Pathways to Excellence

Growing Our Own Training Initiatives Develop A New Generation

Institutions across the country continue to face shortages of medical lab professionals who are vital to the healthcare journey of patients and their families.

Rochester is not immune. Staffing issues existed prior to 2020 and were further exacerbated by the pandemic.

Prior to the shutdown, the Department of Pathology and Laboratory Medicine had already begun to develop solutions to meet the challenge head-on, in part by creating training models that can produce and sustain a new generation of talented employees. With lab workloads only rising, this cannot happen quickly enough.

Volumes are increasing: 11.4 million tests were performed last year at all UR Medicine lab sites, including our six regional affiliate hospitals. Patient Service Centers are seeing 3,000 patients each day.

The ongoing need for medical laboratory staff prompted the department to make moves toward finding ways to train more individuals for a variety of roles, including clinical medical technicians and technologists, phlebotomists and histotechnicians.

“It’s an opportunity to meet our health system’s current, critical needs and build a sustainable pipeline of employees who we have handpicked and trained to excel within our growing team,” said Vicki L. Roberts, M.S., Education Director and Clinical Laboratory Technology Program Director.

The long-time medical technologist who began her career 39 years ago emphasized the incredible satisfaction that comes with the profession.

“The educational experience that graduates take away from our programs is not limited to mastery of the clinical concepts in order to pass a licensing exam,” Roberts said. “The far-reaching, long-term value is about a career that influences thousands of lives for the better.”

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Summer weather in Western New York has once again made its grand entrance, bringing with it growth and renewal in a very literal sense – do you recall what it’s like to finally see green grass and beautiful flowers here after a long winter? This time of year also spurs hopeful feelings of change and progress that are reflected in multiple aspects of life, including our department’s advancement in all our missions.

Clinical

Our department’s clinical workload continues to increase, making us the busiest lab system in the region with total tests performed at all site exceeding 11.4 million. All our teams have seen a significant rise in cases. In this post-pandemic era, with increased staffing, we have been able to reopen all of our Patient Service Centers that had temporarily closed. Volumes have steadily increased, now serving more than 3,000 patients per day. We are investing in technology and purchased a whole-slide scanner, to begin to build an infrastructure that allows for many more slides to be imaged at one time, rather than only a handful, as had been the capability until recently. It also brings the possibility of remote diagnostics closer.

I am happy to report our Clinical Laboratory Relocation and Consolidation Project has received URMC Board approval and construction of the second-floor expansion will officially begin this year. Design development is complete and we’re working on construction plans. The 19,000-square-foot addition for Surgical Pathology and Cytopathology labs will be built over existing Central Lab space. The relocation of teams and equipment is expected in 2024.

Education

This time of year always means saying goodbye – and hello –to pathology learners.

Of the eight graduating fellows moving on to do great things, we are thrilled that two will remain at URMC. And four of our stellar residents have graduated and are moving into new roles (two of them at our medical center!). In their place, we welcome three new residents to our team.

Training programs to “grow our own” are bearing fruit. This spring we celebrated the graduation of 15 medical technologists and I’m pleased to report that 11 of these in-demand professionals have chosen positions with URMC. The next cohort of 15 starts training this fall.

Other partnerships are increasing the pool of available candidates for multiple positions. We provide clinical rotations for more than 30 students attending other institutions to become histotechnicians and cytotechnologists, collaborating with Broome Community College, Monroe Community College, Cobleskill, Daemen College/Roswell Park, Nazareth and SUNY Buffalo.

Our creative Phlebotomy Reimagined initiative was developed and is overseen by the Specimen Management & Phlebotomy teams. This workforce training model allows individuals to be hired as entry-level trainees and provides an additional 80 hours of extensive registration training.

We continue to partner with BOCES/WEMOCO and East High School in Rochester on a certification program for clinical lab assistants that provides a direct path from high school to hire. Last year, four students completed the program, which requires 80 hours of clinical observations. This year we were excited to work with 16 students.

And we have created a pathologists’ assistant program in partnership with Drexel University. Our first student will begin in spring 2024.

Research

Current active extramural funding totals nearly $6 million for research, with $4.4 million coming from NIH and DOD.

New awards in 2022 included funding secured by Raj Bharadwaj (NBIADA), Arch Perkins (DOD), Zhenqiang Yao (NIA, DOD), Ben Frisch (ACS), and Kimberly Burgos Villar (NHLBI).

Our department had a great presence at USCAP 2023, boasting 31 posters, five platforms, six courses and one moderated session.

There is, of course, more work to do.

We are finding ways to increase and retain our department’s workforce, which has suffered from shortages that are all too common in health care in 2023.

We are investing in the latest automation for our labs and development initiatives to help and reward existing, valued staff, many of whom continue to be impacted by the last three years.

The medical center continues its search process to find a new chair of Pathology and Laboratory Medicine. We hope to have news on that front by this fall.

Clinical Medical Technologists

Seeing the writing on the wall more than six years ago, with fewer clinical medical technologists being trained and available for hire, the department developed and launched its own educational program for CMTs in order to increase the pool of eligible applicants.

The Advanced Certificate Program in Clinical/Medical Technology is a full-time, nine-month commitment. It is accredited by the National Accrediting Agency for Clinical Laboratory Science. Graduates are qualified to apply to the American Society for Clinical Laboratory Science (ASCP) to take the national board examination and achieve national certification and New York State licensure as a medical laboratory scientist.

The vision for the program has become a reality. Since August 2017, it has graduated a total of 73 CMT students. Most recently, a 15-member cohort completed their training in May, with 11 of them choosing to become employees with UR Medicine.

“We are graduating well-prepared CMTs who have had the benefit of expertise provided by our own educators and experiences in our own labs,” Roberts said. “We play a role in increasing the numbers across the state and beyond, which impacts health care in many other communities. And a large percentage stay with us to begin their career, greatly influencing the ability of our department to meet the growing needs of our own health system and our regional community.”

The seventh class joins us mid-August.

Heather Sassone is Education Coordinator for the Department of Immunohematology and a Transfusion Medicine Medical Technologist Specialist. She enjoys her role working with the CMT students, who come from all walks of life and contribute to the group’s collective learning. Sassone includes herself in that.

“As the students question things we are teaching them, I am forced to dive deeper into familiar topics and, as a result, am able to continue my own learning. The students definitely keep me on my toes and challenge me.”

With the shortage of healthcare workers of all kinds across the country, including in pathology, it’s important to Sassone that she’s making a positive impact.

“It is extremely fulfilling, training the next generation of med techs,” she said. “Luckily, most of our students enjoy their experience and decide to work at the university. Techs involved in training know that the more time and effort they put into the students, the better the quality of their future co-workers. And we are helping to fill vacancies and therefore improving everyone’s work environment.”

Sassone, who was awarded the 2023 Tai Kwong Excellence in Teaching Award for her efforts, hopes each student finishes with more than just educational aspects needed to become a CMT.

“I want to instill in them that, though most clinical laboratory jobs are behind the scenes, we are directly impacting patient care in a positive way each and every day. I want techs new to the profession to know how important our work is and what a large part of patient care is dependent on the work we do.”

Phlebotomists

Phlebotomists are in high demand to staff UR Medicine’s 40 Patient Service Centers and serve 54 nursing homes, with sites located in communities across the Finger Lakes and Southern Tier regions. Our team of about 175 phlebotomists also provides homebound services, last year performing more than 32,000 draws in patient homes. The phlebotomy team saw a total of 700,000 patients last year.

A department-developed program started in 2021 with a student training model to increase the number of phlebotomists. It required 150 hours of lecture and hands-on training and the commitment was difficult for many who had additional obligations. As a result, the program shifted into an employee training pathway – part of the Phlebotomy Reimagined initiative – that allows for hiring an individual at entry level to bring them formally into the department as an employee.

“Our innovatively approach is providing an opportunity leading to certification while giving individuals the security of having full-time employment and not having to miss work time for the training and practicum,” said Holly Harrington Smock, Assistant Director of Pre-Analytical Operations. “We are able to provide training experiences that directly correlate to new hire training so when they complete the course, they have accomplished much of the new hire base training.”

After successful completion of the seven-week course, graduates are eligible for national certification as a phlebotomy technician with the American Society of Clinical Pathology.

Since 2021, 18 students and trainees have completed the program. Before moving to the employee trainee model, the percentage of graduates who chose UR Medicine for their first phlebotomy position was 64%. It is now 100%. The program’s sixth cohort of five employees completed the training program and were recognized during a certificate ceremony this spring.

Additionally, a new University of Rochester initiative – UR Career Pathways – allows approved UR employees to train

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RESEARCH DAY HIGHLIGHTS PATHOLOGY LEARNERS, FACULTY

Another successful Pathology Research Day – our department’s 42nd annual – was celebrated June 5 in the URMC Kornberg Medical Research Building.

The event included more than 50 poster presentations, in addition to 14 oral presentations delivered by graduate students in the Cell Biology of Disease Ph.D. Program and Pathology residents.

Our keynote speaker was Tami Martino, Ph.D., Distinguished Chair of Molecular Biology and director of the Centre for Cardiovascular Investigations at the University of Guelph. Her talk was titled “Circadian Medicine: Revolutionizing the Treatment of Cardiovascular Disease and Other Major Conditions.”

2023

Research Day Honors

Chair’s Recognition Award: Xiaolan Ou, M.D., Ph.D.

Eric Schenk Teaching Award: Paul Hosking, M.D.

Janet Sparks Teaching Award: Alayna Loiselle, Ph.D., an alumna of our Ph.D. program

The Robert Mooney Award for Outstanding Thesis goes to Dr. H. Mark Kenney, mentored by Dr. Edward Schwarz.

Dr. Kenney is a rising fourth-year medical student in the Medical Scientist Training Program (M.D./Ph.D. program) who defended his thesis in May 2022. He plans to apply to residency programs with the goal of pursuing rheumatology-dermatology or dermatopathology as his specialty.

News Briefs

CULTIVATING THE NEXT GENERATION

For outstanding scientific presentations, residents Ben Gertsen, M.D. (1st place), and Alexander Besen, M.D., and Kyla Jorgenson, M.D., M.S. (tie for 2nd place), as well as graduate students Kiana Chen (mentor Homaira Rahimi, M.D.), Carol Deaton (Gail Johnson, Ph.D.), Zachary Sechrist (mentor Calvin Cole, Ph.D.) and Celia Soto (mentor Benjamin Frisch, Ph.D.) each will receive travel awards.

Additionally, Akash Mahmudul (rotation mentor Zhenqiang Yao, B.Med, Ph.D.) will receive a travel award for his poster in the Cancer category of the of the poster session; Duy Nguyen (mentor Patrick Murphy, Ph.D.) for his poster in the Cell Biology & Genetics category; Sophia Eliseeva (mentor Felix Yarovinsky, M.D.) for her poster in the Hematology & Immunology category and Chen Yu (mentor Roman Eliseev, M.D., Ph.D.) for her poster in the Musculoskeletal and Craniofacial Research category.

The Ph.D. Student Leadership Award was given to Sophia Eliseeva for her work as president of our student council during the 2022-23 academic year. Many thanks to Sophia and the other members of the student council – Emily Whitt (past president) and Vania Lopez-Ruiz (social/communications chair).

Program Administrator Melissa Allen recently spent time with a senior allied health class at Baldwin Union School, located on the South Shore of Long Island. She shared information about the roles of medical laboratory professionals and touted the wide range of job opportunities available. Above is one of many thank-you notes she received from the appreciative students. Thank you, Melissa, for carrying our flag!

BSC CONFERENCE HIGHLIGHTS FUTURE OF BIOMARKERS, TISSUE APPLICATIONS

The 42nd Annual Biological Stain Commission Conference, hosted by the department in June, included speakers from Yale University, Georgia State University, Miami University of Ohio, BSC and URMC, focused on the future of biomarkers and tissue applications.

The Department of Pathology and Laboratory Medicine has lost a valued friend and colleague. P. Anthony (Tony) di Sant’Agnese, M.D., passed away peacefully at his home in Naples, Florida, on October 28, 2022. He was 73.

Dr. di Sant’Agnese was an esteemed member of our Surgical Pathology team for 35 years. He began his career at URMC as a surgical pathologist in 1979, became a full professor in the 1990s, and served as director of Surgical Pathology before retiring in 2014. He was remembered by Pathology colleagues and his family at a memorial celebration at the University of Rochester.

He was deeply respected by faculty, staff, and trainees alike for his expansive knowledge of pathology, his love of teaching, and his innate ability to connect in a way that made others feel welcome.

“I remember Tony’s willingness to always help, and his characteristic laugh that instantly made you comfortable,” said Philip J. Katzman, M.D., who met him as a resident and became a long-time colleague and friend.

“His broad knowledge of pathology often made him the ‘go-to’ person for diagnoses,” Dr. Katzman said. “When we had consensus conference in the multiheaded scope room, he would take the central middle position behind the scope. There is a plaque now in that room to honor the work he did there.”

Dr. di Sant’Agnese was born into a family of medical professionals. His father, Paul Artom di Sant’Agnese, M.D., had been chief of the Pediatric Metabolism Branch within the National Institutes of Health (NIH). His mother, Elizabeth di Sant’Agnese, was a registered nurse and University of Rochester alumna.

He was very bright and inquisitive at an early age and was academically successful in school. He was valedictorian of his high school class at the Landon Academy in 1967 and graduated Cum Laude from Amherst College in 1971. He earned his medical degree in 1975 at Columbia University, College of Physicians & Surgeons. He continued four years of training as a

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resident in surgical pathology and was awarded the Harold Lee Meierhof Memorial Prize for Excellence in Pathology.

A true believer in the positive impact of his work, Dr. di Sant’Agnese continued to follow the latest research even after he retired. During his renowned career, he was published in more than 150 journal articles and book chapters, and will be remembered for his contributions to documenting the endocrine-paracrine cells of the prostate, as well as neuroendocrine prostatic cancer research.

“In 1980, Tony and I were partnered to run the Diagnostic Electron Microscopy clinical laboratory,” said Karen Bentley, M.S., director of the Electron and Cryo Microscopy Resource. “I will always remember how he was so enthusiastic about teaching Surgical Pathology with correlations to the electron microscopic aspects of neoplasms, metabolic, and infectious diseases to pathology residents who eagerly attended his seminars. During the 15 years we worked together, he also trained me in Surgical and Ultrastructural Pathology, which to me demonstrated an incredible level of academic generosity and mentorship.”

He devoted most of his time to medicine but still had time to study the weather and travel the world. He was fluent in French and Italian as he spent many summers abroad. In his earlier days, he was a very good tennis player, golfer, and sprinter.

In addition to his integrated pathology insights in medicine, Dr. di Sant’Agnese was known for his kind heart, generous spirit and his love for his children, Andrew, Adrian, and Gabriella (Adam). His ashes will be laid to rest at Mt. Hope Cemetery in Rochester.

To make a tax-deductible gift to Pathology & Laboratory Medicine, visit www.pathology.urmc.edu and click "Make a Gift." You can also contact Melissa Head at (585) 273-2890 or melissa.head@rochester.edu.