Advice to young embryologists

December 20, 2012Carole 16 Comments »

From time to time, I am contacted by scientists –usually biologists- who want to know how they can become working embryologists or lab directors. Most of my professional life has been a crazy zig-zag of changes in direction, not because I am particularly adventuresome or easily bored, but due to changes and events beyond my control. So how do I advise younger aspiring embryologists just starting their professional life?

My own entry into the ART clinic was accidental.  At the end of my post-doctoral training, my original plan was to find an academic position and support a reproductive research program with grant funding. Instead I became an embryologist, when finishing my post-doctoral fellowship, pregnant with my second child, I found myself moving across the country because my husband, also a reproductive biologist, found a tenure-track position.  I called every professional contact I knew in my new city and landed a position that was not yet advertised based on a tip from someone who knew someone who was looking for a lab director. Only much later did I find out that my new boss was unhappy with my predecessor and my immediate availability exponentially accelerated my predecessor’s exit. In retrospect, the off-site interview setting and lab tour after close of business day probably should have been clues.

A background as a biologist or medical technician is typical for embryologists. Prior to clinical IVF, I did animal research on many reproductive areas directly applicable to IVF and performed IVF techniques in mice and hamsters prior to applying for my first clinical IVF position. I had the technical skill set (cell culture, micromanipulation experience, good record keeping skills) and a good understanding of the science behind IVF and reproductive physiology, but no experience in a health care environment. A good friend of mine who is a clinical lab director schooled me on the clinical aspects of IVF. From him, I learned about the informed consent process, medical documentation, quality control and quality assurance.

Most embryologists come from either a biological research or medical technology background. Medical technologists have specific training in how to work within a clinical lab on patient samples, but often had little education in the reproductive biology or techniques specific to ART. Biologists understand reproductive biology and many have useful technical skills, but they need to learn about the clinical setting and their responsibilities to patients. Whatever the background of the individual, the missing pieces can be learned on the job and every clinic has clinic-specific methods to be learned.  Biologists with previous experience with micromanipulation techniques (intracytoplasmic sperm injection (ICSI) or embryo biopsy) or freezing techniques such as vitrification have an advantage over applicants without this experience, but every new hire will need to become proficient on specific techniques and equipment in their new lab..

Specific embryology training programs (certificate programs or degree programs) are now available. While there are many options for formal embryology training programs in countries like the United Kingdom and Australia who have comprehensive oversight of ART, there are few in the US .One training course is available through the Jones Institute.  The next course  from the Jones Institute was advertised in a recent ASRM bulletin, reproduced here: “On-line Master’s Degree in Clinical Embryology and Andrology (distance-learning program) offered by The Jones Institute for Reproductive Medicine at Eastern Virginia Medical School http://www.evms.edu/education/masters_programs/clinical_embryology_andrology_program/admissions_requirements/ Regular Admission Application Deadline: December 31st, 2012 A limited number of positions are available for the next class that begins in April 2013. This two-year program is designed to meet the needs of embryologists, andrologists, physicians and others who seek in-depth training in the scientific basis and practice of assisted reproduction.  Courses include: cell and molecular biology, reproductive endocrinology, embryology, andrology, ART laboratory, quality assurance, genetics, cryopreservation, as well as ethics and the law.”  If you have the time and the dollars for more schooling, these type of courses are one-stop shopping for the educational background for clinical IVF.

Free resources for more background information about the practical and regulatory aspects of IVF are available on-line through professional web-sites. If you are entering the ART field, it would be good to have some familiarity with these resources before a job interview. Here are a list of websites that provide good background information:

  • Embryomail– archived and current list-serve for embryologists, practical questions and job openings http://embryomail.net/
  • American Society for Reproductive Medicine (ASRM) www.asrm.org Professional guidelines, policy statements, info for both professionals and patients
  • Society for Assisted Reproductive Technology (SART) www.sart.org
  • American Association of Bioloanalysts (AAB) www.aab.org More information for clinical lab testing personnel. The website for the American Board of Bioanalysts (http://www.aab.org/aab/American_Board_of_Bioanalysis.asp) provides information about board examinations and certifications in the fields of Andrology and Embryology for embryologists and High Complexity Laboratory Direction (HCLD) certification for lab directors. To sit for the examination, you must already have performed a number of ART cycles personally so clinical experience is a pre-requisite.
  • Centers for Disease Control (CDC) Assisted Reproductive Technology pages http://www.cdc.gov/art/pubs.htm Much public data about laboratory pregnancy rates for programs in the US.
  • The Food and Drug Administration (FDA) regulates sperm and other reproductive tissues as a part of its duty to prevent the spread of communicable disease via tissue and tissue products. When sperm, eggs, embryos are donated to other parties, the donors of these tissues must be deemed to be eligible as donors based on medical history screening, physical examination and laboratory testing of blood and urine, as applicable. ART facilities who provide third party reproduction services must undergo unannounced FDA lab inspections. http://www.fda.gov/BiologicsBloodVaccines/TissueTissueProducts/default.htm

Why become an embryologist? or lab director? Well, one obvious reason is that biologists in the IVF lab are well-paid compared to most biologists. Embryologists get paid, on average depending on experience, somewhere between $50,000- 70,000 a year. Lab Directors salaries often start at  around $100,000 a year. Why are biologists paid so much? Because they deliver the technical expertise that IVF lab owners (almost always physicians)  need to make the owners hundreds of thousands of dollars in salary-  and millions in program income- in the large volume programs.

With that large salary comes considerable responsibility and legal liability, particularly for lab directors. If the eggs don’t fertilize, the embryos don’t grow, the thawed embryos look poorly or the patient does not get pregnant, sometimes immediately, sometimes later, the question comes- did something go wrong in the lab? If you don’t ask yourself that first, you can be sure the doctor or patient will. So good embryologists become meticulous data collectors and monitors of every lab factor that could possibly go awry, from equipment, to supplies, to training, to environmental factors. Every embryologist who cares about their work has most likely been startled-awake at least once in the middle of the night as they remember something they forgot to to do that day- that might impact the outcome for a patient. Embryologists, including lab directors, can expect to work many weekends and holidays- on rotation with their colleagues. Make sure you and your family understand the expectations of the job.

A word about legal liability. If you are working as an employee in an ART program, make sure you have malpractice insurance to protect you against malpractice claims against the clinic or lab. If you are a hospital employee, you are covered as an employee under the hospital’s medical malpractice insurance plan. If you are an employee in a small program owned by one or more physicians, staff are typically included under the physicians’ malpractice umbrella, but you are wise to ask for a copy of the certificate. Lab Directors and other staff can be added under a rider to a physician policy.

If you do anything in an IVF lab, you may be named in a medical malpractice lawsuit in the event of a lab mistake. As a lab director, you can expect to be named in any lab malpractice lawsuit even if your staff made the error and not you. You are responsible for oversight of the lab. Failure to follow federal law (FDA regulations regarding third party donors) can bring monetary fines and even the possibility of imprisonment. If you don’t have medical liability insurance, you can lose everything you own. It is very difficult to find free-standing medical liability insurance for lab directors if they are unaffiliated with a physician group and are acting as consultant. Errors and omissions policies may not be enough in every case. Speak with an attorney before you begin offering consulting services.

Is being an embryologist or lab director worth it with these cautions? Absolutely!! If you are able to use your skills and knowledge to make someone’s life immeasurably richer by helping them start or grow their families, there is nothing better. If you are lucky enough to work with a team of great people, you will have the most satisfying work life and may even find yourself  a second “work family” in the clinic.  As a lab director, if you are given the authority to actually introduce new services or improve existing services so that you can continually deliver exceptional outcomes to your patients,  you have really achieved something meaningful with your work life.  On the best IVF days, you may find yourself thinking, “I would do this for free!”— just don’t tell your boss. 😉

The current economy presents some challenges in a market-driven health industry. When the economy experiences a down turn, your job is only as safe as your skill set and patient volumes-especially in private programs. The industry rule of thumb is that for every 100 IVF cycles, you need one embryologist. What does this mean for your? If you are one of four embryologists in a program that now runs only 200 cycles a year, you can expect that two of you may be wise to be on the  look-out for other opportunities. If you are a lab director with some  technical duties but mainly administrative duties, you can expect that someday the owners may  hire a consultant at 25% of your salary to satisfy their regulatory obligations to have a high-complexity lab director (HCLD)  on paper if not on-site.  With their savings from eliminating your salary, they can hire an embryologist to replace you and still come out ahead, financially at least. Personally, I think off-site lab direction does not serve labs or patients well over the long run, but short term cost-savings are proving irresistible to many program owners in the current economy. So be prepared to prove your worth at every turn. Make yourself indispensable to the lab’s operation and make sure the owners know what you are contributing to both their outcomes and their bottom line.

I have experienced down-sizing several times, both as the supervisor tasked with letting  people go and also as the employee let go. As a hospital employee, when “reductions-in-force” happened involving a professional HR department, the process was fairly humane with exit interviews, unemployment benefits, severance payments and sometimes, even support for the employee’s transition to a new position. On the other hand, based on numerous accounts and my own experience, small business owners typically walk ex-employees out the back door–“don’t use the front door and don’t talk to anyone”-  with nothing but a cardboard box to carry out their personal belongings.  The legal protections afforded to employees at large institutions are not in effect for small ART shops with less than 50 employees so small businesses can legally fire employees without warning and without cause.

How can you protect yourself? Always keep your skills up-to-date and growing, Keep your resume current. Get to know the owners and physicians in the other local programs and make a favorable professional impression on them- or at least avoid making an unfavorable impression! You may be asking them for a job someday if you want to stay local. Network at professional meetings. Be prepared to relocate yourself and your family to another city, another state, maybe even another country as IVF employment has gone global. If you are a lab director or aspire to be one,  realize that job opportunities to direct labs full time as an on-site employee are shrinking in the current economic client as cheaper consulting arrangements become widespread and one lab director can provide off-site direction to five labs.

Don’t lay down with dogs or you will get fleas. Some programs are just no good. They are no good because they provide poor outcomes for patients or no good because they provide a hostile toxic workplace or no good because their ethical standards and professional integrity are flexible,  especially in response to financial pressures. It is not always possible to recognize a bad work situation before you actually work there for some time. My best advice to anyone is that if at some point, you must choose between your job and your personal integrity, keep your integrity. You can always find another job.

 

 

 

 

 

© 2012, Carole. All rights reserved.

16 Responses to this entry

  • N.L Says:

    Hey. This was very helpful for me. I’m not exactly at the professional stage as yet. I’m only now entering uni.
    I know this was written ages ago but yu started at your post-doctoral training after school and all that. You started working with animals before your clinical setting. I’d love to know what course yu did at uni and the various subjects within that course. Ifff anyone even checks this!!
    Also, I know there can be several pathways to becoming a Clinical Embryologist but weighing the best options. Thnx!

  • Carole Says:

    Hi NL,
    My courses in university were all in science- biology, chem and math.MY BS degree was in Zoology and my PhD degree in Physiology. But as I say in the post, you can become an embryologist through a medical technician track too, which is an undergrad degree. To direct a high complexity clinical lab, you need to have a PhD or MD degree and experience in embryology.It’s a quirk of the law but in the US, a high complexity lab is a semen testing lab but not an embryology lab. You can direct ONLY an embryology lab (no semen testing) if you have an alternate lab director certification called an Embryology Lab Director (ELD). You can find out more about this from this site http://www.aab.org/aab/Certifications_Qualifications.asp If you are outside of the US, the requirements will likely be different. Good Luck! Carole

  • Samchris Says:

    Hey, this gave me hope, because my dream of becoming an embryologist is about to die off. i studied Zoology, since am outside u.s can i go for Masters in clinical embryology, quite alright i had basic clinical experience, if not what will be the best career pathway of achieving my dreams.
    thanks for the post.it is really helpful

  • Meena Says:

    Hi
    Thanks for information

    I am doctor by profession. I have completed my MBBS MD Anatomy.

    I am pursuing PHD in developmental biology.

    want to know career options as embryologist
    Thanks

  • Carole Says:

    Hi Meena,
    Your options probably vary depending on what country you want to work in. In the US, you’ll have the easiest time finding work as an embryologist in a human clinical lab if you have some embryology experience first. Embryologists are also hired in animal science specialties. Here are some options: http://learn.org/articles/Embryologist_Your_Career_and_Salary_Questions_Answered.html As a PhD, you could become board certified as a high complexity lab director (HCLD) and become responsible for running an IVF lab. Certification is obtained through the American Board of Bioanalysis http://www.aab.org/aab/Certifications_Qualifications.asp As a physician, you could become board certified in the Reproductive Endocrinology, then you could be the medical director of the clinic. There are a lot of options depending on what you want to do. Good Luck! Carole

  • Anamika Says:

    hi Carole,
    thanks for this info,very useful.
    I need some guidance from you. I got my masters degree in reproductive physiology and molecular endocrinology from India 8 years back and also got 2 years master in philosophy in zoology. now to start work as an embryologist in US what are the requirements? what is proper path?

  • Carole Says:

    Hi Anamika,
    There is not a single common road. You can can get there from several paths-I wrote on this topic in a previous post:
    http://fertilitylabinsider.com/2012/12/advice-to-young-embryologists/

    Other resources:
    American Association of Bioanalysts http://www.aab.org/aab/default.asp is the accreditation group for lab technicians and lab directors. To understand IVF in the US- here are some resources.
    The Society for Assisted Reproductive technology (SART) at http://www.sart.org is a professional society.
    The American Society for Reproductive Medicine (ASRM) http://www.asrm.org is another professional society- members can place advertisements on their site. I would also recommend that you join embryomail at this url: http://www.embryomail.net/ This is a list serve group for embryologists. Embryologists post questions here and job openings for embryologists are also posted here.
    The biggest hurdle for you will be gaining some IVF experience. If you already have some experience in either animals or the human clinic, that is very helpful when you are looking for work. Many clinics are not willing to train the total novice.If you come with some experience, you will be more competitive for clinical work. If you have animal experience, that is helpful. Good Luck!! Carole

  • Adylene Says:

    Hi, I am currently a highschool student doing a research paper on a career that we are interested in and I always found embryology very intriguing and I have looked everywhere for pros and cons of this career, but so far have found nothing would you possibly help me with some pros and cons of this career i would really appreciate it!!!

  • Bikramjit Singh Says:

    I am b.sc.(hon)in biotechnology pursuing m.sc. microbiology from ksou. I had 2+ year reproductive lab experience. As embryologist. Got trainings in ART and attended workshops, I am member of american society of reproductive medicine and indian society of study of fertility and research. I wana know can I get job as embryologist in america?

  • Carole Says:

    HI Bikramjit,
    You have to find the job postings first. They are posted on the member section of ASRM website so as a member, you should see them, and be able to post your qualifications. Embryomail (http://embryomail.net/) is a list serve where embryology and lab director jobs are posted so I would become a member there. You can also go to the website for the American Board of Bioanalysts http://www.aab.org/aab/American_Board_of_Bioanalysis.asp, become a member of AAB and look into completing the requirements to earn a technical supervisor certificate. You will need a good letter of reference from your employer in India and have legal work permit here in the US. Good Luck!! Carole

  • Hailey Says:

    Hi,
    I’m currently a 4th year Ph.D candidate in a Cell, Molecular, and developmental biology program. I have basic laboratory techniques and some experience micro injecting C. elegans embryos. I would like to become a clinical embryologist. Would you recommend for me to get a post doc in a lab that studies reproduction or apply to a master program? Would it be possible for me to get a job without doing either of those things?

    Thank you in advance!
    -Hailey

  • Enoch Says:

    I holds B.Sc. in Human Anatomy, how can I become an embryologist.
    I’m I eligible to undergo training in ART and ICSI?

  • fifa 17 points Says:

    Love the website– extremely individual pleasant and lots to see!

  • Edrwine Says:

    Hi,
    I am currently in my clinical internship year for my medical technologist BS and I am very interested in working in an IVF/fertility lab, but I know that I won’t have much background in it. Is there a possibility that I could get a job in such labs, being a graduate, and be trained on the job? Or would I need certificate?

  • Excell idabe Says:

    I have a b.sc in human anatomy, please i want to no how will I be able to become an Embryologist.

  • Alejandra Says:

    I am a Human Clinical Embryology and Assisted Conception MSc student in Scotland. I have a degree in Biology with mention in Cellular, Molecular and Genetic Biology.

    I am going to finish my couse in August and my intention is to become an Embryologist after that. I have been told I need a training program to have the Junior Embryologist title and could apply for embryiologist jobs.Which are my options? Where can I do my training? I am open-minded about the place where I could go

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