Second Draft, Joint Annual Report

This is the Annual Survey of Medical Laboratory Science Programs. It is jointly conducted by the American Society for Clinical Pathology Board of Certification (ASCP-BOC), National Accrediting Agency for Clinical Laboratory Sciences (NAACLS), and the American Medical Association (AMA).

NOTE: For your convenience, some of the fields have been pre-populated with the information we have for you on record. If any of the information is incorrect, please make the appropriate changes.

This survey is for the following program only:
1. Program Name: (this will be pre-filled & you should only answer the survey for the program indicated here)
2. Program Type: (this will be pre-filled & you should only answer the survey for the program indicated here)
3. NAACLS ID#: (this will be pre-filled & you should only answer the survey for the program indicated here)

Program Director Information
4. Program Director's First Name:
5. Program Director's Last Name:
6. Preferred Salutation (e.g., Mr., Ms., Miss, Mrs., Dr., etc.) :
7. Professional Credentials (e.g., MEd, MLT(ASCP))
8. Address 1:
9. Address 2:
10. Address 3:
11. City:
12. State:
13. Zip Code:
14. Telephone Number:
15. Extension:
16. Fax Number:
17. E-mail Address:

18. What type of institution houses your program?
__ 4-year College/University
__ 2-year College
__ Hospital or Medical Center
__ Independent Laboratory
__ Military Facility
__ Academic Health Center/Medical School
__ Blood Center
__ Non-degree granting Proprietary Institution

Institutional Information

19. Program's Web Site Address:
20. CEO or President First Name:
21. CEO or President Last Name:
22. Address 1:
23. Address 2:
24. Address 3:
25. City:
26. State:
27. Zip Code:
28. Telephone Number:
29. Extension:
30. Fax Number:
31. E-mail Address:

32. Name of the person completing this survey. If the same as Program Director, please leave this blank.
_______________________________

Program Details

33. Program Status:
Active Inactive Closed

34. If Closed, please put the date that the program closed.
Month (2 digit)
Year (4 digit)

35. Is there a possibility that your program may be discontinued in the upcoming year?
Yes No

36. What is the maximum number of students (Class Capacity) that your program allows per start date or session?

37. How many months does your full-time program last?

38. If your program has a graduate degree, how many months would it take to complete, if attending full time?

39. What is the tuition per year for a full-time student in your program, or, for programs lasting less than one year, what is the tuition for the entire program?
(a) Undergraduate Resident
(b) Undergraduate Non-resident
(c) Graduate Resident
(d) Graduate Non-resident


40. Does your program offer a stipend?
Yes No

41. If Yes, how much is the stipend?

42. In what month(s) does your program begin? (Check all that apply)
__ Open Enrollment __ May __ October
__ January __ June __ November
__ February __ July __ December
__ March __ August
__ April __ September

43. Approximately what percentage of the professional phase of the program can be completed via evening and/or weekend classes?
_________%

44. Approximately what percentage of the professional phase of the program can be completed via distance/on-line education?
_________%

45. Does your program offer education/courses in medical/health care terms in non-English languages?
Yes No

46. Does your program offer education in cultural competence (i.e., courses and/or training to increase student ability to interact effectively with people of different cultures)?
Yes No

Student Data

56. Number of students enrolled from July 1, 2008 to June 30, 2009 who have documented disabilities (e.g., psychological, learning, and/or physical): #__________

57. Of the students graduated from your program from July 1, 2008 to June 30, 2009:
(a) how many found jobs within 6 months? #__________
(b) how many pursued additional education? #__________
(c) how many did Neither of the above? #__________
(d) how many do you not have information for? #__________

58. Of the graduates who found employment within 6 months of graduation, how many were employed in the following settings?
(a) Medical Laboratory #__________
(b) Industrial Laboratory #__________
(c) Research Laboratory #__________
(d) Non-Laboratory Related #__________
(e) Do Not Know #__________

59. How many graduates do you anticipate in your program between July 1, 2009 and June 30, 2010?
(a) # of Graduates, Male
(b) # of Graduates, Female


60. For the number of students who graduated from enrollment between July 1, 2008 to June 30, 2009, please answer the following questions:

(a) How many took the ASCP-BOC exam?
#__________

(b) How many passed the ASCP-BOC exam on their first attempt?
#__________

(c) How many passed on their second or subsequent attempt?
#__________

61. The number of students from July 1, 2008 to June 30, 2009 has:
Increased Decreased Stayed the same

62. In my opinion, the quality of students from July 1, 2008 to June 30, 2009 has:
Increased Decreased Stayed the same

63. Comments: