We need to educate the next generation of medical laboratory scientists to be critical thinkers. Our students can’t be taught to rely on instrumentation alone. Technology is great, but it’s not infallible. Sometimes, it fails. We need more integration of the old and the new, so we can keep everything ready to go at a moment’s notice. When you have an instrument go down, your specimens are still piling up. You can’t let a backlog develop. A second instrument is always desirable, but sometimes you might have to go old school — reverting back to the basics.
The COVID-19 Pandemic taught all of us many things. One of the sectors that the pandemic put a spotlight on was the healthcare industry. The pandemic showed the resilience of the US healthcare system, but it also pointed out some important areas in need of improvement.
In our interview series called “In Light Of The Pandemic, Here Are The 5 Things We Need To Do To Improve The US Healthcare System”, we are interviewing doctors, hospital administrators, nursing home administrators, and healthcare leaders who can share lessons they learned from the pandemic about how we need to improve the US Healthcare System.
As a part of this series, I had the pleasure to interview Craig Fuller.
Craig Fuller, Ph.D., is the director of the Medical Laboratory Science and Health Sciences Program at Centenary University in Hackettstown, N.J. Before entering higher education, he worked in hospitals and reference labs, as well as in the biomedical industry. A graduate of Baylor University, Dr. Fuller earned his doctorate in infectious diseases and microbiology at the University of Pittsburgh.
Thank you so much for joining us in this interview series! Before we dive into our interview, our readers would like to get to know you a bit. Can you tell us a bit about your backstory and a bit about what brought you to this specific career path?
I originally wanted to become a medical doctor, but fell in love with the way the scientific method is studied and decided to go to graduate school instead of medical school. My first foray into medical laboratory science was participating in a study that examined the possibility of antibiotic resistant bacteria in salad bars during graduate school. I also went on to earn my doctorate, studying infectious diseases and microbiology. During my career I have worked in hospitals and reference labs, and also in the biomedical industry. For instance, I’ve worked for American Airlines doing their drug screen testing for their potential and current employees. I also had the opportunity to go to Germany and live there for five years, working for a company introducing flow cytometry techniques and flow cytometry instruments, which is very important now in the clinical lab.
Now, I am director of the Medical Laboratory Science and Health Sciences programs at Centenary University in Hackettstown, NJ, an institution that is significantly expanding its offerings in the health sciences. One of the things that teaching has afforded me is the opportunity to continue some of the elements of my job in industry that I liked most: Training people on new systems and introducing them to new software and all of the new applications.
Teaching is exciting. It’s all about that moment when you see a student who struggled and struggled, and all of a sudden the lightbulb turns on and everything suddenly makes sense to them. You can see the change in their mannerisms, the way they’re listening, and the way they’re participating. That’s why I love teaching so much.
Like any work environment, mistakes can happen in the lab. Is that a good or a bad thing?
Mistakes in the lab can really be a mixed bag. In the worst case, mistakes in the lab can be deadly. They also can have absolutely no impact on what you’re trying to accomplish. But we also must remember that the majority of scientific findings actually were found by a mistake or an accident. When I was doing research on an immunodeficiency virus, we found virus present in the lungs within two weeks following infection, whereas the theory at that time speculated that virus wasn’t present until the late stage of disease. Keeping an open mind, you find some of those novel situations. Many of the really cool findings in the lab were mistakes or happened by chance.
Can you share a story about the funniest incident in your career? Can you tell us what lesson you learned from that?
When I taught anatomy and physiology, we talked about what happens to your oxygen levels when you’re at different altitudes — when you’re at a higher altitude and there’s a lower percentage of oxygen, you feel more confused and delirious. I always talked about going skydiving in class, but had never gone myself. Well, my students encouraged — or dared — me to go skydiving, and the whole experience was videotaped. It was an amazing experience and a fun way to facilitate learning about how the body was working to my students. At first, my students were more interested in watching the video and laughing at my face than hearing about the effects on the body. But I will say that they became so engaged and their understanding of what was happening became more relevant for them. It proves that if we engage students in a way that is fun and relatable, they learn more.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
It would have to be this: “Life is not about being perfect. It’s about striving for the best person you can be.” I struggle with the fact that I want perfection, knowing that it’s an impossible achievement. I encourage my students to embrace failure because that helps you to grow as an individual. It also introduces you to what you were doing when the failure occurred.
It’s all about embracing adversity, learning from your mistakes, and then helping others to avoid those situations.
Are you working on any exciting new projects now? How do you think that will help people?
At Centenary University, we’re investing in new programs in the health sciences, and recently introduced new degrees in Medical Laboratory Science, Health Science, Exercise Science, and Public Health — all of which are key to helping people live more healthy lives. One of the specific projects we’re working on right now is introducing more complex techniques, such as quantitative polymerase chain reaction, qPCR. This technique has been used for a while, but it’s become even more utilized with COVID-19. More people are learning about it and we want our students to have practical experience on how to perform the technique and be scientifically critical of the data that we produce. This is one of the molecular diagnostic techniques we are bringing into the academic programs at Centenary, which helps to strengthen the students’ education and provides them with marketable experience.
How would you define an “excellent medical laboratory scientist?”
An excellent medical laboratory scientist is someone who never stops learning. Years ago, the field was all about adding chemicals to test tubes. Now, we have complicated instrumentation.
You have to understand the technology and learn how to troubleshoot any unforeseen circumstances. An effective medical laboratory scientist has to be able to think outside the box, really know the technology and what it can do, and anticipate all the errors that could pop up.
To work in this field, you have to be filled with integrity, ethics, and be willing to admit when you’re wrong or make a mistake. It’s a lot of responsibility.
Ok, thank you for that. Let’s now jump to the main focus of our interview. The COVID-19 pandemic has put intense pressure on the American healthcare system. Some healthcare systems were at a complete loss as to how to handle this crisis. Can you share with our readers a few examples of where we’ve seen the U.S. healthcare system struggle? How do you think we can correct these specific issues moving forward?
There’s absolutely no question that the U.S. needs more well-trained medical laboratory scientists. This was evident during COVID-19 surges, when labs were so backed up that it took up to a week or even longer, due to the necessity to switch to new testing, the sheer volume, and the need of more high-throughput options. That time lag often defeated the point of contact tracing. One of the biggest issues during this time was the retirement of a very large population of senior medical laboratory scientists. Working in the lab during the pandemic, many opted to retire instead of taking the risk. There was already a growing shortage in the field, so now we had lab employees working even longer hours, which means they were more stressed and exhausted.
Right now, there are too few training programs in this country for medical laboratory scientists and too few students who even know what a medical laboratory scientist does. Currently, some hospital systems are unable to fill their positions with certified medical laboratory scientists and now need to hire individuals who are trained in science to perform less complex testing.
To address this situation, at Centenary we’re considering creating a non-matriculated set of courses for students, which will provide the foundational education needed for these individuals to work in the labs and eventually might be eligible for the medical laboratory science certification.
Of course the story was not entirely negative. Healthcare professionals were true heroes on the front lines of the crisis. The COVID vaccines are saving millions of lives. Can you share a few ways that our healthcare system really did well? If you can, please share a story or example.
The fact that we were able to develop diagnostics that were sensitive and specific, that gave us reliable results in such a swift manner was a big win for our research programs and healthcare system. We had these diagnostics so quickly that we were able to ramp up our ability to test quickly. Yes, there were issues and hiccups, but the speed to address an issue of this enormity is a testament to the impact of science and scientific training in this country, and around the world. Also, the development of a safe, efficacious vaccine in such a short period of time has really changed the trajectory of the virus in the U.S. It was another massive advancement that was done safely and accurately, and we had a head start because of the other SARS viruses we’ve already experienced in other outbreaks. Some of the technology that has now been used is going to become more beneficial to us in the long term. The mRNA vaccines are going to be so amazing. I can’t wait to see them used in more ways.
The other big positive that I think we’ve learned is that the people who work in our labs are so dedicated and resilient. The medical laboratory scientists and the laboratory managers who oversee the work were so very busy due to the pandemic, but remained focused on following all of the guidelines for accuracy and safety.
Here is the primary question of our discussion. As a healthcare leader can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.
Here’s a sobering statistic: Approximately 70 percent of all medical treatment is based on lab findings. So you can see how central medical laboratory science is to the US healthcare system and to individual health outcomes. There are a number of things we can do to improve the system:
- We absolutely must recruit more trained, dedicated medical laboratory scientists. There are just not enough trained medical laboratory scientists to fill the vacancies. That means elevating the status of the field and making sure that they are appropriately compensated for their expertise. In the health professions, many people don’t know what a medical laboratory scientist does. It doesn’t have the same notoriety as being a doctor or nurse. As we expand our health science programs at Centenary University, we’re trying to reach high school students to present the great career options available in this field. We’re even considering summer camps for middle schoolers to get them excited about science, but also to introduce them to the different types of careers out there. You’ve got to plant the seed early.
- The US needs more accredited medical laboratory science training programs. This country has been losing educational programs. In fact, the number of training programs in the U.S. dropped by approximately 40 percent from 1970 to 2015. While there has been a small rebound in programs recently, these programs are underutilized. The demand for laboratory workers has grown 13 percent between 2018 and 2019, and the U.S. Department of Labor estimates that job opportunities in this field will expand by another 13 percent by 2026. These programs are very expensive to operate because students must be exposed to sophisticated instruments and technology, highlighting the importance of strong partnerships with local and regional health systems to help prepare students for their clinicals. At Centenary University, our medical laboratory science program provides all of the foundational courses, and then students do their clinicals at one of our healthcare partners — leading hospitals and labs in northwestern New Jersey that have all of the newest technologies, which are fascinating and expensive.
- We need to educate the next generation of medical laboratory scientists to be critical thinkers. Our students can’t be taught to rely on instrumentation alone. Technology is great, but it’s not infallible. Sometimes, it fails. We need more integration of the old and the new, so we can keep everything ready to go at a moment’s notice. When you have an instrument go down, your specimens are still piling up. You can’t let a backlog develop. A second instrument is always desirable, but sometimes you might have to go old school — reverting back to the basics.
- We must improve salaries for medical laboratory scientists. Remember, roughly 70 percent of all medical treatments rely on lab results. So these professionals are an integral — yet unseen — part of the treatment team. During the pandemic, the field was suddenly thrust into the spotlight. Now, we need to take a step back and evaluate why. It’s all about recruiting more highly trained professionals, but that can’t happen until the salary structure improves. For now, institutions including hospitals and private labs are offering a great number of sign-on bonuses. But that structure can’t be sustained.
- The final thing we can do is educate the public about testing: How it’s done and what it means to their health. During the pandemic, people were frustrated with the pace of testing, partly because they didn’t understand the steps that needed to be taken to receive an accurate result. When it came to COVID-19 tests, the media would say, “Tests are being done at this location.” That wasn’t true: The samples were being collected at that location. From there, the sample had to be processed, then undergo testing, and then results given and reported out. That needed to happen for every single test. Initially, people would think that if they were tested in a drive-up tent, the results should be ready the next day. As a healthcare system, we just weren’t ready for that volume.
Let’s zoom in on this a bit deeper. How do you think we can address the problem of medical laboratory scientist shortages?
One big thing happening in schools right now is an emphasis on STEM (science, technology, engineering, and mathematics). That’s great, but I think we’ve collectively pigeonholed our kids to think that they have to be doctors and engineers. Sometimes, there are also societal or cultural issues at play. Our society and certain cultures place a high emphasis on doctors, for instance, so there’s pressure on students interested in science to go into medicine. Students can face family pressure to choose the highest paying fields, when they may not be suited to that field at all. So, some of our efforts to educate the public about the great opportunities in medical laboratory science and other health sciences should focus on informing parents, teachers, and counselors about all of the students’ career choices. We need to introduce a wide range of careers, so students feel free to find the best fit.
What concrete steps would have to be done to actually manifest all of the changes you mentioned? What can a) individuals, b) corporations, c) communities and d) leaders do to help?
Partnerships between educational institutions, government, and corporations can go a long way. These programs are extremely expensive to start, so government funding is critical to support the educational programs needed to meet the great need for trained professionals in this field. At Centenary University, we’ve forged strong partnerships with some leading labs and hospitals, which have donated instruments and reagents to introduce to the students, as well as the hands-on clinical experience required for certification and their future career.
Another big thing corporations can do to support university-based programs is to get creative about providing them with lab equipment. For instance, one of Centenary’s clinical partners recently donated expired reagents and supplies, as well as outdated instrumentation, to use in our labs for training. This donation was probably worth more than 12,000 dollars and involved materials that our partner could no longer use. To us, it was a huge amount of money that we were able to put to another use to grow our program. The pandemic demonstrated that our society — including our government and corporations — have a vested interest in our programs, which are at the very heart of our nation’s public health.
Thank you so much for these insights! This was very inspirational and we wish you continued success in your great work.