TRAINING AND EDUCATION OF
CYTOTECHNOLOGISTS IN
EUROPE
Anic V. et al. on behalf of EACC
BACKGROUND

Updated, extended and revised version of the
Questionnaire on training of Cytotechnologists in
Europe that was presented at the EFCS meeting
during the 17th International Congress of Cytology
in Edinburgh.

There are included issues related to the numerical
state, academic level, included subjects and
duration of the basic education and training in
cytology. Required number of slides examined
under supervision prior to sign out cervical cytology
specimens.


Accreditation and recognition of education, also
issues related to the strategy of continuing
education and external quality assurance scheme.
We will try to answer the questions about the future
optimal training Cytotechnologists, degrees and
diploma that would enhance the acknowledgement
of Cytotechnologists in Europe.
MATERIAL AND METHODS:


A questionnaire was sent to 25 countries, 14
countries that are EACC members and to the 11
countries that are members of the EFCS but without
representatives in EACC.
On this questionnaire, we received responses from
18 countries.
Countries – EACC
members
Reply
Austria (AUT)
YES
Belgium (BEL)
YES
Croatia (CRO)
YES
Denmark (DEN)
YES
Finland (FIN)
YES
France (FRA)
YES
Germany (GER)
YES
Italy (ITA)
YES
Netherlands (NED)
YES
Norway (NOR)
YES
Slovenia (SLO)
YES
Sweden (SWE)
YES
Switzerland (SUI)
YES
United Kingdom (UK)
YES
Countries EFCS
members – without
EACC representative
Albania
Reply
No reply
Greece (GRE)
YES
Hungary
No reply
Macedonia
No reply
Poland
No reply
Portugal (POR)
YES
Romania
No reply
Russia
No reply
Slovakia
No reply
Spain (ESP)
YES
Turkey (TUR)
YES
Note: Replies from Italy, Greece and Turkey are
excluded from this survey because:



In Italy, education does not exist, and answers to the
rest of questionnaire are not received.
In Greece, Cytotechnologists do not exist as a
profession. Cytopathologists perform screening.
In Turkey there is no official Cytotechnologists,
however few biologists with MSC or PhD are
practising
as
Cytotechnologists
at
some
laboratories.
RESULTS
The approximate number of fully trained and employed
Cytotechnologists:
AUSTRI
A
BELGIU
M
CROATI
A
DENMAR
K
FINLAN
D
300
± 300
225
175
180-200
NORWAY
PORTUGA
L
SLOVENIA SPAIN
130
2000
35
FRANCE
700-800
GERMANY
THE
NETHERLAND
S
2600
600
SWEDEN SWITZERLAND
UNKNOWN 220
UNKNOWN
UNITED
KINGDOM
± 1300

According to competence level most of the
Cytotechnologists are on intermediate level (can
report and sign out negative and unsatisfactory
cervical cytology specimens, can undertake
rescreening and offer a differential diagnosis on
abnormal specimens).

Denmark, Finland, Germany, The Netherlands,
Sweden, UK and Portugal also have some
Cytotechnologists that are on an advanced level
(can report and sign out normal and abnormal
cervical cytology specimens), while only few in all
the countries are on a basic level (cannot report
negative or unsatisfactory cervical cytology
specimens).
BASIC EDUCATION


The basic educational standard required before
entry
into
cytology
training
is
mostly
medical/laboratory
technologist,
but
also
biomedical scientist.
Academic level and duration of the given basic
education is mostly college (in seven countries: AUT,
BEL, DEN, SLO, SUI, ESP, partly UK) in duration of 3
years with bachelor degree after completing
education.


In eight countries (BEL, FIN, FRA, NOR, SWE, POR
partly CRO and UK), academic level of the basic
education is university in duration from 2- 4 years
with master or bachelor degree.
Three countries (partly CRO, GER, NED) have a high
school in duration of 4 years as an academic level
of the basic education.

Cytology, cell biology, molecular biology and/or
biochemistry subjects are included in the basic
education with exception of Portugal where these
subjects are not included and cytology is not
included in Belgium and France.
TRAINING IN CYTOLOGY



The training in cytology is mostly (in seven countries:
CRO, FRA, NED, SLO, SWE, SUI, ESP) given as a
separate course/education.
In five countries (FIN, GER, NOR, UK, POR) it is
possible to have training/education as a part of
general program of in-house training in the
laboratory and as a separate course/education.
In three countries (AUT, BEL, DEN), education is
given as a part of general program of in-house
training in the laboratory.


Duration of the training in cytology as a part of
general programme of in-house training in the
laboratory varies from 3 months up to 2 years.
In most of the countries, gynaecology cytology is
joint with non-gynaecology cytology in the
education. In five countries (AUT, GER, UK, POR,
SLO) gynaecology cytology is separated from nongynaecology cytology in the education.
Duration of gynaecology cytology education is
from 30 up to 120 credit points, or 90 up to 165
hours.
 Duration of non-gynaecological cytology (only
few answers) is from 20 up to 180 credit points,
or from 3 months up to 369 hours.
 Duration of joint education is from 30 up to 120
credit points, or from 100 up to 640 hours.



Possibility of joining just one part of education (only
education for gynaecology cytology) is accessible in
seven countries (AUT, BEL, FIN, GER, NOR, UK, POR),
not possible in seven countries (CRO, FRA, NED, SLO,
SWE, SUI, ESP).
Subjects included in the curriculum are mostly
gynaecology and non-gynaecology cytology,
staining methods, molecular techniques and also lot
of variations from anatomy, pathology, histology,
quality assurance etc.

Academic level that instructors/training officers at
the workplace possess varies from senior
cytotechnologists, staff with master or bachelor
degree, with IAC exam certificate, cytopathologists,
pathologists....


Required number of slides screened with supervision
before the Cytotechnologists trainees can sign out
cervical specimens is from 770 up to 7000 slides,
but mostly around 1000.
Approximate number of persons training to be
Cytotechnologist varies from three up to 25 each
year (Spain from 800 -1200 ?)


Who decides the training requirements for
Cytotechnologists in the country ?
In six countries, it is professional society, in three
Ministry of education, government in two and
nobody in four countries!
ACCREDITATION AND CERTIFICATION

Cytology training programme is accredited from
academic institution on university level in five
countries (AUT, FRA, NOR, SWE, POR) , on college
level in one country (ESP), on high school in one
country (NED).

In the other countries, cytology training programme
is accredited from other institutions: professional
society, Ministry of health or education and
institution that carry out the above mentioned
education, in one country education is without
accreditation.

Training programme is recognized nationally in
almost all of the countries, exception is Belgium,
Finland and Sweden where training programme is
not recognized.
Students who complete training programme are awarded a:
DIPLOMA
DEGREE
CERTIFICATE OF
COMPETENCE
France
Croatia
Austria
The Netherlands
Finland
Belgium
Norway
Sweden
Denmark (QUATE exam)
Spain
Germany
Switzerland
Portugal
United Kingdom
Slovenia
CONTINUING EDUCATION AND
QUALITY ASSURANCE



Arrangements/strategies for continuing education in
cytology: almost all have annual meetings and
courses that are usually not mandatory, but
mandatory for all staff reporting cervical cytology
in UK and Norway.
Congresses are also represented in most of the
countries, but not mandatory.
From the other options accessible are slide seminars,
one-day meetings and workshops.
Approximate number of cytotechnologist who has taken and
passed the exam of the:
COUNTRY
IAC
QUATE
Austria (300)
22
32
Belgium (±300)
few
few
Croatia (225)
0
0
Denmark (175)
19
Approx. 130
Finland (±200)
40-50
0
France (±800)
17
0
Germany (2600)
15%
Very few
Netherlands
(600)
No data
No data
Norway (130)
20
20
Portugal (2000)
60
20
Slovenia (35)
0
1
Spain --
10-15
Sweden (220)
18
5
Switzerland --
No data
No data


On the question “Is the Eurocytology Website
learning platform widely used in their countries ?” all participants answered with NO!
Eurocytology Website learning platform is not
widely used in their countries.
Is there an organised external quality assurance (EQA) scheme
running in your region or country and how frequently does it run?
AUSTRIA BELGIUM
CROATIA DENMARK
FINLAN
D
NO
NO
YES
NO
NO
FRANCE
NO
1 x /year
NORWAY
NO
PORTUGAL
NO
SLOVENI
A
SPAIN
SWEDEN
YES (IMC)
YES
YES
4 x / year
4 × /year
1 x / year
GERMANY
THE
NETHERLANDS
YES
YES
1 x /year
every 1-3 year
SWITZERLAND
YES
1x every 2 years
UNITED
KINGDOM
YES
1×/year
OPTIMAL EDUCATION?


Finland, the Netherlands, Norway, Switzerland, and
Portugal believe they have the optimal or close to
optimal education of Cytotechnologists.
All the others answered that they do not have the
optimal education of Cytotechnologists in their
country and thinks that the optimal education will be
on the university level.

Every participant have the opinion that diploma
certified or accredited by EFCS would or probably
would enhance the acknowledgement of
Cytotechnologists in Europe.
CONCLUSION


The results of this survey is a summary of an existing
and accessible education and training of
Cytotechnologists.
What is common and what is different in 18
European countries, as well as suggestion for
guidelines on which future training and education
should be developed based on needs and
deficiencies of the existing.