Medical laboratory scientist

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A medical technologist (MT) is a healthcare professional who performs diagnostic analytic tests on human body fluids such as blood, urine, sputum, stool, cerebrospinal fluid (CSF), peritoneal fluid, pericardial fluid, and synovial fluid, as well as other specimens. Medical technologists work in clinical laboratories at hospitals, doctor's offices, reference labs, and within the biotechnology industry.

Educational Requirements

In most four year degree programs the student attends classroom-based courses for 3 years and clinical-based rotations for 1 year. This is called a 3+1 program; there are also 2+2 and 4+1 programs. In clinical rotations, the student experiences a hands-on approach to learning while going through the different disciplines of the laboratory. Under the supervision of laboratory supervisors and/or senior technologists the student actually performs diagnostic testing in a functioning laboratory. These laboratories could be in medical centers, rural hospitals, or reference laboratories. The student usually works 40 hours a week for 20 to 26 weeks, which allows the experience of working in medical technology as a full time job. The downside is that the student is not compensated as a full-time employee, as is true with most college intern programs. A medical technologist typically earns a bachelor's degree with a major in Medical Technology (Clinical Laboratory Science) or a four-year degree in a life science, in which case certification from an accredited training program is also required.

Certification and Licensing

Medical technologists who are certified by, and remain in good standing with, the American Society for Clinical Pathology (ASCP) are entitled to use the credential "MT" after their names. If they are credentialed by the National Credentialing Agency for Laboratory Personnel, they may use the credential "CLS" (Clinical Laboratory Scientist).

In the United States, the Clinical Laboratory Improvement Amendments define the level of qualification required to perform tests of various complexity. A medical technologist holds the highest such qualification, and is in general qualified to perform the most complex clinical testing, such as HLA testing (tissue-typing) and blood type reference testing.

In addition to the national certification, approximately 15 states also require a state license. Some of these states include California, Florida, Hawaii, Louisiana, Nevada, and New York. For the majority of these states, the process to obtain a license merely involves filling out paperwork, paying the state a fee, and showing proof of certification by a national accrediting agency. California, Florida, and New York are exceptions. For these three states, the state license is more difficult to obtain because they develop and administer their own examinations. Both national certifications and most state licensures require annual continuing education credits in order for the certification/license to be renewed.

Medical Technology Specialty Areas

Most medical technologists are skilled in all areas of the lab and are called generalists. However, some medical technologists may choose to specialize in a particular laboratory area either based on their undergraduate education or through additional education in a specific area. If an MT chooses to specialize, potential areas of specialty include microbiology, immunohematology (blood bank), immunology, hematology, urinalysis, coagulation, clinical chemistry, toxicology, virology, cytology, and cytogenetics. In these cases, a medical technologist may choose to use additional credentials with his or her name, such as "SBB" (Specialist in Blood Banking) with certification from the American Association of Blood Banks, or "SH" (Specialist in Hematology) from the ASCP. These additional accolades can be appended to the base credential, for example, "MT(ASCP)SBB".

Job Duties

A medical technologist analyzes human fluid samples on advanced analytical equipment or by using lower-tech analytic techniques available to the clinical laboratory, such as manual white blood cell differentials, bone marrow counts, and analysis via microscopy.

In addition, the medical technologist must also monitor, screen, and troubleshoot any analytical device responsible for deriving critical patient information. These tasks include performing calibrations, quality control, "on the fly" or run-by-run assessment, instrument maintenance, statistical control of observed data, and recording of normal operations.

Despite the high cost and quality of the instruments, their performance is not always flawless, and the medical technologist may have to troubleshoot, and then adjust or repair, complicated instruments "on the fly". In order to do this efficiently, the technologist must recognize abnormalities and know how to correct them.

A medical technologist is the sentinel diagnostician regarding body fluids. If a body fluid has potentially been contaminated or collected improperly, the medical technologist must reject the sub-standard specimen to maintain the integrity of the laboratory process. The medical technologist must recognize any and all factors that could introduce error into the analysis.

Common tests performed by medical technologists are complete blood count (CBC), complete metabolic panel (CMP), electrolyte panel, liver function test (LFT), urinalysis, prothrombin time (PT/INR), and activated partial thromboplastin time (PTT or APTT).

The Medical Technologist's Role in the Healthcare Process

A medical technologist's role in the healthcare process is to provide accurate laboratory results in a timely manner. These results will ultimately be used to confirm a diagnosis or to monitor treatment, so there are many safeguards to ensure they are accurate. Some of these safeguards include experimental controls, calibration of laboratory instruments, delta checks (changes within a normal series of results), and periodic surveys from the College of American Pathologists (CAP).

The Medical Technologist's Place in the Hospital

Unlike doctors and nurses, who are clearly visible, a medical technologist's place in a hospital is usually hidden away from view in the clinical laboratory. Phlebotomists (those who draw blood) are often seen as the "face" of the laboratory. Depending on the size of the institution, most medical technologists do not often draw blood; however, they are well trained to do so. Phlebotomists are well acquainted with the clinical laboratory as they are the primary patient contact in large hospitals.

Nomenclature: "Lab Tech" vs Medical Technologist

One source of confusion regarding the role of the medical technologist is the abundance of titles given to people in the medical profession. Besides being called clinical lab scientist, clinical lab technologist, and medical technologist, they are also referred to as "med techs", which can easily be confused with "lab tech". This shorthand term has been deemed appropriate and acceptable by most healthcare employees, but many medical technologists find the term "lab tech" inappropriate and ambiguous.^{[citation needed]}

The term "med tech" is also confusing because there are many "techs" in a hospital environment, including pharmacy techs, respiratory techs, and cardiology techs. In these instances, "tech" usually refers to a technician as opposed to a technologist. Radiology techs are Technologists in the same manner as Lab Technologists. Technicians may not have the same education or experience level of a technologist. Medical technicians are generally called medical laboratory technicians or MLT's. The major distinction is that a MLT generally holds a two-year associate degree while a medical technologist holds a four-year bachelor's degree. Also, the technician is not certified to perform tests of high complexity [1] under the Clinical Laboratory Improvement Act (CLIA) of 1988. [2] Both MTs and MLTs, however, are required to sit for a national examination before being certified.

The Medical Technologist Shortage

Currently, the United States is experiencing a labor shortage for medical technologists as well as virtually all other healthcare positions. Student enrollment in MT programs is steadily declining.^{[citation needed]} Many universities cut budgets for Clinical Lab Science programs, or closed them altogether.^{[citation needed]}

The primary reason for this decline is the vast disparity in salary, as compared to other healthcare workers. A typical medical technologist's salary is only 50 to 70 percent that of a registered nurse (RN), depending on geographical location. For instance, in Washington, D.C., the median MT salary is $37,378 compared to $67,695 for a RN, assuming equal levels of experience. The 2005 data for the US Bureau of Labor Statistics lists the median annual income for a medical technologist in California as $64,540. That is the highest average in the nation. [3]

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