# An Analysis of the Career Pathway of Clinical Laboratory Scientists: Identifying Access Barriers and Best Practice to Increase Diversity in the Workforce

## TL;DR

This paper explores barriers to diversity in clinical laboratory science careers and suggests strategies to improve access and inclusion for underrepresented groups.

## Contribution

The paper introduces a 'trickle up approach' to address diversity issues in clinical laboratory science education and workforce development.

## Key findings

- Foundation routes effectively broaden access to clinical laboratory science degrees.
- Curriculum inclusivity and decolonization reduce disparities in degree completion for ethnic minorities.
- Unpaid clinical training is a major barrier to workforce diversity.

## Abstract

Widening participation among the clinical laboratory scientific workforce is essential to meet future needs of healthcare systems. The advantages of more diversity in this clinically pivotal workforce include better decision making, improved diagnostics and a wider pool of appropriately trained applicants for new and advanced posts. This review summarises a sustainable “trickle up approach” to increase diversity and widen participation at all levels of the career pathway for clinical laboratory scientists with a focus on socioeconomically disadvantaged and minoritised scientists. Issues of access to appropriate degrees are present years in advance of university application and can be addressed through meaningful outreach programmes from universities and professional bodies. Interventions to broaden degree entry access including foundation routes have proven efficacy, whereas the role of degree apprenticeships in widening participation appears to be minimal, currently. There is a higher proportion of ethnic minorities, particularly black students, who don’t complete their degree programme or attain lower awards than colleagues. Contributory factors include curriculum design along with psychosocial deficiencies in delivery. Decolonising and making biomedical science curricula and delivery more inclusive have proven effective in reducing these risks. Furthermore, socioeconomically disadvantaged students face a new challenge from generative artificial intelligence tools, where those that can pay get access to more powerful tools, creating a new gap, unless these tools are used judiciously and free at point of use. A graduate is required to complete training in a clinical laboratory to gain HCPC or equivalent registration, these places are competitive, and often unpaid. This appears to be a key barrier to widening participation, with a majority of graduates not pursuing careers as Biomedical Scientists. A state and financially supported training programme is required to broaden involvement at and post-registration. There is a paucity of information regarding the makeup of the workforce at promotional grades. However, an analysis of postgraduate study and research avenues reveals challenges for those from minoritised backgrounds and working mothers. These can be addressed through diversity in academic institutions and tailored, personalised approaches to research for working mothers to maximise participation at management and clinical leadership roles in the diagnostic laboratory.