Application for Admission: Categorical Certificate Training Program



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Medical Technology Program Stevenson University 1525 Greenspring Valley Road Stevenson, MD 21153 (410) 601-1113 vgriffey@lifebridgehealth.org http://www.stevenson.edu/academics Application for Admission: Categorical Certificate Training Program Application CC rev. 7-7-2014. Page 1

Application for Admission: Categorical Certificate Training Program This part-time program provides rapid training for individuals who possess a bachelor s degree in biology, biotechnology, chemistry or other basic science to enter the clinical laboratory workforce. Students who successfully complete all the requirements of a structured program in one of the specialty disciplines within the auspices of a NAACLS-accredited Medical Technology Program receive a Certificate of Completion and are eligible to take a categorical examination for certification as a Categorical Technologist through the American Society for Clinical Pathology Board of Certification (ASCP-BOC). An applicant must have obtained a baccalaureate degree from a regionally-accredited college/university with a combination of 30 semester hours of biology and chemistry and, meet all admission criteria for the certificate program. Application for the Categorical Certificate Training Program is located on the Medical Technology pages of the University website. Categorical Certificate Options The categorical certificate options are (all programs are three semesters in length): Technologist in Blood Banking BB(ASCP) - 20 credits *MT 210 - Principles of Laboratory Science (3) MT 310 - Hematology I (3) MT 335 - Clinical Laboratory Management (3) Fall Semester MT 338 - Molecular & Immunologic Diagnostics (4) MT 405 - Transfusion Medicine (4) MT 434 - Clinical Immunohematology Practice (3) Prerequisites Genetics, Organic Chemistry I and Statistics Technologist in Clinical Chemistry C(ASCP) - 20 credits (BS in Chemistry OR 30 semester hrs with 16 in chemistry is required for this option) *MT 210 - Principles of Laboratory Science (3) MT 335 - Clinical Laboratory Management (3) Fall Semester MT 325 - Physiological Chemistry (4) MT 338 - Molecular & Immunologic Diagnostics (4) MT 425 - Clinical Biochemistry (3) MT 431 - Clinical Chemistry Practice (3) Prerequisites Anatomy & Physiology, Genetics or Molecular biology, Organic Chemistry II or Biochemistry and Statistics Application CC rev. 7-7-2014. Page 2

Technologist in Clinical Microbiology M(ASCP) 21 credits (30 semester hrs with 16 in microbiology is required for this option) *MT 210 - Principles of Laboratory Science (3) MT 335 Clinical Laboratory Management (3) BIO 320 Pathogenic Microbiology (4) Fall Semester MT 338 - Molecular & Immunologic Diagnostics (4) MT 420 - Clinical Microbiology (4) MT 433 - Clinical Microbiology Practice (3) Prerequisites Genetics or Molecular biology, Organic Chemistry I, Pathogenic Microbiology and Statistics Technologist in Hematology H(ASCP) 20 credits MT 210 Principles of Laboratory Science (3) MT 310 Hematology I (3) MT 310L Hematology I Laboratory (1) MT 335 Clinical Laboratory Management (3) Fall Semester MT 410 Hematology II (3) MT 338 Molecular & Immunologic Diagnostics (4) MT 433 Clinical Hematology Practice (3) Prerequisites Anatomy & Physiology, Genetics or Molecular biology, Organic Chemistry I and Statistics *MT 210 is offered in the summer as an on-line course. Admission Criteria Consideration for admission to the Categorical Certificate Program is based on the following criteria: An applicant must have obtained a baccalaureate degree from a U.S.-accredited college/university with a combination of 30 semester hours of biology and chemistry. Graduates of non-u.s. schools must have a transcript evaluation for U.S. degree equivalency. English proficiency is required. See Admission Policies in the University Catalog. Minimum cumulative GPA of 2.8 (scale of 4.0) in all college work attempted. Grade of C or better in all prerequisite coursework in chemistry or biological sciences that pertains to the courses in the specialty discipline the student wishes to pursue; and Ability to meet published non-academic Essential Functions (page 4). Directions for Applying to the Categorical Certificate Training Program The Categorical Certificate applicant is classified as a non-degree seeking student; therefore, does not need to apply to the University. However, the applicant must submit the following: 1. Application for Admission: Categorical Certificate Program a. Download or print the application form. b. Type or print legibly with a ballpoint pen. c. Sign the application form. Application CC rev. 7-7-2014. Page 3

2. Letters of Recommendation a. Two letters of recommendation are required using the form provided in the application packet. b. At least one recommendation from a source who can address both your academic and technical laboratory skills. c. Request these letters well in advance of the due date, at least 2 weeks. d. Give each recommender the signed form provided in the application packet. e. A recommendation consists of: 1) Applicant Characteristics and, 2) A letter of recommendation typed on college/ business letterhead f. The recommender should mail the Recommendation Form and letter together in a sealed and signed envelop directly to the MT Program Director. 3. Personal Statement of Academic Goals a. All Personal Statements must be typed and should not exceed two pages. b. Put your full name at the top of your statement. c. Applicant should discuss: 1) Reason for entering the field of medical technology 2) Career/professional goals 3) Strengths and weaknesses in coping with a rigorous science-based curriculum 4) Any other information you believe is important for the Admissions Committee to know about you 4. Official transcript from every institution where college-level credit was earned must be submitted in an officially sealed envelop. 5. Courses in Progress Form (if applicable) This form should include the semester and the location where all remaining prerequisite requirements will be completed. Official transcripts for courses completed after your application is mailed must be received within one month of conclusion of the course. Application Deadline A complete Application for Admission, including recommendations, must be received by the Program Director by February 15 for fall admission and October 30 for spring admission. Incomplete files will not be processed. Selection is determined by the Medical Technology Admissions Committee. Applicants will be notified of the committee s decision in writing within three weeks of the application deadline. Mail application documents to: Vivi-Anne Griffey Program Director, Medical Technology Stevenson University 1525 Greenspring Valley Road Stevenson, MD 21153 Non-Academic Essential Functions In order to participate in the program, students must be able to comply with programdesignated Essential Functions. The Essential Functions are the non-academic requirements of the program comprising the physical, emotional and professional Application CC rev. 7-9-2014: Page 4

demands of the medical technologist. To ensure that the decision to pursue a career in Medical Technology is the correct one for the individual student, each applicant is asked to determine if they are able to comply with all of the Essential Functions listed below. The Medical Technology student must be able to: 1. Possess visual acuity sufficient to: a. Differentiate colors and color changes in the performance of laboratory tests and procedures. Color blindness, of itself, does not preclude admission. b. Identify cellular components and microorganisms utilizing a microscope. c. Read laboratory instrument procedure manuals, standard operating procedures specimen labels and other pertinent materials for patient care and professional practice. 2. Possess sufficient manual dexterity in order to: a. Process specimens and perform laboratory testing procedures. b. Lift and handle typical hand-held medical laboratory equipment and tools. c. Operate clinical laboratory instruments and equipment, including computers. d. Perform delicate manipulations that require good eye-hand coordination. 3. Perform laboratory procedures accurately within an established time-frame while maintaining efficiency and organization. 4. Exercise independent judgment and use critical thinking skills to solve problems. 5. Communicate in a professional and positive manner with faculty, classmates, patients, laboratory personnel, and other healthcare and non-healthcare personnel. 6. Maintain patient confidentiality and exercise ethical judgment, integrity, honesty, dependability, and accountability in the classroom and clinical laboratory. Tuition and Fees The categorical certificate student will enter Stevenson University as a non-degreeseeking student subject to the tuition and fees of all part-time students (students enrolled in 11 credits or less per semester). Tuition and fees are subject to change without prior notification. Updated tuition information may be obtained from the University website. Financial Aid Non-degree seeking students are limited to part-time status and may not receive financial aid. Completion of Program Students who successfully complete all the requirements in one of the specialty disciplines of the Medical Technology Program will receive a Certificate of Completion in that discipline (e.g. Clinical Microbiology). Medical Requirements All full-time, part-time and categorical certificate students admitted to the junior (3 rd ) year of the MT program must submit the following forms: Stevenson University Student Health Form to the Wellness Center Supplemental Immunization Form for Medical Technology Students to the Administrative Assistant in the School of the Sciences. Application CC rev. 7-9-2014: Page 5

The forms can be printed from the Wellness Center and Medical Technology websites. 1. Laboratory confirmation of immune status by positive immune titer is required for the following: Measles, Mumps, Rubella (MMR immunity profile) Varicella (Varicella-Zoster Virus IgG Antibody) Hepatitis B (Hepatitis B surface antibody = anti-hbs) 2. You may choose to decline the hepatitis vaccine, but you must sign the Hepatitis Declination Form that you understand you will be at risk of acquiring hepatitis B. 3. Students enrolled in MT courses (except MT 210) must submit documentation of all required immunizations and titers listed in the Supplemental Immunization Form by July 1 for fall courses and January 2 for spring courses. If the documentation of immunizations and titers or signed declination form is not on file by the deadline, the student will be dropped from any registered MT course. 4. Students entering the senior (4th) year of the program must also present documentation of a negative tuberculosis screening test (PPD or chest x-ray) prior to the start of classes in the fall semester. 5. Students are financially responsible for any costs incurred due to illness or injury experienced by the student in conjunction with the student labs and clinical practicum. It is strongly recommended that students maintain personal medical insurance. Program Policies Students enrolled in the Categorical Certificate Training Program are subject to the same program policies as degree-seeking medical technology students, as stated in the Catalog. Application CC rev. 7-9-2014: Page 6

Application for Admission: Categorical Certificate Training Program Please Type or Print 1. Legal Name: Last First Middle 2. I am applying for a Categorical Certificate in: 3. Date of Request: 4. Current Mailing Address: Street City State Zip Code 4. Telephone Numbers: (Home) (Cell) 5. Email address: 6. Letters of Recommendation Requested from: I am in full understanding of the conditions for admission to the Categorical Certificate Program. I understand that completion of this application process does not guarantee admission to the Categorical Certificate Program. I am aware that the Medical Technology Program has only 10 total spaces per year, which includes those in the BS degree program, and that those students are given priority for seats in these classes. I have received a copy of the Non-academic Essential Functions of the program. These requirements have been sufficiently explained to me and I believe I am capable of meeting the Non-academic Essential Functions, with or without reasonable accommodation. Student s Signature Student s Name (Print) Date For Office Use Only: Received by: Signature Date Application CC rev. 7-9-2014: Page 7

Courses in Progress Form Indicate all courses you are currently enrolled in or you expect to enroll in during the current academic year and return this form with your application packet. Type or Print legibly in ink. Applicant: SS#: Last First MI College: Term: Fall Winter Spring Summer Began (mm/dd/yyyy): Ended (mm/dd/yyyy): Course # Course Title Credits-Semester (S) or Quarter (Q) Hours College: Term: Fall Winter Spring Summer Began (mm/dd/yyyy): Ended (mm/dd/yyyy): Course # Course Title Credits-Semester (S) or Quarter (Q) Hours College: Term: Fall Winter Spring Summer Began (mm/dd/yyyy): Ended (mm/dd/yyyy): Course # Course Title Credits-Semester (S) or Quarter (Q) Hours Signature: Date: Application CC rev. 7-9-2014: Page 8

Recommendation Form c/o Vivi-Anne Griffey, Program Director Stevenson University 1525 Greenspring Valley Road Stevenson, MD 21153 To the Student: Give a copy of this recommendation form to the person who will offer recommendation on your behalf. This recommendation is required for a complete application and must be returned to the above address in a sealed, signed envelop. Read your rights provided by the Family Educational Rights and Privacy Act of 1974 on the Stevenson University website (www.stevenson.edu). The student must initial one of the following statements and sign this form before submitting it to the evaluator. This request is in compliance with Federal Law P.L. 93-380 (Family Educational Rights and Privacy Act of 1974). I have read the summary of the Family Education Rights and Privacy Act on the Stevenson University website. I understand that federal legislation provides me with a right of access to confidential letters of evaluation relating to applications for admission to another school, for a job, or for an award, and that no school or person can require me to waive this right. In connection with my application to the Medical Technology program: I hereby voluntarily waive and relinquish any right of access to this confidential letter of evaluation. I retain my right of access to this letter of evaluation. Student s Name (Print) Student s Signature Date To the Recommender: 1. Please give your impression of the applicant by placing a in the most appropriate boxes in the chart below and sign at the bottom of this form. 2. Additionally, provide a written assessment on college/ business letterhead of the applicant s strengths, weaknesses and any characteristics that would help the Admissions Committee evaluate his/her potential to succeed in a medical technology program. Attach it to this form and return the evaluation in a sealed, signed envelop to the address listed at the top of this form. Applicant Characteristics Analytical ability Breadth of General Knowledge Ability to Express Self Orally Writing Ability Perseverance Emotional Maturity/Judgment Organizational Skills Manual Dexterity Overall Academic Potential Excellent (Top 10%) Above Average (Top 10-25%) Average (Top 25-50%) Below Average (Bottom 50%) Signature: Date: Name (Please Print): Application CC rev. 7-9-2014: Page 9

Application for Admissions: Categorical Certificate Program Applicant Checklist Do not submit with application 1. BS degree in biology, biotechnology, chemistry or related science 2. Total combined 30 semester credits in chemistry and biology 3. Minimum cumulative GPA of 2.8 4. Grade of C or better in ALL prerequisite courses in chemistry, biology, and math 5. Completion of, or anticipation of completing, ALL prerequisite courses listed in application 6. Official transcript from each academic institution attended 7. Courses In Progress Form (If applicable) 8. Application page, signed and dated 9. Ability to meet published Non-academic Essential Functions (see Application) 10. Personal statement 11. Two letters of recommendation that address your academic AND technical laboratory skills 12. Complete application documents received by Program Director by Oct 30 / Feb 15 Application CC rev. 7-9-2014: Page 10