EXECUTIVE SUMMARY

 

Both Montana State University-Bozeman (MSU) and the University of Montana-Missoula (UM) propose to establish an agreement as part of the Montana University System (MUS) with three clinical laboratory training centers. Both MSU and UM currently have separate affiliation agreements with the University of North Dakota (UND) which allow each of the institutions to send students to UND for three semesters of training. In this agreement students spend a summer semester at UND and then return to hospitals throughout Montana for two semesters of clinical bench training. The credits they earn during this year of professional training contribute to a degree in Microbiology at MSU and post-baccalaureate credits at UM.

We will continue this affiliation but propose that a MUS affiliation be instituted so that all students from both universities have an equal opportunity to participate in the training program. In addition, both MSU and UM would like to affiliate with two additional programs to give our students a greater choice in their clinical training. These programs include the HealthONE School of Medical Technology in Denver, Colorado and the Sacred Heart Medical Center School of Medical Technology in Spokane, Washington. Both Schools have a three-semester program similar to UND, but students remain in their respective hospitals for the entire year. Both programs are excellent, have openings for 2-5 students from the MUS and have a keen interest in training laboratory professionals for the region. Each training center is acutely aware of the current shortages in personnel for clinical laboratories and is more than willing to provide training and transfer credit for students to each university. The training and credits from all three programs will allow students to fulfill the requirements needed to take the national examinations to become certified clinical laboratory scientists or medical technologists. All students enrolled at each training program will remain MUS students. They will be assessed tuition from each university for 37 credits (three semesters) and in turn, each university will reimburse the programs from $135 to $169/credit as agreed upon under their respective affiliation contract.

Entering into an agreement with three programs and one university system, will provide the greatest opportunity for all students in Montana to choose the type of program that best suits their needs. It will also provide both universities the opportunity to send more students to each center and have a better negotiating position to keep the cost/credit at a reasonable level. This agreement also signifies a cooperation between institutions within Montana and a broader regional effort to train personnel in an important allied health profession.

INTRODUCTION

In 1997 the Board of Regents approved the change of curriculum in the Medical Laboratory Science option at Montana State University from a 4 +1 year program to a 3 + 1 year program. This meant that students could obtain their degree and clinical training in four years instead of five (3 years at MSU + 1 year of clinical training through UND). A successful change in curriculum was accomplished that year and MSU entered into a formal agreement with UND to provide training for students in their senior year. The agreement meant that students would spend a summer semester in laboratories at UND and then return to Montana hospitals for two semesters of bench training in clinical laboratories. Since then ten students have taken advantage of this agreement. Five have successfully completed their accreditation and are practicing clinical laboratory scientists in laboratories throughout Montana. The other five are in their final semester of training and will take their certification exams in June, 2000.

In 1998 the University of Montana asked and received approval from the Board of Regents to enter into a similar agreement with UND to provide post-baccalaureate training for UM students. These students graduated from UM with a degree in Medical Technology. Since then 5 students have completed or are in the third semester of training with UND. It is expected that all UM and MSU students will be employed in Montana clinical laboratories.

The current UND affiliation agreements provide that students pay either MSU or UM tuition for three semesters and 37 credits. In addition, in order to pay UND for the increased cost of providing student laboratory instruction, each student also pays an extra laboratory fee. Some of the tuition is, in turn, distributed to the affiliated hospitals to help reimburse each laboratory for training costs.

UND wants to continue their affiliation with both universities in new, separate agreements which will be signed in May of 2000. However, MSU and UM would like to guarantee that both universities have the same agreement, students from both universities have an equal opportunity for training and that the cost of tuition for this program does not increase substantially. Therefore, both universities are seeking a single, cooperative agreement with UND that will be administered through the Office of Commissioner for Higher Education. They are also asking permission to enter into affiliation agreements with two other quality programs in Denver and Spokane.

JUSTIFICATION

1. Why do MSU and UM want additional affiliation agreements?

Although the 3 + 1 program at MSU and the post-baccalaureate program at UM have allowed many students the opportunity to train and become employed in Montana, this program does not fit the needs of all students. The tuition and lab fees for the UND program are over $6,000 and rising. In addition, not all students want the UND program and instead would like to train in larger metropolitan hospitals to obtain broader clinical experiences. Since each student=s desires are unique, both institutions would like to broaden their affiliations. In addition, this would provide more students the opportunity to train in highly qualified training programs, and students from MSU could do this in 4 instead of 5 years.

As mentioned in our previous Board of Regents proposal, many clinical laboratory science/medical technology programs have closed within the last ten years. This is due to the heavy costs of financing a burgeoning health care system. Therefore, it is important that new and innovative ways of allowing students to become practicing professionals be found. The UND program is unique and fits the needs of many students. However, both universities believe that it should not be the only program available to students. An affiliation with HealthONE Hospital in Denver and Sacred Heart Medical Center in Spokane should be available to all qualified students from MSU and UM. A single affiliation agreement with all three training programs will allow all students equal opportunity to compete for training slots. In addition, an increased number of students from Montana, represented under one agreement, gives programs an incentive to keep tuition and laboratory fees competitive with the other programs in order to fill their training positions. In short, MSU and UM would like to combine efforts to obtain a broader number of training opportunities for all our students and to keep the cost for training at a reasonable level.

2. Is there still a demand for Clinical Laboratory Scientists?

There has been and continues to be a high demand for qualified appropriately trained laboratory professionals. In addition, the 1993 legislature of the State of Montana passed a personnel licensure bill for medical laboratory professionals which insured the public that qualified personnel were performing laboratory testing. The public can now be assured that a recent high school graduate or Asomeone off the street@ is not performing complex, multi-step procedures such as testing of blood to be used for transfusions in life-threatening situations. However, the licensure bill has increased the need for trained and certified laboratory professionals.

Graduates from the few remaining training programs have many job opportunities. For example, the students from the Benefis Health Care Medical Technology Program in Great Falls have numerous job offers, especially in rural areas of the state. Students from the UND program also have had many opportunities for employment.

Another important consideration is the increasing age of practicing laboratory professionals. For example, in the Great Falls area concern exists that because >70% of the workforce is over 50 years of age, many of these professionals will soon retire. An increased number of qualified personnel must be available to take their place. This is more than likely the case in many areas of the state, especially in rural Montana.

The Montana Society for Clinical Laboratory Science (MTSCLS) has endorsed our affiliation with UND and efforts to increase the numbers of students who can obtain training in the state of Montana. Because of the increasing demand for qualified personnel, they have encouraged technologists in many hospitals to train students during the bench phase of their clinical training. Most have agreed that having students in laboratories has challenged technologists as professionals and kept them more acutely aware of procedures and practices in the clinical laboratory.

In addition to working in laboratories where clinical analyses are performed, other career opportunities are available to medical technology/medical laboratory science graduates. These include working in industry (pharmaceuticals, marketing, biomedical technology research and development, food analysis, environmental and occupational health, etc); working in research laboratories (medical research laboratories in immunology, virology, oncology, endocrinology, nuclear medicine, pathology, etc); becoming health care administrators (laboratory directors, hospital administrators, laboratory consultants, hospital infection control officers, health promotion officers, etc.); working in the public health sector (epidemiology, crime laboratory science, community health administration, Peace Corps, Red Cross, etc.); teaching in higher education (instructor at university, clinical instructor, program director, science news writer, etc.); and some graduates are more than qualified for graduate school, medical school, dental school, veterinary science, health law or even public health policy.

3. Why are joint affiliation agreements with MSU and UM important?

Students from both universities would benefit if they were not competing under two different arrangements for training positions. This situation could arise if programs develop a preference for one type of student due to the strength of the curriculum or whether they have four instead of three years of undergraduate courses. UM hopes to eventually change their undergraduate curriculum to reflect a 3 + 1 curriculum that is suitable to the affiliated programs. Because UM and MSU will have a cooperative agreement with three training programs in place, UM students will be easily matriculated into a 3 + 1 program.

Another important consideration is cost of the training. Because both universities had only one affiliation and MSU had a guaranteed published 3 + 1 curriculum, it is important that a professional training component be in place. Therefore, in order to guarantee that program changes not be dictated by UND whenever they deemed appropriate, both universities have decided that greater combined student numbers had more impact than each university=s smaller numbers alone. For example, when both universities collectively said no to UND=s desire that Montana students must enroll as UND students and pay nonresident fees, they agreed on other options which were less costly to Montana students. This was, in part, because they became acutely aware that ten students and not five would be lost to their program if both universities decided not to sign another affiliation agreement.

After this incident, both UM and MSU realized the importance of having more options available to students in case it is deemed necessary to terminate an affiliation with one of the programs. Having two additional clinical training sites gives the universities, as well as their students, more choices for training and most probably stabilizes the cost of training due to competition among programs for Montana students.

PROGRAM STRUCTURE

A description of the affiliated programs, how the universities will coordinate activities on campus and the resources necessary to do this is included below. All three training programs are accredited by the National Association for Accreditation of the Clinical Laboratory Sciences.

1. UND Training Program

The curriculum and mechanism for senior students at MSU and post-baccalaureate students at UM to apply, be accepted and obtain the clinical training through the UND program will remain the same. Each student will spend the summer semester in Grand Forks on the campus of UND for student labs and lectures. They will then move to an assigned hospital to complete their bench training during the fall and spring semesters. Three semesters and a total of 37 credits will be taken by each student B 12 credits in the summer, 13 in fall and 12 in spring. After successful completion of this year, MSU will award a Bachelor of Science degree in Microbiology/Medical Laboratory Science option and all students will take one or more national certifying examinations. After passing the exam(s), each student is qualified to work in a clinical laboratory.

The current cost for the entire year is resident tuition for Montana students and a laboratory fee each semester. UND will charge each institution $169 per credit for a total of $6,253 for 37 credits. Each semester, students enroll at MSU or UM, pay tuition and fees and each institution pays a bill received from UND. Except for the increase of $15 per credit and minor changes in how this is done, the agreement will remain the same as before but be administered by the Commissioner for Higher Education of the Montana University System.

2. HealthONE Hospital Training Program

The HealthONE School of Medicial Technology is located in Denver, Colorado and is housed in HealthONE Hospital. HealthONE Hospital is a partner with Columbia HCA making them the largest healthcare provider in the Rocky Mountain region. The curriculum for the program is designed so that students have an intensive laboratory experience with didactic and technical training before clinical rotations. The clinical rotations are in laboratories throughout Denver such as Presbyterian/St. Luke=s Medical Center, Aurora Regional Medical Center, Swedish Medical Center and others. Students are also able to have unique experiences with other patient service departments within the Columbia-HealthONE system and a variety of physicians, nurses, technologists and research personnel. This means they are exposed to other equipment and methods, career options, other working environments and health professionals. They also have an elective program that allows students to choose their areas of interest and participate in a research and development project of their choice. They currently have affiliate relationships with over 50 elective sites including rural laboratories and are willing to consider Montana Hospital sites in the future.

Students from MSU and UM (either 3 +1 or 4 +1) will apply to HealthONE School of Medical Technology and once accepted, stay in the Denver area the entire year. Students will register for the same three semesters and 37 credits as in the UND program. HealthONE will bill either MSU or UM $5,400 ($146/credit) for tuition and fees and in turn the institutions will collect tuition and lab fees from the students. If a student is attending in their senior year at MSU they will receive a degree upon successful completion of the coursework. In addition, all students will be eligible for national certification exams after completion of the year. The undergraduate curriculum at MSU and UM meets the admission requirements by HealthONE. Although the final acceptance into the program will be made by HealthONE faculty, recommendations for acceptance will be made by the institutions in Montana.

3. Sacred Heart Medical Center School of Medical Technology Training Program

The Sacred Heart Medical Center (SHMC) is a large 623-bed non-profit Catholic hospital that offers a complete spectrum of medical services to Spokane residents and patients throughout the northwest. It offers a wide array of medical services and treatments that reflects today=s healthcare advances. The Medical Center has 19 operating rooms and maintains the latest in therapeutic and diagnostic equipment. The Department of Laboratory Medicine performs approximately 600 different procedures and handles around 1.6 million samples per year. The School of Medical Technology is in the Department of Laboratory Medicine and has been accredited since 1932. In the 1950s the program was a 3 + 1 program and in 1979 became a 4 + 1 program requiring a baccalaureate degree prior to clinical training. They recently agreed to accept a mix of qualified 3+1 and 4 +1 students into their program.

Students who attend SHMC=s School of Medical Technology will experience a wide variety of clinical experiences as they receive didactic lectures and rotate through the laboratories at SHMC, Pathology Associates Medical Laboratories and the Inland Northwest Blood Center. Students also have the opportunity to rotate to a small laboratory such as a community hospital or physician office laboratory prior to graduation. This provides them with exposure to laboratory technology from the perspective of a smaller facility.

Many MSU and UM students who have graduated have been accepted into the SHMC program, have successfully completed their training and many have returned to Montana to work in clinical laboratories throughout the state. SHMC currently does not charge tuition to 4 + 1 students and that is expected to remain the same. However, a fee of $135/credit will be assessed to 3 + 1 students as they will receive college credit for the coursework and clinical rotations they successfully complete. The 3 + 1 students will register at MSU for 37 credits over three semesters and pay tuition and a laboratory fee similar to students who attend the other affiliated programs. As soon as the curriculum for a 3 + 1 program at UM is adopted, UM students will do the same. Although the final acceptance of students into the program will be made by SHMC faculty, recommendations for acceptance will be made by the institutions in Montana.

4. Number of Students affected by the Affiliations

Each year 20 to 30 students from MSU and UM apply for internship programs. These programs exist in almost every state and students who graduate with a degree from either institution are eligible to apply for training. Since the number of training programs has diminished but the number of applicants has not, it is important that the additional formal affiliations with two other programs be obtained so that Montana students may have an advantage in obtaining training positions. The 3 + 1 student will especially benefit because more and diverse opportunities will exist for completion of their degree and training at the same time. It is estimated that 10 to 15 MUS students will attend one of the three affiliated programs.

5. Administration of the Agreements

Each program will have a single agreement with the Montana University System. This agreement will be administered through the Office of the Commissioner for Higher Education and each university will operate under the same terms as set forth by the agreement. In addition, each campus will have a faculty member who will assist students in the application process, coordinate the curriculum for the undergraduates involved in the 3 +1 and 4 +1 programs and handle administrative aspects of the program. The agreement will be similar to the previous affiliation contract used by UND and each of the Montana universities. In the best interest of both universities and the programs, the affiliation agreements are expected to be in effect for 2-3 years. At that time, the agreements will be reviewed and edited to reflect any changes that the institutions or programs deem necessary.

As stated previously, MSU and UM will collect tuition and a laboratory fee from students. The extra laboratory fee will vary and be dependent upon the tuition rate at each program. Each university department administering their end of the program will retain a small portion of the tuition to handle administrative costs. This would include travel for the coordinators to attend meetings with each training program.

Resources Required by MSU and UM

Faculty advisors in the Microbiology Department at MSU and the Division of Biological Sciences at UM are currently coordinating activities with the UND affiliation. It is expected they will continue to administer the university portion of the programs and recover additional fees the university will attach to each student=s tuition to do so. An important aspect of the proposal is that MSU or UM will not have to provide additional facilities or faculty and yet more MUS students will have the opportunity to become practicing laboratory professionals in a cost-effective and efficient manner.