In this Nexus series, Get My Job, we interview alumni and faculty from one of the University’s 160-plus undergraduate and graduate professional programs.
The latest installment features Taryn Waraksa, a cytotechnologist at Fox Chase Cancer Center. The 2014 Jefferson grad recently made the ASCP 40 Under Forty List, an honor given to high-achieving pathologists, pathology residents and medical laboratory professionals under age 40. Waraksa shares how she developed a Jefferson course, what she loves most about her job, advice for those considering this dynamic field and more.
What did you major in at Jefferson, and how did that program best prepare you to enter the field?
I received my accelerated professional master’s of science in cytotechnology and cell sciences in the Jefferson College of Health Professions. The program features labs immediately following our cytotechnology lectures, so students experience a unique didactic-clinical hybrid format that helps reinforce the lecture materials.
During the summer clinical practicum, I rotated through four different hospital/lab settings, generating an understanding of private lab vs. teaching hospital vs. private hospital pathology settings.
When I entered cytotechnology six years ago, my more experienced colleagues had fears of uncertainty regarding the future of our profession. They had heard of the up-and-coming molecular diagnostics and imager algorithms that might replace the skills of the human eye. However, when I completed my master’s at Jefferson, I felt more prepared and immersed in these modalities. I knew that our careers would never be replaced but, rather, enhanced by these diagnostic tools.
What was your career path to land in your current position?
I’ve always been fascinated with medicine and the human body, knowing that I wanted to make a career of it since childhood. I was taking an elective summer course in histology when a relative was diagnosed with cancer. That’s when I recognized pathology/laboratory medicine was my specialty. I needed answers and more details regarding the diagnosis and treatment of cancer, and that quest propelled me to apply to Jefferson.
When I secured my job as a cytotechnologist at Fox Chase Cancer Center, my professor/mentor Dr. Tatiana Zorina asked me to return to Jefferson’s cytotechnology program to create and instruct a grad-level course in cellular, molecular and immuno diagnostics. I designed the course to educate students in the integration of microscopy skills with findings in immunophenotyping and molecular tests, and the implementation of the patient’s clinical history in the formulation of a diagnosis.
The objective was to exercise students’ ability to make a differential diagnosis based on morphology in conjunction with results of the ancillary technologies with special emphasis on the concept of detection of the tumor markers by the immunocyto- and histochemistry, flow cytometry, fluorescence in situ hybridization, molecular sequencing and other studies.
I created this course to better prepare future cytotechnologists in a dynamic profession and to stress that we cannot work alone in making a diagnosis, not with personalized medicine. As lab professionals, we work as a comprehensive team and take a more holistic approach to pathology diagnostics.
In triaging specimens, we’re piecing together the clinical puzzle and promoting personalized medicine for each patient.
Describe your core job responsibilities today?
Since graduating in 2014, I’ve worked as an ASCP board-certified cytotechnologist at Fox Chase Cancer Center. A typical day includes screening both gynecologic and non-gynecologic microscopy slides for cancer cells, infectious agents and other diagnostic abnormalities. I also assist clinicians with fine needle aspiration biopsies and perform rapid onsite assessments for specimen adequacy and preliminary diagnosis.
I took another ASCP board exam in 2017 and became a specialist in cytotechnology and received my international certification through the International Academy of Cytology in 2019. With these added credentials, I’m also responsible for preparing all of our monthly and annual quality assurance statistics, performing validation studies on new techniques and equipment, purchasing supplies and assisting in preparation of the annual budget.
Most recently, I was asked to lead the cytology department in our laboratory information system upgrade, implementing a barcoding system interface to streamline specimen tracking and reduce errors and turnaround time.
What are your favorite parts of your job?
Triaging specimens with other members of the clinical care team. By performing rapid on-site evaluations on fine needle aspiration biopsies, we get a first-hand look at the patient’s cells. Initially, the radiologist, pulmonologist or gastroenterologist will tell us their impression from the patient’s imaging and any pertinent medical history.
Once we receive a fine needle aspiration to process, we smear a portion of the sample on a slide and stain the material using a Diff-Quik (modified Wright-Giemsa) method. And that’s when both the art and science begin on our part. Using our microscopes, we perform an adequacy assessment on the sample, examining the overall cellularity of the specimen and ensuring we have sufficient material to interpret the etiology of the cells. When using telepathology, our cytopathologists can remotely provide a preliminary rapid assessment and communicate with the clinician performing the biopsy.
Once we’ve ensured we have an adequate sample to make a definitive diagnosis based on morphology, we then advocate for extra material in our conical tubes to be spun down into a cell block for ancillary studies, such as immunohistochemistry, flow cytometry, molecular and protocol support. In triaging specimens, we’re piecing together the clinical puzzle and promoting personalized medicine for each patient.
As a cytotechnologist, I get to work alongside clinicians, nurses, radiology techs, respiratory therapists, medical lab professionals and pathologists as we draw the patient’s story together, one radiologic image, one critical value and one cell at a time.
Always treat each specimen handled, every slide interpreted and every cell analyzed as it belongs to a loved one.
What’s the most challenging aspect of your job?
Trying to cope with the fact that, on the rare occasion, biopsy samples are inadequate. Some tumors don’t yield enough cells via fine needle aspiration biopsy for the cytotech to render a definitive diagnosis.
For someone who thrives on providing an answer for the patient, it’s difficult to not have one other than “insufficient cellular material” or “atypical cells, non-diagnostic.” I screen the slides and send the case to the pathologist and walk away wondering if I could’ve done more or something different. Again, some tumors just aren’t as generous with cells, and coming to terms with that is most trying.
What’s your one piece of advice for students considering entering this major or profession?
Always treat each specimen handled, every slide interpreted and every cell analyzed as it belongs to a loved one. For future cytotechnologists, remember that the human eyes are powerful diagnostic tools, saving numerous lives every day.
What’s an interesting fact about you that may surprise some people?
When I’m not screening microscopy slides or assisting with fine needle aspiration biopsies, I spend my free time scuba diving and exploring the oceans, freshwater springs and quarries as a certified rescue diver. I regularly dive in Florida’s deep freshwater caverns and hope to eventually get my full cave diver certification.
