CAAHEP Communiqué October 2010

Prepared by Deborah McIntyre, CPRC Coordinator, and Members of the Cytotechnology Programs review Committee

In the pioneer days of diagnostic pathology, it was the rare pathologist who did not have an associate who, although aiding throughout the process from patient to microscope, had little or no formal training. These first technical "assistants" were always the product of apprentice-type training. Some of the earliest "assistants" of pathologists working in cytology were those trained by Dr. George N. Papanicolaou, famed pioneer of the GYN Pap smear (or test). These individuals were initially referred to as cytologic technicians and subsequently as cytotechnologists. We owe much to these individuals, who not only paved the way for the development of an exciting subspecialty, but were also critical in defining the art and science of cytopathology. Gynecologic (Pap test) screening, fine needle aspiration cytology, and currently molecular diagnostics have been made possible and advanced through their efforts, in collaboration with the cytopathologists and scientist communities.

As the number of cytotechnologists and "apprentice programs" grew, a need for certification arose. In order to meet this need, the Board of Registry of the American Society for Clinical Pathology (ASCP) offered the cytology technician examination for the first time in 1957. Five years later, the Essentials of an Acceptable School for Cytotechnologists were developed by the ASCP and adopted by the House of Delegates of the AMA. In 1975, the American Society of Cytology (currently the American Society of Cytopathology or ASC) was recognized as the organization that would collaborate with the AMA Council on Medical Education. To fulfill this role, the ASC formed the Cytotechnology Programs Review Committee (CPRC). Today, the CPRC serves as the Committee on Accreditation (CoA) of all CAAHEP-accredited cytotechnology training programs.

Cytotechnology is an allied health speciality offering many exciting possibilities for those interested in a career in patient care, science, and research. Simply put, cytotechnologists are cell detectives who play a crucial role in the discovery of disease processes using a microscope to examine and study human cells. They are trained to search for morphologic abnormalities such as cancerous cells, pre-cancerous cells and/or infectious organisms. Most notably, cytotechnologists are responsible for the screening and often complete interpretation of the Pap test, caring for millions of women annually. This classical role has significantly expanded of late, in part due to the growth of technology and services offered throughout laboratory medicine. Cytotechnologists today play pivotal roles in molecular diagnostics, quality assurance and hospital risk reduction, administration, and education (as pathology residents, cytopathology fellows and cytotechnology students). Cytotechnologists are employed in hospitals, private laboratories, university medical centers, government facilities, and industry settings. Currently, there are 33 accredited programs in Cytotechnology in the United States and Puerto Rico, offering baccalaureate, post-baccalaureate (certificate) and Master level programs.

Unfortunately, the number of cytotechnology programs has steadily decreased from 48 programs in 2005 to 33 programs in 2010, due mainly to financial constraints and uncertainties about the future of the profession. In April 2009, cytotechnology educators convened to assess the current state of cytotechnology education and begin the process of collaboratively designing a bold and innovative plan to ensure its strong future. Key issues were identified and blended into a Future Cytopathology Summit, which occurred in November 2009, examining the evolving role of the entire field of cytopathology and where the future of our professional community lies. Although the economic downturn and public perception remain challenges today, the outlook for the profession is truly positive. Opportunities continue to grow in molecular research and diagnostic testing, clinician and patient interaction via on-site fine needle aspiration review, informatics, and roles within hospital leadership and quality/performance improvement. As with the light microscope to which we owe much, the future is a bright one indeed.