We can work it out (Musings on transfusion association annual meetings)

Last revised: 2 June 2019  (See ADDENDUM below)

INTRODUCTION
As the CSTM annual conjoint meeting with CBS and Héma-Québec is now on May 29 to June 2, I thought I'd muse on annual meetings in general. As readers of this blog will know, I've had a long career in transfusion starting at the bottom without qualifications but being incredibly fortunate in my employers.

I'm an outlier of sorts with atypical views and being an oldster gives me the freedom to say things that colleagues likely would not. Perhaps many may disagree with me on this blog's points. That's okay too as I'd be concerned if all, even most, agreed with me. Included are tidbits I think contribute to quality presentations at meetings.

Professional associations exist to serve and represent the interests of their members, which applies to the three associations I belonged to during my long career as a medical lab technologist turned educator: AABB, CSMLS (includes IFBLS membership), CSTM. The latter two are Canadian organizations, the first American but AABB has branched out to become international, though its headquarters remains in the USA as does its primary focus.

The blog's title is based on a 1965 Beatles ditty, We Can Work It Out.

LESSONS LEARNED
Over the years I've attended many meetings, aka conventions and congresses. With a few exceptions most of all those attended were held in Canada by CSMLS or CSTM. One memorable one (IFBLS) was held in Oslo in 1996. Why memorable? Most of all it was because I met a Norwegian med lab technologist who worked in transfusion and we've been good pals ever since.

To me, that's Lesson #1 of what's important at annual meetings. It's not so much the scientific presentations you hear and what, if anything, you learn from them (commit to long-term memory). Face it, if you read professional journals you're pretty up-to-date on the latest and greatest. During my career the AABB journal Transfusion and similar were kept in the bathroom as a welcome distraction or read while basking outside in Canada's all too short spring, summer, fall.

Of course, I suspect not many transfusion technologists and nurses in the trenches regularly read journals. Take a peak at the index of Transfusion 2019;59(5). How many articles would you read let alone understand?

Today, keeping current also applies to those on social media platforms like Twitter where journals and associations alert folks to the latest developments. But how many of you use Twitter?

LESSON #1: The most valuable benefits of meetings are the interactions with peers, sharing experiences and knowledge that's not in journals or textbooks, including the friendships made. Often such interchanges are shared during a night-out over a meal or glass of wine/beer. Typically, chitchat involves practical and tacit knowledge only gained from experience.

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Pretty certain that Lesson #2 will be familiar to medical lab technologists/scientists world-wide, at least those lucky enough to attend meetings:

• So many of the presentations at transfusion association meetings are by physicians and researchers, though it's slowly changing. 

What this means is the information and research presented, though significant, is often not particularly meaningful nor of immediate use to those in the trenches, whether transfusion med lab techs, nurses, physicians without university appointments. And being able to use new meaningful learning right away is important to busy adult learners. In continuing education and professional development courses it's critical because 'adults vote with their feet' as the cliché goes.

Indeed, I wonder in the age of the smart phone how many meeting attendees during presentations  spend most of the time checking e-mail, texting and browsing. Suspect it's far too many. Best take is they're live tweeting but no, that's not it.

Reality is that much transfusion research is esoteric, of interest mainly to those involved in similar, narrow research.  Kudos to CSTM for its full day of workshops relevant to front-line professionals.

LESSON #2: Many presentations at scientific meeting are of minimal value to attendees, especially those who work in the trenches on the front-lines of transfusion, those in the lab and those on the wards. If you're a PhD or MD/PhD researcher and the topic coincides with your interests, the talks are no doubt fascinating.

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Lesson #3 relates to a sad fact of life for many in the trenches. Years ago funding for CE/CPD was scaled back significantly. The result is fewer and fewer attend national meetings (unless local), let alone international ones. Today the cost of airfare and hotels is increasingly exorbitant.

Who can afford it? My guess includes

• Physicians and researchers who get funding support or earn large salaries, along with those in senior positions. 
• Bench technologists and front-line transfusion nurses not so much. 
• Educators and those in health profession unions who get discretionary funds to use for CE/CPD but the funding wouldn't come close covering travel and hotel costs to attend meetings outside their locale. 
• Some associations fund invited presenters, but not all.
• An association's board of directors, whose members are volunteers and put in much dedicated time and a tiny perk is funding to attend meetings.

Many transfusion associations/organizations now offer local CE/CPD events across the country or provincially, including CSTM's Education Days. And thanks to the Internet, technology makes webcasts and podcasts possible.

LESSON #3: To what extent have annual meetings become a place for the 'elites' to meet and interact?  By elites, I mean those professionals fortunate to have funding or be wealthy enough to attend if the meeting is not in their locale and schmooze with other elites? It's a question to which I do not have an evidence-based answer, yet suspect it may be true.

~~~~~~~~~~~~~~~~

Lesson #4 has been a pet peeve of mine for ages and relates to the quality of presentations at meetings by the biggies, the so-called 'thought leaders' of a profession. My experience is presentation quality is often awful, bordering on pathetic.

It's one reason I'm so glad that Medical Laboratory Science at the University of Alberta has a communications course that includes how to give presentations and gives students opportunities to practice the skills, including presenting their research projects.

Wish all MSc/PhD graduate and medical education programs included such a course. About physicians, my experience is, if a communication course or any professional development program, is not given by a physician, they devalue it. Apparently only physicians can teach physicians.😞

To me the biggest, common presentation failures include NOT doing the following, relevant to physicians, especially. BTW, the points are basic, equivalent to Presentation 101 courses.

• Begin with a personal anecdote to grab audience attention immediately and get them to appreciate your authenticity, that you've 'been there, done that,' and dig their professional realities.
• Explain up-front why the talk is relevant to the audience.
• For gawd sake, don't keep it a secret.
• Briefly outline what the talk is about, perhaps even say, if that's not what you expected, feel free to exit now. 
• Shows you  respect the needs of audience.
• Mention there will be time at the end for questions, if the person who introduced you did not.
• Distribute handouts at the end and say that up front. 
• Include your speaker notes in handouts so the audience has something substantive to take away.
• In the early days of Powerpoint I don't know how many handouts I brought home from meetings, including making notes on each slide myself, that were all but useless and eventually tossed in a trash can.
• Fact: If you distribute handouts at the start of a talk, the audience will concentrate on them, not what you are saying.
• Use mostly graphics in the presentation vs bullet points. It's a way to get folks to listen to what you say.
• If you use a few slides with bullets, do NOT use complete sentences and, regardless, NEVER read the points word for word unless you want to put the audience to sleep.
• Forget about using any busy slides you have where the writing is minuscule and unreadable.
• Just don't, no matter what.
• Saves you the trouble of cynically apologizing for it being busy.
• Because obviously you included the slide anyway, thus disrespecting your audience's intelligence. 
• Throughout the talk refer to the experiences of colleagues and audience members you recognize, and sprinkle the presentation with their work.
• It's not all about you, it's about those who helped you succeed.
• Self-deprecating humour, if sincere, is appreciated by listeners.
• Focus on key points only.
• Though tempting, do not succumb to presenting all your data and conclusions.
• Few viewers are as obsessed with the topic as you are.
• The fewer key learning points, the more they will be remembered because of info overload.
• At talk's end, briefly tell the audience what you told them and reinforce why it's significant and relevant to them. 
• Thank the audience for their attention and thank conference organizers for inviting you.
• With questions at the talk's end, even if you get snarky questions (yep, there are always all-about-me colleagues), try to be gracious, realizing that to most in the audience, the asker is showing themselves in a bad light and you are better than them.
• Taking the high road always wins.

LESSON #4: Physicians and researchers, at least try to learn how to present well. I realize you could care less as you've gotten away with pathetic presentations forever and have zero motivation to change. But please try to be better because it has many rewards, adds to your reputation.

 ~~~~~~~~~~~~~~~

ADDENDUM

First a disclosure. Folks, for most of my career I was one of the fortunate 'elites' I referenced earlier, mainly by virtue of volunteer positions for professional associations, being an invited speaker at conferences where organizers funded travel and hotel costs, or as a perk of being an educator at a university. 

One thing I noticed in those days of yore versus today's national meetings is that now there seem to be fewer young attendees. Perhaps it's my imagination or just that all professions are aging and those in senior positions are older than before. Or maybe not.

While I hesitate to mention this, one reason could be that younger med lab technologists/scientists may not be as keen as we were in what I call the 'golden age of immunohematology.' Perhaps when considering annual fees, younger folks and many older ones too, wonder if it's worth it, questioning the benefits of membership. That is, they first ask 

• What will the association and being a member do for me? vs
• What can I do for my association?
• How can I give back to my profession?

Or it could be that membership for some has become a financial burden. For example, in Canada registration with provincial regulatory colleges is compulsory for med lab techs,e.g. CMLTO annual fees. In contrast, membership in professional associations is voluntary and annual fees are a bargain in my opinion, e.g., CSTM $120 and CSMLS $167. But if you worked in Ontario and belonged to all three, the total would be $671.20. To me, that's just a tiny percentage of annual salaries and the benefits are many. 

Which brings me Julie Hendry's presentation. Julie is this year's recipient of the CSTM's  Buchanan Award, who included this slide at the end of her talk (click to enlarge - Julie's slide was tweeted by Geraldine Walsh and Clare O'Reilly on Twitter): 

Julie's challenge is a great one for CSTM members and members of all professions. We in the health professions are so lucky. 

FOR FUN
I chose this Beatles song because its lyrics fit the blog's content.

• We can work it out

As always, comment are most welcome (and there are some below).

The thing called love (Musings on folks who work in medical labs)

Last updated: May 3, 2019 (See ADDENDUM below)

Another short blog, this one about National Medical Laboratory Week (NMLW), April 21-27, 2019. My story is one that's hardly ever told because oldsters like me don't normally write blogs,

Folks, I came to work in a clinical lab by an atypical route. To test myself, as an individual who was terrified of being asked a question in high school, I followed some of my pals into unusual UManitoba teacher training. We were to spend several summers in Faculty of Education and get BEd.

My most vivid memory was the Dean telling me I'd never be a good teacher because my handwriting was poor. Hard to believe but the dude said it to my face. Regardless, after the first 3-month summer session I was hired by a HS in Baldur, MB. That experience was wonderful and I'll never forget it. Many students were older than 20-yr-old me and their parents totally supported teachers.

However, when the opportunity arose to move back to Winnipeg and be near to my family, I took it. The opportunity came from a university pal who told me that Canadian Red Cross Blood Transfusion Services (CRC-BTS) hired BSc grads. In retrospect that was crazy as folks like me knew nil about blood and laboratory medicine.

Note: Winnipeg's CRC-BTS was unique in Canada, a combined blood centre and transfusion service for Winnipeg and the province of Manitoba and beyond into northern Ontario. BSc grads were hired because training for med lab technologists in Winnipeg was poor. CRC-BTS was the only show in town and the training community college students received was inadequate. Most were afraid to work in transfusion labs. Hence they hired untrained innocents like me.

Fact: When hired in 1964, I well recall asking CRC-BTS colleagues what the yellow stuff was after the whole blood donation had settled. My knowledge was NIL. Today I would never be hired and that's a good thing.

ADDENDUM
To flesh out the above tale of my start at CRC-BTS an excerpt from a 2014 blog, Bridge over troubled water (Musings on what to be thankful for as TM professionals):

The reason Canadian Red Cross Blood Transfusion Service hired BSc grads because most med lab tech grads from Red River Community College (RRCC) were afraid to work there.' I later learned the fear was largely because the clinical rotation was pathetic. Students spending most time labelling tubes and similar scut work in between being told by technologists to get the ABO group right or they could kill a patient. Did I mention the clinical rotation was only 2 weeks then? 

Soon I started work in a large combined blood centre and transfusion lab, the latter doing compatibility testing for all city hospitals and beyond, plus prenatal testing for northwestern Ontario. At first, I did not even know what the yellow stuff was when the red cells settled. 

I'm so thankful for the mentoring of generous colleagues. And for wanting and needing to read the 'bibles' of TM from front to back (every word). The books were penned by such icons as Issitt and Mollison, and included the AABB Technical Manual and a 'little red book' written for Red Cross staff by Dr. B.P.L. (Paddy) Moore (and others), National Director of the Red Cross Blood Group Reference Laboratory, who died in 2011. I wrote about Dr. Moore in a 2007 blog, 'My life as a blood eater.'  

I worked in Winnipeg for 13 years, got Subject certification in Transfusion Science (no longer offered) from what is now CSMLS. My last 3 years were as the clinical instructor for new laboratory staff, RRCC students, and medical residents doing a transfusion medicine rotation in the only show in town. How crazy is that?

Looking back, I'm thankful that I worked in a busy laboratory where you never knew what to expect. Besides the routine of pretransfusion testing for scheduled surgery and anemic patients, at any time 24/7 patients might need massive amounts of blood in a hurry from a ruptured aneurysm to a GI bleed to a placenta previa during delivery. Often the lab was chaotic but it was organized chaos, even if that's an oxymoron.

Moreover, I'm thankful that in those days work was mostly hands-on and issues arose daily that required problem solving. For example, I worked with Dr. John Bowman when he did the first trials of antenatal Rh immune globulin and was involved in the work that led to this paper (I'm the Pat mentioned in the paper):

• Lewis M, Kaita H, Anderson C, Chown B. Independence of Colton blood group. Transfusion. 1971 Jul-Aug;11(4):223-4.

Which is why I'm so privileged to have worked in transfusion for more than 50 years. Why I love my kind Med Lab Sci colleagues at the University of Alberta who overlooked my weaknesses and generously taught me what I didn't know. Why I love my students, who were smarter and more knowledgeable than I was, who tolerated me calling them 'kids.' And so many went on to become leaders in many areas.

FOR FUN
Chose Bonnie Raitt ditty because I'm a fan and it's how I feel about medical labs, especially transfusion services.

• The thing called love (Bonnie Raitt and Bruce Hornsby) 

As always, comments are most welcome. See some below.

Musings on bullying in health care

Stay tuned: Revisions are likely to occur

Today, the last day in February, is #pinkshirtday in Canada, a day to stand up to and prevent bullying of any kind. Taking a stand against bullying with pink shirts began in 2007, when on his first day of school, a student wore a school pink polo shirt and bullies called him a homosexual for wearing pink and threatened to beat him up. Two other students decided enough was enough and began a 'sea of pink' campaign.

Earlier this month a biomedical scientist (aka clinical or medical laboratory scientist, medical laboratory technologist) working as a senior manager in the Haematology and Blood Transfusion department of a hospital in Dumfries, Scotland was suspended for 18 months after a campaign of bullying abuse, creating a 'culture of fear' in the workplace for over five years (Further Reading).

The full transcript of the UK Health and Care Professions Tribunal Service hearing of the Registrant's case is online (Further Reading). The Allegation, Finding, Order, Notes are well worth reading.

ALLEGATIONS
Just a few of the many allegations made against the Registrant:

• Said to colleagues in the blood bank, 'Am I talking a foreign language?! Or am I working with a bunch of  f*cking thickos?!'

• Referred to a colleague's flat shoes as 'lesbo' shoes.

• Sent a text message to a colleague describing another  colleague as '‘a f*kin lying *rse wipe sh*te'.

• Asked a colleague to sign off his competency log despite the fact she had not witnessed his competencies. 

• In the presence of another colleague 
• Referred to a colleague as a 'b*tch' ;
• Threatened to slash a colleague's tyres; 
• Referred to having a 'hit list' of people he would pay back. 

DELIBERATIONS
The Registrant did not attend the hearing despite five months notice and instead submitted a written response to the allegations. Some he denied and a few he sloughed off a merely banter. All but one allegation was found to be proven. The witnesses were found to be credible.

The issue was whether the proven charges of serious professional misconduct, including dishonesty, and creating a “culture of fear” were enough to be stricken off the Registrar or if some other sanction should be applied. Be aware that the purpose of a sanction is not to punish, but to protect members of the public and to safeguard the public interest.

The factors considered by the panel as mitigating factors are fascinating and informative. One that struck me in particular:

• The Registrant’s increased workload appeared to increase his stress levels and cause a deterioration in his workplace behaviour.

Increased workload is a reality for clinical labs everywhere these days and has been for decades. Under the umbrella of cost effectiveness and cliches like 'working smarter, not harder', staff have long been expected to do more with less. Does it create stress? Of course, but I'm unsure that's a valid mitigating factor for abusing staff.

In Canada, CSMLS's CEO Christine Nielsen has said that 35% of society members report feeling stressed or burned out on a weekly basis while on the job (Further Reading). Educating new staff becomes difficult as finding clinical placements in short-staffed laboratories becomes increasingly onerous. The situation is complicated by an aging workforce and is likely to get worse before improving. 

The news item reveals the hearing's outcome, an 18 month suspension. To me this case is an ideal candidate for teaching professionalism to students in all health disciplines. If you are like me, you've experienced and witnessed bullying and unprofessionalism at work.

Sad but it happens in health care more often than we like to admit. And how often do we do something about it, given those bullying are usually in positions of authority?

As always, comments are most welcome. We have some - see below.
FURTHER READING

Dumfriesshire scientist suspended for 18 months for bullying staff (13 Feb. 2018)

UK Health and Care Professions Tribunal Service hearing (Jan. 29-Feb. 2, 2018) | See Allegation, Finding, Order, Notes

Medical lab technologists across Canada feeling the pressure of high job vacancies (15 Feb. 2018)

I've been everywhere, man (Musings on fast-tracking those with foreign credentials)

This blog is a revised version of a recent personal blog, 'Want to work in Canada as a medical technologist? Forget it!'

Last updated: 16 May 2012 (see Addendum below)

 As a promoter of international job mobility, it has long saddened me that foreign-trained medical laboratory technologists from English-speaking nations such as Australia, NZ, and the UK face so many obstacles when seeking work in Canada. 

Do physicians and nurses face similar obstacles? Perhaps not, because everywhere in Canada, I hear physicians with British, New Zealand, South Africa, and Aussie accents. And since 'Down Under' countries are always holding job fairs in Canada for nurses, I suspect that mobility may be reciprocated, i.e., Aussi and Kiwi RNs can work in Canada without too much difficulty. But for medical technologists, it's a different story. Working in Canada is onerous, indeed.

If you are a physician or nurse, I encourage you to read (even skim) the technologist-related details below to assess how job mobility for your profession compares.

This blog derives from a Dark Daily report: "Medical laboratory technologists with foreign credentials to get fast-track acceptance in Canada."

Its title derives from an old Hank Snow ditty, I've been everywhere, man.

I love Dark Daily, but its headline and article are misleading. If I were asked about foreign-trained medical laboratory technologists from AU, NZ, UK, and USA, where English as a second language is a non-issue, and where education and training are world class, my response would be:

• All the fast-tracking in the world won't help.

As background, Canadian employers (mainly government-funded health regions) are always moaning and groaning about the shortage (soon to become worse with impending retirement of baby boomers) of nurses and physicians, as well as other health professionals such as medical laboratory technologists and diagnostic imaging technologists. In response, governments have created various fast-track schemes that supposedly will allow faster immigration and employment of qualified needed health professionals. 

USA GRADS
First, USA grads do not qualify because their general certification does not include histotechnology. In Canada, besides clinical chemistry, hematology, clinical microbiology, and transfusion science, general certification requires education and a clinical rotation in histotechnology.

Second, obtaining subject certification for USA grads in the other 4 main disciplines is out because Canada offers subject certification only in clinical genetics and diagnostic cytology.

Reasons that CSMLS does not offer subject certification in other disciplines include

• Cost (subject exams are costly to maintain) 
• Employer preference for flexible grads who can work in all disciplines
• Fear that employers may use those with subject certification to work in lab sections for which they are untrained

Accordingly, the path to employment in a clinical laboratory for a USA-educated and trained medical technologist / clinical laboratory scientist is a torturous path:

• Step 1: Attend an educational institution (Canada or US) and take a course equivalent to an histotechnology course taught at Canadian institutions. For example, see MLS 250 at the University of Alberta.
• Step 2: Convince a potential employer to provide a clinical rotation in histotechnology. In Canada this is ~4 weeks. And it's next to impossible because employers can barely offer clinical rotations to Canadian-trained students.
• Step 3: Apply to CSMLS for a 'Prior Learning Assessment'.
• Step 4: If eligible, arrange to write the CSMLS general certification exam (based on a competency profile) covering the five disciplines specified on the CSMLS website.

AUSTRALIA, NEW ZEALAND, UK

Background

In my experience, education and training 'Down Under' and in the UK are excellent and in some ways exceed that of the typical Canadian graduate, since Canada rejected the BSc as entry-level several years ago.

This decision created barriers for Canadian medical laboratory technologists to work outside Canada. 

People who did not support the BSc were employers and bureaucrats in provincial government departments of health. Reasons for rejecting the BSc varied but included:

• They perceived the BSc as entry level for nurses  as credential inflation leading to increased salaries without sufficient return on investment and they were determined to stop this happening for medical laboratory technologists.

• Employers wanted the cheapest possible medical laboratory technologists, those who could be 'turned out' as quickly as possible and paid as little as possible. 

• In their short-sighted view, with the move to increased laboratory automation and centralized testing, who needed a technologist whose education and training took 4 years?

Exception

Canada has two programs that provide both a BSc and professional certification by CSMLS:

• MLS program at the University of Alberta (UA) is the longest existing program: its first BSc (MLS) degrees were awarded in 1961. MLS also offers a post-diploma BSc.

• University of Ontario Institute of Technology (UOIT), which opened in 2003, offers a Bachelor of Health Science (Hons) in MLS.

All other programs are 2- or 3-yr diploma programs at technical institutes or community colleges (equivalent of USA 'associate degrees').

For interest, UA MLS grads enjoy international job mobility. They are eligible to write the American MT(ASCP)* exams and many have. (*To change once the ASCP's Board of Registry and NCA merge to form a single USA certification agency.)

This allows UA MLS grads to work in the USA and many did during the mid-90s when laboratory jobs greatly decreased in Canada and many educational programs closed.

As well MLS is the only Canadian program whose grads are eligible to work in NZ without writing certification exams. 

What about job mobility for technologists trained in other English speaking countries besides the USA? Can university educated and trained UK, Oz, and NZ grads easily work in Canada as med lab techs?;

Unfortunately, no. The main reason is that programs in these countries, while providing education in the 5 basic disciplines, do not require clinical rotations in all 5 disciplines.

For example, NZ graduates of university programs  are ineligible to work in Canada because they may do a year's rotation in only 2 disciplines, e.g., 6 mth clinical rotations in their 4th year in each of 2 disciplines (e.g., hematology and transfusion science or clinical chemistry and hematology, etc.), as in the Massey University program.

In contrast, a typical Canadian grad may spend 3 mths in a hematology lab and one month in a transfusion service lab, only one-third of the total time spent by NZ grads in these labs, and in the case of transfusion science, one-sixth as much. But NZ MLS grads are not eligible to write the CSMLS general certification exam without obtaining equivalent clinical rotations in all 5 disciplines.

Is this not nuts, given that NZ MLS grads clearly have more basic education than most Canadian grads, as well as more practical experience in at least 2 clinical laboratories?

OZ and UK grads are similarly stymied if they want to work in Canada because graduates of Australia and UK's university programs can specialize. Examples:

• Australia: BSc in Laboratory Medicine from Curtin University's School of Biomedical Sciences 
• UK: Bradford University's BSc (Hons) in Biomedical Science (also see Details & Modules tabs)

Why do these medical laboratory technologists face significant barriers to working in Canada? Is it all about protecting public safety by ensuring medical laboratory professionals meet Canadian standards of education and training? Or is it about protecting Canadian jobs for Canadians?

And why do graduates of Oz, NZ, UK, and US programs who are certified by their county's professional body and have worked for years in one or more areas of a clinical laboratory, need to write the CSMLS general certification examination covering all 5 disciplines to work in Canada? Beats me.

CSMLS CERTIFICATION

If the educational programs of foreign-trained technologists are deemed equivalent to Canadian programs (or better), foreign-trained candidates must still write the CSMLS general certification exam to work in almost all Canadian medical laboratories.

Most Canadian provinces have regulatory bodies that de facto require that medical laboratory technologists be certified by the CSMLS as a condition of employment in a clinical lab that performs diagnostic tests on patients.

For lab professionals with experience (e.g., those who trained 10-15 yrs ago), and who have likely worked in one discipline (perhaps two) for years, writing an exam covering knowledge and competencies in 5 disciplines is not easy. And getting clinical rotations in Canadian labs is pretty much impossible.

MUSINGS
I personally know NZ-, UK-, and USA-trained lab professionals who are better educated and trained than many Canadian grads, have ample current experience, and would make valuable contributions to Canadian labs and be exemplary employees. But they cannot work here, despite the fast-track 'BS' of our governments.

True fast-tracking would allow

• Different routes that don't require candidates to re-learn  specific disciplines (e.g., histotechnology), which they will never work in;
• Restricted licenses to practice and work only in the area or areas for which they are well qualified.

The situation is different for those for whom English is a second language:

Besides becoming fluent in English, these technologists often need to upgrade their education and training to Canadian equivalency. As but one example, in transfusion science, the association of the Rh blood group system with severe hemolytic disease of the fetus and newborn would not have been taught in Asian countries where almost everyone is Rh positive.

Upgrading programs are rare but exist. If candidates pass English language competency tests, successfully complete whatever minimal upgrading is deemed necessary, write and pass the CSMLS general certification exam, they still may not be hired if their English remains weak. That's the reality of today's clinical laboratories where staff are stressed to the max, mainly due to under-staffing.  

If asked, I often advise foreign-trained grads to enroll in a Canadian medical laboratory technology program. It's a tough sell because they have to support themselves and their families. But in the end, this route can prevent much grief and frustration.

Not a pretty picture....

Talk of fast-tracking foreign-trained medical laboratory technologists / medical lab scientists / biomedical scientists is largely smoke and mirrors.

Your thoughts and experiences are valued. Please offer feedback anonymously (or provide your name in the body of your response) by commenting below.

 Whether medical technologist, nurse, or physician:

• Is there an impending shortage in your country that would benefit from greater international job mobility?
• Does international job mobility of needed health professionals work well in your country? 
• Do foreign-trained workers face significant barriers? 
• Is fast-tracking a reality? 

Similarly, have you tried to work in another country and what obstacles, if any, did you face?

For fun
'Golden oldies' by Canada's inimitable Hank Snow: 

• I've been everywhere, man 
• I'm moving on (Intro by Johnny Cash)

And just because I love it:

• Across the universe (Beatles)

 As always, the views are mine alone.

ADDENDUM (16 May 2012)

Thanks to 'Anonymous,' who left a comment but perhaps withdrew it:

Well, it seems that both nurses and doctors have to sit exams in Canada in order to work here.... I wonder if it is possible to flood the ears of those desperately in need of lab staff with credentials of American or Australian or New Zealand educated professionals, so that the potential employer is motivated to seek change in the requirements.

The comment motivated me to suss out the following info on foreign-trained physicians and nurses wanting to work in Canada.

PHYSICIANS
Source: Global Medics

The basic core requirements for medical registration in Canada: 

A medical degree from any country that is listed in the International Medical Education Directory (IMED)

GP or specialty training that has been completed in Australia, Canada, Ireland, New Zealand, UK or USA
Authentication of medical certification by the Physicians Credentials Registry of Canada (PCRC). 

Some provinces require full verification before they will issue your license. Others will allow you to complete PCRC verification after starting work in Canada. Most provinces also require completion of the Medical Council of Canada Evaluating Exam (MCCEE).

Before taking the MCCEE, internationally-trained physicians must apply to the Physician Credentials Registry of Canada (PCRC) and send a certified copy of your final medical diploma. The MCCEE is a computer-based examination available at 500 test centers in 72 countries. 

Also see Info for foreign-trained medical doctors

NURSES

See Info for foreign-trained nurses

Process is similar to that for medical technologists (assessment, national exam). Exam info:
Canadian Registered Nurse Examination

More....

• Foreign-trained nurses in Canada wasted during shortage
• Govt. help for internationally trained nurses
• Centre for Internationally Educated Nurses