Fixation on Histology

Histotechnology Workforce Development: Shortages Have Reached Critical Status


Histology Workforce ShortagesWorkforce shortages in the lab have reached critical status. During the 2021 Clinical Laboratory Legislative Symposium and the Fall 2021 ASCP Board of Certification Board of Governors meetings, staffing shortages and workforce development were top of mind. The data surrounding workforce is shifting faster than we can collect or document it accurately. We believe the data we do have is a lagging indicator of what is happening.

To understand our current situation we need to look at external macro drivers first. NSH has used the American Society of Association Executives (ASAE) Foundation’s Foresight Works on strategic drivers to evaluate its strategic plan. When discussing workforce development, we focused on the Aging World, Automating Work, Bifurcated Workforce, Mentoring 2.0, and More Human Humans. To summarize, our world, and thus our workforce, is aging, causing accelerated retirements and the cost of caring for an older society. We already see increased automation in the histology lab. A bifurcated workforce looks like button-pushers and problem solvers, and mentoring takes on new forms but remains a central way of sharing knowledge.  Automation will steadily increase the relative value of certain human qualities in work, including social skills and creativity. In a world of automation and artificial intelligence, humans will remain relevant not by knowing but by thinking, listening, relating, and collaborating at the highest level. Cultivating critical thinking skills will be a path to career advancement. It is interesting to note that the NSH 2020 Workload Study showed that automation did not equate fewer FTEs. Automation freed up time for employees to perform other duties.[i]

On top of these macro-level drivers, we have layered the COVID-19 pandemic. The September 2021 Department of Labor shared that resignations are the highest on record, up 13 percent over pre-pandemic levels.[ii] The retirement rate is currently 11 percent. When reviewing the 2018 ASCP pre-pandemic vacancy and retirement rates, Anatomic Pathology labs had 12.99 percent overall retirement rates, with supervisor retirements at 27.13 percent. Histology labs were at 11.83 percent overall retirement rates and 18.24 percent for supervisors[iii]. The market is moving faster than we can document our current needs.

At the 2021 Clinical Laboratory Legislative Symposium, we focused on legislative remedies to workforce shortages. It is safe to say that we are not educating histotechs at the rate required to replace those techs exiting the workforce. Access to clinical education is a barrier to entry in addition to the average wages earned by histotechnicians and histotechnologists, which have barely kept up with inflation since 2015. We were fortunate to have two of our New Professional Legislative Leadership Scholars join us during the symposium. Sean Moynihan, MS, HTL(ASCP), QIHC, and Pearl A. Gaidelis, MS, HTL(ASCP). For NSH to make a difference with a legislative remedy, we need your voice. Histotech shortages are making it difficult to travel to Washington, DC.

However, you can visit your congressional members’ district offices to share our story and our need to build the workforce. Invite them to visit your lab. Please help them understand how histotechs are heroes behind the scenes saving lives one slide at a time. Tell your loved ones’ stories about how a histotech processing a specimen saved a life, similar to the story I shared with you in St. Louis about how a histotech processed my Mom’s breast biopsy. At the same time, she was under anesthesia, waiting for the all-clear to receive her liver transplant.  My Mom lived an additional 26 years, getting to know her grandchildren. When I share that story on your behalf on the Hill, it gets the staffers’ attention. Then, they are ready to listen to our ask. Tell your story and share your need. Build a relationship with your members as a trusted advisor on all things histotechnology, so they come to you for information when legislation is considered.

Written by Sharon Kneebone, FASAE, CAE


[i] Kathleen Dwyer, Debra Siena, Aubrey M.J. Wanner, Connie I. Wildeman, National Society for Histotechnology, National Society for Histotechnology Workload Study, Journal of Histotechnology, Volume 43, Issue 1, March 2020, Pages 38-46

[ii] Quits: Total Nonfarm-100 | FRED | St. Louis Fed (

[iii] Edna Garcia, MPH, Iman Kundu, MPH, Karen Fong, American Journal of Clinical Pathology, Volume 155, Issue 5, May 2021, Pages 649-673,

1 comment



11-09-2021 20:35

Sharon, great article! I will reach out to both- my local congressional office as well as NYC's. NYS is facing a hiring crisis along with all the other states. In NYS you need a license besides ASCP certification which makes it very difficult to find qualified personnel. I am trying to reach out to local high schools and give presentations to inform students of this profession. I even meet interested students and have coffee with them to explain to them what a wonderful profession histology is. Thanks again for this very informative article. 

Camille McKay, M.Ed., BSHCA, HTL, CLT

Regional Pathology Manager at MSKCC