Medical laboratory scientist

MLS in his work environment.

A Medical Laboratory Scientist (MLS) (also referred to as medical technologist or clinical laboratory technologist) is a healthcare professional who performs chemical, hematological, immunologic, microscopic, and bacteriological diagnostic analyses on body fluids such as blood, urine, sputum, stool, cerebrospinal fluid (CSF), peritoneal fluid, pericardial fluid, and synovial fluid, as well as other specimens. Medical Laboratory Scientists work in clinical laboratories at hospitals, doctor's offices, reference labs, and biotechnology labs.

Educational requirements

A Medical Laboratory Scientist typically earns a bachelor's degree in clinical laboratory science, biomedical science, medical technology or in a life / biological science (biology, biochemistry, microbiology , zoology , etc.) , in which case certification from an accredited training program is also required. In most four-year medical laboratory degree programs, the student attends classroom courses for three years and clinical rotations are completed in their final year of study. This combination is called a 3+1 program. There are also 2+2 programs which specialize in accepting students who have completed their lower division coursework and completing their last two years of study in the CLS program. A 4+1 program would typically be completed after a student has completed a bachelor's degree and usually takes place primarily in a clinical site rather than a college. In clinical rotations, the student experiences hands-on learning in each discipline of the laboratory and, under supervision, performs diagnostic testing in a functioning laboratory. Although not compensated, a student in the clinical phase of training usually works 40 hours per week for 20 to 52 weeks, experiencing work as a full-time employee. In addition, some universities now offer graduate level programs to allow students who have undergraduate degrees in disciplines unrelated to science to enter the field.

In the United States, a similar two-year degree qualifies the graduate to work as a medical laboratory technician (MLT). Depending on the state where employment is granted, the job duties are very similar, but MLTs receive training more exclusively in laboratory sciences. The shorter training time is attractive to many students, but there are disadvantages to this route. For example, CLSs usually earn higher salaries than MLTs, and some institutions do not employ MLTs at all.

In Canada, three-year college programs are offered that include seven semesters, two of them comprising an unpaid internship. The student graduates before taking a standard examination (such as the Canadian Society for Medical Laboratory Science, or CSMLS, exam) to be qualified as a medical laboratory technologist.^[1] Many MLTs go on to receive a bachelor of science degree after they are certified, but a few university programs affiliate with a college MLT program to allow students to graduate with both MLT certification and a degree.

Certification and licensing

MLS foraging for cells.

Medical Laboratory Scientists who are certified and in good standing with the American Society for Clinical Pathology (ASCP) are entitled to use the credential "MLS" after their names. Formerly before the merger between ASCP and the National Credentialing Agency for Laboratory Personnel (NCA), Medical Laboratory Scientists certified by (ASCP) were entitled to use the credential "MT" (for Medical Technologist) ^[2][3] and if credentialed by (NCA), the credential "CLS" (Clinical Laboratory Scientist) was used.^[4] Those certified by the Department of Health Services (HHS formally HEW), the American Association of Bioanalysts (AAB) and the American Medical Technologists (AMT) are still entitled to use the credential "MT." ^[5] Additional certifying agencies include the National Healthcareer Association, National Phlebotomy Association, the National Center for Competency Testing, and the Accrediting Bureau of Health Education Schools. However the NCA and ASCP have now merged into the major certification agency. ^[6]

In the United States, the Clinical Laboratory Improvement Amendments (CLIA '88) define the level of qualification required to perform tests of various complexity.^[7] Clinical Laboratory Scientists is the highest level of qualification, and CLSs are generally qualified to perform the most complex clinical testing including HLA testing (also known as tissue typing) and blood type reference testing.

In addition to the national certification, 12 states (California, Florida, Georgia, Hawaii, Louisiana, Montana, Nevada, North Dakota, Rhode Island, Tennessee, West Virginia and New York) and Puerto Rico also require a state license. Minnesota, Texas, Illinois, Massachusetts, Michigan, Vermont, Washington, New Jersey, Iowa, Utah, Ohio, South Carolina, Wyoming, Pennsylvania, Virginia, South Dakota, Delaware, Missouri, Georgia and Alaska are currently attempting to obtain licensure. All states require documentation from a professional certification agency before issuing state certification. A person applying for state certification may also be expected to submit fingerprints, education and training records, and competency certification. Some states also require completion of a specified number of continuing education contact hours prior to issuing or renewing a license.

Some states recognize another state's license if it is equal or more stringent, but currently California does not recognize any other state license.^[8]

In the UK Medical Laboratory Scientists are known as Biomedical Scientists and must hold an honours degree from a university accredited by the Institute of Biomedical Science before they can embark upon a period of in-house training of at least 1 year before being assessed by the IBMS for state registration purposes. The title "Biomedical Scientist" is a protected title and can only be used by a person registered on the Health Professions Council register.

Specialty areas

Most Medical Laboratory Scientists are generalists, skilled in all areas of the clinical laboratory. However some CLSs are specialists, qualified by unique undergraduate education or additional training to perform more complex analyses than usual within a specific field. Specialties include clinical biochemistry, hematology, coagulation, microbiology, bacteriology, toxicology, virology, parasitology, mycology, immunology, immunohematology (blood bank), histopathology, histocompatibility, cytopathology, genetics, cytogenetics, electron microscopy, and IVF labs. Medical Technologists specialty may use additional credentials, such as "SBB" (Specialist in Blood Banking) from the American Association of Blood Banks, or "SH" (Specialist in Hematology) from the ASCP. These additional notations may be appended to the base credential, for example, "MLS(ASCP)SBB".

Job duties

Medical Laboratory Scientists work in all areas of the clinical laboratory including blood banking, chemistry, hematology, immunology, histology and microbiology. They perform a full range of laboratory tests – from simple prenatal blood tests, to more complex tests to uncover diseases such as HIV/AIDS, diabetes, and cancer. They are also responsible for confirming the accuracy of test results, and reporting laboratory findings to pathologists and other physicians. The information that a Medical Laboratory Scientist gives to the doctor influences the medical treatment a patient will receive. Medical Laboratory Scientists operate complex electronic equipment, computers, and precision instruments costing millions of dollars.^[9]

A Medical Laboratory Scientist analyzes human fluid samples using techniques available to the clinical laboratory, such as manual white blood cell differentials, bone marrow counts, analysis via microscopy, and advanced analytical equipment. Medical Laboratory Scientists assist doctors and nurses in choosing the correct lab tests and ensure proper collection methods. Medical Laboratory Scientists then receive the patient specimens, analyze the specimens, interpret and report results. A Pathologist may confirm a diagnostic result, but often the Medical Laboratory Scientist is responsible for interpreting and communicating critical patient results to the physician.

Medical Laboratory Scientists must recognize anomalies in their test results and know how to correct problems with the instrumentation. They monitor, screen, and troubleshoot analyzers featuring the latest technology available on the market. The MLS performs equipment validations, calibrations, quality controls, "STAT" or run-by-run assessment, statistical control of observed data, and recording normal operations. To maintain the integrity of the laboratory process, the medical laboratory scientist recognizes factors that could introduce error and rejects contaminated or sub-standard specimens, as well as investigates discrepant results.

Common tests performed by Medical Laboratory Scientists are complete blood count (CBC), comprehensive metabolic panel (CMP), electrolyte panel, liver function tests (LFT), renal function tests (RFT), thyroid function test (TFT), urinalysis, coagulation profile, lipid profile, blood type, semen analysis (for fertility and post-vasectomy studies), serological studies and routine cultures. In some facilities that have few phlebotomists, or none at all, (such as in rural areas) Medical Laboratory Scientists may perform phlebotomy on patients, as this skill is part of the clinical training.

Role in the healthcare process

A Medical Laboratory Scientist's role is to provide accurate laboratory results in a timely manner. Safeguards, such as experimental controls, calibration of laboratory instruments, delta checks (monitoring of significant changes within a normal series of results, formerly known as the "previous patients check"^[10]), and periodic surveys from the College of American Pathologists (CAP), ensure accuracy. Laboratory results aid clinical practitioners in confirming or ruling out diagnoses, monitoring chronic disease changes, and analyzing the effects of medical therapies.

Job title

The informal abbreviations of job titles may be a source of confusion. Medical Laboratory Scientist (ASCP) and Medical Technologists (AMT) or (AAB) are often called "med techs" (based on the era in which they were known as "medical technologists"), but this shorthand term is shared by other healthcare employees, including pharmacy techs, x-ray techs and, formerly, respiratory techs, (now called respiratory therapists) and medical laboratory technicians (MLTs).

There is a formal distinction between an MLT and an MT/CLS that is not always understood by others. Both may be certified or registered by one or more nationally-recognized professional organizations, but technicians have a two-year associates degree, and may have less classroom training than other professionals. MTs and CLSs have a bachelors degree and usually do more difficult, complex analyses than technicians are trained to do. Scientists and technologists generally earn a higher income than technicians do and have more opportunities for advancement.

Much of the confusion could also be from the fact that the NCA and the ASCP certification agencies had different titles (clinical laboratory scientist and medical technologist respectively) but with the merging together into a "newer" ASCP and that organization choosing the name "Medical Laboratory Scientist", it can be said that finally the field has a "unified" title, however, the AMT still continues to use the title Medical Technologist.

See also

Allied health professions Automated analyser Blood bank Blood test Biomedical Scientist similar career outside of the US Body fluids Clinical pathology ISO 15189

Laboratory centrifuge Laboratory information system Medical technology Medical laboratory Phlebotomist Reference ranges for common blood tests Urine test

External links

• Canadian Society for Medical Laboratory Science
• U.S. Department of Labor information on Clinical Laboratory Technologists and Technicians
• American Association for Clinical Chemistry
• American Society of Clinical Pathology
• American Society of Clinical Laboratory Science
• National Credentialing Agency for Laboratory Personnel
• National Accrediting Agency for Clinical Laboratory Science
• Medical Technologist Continuing Education
• AIMS: Australian Institute of Medical Scientists

References

1. ^ ASCP certification requirements
2. ^ ASCP career information
3. ^ AAB certification requirements
4. ^ National Credentialing Agency for Laboratory Personnel
5. ^ Letter to the editor of Advance for Medical Laboratory Professionals from the executive director of AMT
6. ^ [1]
7. ^ Clinical Laboratory Improvement Amendments
8. ^ ASCLS licensing information
9. ^ http://www.ascp.org/pdf/TheMedicalTechnologistandMedicalLaboratoryTechnician.aspx
10. ^ Arkansas State University Hematology Course Overview

• http://www.cms.hhs.gov/CLIA/10_Categorization_of_Tests.asp#TopOfPage
• http://dhi.health.state.nm.us/CLIA/index.php