By - February 14, 2023
The medical laboratory is in crisis. Its workforce has drastically diminished over the past several years, negatively affecting laboratories’ abilities to deliver timely test results, which in turn affects the delivery of quality patient care. We know the factors that have contributed to workforce decline: Baby boomers retiring, burned out professionals leaving the field, the closing of costly training programs, and the demand for testing that skyrocketed during the COVID-19 pandemic.
A lesser-known factor is the amount of debt that students need to take on to enroll in laboratory training programs. This article will examine how crushing student loan debt is creating a barrier for many aspiring scientists to enter and stay in the laboratory field.
To address this crisis, ASCP has developed a multi-pronged strategy to bolster the laboratory workforce. First, let’s take a brief look at some of ASCP’s recent initiatives to address workforce issues.
In 2021, ASCP and the University of Washington Center for Health Workforce Studies released the results of a groundbreaking study, Clinical Laboratory Workforce: Understanding the Challenges to Meeting Current and Future Needs, which proposed strategies such as introducing medical laboratory careers to students as young as elementary school and building a more diverse and inclusive laboratory workforce.
In March 2022, the Society launched a Workforce Steering Committee to develop a comprehensive approach to oversee ASCP initiatives to increase visibility of the project; recruit more people into the profession; support and retain existing laboratory staff; and build a more diverse and inclusive workforce.
In Summer 2022, ASCP’s Institute for Science, Technology and Policy conducted research on the number of loan repayment and forgiveness programs available to laboratory personnel. ASCP’s findings—that there were far fewer debt relief programs available to laboratory professionals vs. medical and nursing students and other allied health professionals—were deeply discouraging.
One of the key factors affecting these shortages is the high cost of college education, with the costs for healthcare professionals notably higher. Student debt reform has received significant coverage in the news lately, even more so as the Biden Administration seeks to reduce the crushing debt load that many college degree holders carry long after they graduate.
In 2022, the average total cost of a bachelor’s degree at a public college of university was estimated at $103,000 for in-state students and $174,000 for out-of-state students according to the Education Data Initiative (EDI).1 EDI estimates the cost at $219,000 for private colleges and universities. When it comes to student loan debt, EDI estimates that the average amounts are $132,268 for PhD holders, $80,494 for master’s degree holders, $37,667 for bachelor’s degree holders, and $20,000 for individuals with a two-year degree—and educational costs for healthcare professionals tend to be greater than for non-healthcare professionals. It takes loan holders roughly 20 years, on average, to pay off their loans, despite the fact that the standard repayment plan for student loans is 10 years.2
Another concern about the educational costs borne by health professionals is that they pose a considerable barrier to career entry for many underrepresented minority students, whose economic resources tend to be, on average, less than those of other students. On average, black college graduates have $25,000 more academic debt and LGBTQ+ graduates have $16,000 more debt. As a result, addressing the high costs of education is not only necessary to addressing laboratory workforce shortages, but it is also critical to increasing diversity, equity and inclusion in the healthcare workforce.3
Meanwhile, the average hourly wage for a medical laboratory scientist is $33.13 (or the equivalent of $68,910 a year), according to the ASCP 2021 Wage Survey report, published in Fall 2022. The gap between education costs and salary is vast, making it very difficult for laboratory professionals to get out of debt for many years after they graduate.
A challenge for younger laboratory personnel is that if they are unable to retire their debt quickly, it could sneak up on them and then they may not have the ability to put money toward their future retirement. If the profession wants to fill the gaps in the workforce, then it is critical to make it easier—and more affordable—for laboratory professionals to enter the field.
The study of existing debt relief programs, conducted by Institute for Science, Technology and Policy fellow Haleigh Mauldin last year, found there are a number of programs (Table 1) to assist professionals in more visible sectors of the healthcare workforce, such as physicians and nurses. However, there are not many loan assistance options for laboratory professionals. Laboratory professionals may be eligible for financial assistance through the Indian Health Services (IHS) Loan Repayment program, for example, but given this program’s limited funding it does not have the bandwidth significantly impact on laboratory workforce challenges.
Table 1: Federal Options by Profession
Of Major Federal Student Forgiveness Programs
· 9 are available for nurses
· 8 are available for physicians
· 6 are available for pharmacists
· 4 are available for laboratory professionals
In December 2022, a massive federal spending bill was passed, which included two workforce programs for which laboratory professionals are eligible: The Public Health Workforce Training Program and the BIO Preparedness Workforce Pilot Program. The former would allow recipients to receive up to $50,000 a year for loan forgiveness if they put in a minimum of three years of work, thus totaling up to $150,000 per person.
A study conducted by Haleigh Mauldin, 2022 ASCP Carter Stephen Ainsworth Health Policy Summer Fellow, of student loan forgiveness programs for laboratory professionals: concluded:
· Laboratory Professionals are overlooked for loan forgiveness programs
· Laboratory training programs are not eligible for Health Resources and Services Administration (HRSA) grants
· Lab professionals are predominantly women, especially in lower paying laboratory positions
· Women have higher average student loan debt than men
· As the field becomes more diverse, more members could have higher student loan debt
One option is the Public Service Loan Forgiveness (PSLF) program that provides relief from student loans for individuals working in certain occupations, which include healthcare. Although the PSLF is open to laboratory professionals employed in many sectors of public service, it has been extremely difficult to secure debt relief from the program. That said, the Biden Administration has made it a priority to reform this program, and it hopes new regulations will increase access to loan forgiveness. To secure benefits, individuals must have paid 120 consecutive payments (or 10 years) on their loan payments and provide 10 years of service in eligible occupations. Click here for more information on this program.
Looking to the future of the profession, ASCP is urging the federal government to expand options for federal student loan forgiveness to laboratory professionals to mitigate the ongoing shortage in the field. A continued dearth of personnel to perform the diagnostic tests will add even more strain on an already overburdened healthcare workforce.
Specifically, the Society is recommending the federal government create a health program that allocates funds to the allied health professions, similar to the current federally funded National Health Service Corps (NHSC). Creating a loan forgiveness program designed to benefit laboratory personnel would alleviate some of the stress on the laboratory workforce that plays a critical, yet often overlooked role as part of a patient’s care team.
ASCP recognizes that part of the solution for addressing the workforce shortage is helping those interested in the profession afford the education and training necessary to enter the field. ASCP continues to advocate for loan forgiveness scholarships and fellowships, programmatic funding and other policies that can increase interest in the lab field and increase training opportunities.
In late December 2022, President Joe Biden signed into law a massive spending bill that included two workforce loan repayment programs that ASCP had strongly advocated for—the Public Health Workforce Training Program and the BIO Preparedness Workforce Pilot Program, which will incentivize healthcare professionals to pursue careers in infectious disease and bio-preparedness in underserved communities and health professional shortage areas via a targeted loan forgiveness program.
Despite the new programmatic offerings in the new federal spending plan, ASCP believes much work needs to be done to alleviate the economic barriers to entry to the medical laboratory profession. Effectively addressing the laboratory personnel shortage involves several actions. It involves increasing the number of, and access to clinical training programs and increasing training program capacity. It will also require steps to make the costs of education more manageable, such as providing laboratory personnel with access to federal, state, and other scholarships and fellowship funds, as well as the targeted student loan relief currently reserved for other health care providers.
1. Hanson, Melanie. “Student Loan Debt Statistics” EducationData.org, October 26, 2022,