate schools for students thinking "casual" meant variations of club-wear.... And flip flops will not protect you if you drop a glass tube on your foot. Think professional.

Break Times:

Finally? Each department generally has a break schedule of where they go each day. Take at least the first few days and follow along to get to know people, and how the department functions. Show off your social skills, and that you can fit in. After those few days, feel free to eat where you want, but if you don't follow your trainer to where ever the pack eats, people will think you are stuck up, socially maladusted, or simply not remember you from the multitude of other students coming through. All are negatives when it comes hiring time.

[Case Study] Bright Green Urine

Patient A is admitted for cardiac surgery on January 10. All his pre-op chemistry tests are normal, and he is cleared for surgery. His surgery is sucessful, and post-op blood and urine samples are submitted to check his status. His urine sample immediately drew notice upon arrival to the lab. Upon analysis, the urine showed:

Colour: Bright Green
Clarity: Clear
pH : 5.5
Specific Gravity: 1.015
Leukocytes: Negative
Hemoglobin: Trace
Protein: Negative
Ketones: Negative
Urobilinogen: Negative
Nitrite: Negative

Microscopic analysis confirmed the occasional red blood cell and 6-10 epithelial cells. No bacteria were seen.

The pre-operative urine sample was pulled, and the colour was a normal clear yellow with normal results.

But what was causing the urine to be so oddly coloured? Was it clinically significant? Upon investigation, the ward confirmed sample quality and a list of possible causal drugs were produced. Among those drugs was a short-acting, intravenous sedative-hypnotic agent by the name of Proprofol (Diprivan). Used to induce and maintain anesthesia or sedation, one of the more infrequent side effects (in < 1%) from Proprofol is a production of bright green urine. It is not clinically significant, and the colour change is known to cease once the proprofol is discontinued.

Other more common causes of the colour change are:

1. Methylene Blue: (Blue + Yellow = Green): used in treatment of malaria (third world countries due to cost), methemoglobinemia, cyanide poisoning, and cancer. Also a component of an older urinary analgesic.
2. Pseudomonas infection: This produces a deeper, forest green colour with a grapey smell.
3. Dietary changes: Examples are excess quantities of Clorets or Blue Listerine
4. Magnesium Silicate (Doan's pills): A NSAID used for back pain. OTC medication.
5. Medical imaging: Some dyes such as biliverdin are used to assist in in vivo scanning.

Medscape has done an article on similiar cases here.

So you want to be a Medical Laboratory Technologist --Schools

Congratulations -- So you're thinking that you may want to be a medlab tech too.

Basic Info: Starting Salary at entry level is about $50 000, with pay increases as you gain experience and responsibilities. You can be employed at hospitals, research centres, vetrenary centres, private labs, or in commercial pharmeceutical development. This job is not suitable for those who are squeamish, who have open sores/bad acne, colour-blindness, or who cannot make appropriate decisions under pressure. It is suitable for those who love science, enjoy helping people, and solving problems under the clock.

First things first. Do you have a solid science background in highschool? Have you taken(and done well in) Biology 12, Chemistry 12, Physics 11, University Math 12, and English 12?
These are all baseline necessary for entry.

Note that the links of below schools have a list of basic requirements, but also all have a fine print line stating that most sucessful applicants have at least first year university science experience as well. I would recommend at least first, and maybe second year university science before applying to the program -- Of the six fresh-from-high-school students in our class of sixty-five, only one graduated with us. That girl's mother was a medlab tech.
'Nuff Said.

Also note that all practicums below are UNPAID. Do not rely on having to have a job to get through that year period, as working practicum full time and being responsible for online classes is not a good formula for keeping a second job.

Most programs fill up at least a year in advance, so apply early. For example, this year's BCIT intake in 2012 is already full. They are starting to take applications for 2013 now.

There are four main schools in Western Canada that are able to prepare you for the CSMLS exam necessary to work in Canada. I'm going to go over the basic differences of each.

1) BCIT: (2.5 year program) Includes interspersed practicum to make those all important
contacts. Students can finish early, and work as QNR(Qualified
Not Registered) to make some extra cash while waiting to take
their CSMLS exam. Usually about 60 to 70 seats available each
year. Requires 30+ hours of health care volunteer experience.


2) NAIT: (2.0 year program) Includes one year of in school studies, one year of practicum.
Special post-secondary requirements of an Accredited Medical
Terminology course and a year of university Anatomy and
Physiology with a minimum grade of 60%. Typical successful
Applicants have a 80-83% average in these. Seats unknown.

3) SAIT: (2.0 year program) Includes one year of in school studies, and a second year of 1/2
practicum/1/2 in class studies. No special requirements over
high school classes. 48 seats available each year.
Already full for Fall 2011.

4) U of Alberta (4.0 year program)
Format is two years university classes, then a year of practicum,
followed by a final year of university classes. Note that the first
year is a "pre-professional year" at any university. That's when
you take the same 30 credits of courses as all the other hopefuls
and then apply to the Medical Laboratory Program at the
beginning of second year. B- average at university or higher was
last year's standard to get in. 29 seats are available each year.

Whoah, information dump. Wrapping this up and will continue in a followup post.

Medical Laboratory Education -- Bachelor's versus Certification

At first glance, the question of which of a bachelor's degree at a nationally recognized university or a three year certificate at a technology institute is more employable looks rhetorical.

Of COURSE a bachelor's degree in Medical Laboratory Science will get you job in a hospital faster...right?

Wrong.

One of the traps students fresh from high school fall in each year is thinking that a Bachelor's in Medical Laboratory Science from UBC/U of Calgary will enable you to work in hospital laboratories. They don't. Such programs are for job steams that focus on either university research(mainly in universities, so you will be competing will all those other Science degree graduates for graduate student salaries), or for those who already have a certificate and are returning to gain ART or management level equivilents.*

In order to work in a hospital laboratory here in British Columbia, one must pass the Canadian Society for Medical Laboratory Science national exam.

In order to be eligible to even take said exam, one must have taken an accreditted CSMLS course. The University of British Columbia is not accreditted by CSMLS, so thus you are not even eligible to take the qualifying exam.

Thus, to become employable, the student rockets off to to BCIT, NAIT, or SAIT to take the full three year course to qualify for hospital work. That's right -- seven year's minimum of school to start working, if you take the university route. Ug. And that's wishing that you knew straight from the starting gate what you wanted to do with your life. Many of my classmates at BCIT had bachelor's or Master's degrees in biology, chemistry, and microbiology before starting at BCIT.

If you're interested in becoming a medical laboratory technologist, there is a post coming about just that.



*The exception here the Bachelor of Medical Laboratory Science of the University of Alberta. The program is four years in length, and focuses on university theory, the nitty gritty needed in the workplace, and the knowledge base to pass the CSMLS exam.

Links of Interest

Been a while since I've posted, so I thought I'd toss out a couple links on interesting developments in the medlab world.

1)Should herbalists use lab tests in their practise? Jake Fratkin discusses.

2) The development of a painless needle -- Japanese Researchers are working on the development of a serrated needle, based on the shape of the probiscus of a mosquito. See here for more information.

3) The development of a patch to apply vaccinations instead of needles -- See here.

4) An article on needle-free injections, including nasal sprays, patches, and genetically-altered potatoes that protect you from cholera -- here.

5)Here's an older peice detailing the pain patches that hospitals such as BC Children's Hospital have in use for before-venipuncture. In short, the patch uses a small electric current to dispense lidocaine directly to the venipuncture area, numbing it up. It's always good to know your technology before you need it.

Hot Topic: H1N1 Snapshot : BC September 14

14 September; school is back in, and infections begin to rise. BC stats for this week include:

• 865 confirmed H1N1 cases
• 48 hospitalized due to H1N1
• 5 deaths.

(facts found at BCCDC FluWatch, ILI Watch, and Authority Bulletins)

As one dives into the spreadsheets and graphs, a picture begins to make sense beyond the obvious. Although children between the ages of 10 and 19 have the highest number of positive cases, when taking into account they were also the most extensively tested this week (possibily due to parental concerns upon sickness following return to school), it makes sense that the most positives were found in this demographic. Remember, testing of mild cases is now discouraged in otherwise healthy adults.

What concerns me from this weeks picture is that those healthy adults(20-39) seem to be the hardest hit, and most hospitalized. Usually the flu preys on "weak" populations, those with other conditions, the old, the very young, or in vulnerable states such as pregnancy. H1N1 has almost been taking a spanish flu like approach instead; the majority of hospitalized patients in this bulletin were adults or young adults.

As well, new this week is the magic percent of known positive cases upon which WHO suggests schools are to close: *drum roll* The magic number is: one percent. That means if a school of 700 has seven ill students, WHO suggests closing. That said, the Public Health Agency of Canada promptly replied that unless the severity of the pandemic gets a lot worse, or massive numbers of children fall ill, it is unlikely they will activate school closures. (http://www.cbc.ca/health/story/2009/09/11/h1n1-school-close-who.html.

Still no vaccine available in Canada, not even for health care workers.

Hot Topic: H1N1 Basics

H1n1 Basics: Recognition

The following symptoms have been found in patients testing positive:

• 92% had fever
• 92% had a cough, mild to heavy
• 66% had a sore throat
• Only 25% had diarhoeae or vomiting/nausea.

(Note that in elderly patients, the fever can be absent, substiting instead with delirium or decreased level of consciousness.)

H1N1 has not been a nosocomial infection, but instead has been transmitted via the community(on your commute, in the workplace, in the schools, etc). You do not need to be around one of these hospitalized sick people, or someone who has been to Mexico, to contact the flu anymore.

H1n1: So I have the above symptoms.... What next?

DO NOT run to the emergency room for mild flu symptoms. This clogs up the system!

DO take a self inventory. Are your symptoms mild? moderate? debilitating?

If your symptoms are mild and you don't have underlying issues, the BCCDC is not even recommending you go and get tested at the moment. If your symptoms are moderate or if you are pregnant, have concerns about a newborn, or immunocompromised, testing and follow up are still recommended.

The BC Centre for Disease control is currently recommending people who have a fever and respiratory symptoms do the following:

1. Self Isolate for seven days after your symptoms first start. This will prevent spreading.
2. Practise Hand Hygiene (Wash your hands with a non antibacterial soap often)
3. Practise Cough Etiquette (Cough into your elbow, or into a handerchief).
4. If your newborn has H1n1, encourage breastfeeding; this will help.
5. If you DO go out in public, use a surgical mask to prevent spread to other people.
6. Do NOT go to work.

If your symptoms worsen, there are several medications that are effective, as well as the vaccine coming out later this year.