TRAINING AND EDUCATION OF CYTOTECHNOLOGISTS IN EUROPE

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TRAINING AND EDUCATION OF CYTOTECHNOLOGISTS IN
EUROPE
Anic V. et al. on behalf of EACC
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BACKGROUND

• Updated, extended and revised version of the
  Questionnaire on training of Cytotechnologists in
  Europe that was presented at the EFCS meeting
  during the 17th International Congress of
  Cytology in Edinburgh.

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• There are included issues related to the
  numerical state, academic level, included
  subjects and duration of the basic education and
  training in cytology. Required number of slides
  examined under supervision prior to sign out
  cervical cytology specimens.

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• Accreditation and recognition of education, also
  issues related to the strategy of continuing
  education and external quality assurance scheme.
• We will try to answer the questions about the
  future optimal training Cytotechnologists,
  degrees and diploma that would enhance the
  acknowledgement of Cytotechnologists in Europe.

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MATERIAL AND METHODS

• A questionnaire was sent to 25 countries, 14
  countries that are EACC members and to the 11
  countries that are members of the EFCS but
  without representatives in EACC.
• On this questionnaire, we received responses from
  18 countries.

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Countries EACC members Reply
Austria (AUT) YES
Belgium (BEL) YES
Croatia (CRO) YES
Denmark (DEN) YES
Finland (FIN) YES
France (FRA) YES
Germany (GER) YES
Italy (ITA) YES
Netherlands (NED) YES
Norway (NOR) YES
Slovenia (SLO) YES
Sweden (SWE) YES
Switzerland (SUI) YES
United Kingdom (UK) YES
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Countries EFCS members without EACC representative Reply
Albania No reply
Greece (GRE) YES
Hungary No reply
Macedonia No reply
Poland No reply
Portugal (POR) YES
Romania No reply
Russia No reply
Slovakia No reply
Spain (ESP) YES
Turkey (TUR) YES
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Note Replies from Italy, Greece and Turkey are
excluded from this survey because

• In Italy, education does not exist, and answers
  to the rest of questionnaire are not received.
• In Greece, Cytotechnologists do not exist as a
  profession. Cytopathologists perform screening.
• In Turkey there is no official Cytotechnologists,
  however few biologists with MSC or PhD are
  practising as Cytotechnologists at some
  laboratories.

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RESULTS
The approximate number of fully trained and
employed Cytotechnologists
AUSTRIA BELGIUM CROATIA DENMARK FINLAND FRANCE GERMANY THE NETHERLANDS
300 300 225 175 180-200 700-800 2600 600
NORWAY PORTUGAL SLOVENIA SPAIN SWEDEN SWITZERLAND UNITED KINGDOM
130 2000 35 UNKNOWN 220 UNKNOWN 1300
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• According to competence level most of the
  Cytotechnologists are on intermediate level (can
  report and sign out negative and unsatisfactory
  cervical cytology specimens, can undertake
  rescreening and offer a differential diagnosis on
  abnormal specimens).

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• Denmark, Finland, Germany, The Netherlands,
  Sweden, UK and Portugal also have some
  Cytotechnologists that are on an advanced level
  (can report and sign out normal and abnormal
  cervical cytology specimens), while only few in
  all the countries are on a basic level (cannot
  report negative or unsatisfactory cervical
  cytology specimens).

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BASIC EDUCATION

• The basic educational standard required before
  entry into cytology training is mostly
  medical/laboratory technologist, but also
  biomedical scientist.
• Academic level and duration of the given basic
  education is mostly college (in seven countries
  AUT, BEL, DEN, SLO, SUI, ESP, partly UK) in
  duration of 3 years with bachelor degree after
  completing education.

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• In eight countries (BEL, FIN, FRA, NOR, SWE, POR
  partly CRO and UK), academic level of the basic
  education is university in duration from 2- 4
  years with master or bachelor degree.
• Three countries (partly CRO, GER, NED) have a
  high school in duration of 4 years as an academic
  level of the basic education.

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• Cytology, cell biology, molecular biology and/or
  biochemistry subjects are included in the basic
  education with exception of Portugal where these
  subjects are not included and cytology is not
  included in Belgium and France.

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TRAINING IN CYTOLOGY

• The training in cytology is mostly (in seven
  countries CRO, FRA, NED, SLO, SWE, SUI, ESP)
  given as a separate course/education.
• In five countries (FIN, GER, NOR, UK, POR) it is
  possible to have training/education as a part of
  general program of in-house training in the
  laboratory and as a separate course/education.
• In three countries (AUT, BEL, DEN), education is
  given as a part of general program of in-house
  training in the laboratory.

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• Duration of the training in cytology as a part of
  general programme of in-house training in the
  laboratory varies from 3 months up to 2 years.
• In most of the countries, gynaecology cytology is
  joint with non-gynaecology cytology in the
  education. In five countries (AUT, GER, UK, POR,
  SLO) gynaecology cytology is separated from
  non-gynaecology cytology in the education.

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• Duration of gynaecology cytology education is
  from 30 up to 120 credit points, or 90 up to 165
  hours.
• Duration of non-gynaecological cytology (only few
  answers) is from 20 up to 180 credit points, or
  from 3 months up to 369 hours.
• Duration of joint education is from 30 up to 120
  credit points, or from 100 up to 640 hours.

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• Possibility of joining just one part of education
  (only education for gynaecology cytology) is
  accessible in seven countries (AUT, BEL, FIN,
  GER, NOR, UK, POR), not possible in seven
  countries (CRO, FRA, NED, SLO, SWE, SUI, ESP).
• Subjects included in the curriculum are mostly
  gynaecology and non-gynaecology cytology,
  staining methods, molecular techniques and also
  lot of variations from anatomy, pathology,
  histology, quality assurance etc.

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• Academic level that instructors/training officers
  at the workplace possess varies from senior
  cytotechnologists, staff with master or bachelor
  degree, with IAC exam certificate,
  cytopathologists, pathologists....

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• Required number of slides screened with
  supervision before the Cytotechnologists trainees
  can sign out cervical specimens is from 770 up to
  7000 slides, but mostly around 1000.
• Approximate number of persons training to be
  Cytotechnologist varies from three up to 25 each
  year (Spain from 800 -1200 ?)

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• Who decides the training requirements for
  Cytotechnologists in the country ?
• In six countries, it is professional society, in
  three Ministry of education, government in two
  and nobody in four countries!

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ACCREDITATION AND CERTIFICATION

• Cytology training programme is accredited from
  academic institution on university level in five
  countries (AUT, FRA, NOR, SWE, POR) , on college
  level in one country (ESP), on high school in one
  country (NED).

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• In the other countries, cytology training
  programme is accredited from other institutions
  professional society, Ministry of health or
  education and institution that carry out the
  above mentioned education, in one country
  education is without accreditation.

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• Training programme is recognized nationally in
  almost all of the countries, exception is
  Belgium, Finland and Sweden where training
  programme is not recognized.

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Students who complete training programme are
awarded a
DIPLOMA DEGREE CERTIFICATE OF COMPETENCE
France Croatia Austria
The Netherlands Finland Belgium
Norway Sweden Denmark (QUATE exam)
Spain Germany
Switzerland Portugal
United Kingdom Slovenia
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CONTINUING EDUCATION AND QUALITY ASSURANCE

• Arrangements/strategies for continuing education
  in cytology almost all have annual meetings and
  courses that are usually not mandatory, but
  mandatory for all staff reporting cervical
  cytology in UK and Norway.
• Congresses are also represented in most of the
  countries, but not mandatory.
• From the other options accessible are slide
  seminars, one-day meetings and workshops.

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Approximate number of cytotechnologist who has
taken and passed the exam of the
COUNTRY IAC QUATE
Austria (300) 22 32
Belgium (300) few few
Croatia (225) 0 0
Denmark (175) 19 Approx. 130
Finland (200) 40-50 0
France (800) 17 0
Germany (2600) 15 Very few
Netherlands (600) No data No data
Norway (130) 20 20
Portugal (2000) 60 20
Slovenia (35) 0 1
Spain -- 10-15
Sweden (220) 18 5
Switzerland -- No data No data
United Kingdom (1300) No data No data
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• On the question Is the Eurocytology Website
  learning platform widely used in their countries
  ? - all participants answered with NO!
• Eurocytology Website learning platform is not
  widely used in their countries.

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Is there an organised external quality assurance
(EQA) scheme running in your region or
country and how frequently does it run?
AUSTRIA BELGIUM CROATIA DENMARK FINLAND FRANCE GERMANY THE NETHERLANDS
NO NO NO NO YES NO YES YES
1 x /year 1 x /year every 1-3 year
NORWAY PORTUGAL SLOVENIA SPAIN SWEDEN SWITZERLAND UNITED KINGDOM
NO NO YES (IMC) YES YES YES YES
4 x / year 4 /year 1 x / year 1x every 2 years 1/year
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OPTIMAL EDUCATION?

• Finland, the Netherlands, Norway, Switzerland,
  and Portugal believe they have the optimal or
  close to optimal education of Cytotechnologists.
• All the others answered that they do not have the
  optimal education of Cytotechnologists in their
  country and thinks that the optimal education
  will be on the university level.

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• Every participant have the opinion that diploma
  certified or accredited by EFCS would or probably
  would enhance the acknowledgement of
  Cytotechnologists in Europe.

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CONCLUSION

• The results of this survey is a summary of an
  existing and accessible education and training of
  Cytotechnologists.
• What is common and what is different in 18
  European countries, as well as suggestion for
  guidelines on which future training and education
  should be developed based on needs and
  deficiencies of the existing.