When a doctor sends a biopsy sample to "the lab" they're referring to a pathology lab, where technicians and pathologists prepare and analyse the tissue for cancer or other diseases. Absolute accuracy here is a core job requirement, but what else is involved?
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To learn a little about this work, we spoke with a histotechnician at a breast cancer molecular laboratory. A histotechnician — sometimes called a histotechnologist — is primarily responsible for preparing and optimising the samples for analysis, as well as running the lab with an immaculate level of quality control. Their work is largely unseen by the public, but they are essential to the healthcare process.
Tell us a little about yourself and your experience.
After 10 years in the Histology/Anatomical Pathology industry, I am happily employed as a Histotechnician II at Agendia, a leader in molecular diagnostic testing. At home I am married to a wonderful man, Mikey and we have two kiddos, ages nine and four. In my current position, I am lucky to have a hybrid job, half on the bench working with patient samples and half administration, dealing with equipment and ordering supplies. My next project is getting new software up and running in my lab to help pathologists identify and quantify tumour cells in breast tissue on digital images, saving them time and our company money.
What drove you to choose your career path?
Originally I wanted to be a nurse. I thought that if you wanted to be in the medical science field, you were either a nurse or doctor. I never knew there was a whole world behind the scenes, helping provide the tools and tests doctors need to diagnose and treat patients. UNTIL… I was waitlisted for the nursing program. After two years of college classes and my prerequisites completed, I simply had to wait to get in. I needed to be in school for two reasons: my sanity and to stay on my parents' health insurance! Literally the next day I received a flyer about the histotechnican program at Mt. San Antonio College, which I was attending while waiting to get into nursing school. My Mum was the one that urged (nagged, let's be honest here) me to try it out, reminding me I had nothing to lose, and that she knew I would make a better scientist than nurse. For once I listened and enrolled. Ironically, the month I graduated I finally was accepted into the nursing program. Never looked back!
How did you go about getting your job? What kind of education and experience did you need?
Luckily I knew what type of histotechnican position I desired right out of school. During the two years in the program, we intern EVERYWHERE. Hospitals, vet clinics, small labs, giant labs, coroner offices, etc. I knew I was best suited in a small lab; I am self-motivated and love to learn the inner workings of everything. I needed to be constantly challenged and not just be pushing samples through processes. Luckily, when I graduated I was already employed, fortunately! I was in school for four years: two years of general education and prerequisites and two years enrolled in the program. Then once I graduated I was able to sit for the exam offered through ASCP (American Society of Clinical Pathology). Now I have fancy letters after my name, and more importantly, a licence to work as a histotechnician, processing biopsies in a laboratory and providing the tools for clinicians to diagnose and treat patients.
What kinds of things do you do beyond what most people see? What do you actually spend the majority of your time doing?
Most people don't know we even exist, but anyone who has had a biopsy, a surgery or even a mole removed — we have helped you and your doctor. We essentially prepare very thin sections of the specimen, less than a cell in thickness, and stain the cellular components for viewing under a microscope. That is the part that truly hooked me in this career. Looking at human tissues at a cellular level, stained in contrasting colours, it's a beautiful thing. Even more amazing is that we can tell a lot about the health of that person based in the pattern of those cells. Pathologists are the recipients of our prepared glass slides of the biopsy, and can help devise treatment based on our work. No pressure.
The majority of the time I am on the bench, working with my two colleagues on setting up the patient samples for testing. We take the sample from the door to the beginning of the molecular testing. Specific to our laboratory, we only look for certain types of breast cancer, based on a set of guidelines, to qualify the sample for further molecular testing. We make sure there are enough cancer cells and that they are of decent quality. This takes a great deal of special treatment for each sample, and a close relationship with our pathologist and molecular scientists The slides are scanned on a large microscope computer that generates large images of the sample. The benefit to this machine is that the doctor can look at the slide images on any computer, even [on the other side of] the world. Much of my time is spent facilitating an open line of communication between all the departments of our laboratory, and I wouldn't have it any other way.
What misconceptions do people often have about your job?
Many people in the healthcare industry assume we just know how to prep slides and that is the end of it. We are required to know what we are prepping, and troubleshoot if anything is not perfect. This means knowing tissue structures, stain components, and any chemical reactions that aren't performing. We work closely with pathologists to perfect the stains, to provide the best materials for them. I spent two years in school attached to a microscope, looking at several different tissue types at various disease progressions, and that barely scratches the surface. I continue to learn even 10 years in.
What are your average work hours?
Most work weeks are 40-45 hours, but can creep up to 55-60 if we have any special clinical trials coming in.
What personal tips and shortcuts have made your job easier?
Tips I would give to anyone looking for a challenging career as a histotochnician is to really work at your internships. Most of my connections were made then, and it is a small world. Not to mention you get to test out jobs! If you hate it you can walk away when your hours are done. Strive to learn all the inner workings of a laboratory — the bench is only a part. How are supplies ordered and quality controlled? What kind of standards of operations are in place, and how can we streamline them? What can we do to stay ahead of the curve? A proactive approach in any laboratory will be beneficial to the employees!
What do you do differently from your coworkers or peers in the same profession?
I ask questions and get involved when I am needed. My goal is to be an integral laboratory employee, essentially be as cross-trained as possible! The culture is just that at my lab: we are small and cross-training is almost a necessity. But I also know there other processes that rely on you completing yours with care, and are important to be aware of.
What's the worst part of the job and how do you deal with it?
The worst part is knowing that there are scared patients on the other end waiting for the result. Most importantly, the CORRECT result. So much of their lives are changed by the information we generate for them. It's hard to, but you have to put yourself in their shoes, you have to remain vigilant, and know what you are generating is of quality.
What's the most enjoyable part of the job?
Definitely the people. I get to hang with scientists and technicians all day. I see them more than my family, so I guess it's good that I like them so much. We are a little nerdy science family!
How do you move up in your field?
WORK HARD! And don't burn bridges. Constantly keep learning, and make yourself a valuable employee by cross-training if possible.
What advice would you give to those aspiring to join your profession?
Get into an accredited school, and take your internships seriously!
Career Spotlight is an interview series on Lifehacker that focuses on regular people and the jobs you might not hear much about — from doctors to plumbers to aerospace engineers and everything in between.