What is a Histotech?

By Lynn McCain | March 10 2023

Rodney Barber 2021 500.jpgIn honor of Histotechnology Day, March 10, 2023, we recently sat down with Rodney Barber, a Histotechnologist working at Michigan Medicine Department of Pathology. Barber has been a Histotechnologist for 23 years, joining the Department of Pathology in July 2019. Originally from Ann Arbor, he relocated to North Carolina, ironically enough, to play ice hockey for a junior team. However, when he married and started a family, he decided it was time to hang up the skates and get a real job. That is when a friend introduced him to a Histotechnology training program.

Barber completed his training program and began to work at Presbyterian Hospital in Charlotte, North Carolina. Four years later, Barber returned to Michigan. “I have worked at pretty much every hospital in Southeastern Michigan. I even worked in autopsies for 10-12 years, but I always wanted to work for Michigan Medicine. My mom retired from here. Many family members have worked here; and I finally got an opportunity in 2019.”

Barber was only at Michigan for a few months before the pandemic hit the state. “It was a big challenge. We had to split staff with half working one week and the other half working the next week. But surgeries were still happening, and we were still getting many cases. It is a true testament to our staff that we were able to get through the pandemic with consistent turnaround times, getting results to doctor and clients.” Barber went on to express his appreciation for all the support the staff received during the pandemic. “They made sure we were good and gave us a lot of kudos, which goes a long way when you are working in the trenches. I tip my hat to them.”

Rodney Barber mixes stains which will be used to identify antibody markers on patient slides.Histotechnologists play a key role in healthcare. Care that could not happen without them. When surgical specimens are taken from patients, such as tumors, skin lesions, or other tissues, the histotechnologists are responsible for preparing those specimens for the pathologists. First, specimens are processed, which involves dehydrating the specimen and then rehydrating it in a special manner. Once the specimens are processed, the histotechnologists embed the tissue in paraffin wax blocks. Approximately 1500-2000 blocks are made every single day. These blocks are then run on a microtome, which is like a very sharp meat slicer, to make thin slices that are affixed to glass slides. The histotechs then stain those slides with a Hematoxylin and Eosin (H&E) stain. Pathologists review the slides and may order additional types of stains, such as immunostains and histochemical stains, to make a diagnosis. Highly skilled histotechnologists are essential to ensure every step of this process is completed properly for clinicians to receive the correct diagnoses for their patients.

When Barber started as a histotech, processes were less automated. “The stains would come as powders, and we would have to mix them. Today, they come pre-mixed. We used to have to embed the tissues in the paraffin manually, which required a lot of time hunched over. Now there are automated embedding machines. The microtome was hand cranked, which led to a lot of shoulder, elbow, and hand issues for histotechs. Today, there is a foot pedal to start and stop the microtome.” Improved ergonomic design of workstations, including height-adjustable work surfaces and better chairs have also enhanced the work processes. “Most histotechnology sections are in windowless basements. At the NCRC (North Campus Research Complex), we have large windows. We can enjoy the sunshine. I used to arrive at work in the dark, work in a windowless basement, then go home in the dark. At Michigan, I can look out and see the day.”

According to the National Society for Histotechnology, “Histotechnologists are certified through the American Society for Clinical Pathology. To qualify for the HT certification exam, an aspiring Histotechnologist can either attend an accredited histology program, which is offered at various colleges, as well as online universities, or they can train on the job, with a two-year degree that includes chemistry, biology, and mathematics credits. For those who wish to further their knowledge and expertise, an aspiring Histotechnician may pursue their HTL certification. The HTL is an advanced-level certification that allows the holder to perform high-complexity testing, such as performing gross examinations, IHC, and digital pathology. The HTL requires a bachelor's degree and either graduating from an accredited histology program or on the job training. Certification is not required to work in histology but in the highly competitive market it is strongly encouraged.”

One of the greatest challenges the field faces, according to Barber, is its lack of knowledge. “People do not know about histotechnology or what a histotech does. They do not understand the rewards of having a tough day with a lot of specimens and successfully getting them processed and handed out to the pathologists. I recall a Friday when, at the end of the day, a pathologist called with a special stain that was needed. The patient was a kid at Mott. I stayed and performed that stain. As a result, they were able to diagnose this kid and give him the correct treatment, which helped him recover. That is extremely rewarding.”

The Department of Pathology is grateful for the hard work and dedication of all our histotechnologists and histotechnicians. Thank you for all you do! Histotechs who may be interested in pursuing a career at Michigan Medicine should visit https://careers.umich.edu and search for histotechnologist. We are currently recruiting!