American Society of Cytopathology's cytopathology workforce survey in the United States

Introduction: To assess the current state of the cytopathology workforce shortage in the United States. Materials and methods: A survey comprising 32 questions was developed by the Government Affairs and Economic Policy Committee of the American Society of Cytopathology using Survey Monkey software. It was distributed to the American Society of Cytopathology membership through email, and the anonymous responses were compiled into an Excel spreadsheet. Results: We received a total of 200 responses nationwide. Of these, 86.7% of respondents experienced a cytopathology/laboratory workforce shortage with 35.8% facing this issue for more two years. The most significant reported shortages were cytologists (72.1%) followed by histotechnologist (52.9%) and cytopreparatory personnel (47.1%). The impact of these shortages included stress (70.4%), patient care compromise, and job changes. The primary cause cited was noncompetitive salaries along with a decline in cytologist training programs. Other factors included job security concerns, increased workload, negative work culture, lack of flexibility, lack of appreciation, limited career growth opportunities, government policies, geographic location, retirements, and the COVID-19 pandemic. The most common reported mitigation strategies include redistributing work amongst the existing staff, outsourcing excess workload to a reference laboratory, and offering overtime. Additional measures included employing travel cytologists, cross-training technical staff from other areas of the laboratory, and assigning pathologists to perform technical tasks. Conclusions: This study enhances the understanding of the cytopathology workforce shortage in the United States, including perceived reasons of the shortage. The results offer valuable insights and a foundation for future surveys or intervention studies aimed at addressing this issue.