telling another one how to do it rather than an elaborate educational program?

Dr. MANN. Yes.

Mr. ADAMS. And therefore if we simply train more people for 4 and 5 years both at the baccalaureate and masters level we may well drain away some people who would otherwise stay in offices and work?

Dr. MANN. Yes. As far as dentistry is concerned you would help to some extent with the further education of the dental hygienist and to no other extent other than the preparation of teachers for dental hygienists and dental assistants. You would not increase the supply appreciably.

Mr. ADAMS. Is there some other type of examination or accrediting system for dental assistants and dental laboratory technicians? Dr. MANN. There is an accreditation program for training.

Mr. ADAMS. If somebody comes out to be a dental laboratory technician, in X city does it vary State by State and county by county as to whether or not he can go to work?

Dr. MANN. If you will permit me I would like to ask Mr. Miller, who works in this field daily, to answer that.

Mr. MILLER. There are two certification programs for the dental auxiliaries, for the dental assistants and for the dental laboratory technician.

However, these are voluntary certification programs and they are not conditions of employment. They would indicate competence and skill beyond the average dental assistant or dental laboratory technician if a person were certified. There are national certifying boards for both auxiliaries.

Dr. MANN. If somebody is trained either in junior college or community college or by a dentist to be a dental assistant and goes to a dentist's office and says I am a dental assistant and can perform, there is no board to be passed or no particular license.

No compulsory requirement.

Mr. ADAMS. Thank you, Mr. Chairman.

I have no further questions.

Mr. ROGERS of Texas. Thank you, gentlemen.

Dr. ROVELSTAD. Thank you, Mr. Chairman.

Mr. ROGERS of Texas. The next witness is Miss Ruth Hovde, Division of Medical Technology of the College of Medical Sciences of the University of Minnesota, representing the American Society of Medical Technologists.

Miss Hovde, it is nice to have you before the committee and you may proceed.

STATEMENT OF MISS RUTH HOVDE, PROFESSOR AND DIRECTOR, THE DIVISION OF MEDICAL TECHNOLOGY, COLLEGE OF MEDICAL SCIENCES, THE UNIVERSITY OF MINNESOTA, ON BEHALF OF THE AMERICAN SOCIETY OF MEDICAL TECHNOLOGISTS

Miss HOVDE. Mr. Chairman and members of the committee, my name is Ruth F. Hovde. I am professor and director of the Division of Medical Technology in the Department of Laboratory Medicine of the College of Medical Sciences at the University of Minnesota. As a past president of the American Society of Medical Technolo

gists, I am appearing on behalf of this organization whose active membership consists of 10,000 professional medical technologists whose standards of education and certification meet the requirements of the Council on Medical Education of the American Medical Association as well as the National Commission on Accrediting.

A medical technologist has an educational background of 4 years of academic and professional study in basic sciences related to health. Three of these years are in college with the final year in a hospital laboratory approved for clinical training.

As an educator for the past 20 years in medical technology, I am pleased to appear here in support of this bill (H.R. 13196) which provides for improvement of the quality of educational programs and increase in educational opportunities for students in the allied health professions.

You are all well aware of the overall factors involved in the tremendous task of providing total health care to the people of this Nation and of the major problems of an adequate supply of qualified personnel, and adequate facilities for service, education, and research. I am here today to speak specifically about only one of the allied health professions, medical technology, which can be defined briefly as "the application of principles of natural, physical, and biological sciences to the performance of laboratory procedures which aid in the prevention, diagnosis, and treatment of disease."

In the last 15 to 20 years the amount of knowledge in all basic sciences related to health and disease has expanded at an incredible rate. Even without the impact of medicare and the regional medical complexes, it has been estimated that the utilization of laboratory services has been increasing between 10 and 30 percent annually.

This increase in service is not merely an increase in numbers of existing procedures but reflects also the introduction of new methodology and instrumentation making possible more precise and accurate determinations in less time. Contrary to popular opinion such methods and instruments require more, not less, scientific education. The critical shortage of medical technologists has developed primarily because of lack of sound educational programs under good instruction, lack of adequate facilities for classrooms and laboratories, and lack of financial support for educational opportunities in medical technology.

The early development of laboratory services relied on personnel with on-the-job or apprenticeship training. Now with the increasing sophistication of modern science in methodology and utilization, this pattern of training is outmoded, inefficient, and inept. To meet today's and, indeed, future needs, educational programs for medical technology require emphasis on sound academic curriculums properly balanced with clinical experience to prepare the graduate for demands being made of him.

The quality of any medical laboratory service depends on the quality of the personnel. First and foremost, of course, is the individual who must possess the intelligence, the devotion, and the integrity to do the job. But this individual, however otherwise qualified, must also have the basic scientific knowledge and skills with which to work.

This is obtained through a strong academic and professional program under the best instructors available. But no matter how excellent a program may be in content and instruction, it must also be

given in proper physical facilities. To go further, good programs, instruction, and facilities are meaningless without students.

Opportunities for loan, scholarship, or traineeship programs for students in medical technology at the collegiate or graduate level have been practically nonexistent. Financial assistance for students must be made available if the shortages are to be corrected.

To my knowledge there are no current valid figures regarding exact needs in medical technology education specifically or in allied health fields generally. Therefore I am going to draw on my experience at one university, the University of Minnesota, on the assumption that this situation is not unique but rather is representative of the whole. For the past year I have served as a member of the ancillary professions subcommittee of a large committee on the future planning for the health sciences at the University of Minnesota. This subcommittee was charged with the responsibility of envisioning future activities in the ancillary health professions under optimal programs with reference to faculty, to facilities, to space needs and location, and to student numbers and services, and with special consideration to local and national health needs.

This committee has completed a preliminary study on 14 ancillary disciplines; 7 are established teaching programs and 7 include partially developed or proposed programs.

Although these following data are strictly preliminary and in some instances incomplete at this time, they are significant. From the survey it is estimated that for the ancillary programs in 5 to 10 years, 40 percent increase in physical facilities-classrooms, laboratories, et cetera-over present facilities will be needed with a 100-percent increase in 15 to 20 years.

It is estimated that student enrollments in the ancillary professions will increase 75 percent over the present numbers in the next 10 years and up to 120 percent in the next 15 to 20 years.

It is estimated that an 80 percent increase in academic faculty over the present numbers will be needed in 5 to 10 years, with a 175 percent increase in 15 to 20 years.

These estimates and again, I must emphasize these figures are preliminary and incomplete point up dramatically the immediate need and urgency in providing for better facilities and for more teachers in these areas.

In the United States today there are only 10 universities offering graduate education in medical technology. Only at the University of Minnesota and Temple University are teaching methods and education courses incorporated with the scientific course of study to provide graduates specially trained as teaching supervisors and instructors for medical technology.

These qualified teachers are needed in the 780 hospital laboratories to teach the fourth year of clinical training for the medical technologist, and other specialized courses.

It is obvious that two graduate schools cannot begin to provide the number of instructors needed for these expanding educational programs, even if they were filled to capacity. Here again, may I borrow from the experience of the University of Minnesota.

Since our graduate program was established 7 years ago, only 28 applicants have been accepted. Of these 28, 4 have completed the

62-707-66- -6

requirements for the M.S. degree, 5 are currently matriculating, and the remaining 19 were unable to remain in school because of lack of funds.

There have been no traineeships available for them, and they had to rely on part-time employment to support themselves and sometimes their families. Holding a job while meeting scholastic and academic demands of graduate school is difficult.

During these 7 years there were 66 other applicants for the graduate program in medical technology, 40 or roughly 60 percent, were not accepted because of inadequate undergraduate preparation, and 26, or roughly 40 percent, who were adequately prepared were refused admission because of lack of space and faculty advisers.

To me these figures emphasize again the urgent need for funds for improvement of undergraduate programs as well as funds for facilities, faculties, and traineeships on the graduate level.

Another area of need in medical technology education arising from the expanding scientific knowledge and methodology is in the emerging role of the specialist as an essential and integral part of laboratory services. Fortunately, the sound basic academic preparation in medical technology provides the foundation on which the person can then build his acquisition of knowledge and use of skills within the area of the specialty.

Programs specially designed to train the immunohematologist, virologist and mycologist are examples. The inclusion in the legislation of grants to develop new or improved curriculums for training is farsighted.

We cannot speak of responsibilities of educational institutions without including provisions for continuing education. As professional people, medical technologists are well aware that education does not and cannot end with a degree at the baccalaureate or graduate level but rather is a continuing process. The scientific discoveries and changing methodologies applied to laboratory medicine intensify the need for seminars, symposia, workshops, tutorials, institutes, and so forth, on a short-term basis. But again, such programs are expensive and need support for both the participant and the institution. Schools should be encouraged and assisted in developing a well-integrated system of continuing educational programs.

On behalf of the members of the American Society of Medical Technologists, I thank you for this opportunity to give some of their views on medical technology education. Ours is a young profession and your understanding of the related manpower and education needs is sought.

Your approval of assistance in developing educational programs, opportunities for students, teaching facilities, and expansion of educational facilities will enable medical technologists to continue giving high-quality service on an expanded level.

Mr. ROGERS of Texas. Thank you, Miss Hovde. Mr. Rogers, do you have any questions?

Mr. ROGERS of Florida. Thank you, Mr. Chairman.

I think your statement is exeellent. You point up here an area that does need help, I am sure, as we try to find increased services for the people in this country. Do you have any program for training of medical technologists, say in the junior college program-2 years and then 1 year in a laboratory, or any such program?

Miss HOVDE. At our particular institution we do have a training program for medical laboratory assistants. There are about a hundred such programs throughout the country at this subcollege level or vocational level.

Mr. ROGERS of Florida. Would there be any reason why it would not be feasible to include those in this legislation?

Miss HOVDE. It is my understanding that legislation under the Vocational Manpower Act, for example, has provided for this type of person. One of the reasons why, in my opinion, some of these programs have had great difficulty in getting off the ground is that they have had no one to teach in them.

Mr. ROGERS of Florida. Yes, I can understand this problem, but while we are trying to teach, we also want to try to produce them at the same time. I wonder if it would not be wise to at last make available the benefits of this law to any reasonable institution that can help contribute.

Miss HOVDE. I am strictly in favor of anything that is going to help us in this total problem of providing qualified laboratory personnel. Mr. ROGERS of Florida. Now you say there are only two colleges that are doing graduate work in the training.

Miss HOVDE. Including education. There are 10 universities that give graduate work in medical technology, emphasizing one of the basic sciences areas, and 2 of the 10 include in their curriculum specifically courses in educational administration and educational methods. Mr. ROGERS of Florida. How many do you think would be encouraged to do this as a result of this bill?

Miss HOVDE. As I say in our own experience we had to turn down all of these applicants because we did not have space and money for them. It was a good group.

Mr. ROGERS of Florida. I mean how many institutions do you think would be encouraged as a result of this legislation?

Miss HOVDE. I think there would be many institutions that would be encouraged to do this if they had space, faculty, facilities to do this. I believe this is an important part of your legislation, to encourage the development of new programs and new curriculums.

Mr. ROGERS of Florida. Thank you very much.

Mr. ROGERS of Texas. Mr. Nelsen.

Mr. NELSEN. I wish to welcome a fellow Minnesotan before this committee. I might mention that the name Hovde rings a bell with the Golden Gophers.

Miss HOVDE. That is right.

Mr. NELSEN. What percent of the students who have finished your medical school in Minnesota stay within the State?

Miss Hovde. The majority of our graduates in medical technology stay within the State of Minnesota. I would say roughly 60 percent. at least would stay in the State.

Mr. NELSEN. What about the School of Public Health Nursing? I think we pioneered in that program. Many leave the State, do they not?

Miss HOVDE. I am sorry, I have no information on that.

Mr. NELSEN. Of course the reason I ask the question is to emphasize that it would seem justified that there be some assistance through the Congress to the medical school and to a school of public nursing because some of the students who are trained in these schools go to other States which do not have such facilities.