Educational Requirements for Medical Laboratory Sciences
Adopted by the General Assembly of Delegates (GAD) in Singapore, 1 July 1998
Medical Technology and Clinical Laboratory Science have existed as a part of healthcare for almost one hundred years. Initially laboratory physicians (pathologists) and/or academic researchers trained individuals to perform procedures under their guidance. As these procedures acquired a clinical/patient application a number of industrial countries established formal basic training programmes around the mid-1920s. At that time the limited number of clinical laboratory tests were based on manual techniques and performed by an assistant/aide who had little or no theoretical or technical education. These workers were directed and supervised by a pathologist (anatomical and/or clinical laboratory physician) who received the test orders from the patient's physician.
In many of the developed countries, formal training/education programmes for laboratory assistants/technicians were established by the late 1920s under the guidance of pathologists. By the late 1940s clinical laboratory techniques, patient testing and test results were firmly established in hospitals as a part of the practice of medicine and the delivery of health care.
In the 1950s and 1960s, the explosion of knowledge in the biological and clinical sciences, the development of automation and more sophisticated laboratory techniques, the explosive growth of the clinical test menu, the expanding work load of clinical laboratories and its relevance to the delivery of health care, created the need for well defined and more academically organised medical technology/clinical laboratory science programmes. What had begun as a training programme at the laboratory bench with the addition of formal lectures soon became organised as curricula in educational institutions. The content applied to bio-science principles (biology, chemistry, physics, mathematics, statistics, anatomy and physiology) and manual/automated clinical laboratory techniques with appropriate continuous quality assurance data prior to reporting test results and problem-solving methods. By the 1980s many degree granting institutions had established curricula in Medical Technology / Medical Laboratory Science / Clinical Laboratory Science.
LEVELS OF EDUCATION
Since the early 1950s progress made in clinical medicine directly influenced and expanded the content of the medical technology/clinical laboratory science knowledge base and increased the test menu to hundreds of procedures. This dramatically increased the need for knowledge of these principles and appropriate technical skills. Concurrently increased were the overall professional responsibilities of medical technologists/clinical laboratory scientists in the day-to-day operation in clinical laboratories. There was a continual development of the academic level of the profession, from Assistant to Technician to Technologist to Scientist. As a result of these events the professional requirements advanced from "no formal qualifications" in the 1940s and 1950s, to bachelors degree in the 1960s and 1970s, followed by the masters degree and doctoral degree programs in the last 30 years.
In developed countries where certificate programs still exist, the general rule has been the establishment of academic pathways to allow those prac titioners access to academic institutions and credits for prior learning. This provides the opportunity for diploma holders to advance to bachelor's degree level and then to proceed to master's degree, and in some institutions to doctoral degree.
In developing countries the level of knowledge, education and competence of professional clinical laboratory practitioners varies considerably, depending upon the national level of medical practices, the availability of trained/educated clinical laboratory practitioners and the economic environment. Today the majority of clinical laboratory education exists at the associate and bachelor degree levels, with the appropriate diploma level courses being in parallel to either of these degrees. Academic institutions have established various procedures to recognise prior knowledge and education, allowing practitioners to advance to the formal bachelor's degree, and offering opportunities for further advancement to the masters and doctorate degrees.
Today, Medical, or Biomedical, Laboratory Science is a well developed body of knowledge that includes portions of the basic and medical sciences, medical techniques and research methods. This facilitates and ensures the production of quality medical diagnostic testing. The results have value and meaning to health care practitioners and assist in the detection, diagnosis, treatment and prognosis of diseases. The main academic basic sciences include: anatomy, physiology, molecular biology, biochemistry, immunology, microbiology, pharmacology, haematology and histopathology. There is considerable content from clinical pathology in the academic and technical sciences, as well as some content from internal medicine, family practice, obstetrics, gynaecology and paediatrics. Additional principles and processes include information technology, management of all aspects of the laboratory - financial, health and human resources. All practitioners realise the importance and need for continuing education.
RECOMMENDATION OF EDUCATION AND SCOPE OF PRACTICE
The educational authorities recognize the levels of Ph.D., MSc and B.Sc. Laboratory Aide/Assistant is not recognised as a professional in laboratory. The high quality of laboratory work also needs qualified personnel to carry out the demanding tasks and it is one part of the guarantee of Quality Assurance in clinical laboratories.
Education: Usually Laboratory Assistants have a high-school certificate and very limited, if any, related scientific and/or technical theory. The training is "at the bench" or "on the job", given by a technologist. Usually, very simple procedures are taught, and independent decision making is not part of the process.
Scope of practice: Laboratory Assistants work under the supervision, direction and control of a technologist.
Education: The educational knowledge at bachelor's level includes
a broad, but solid background in the basic sciences the principles and techniques of numerous clinical procedures a high level of skill in performing these tests the continuous quality assessment of all reported results economical management of time and personnel basic management skills
Scope of practice: Practitioners are competent in:
integrating information and interpreting results performing as a Scientist description and use laboratory techniques description and use laboratory equipment application of safe practices ensuring quality engaging in research and development practising as a professional communication
Education: The Masters degree graduate has specialist education and training in a specific discipline of the profession.
Scope of practice: Practitioners are qualified to function as
Medical Laboratory Managers Consultants Lecturers Researchers Industrialists Administrators
Education: This represents the pinnacle of education of Medical Laboratory Scientists. The doctorate level focuses on developing high research skills in medical laboratory sciences.
Scope of practice: The doctoral Medical Laboratory Scientist may
become Laboratory Director University Lecturer Health Administrator Research Scientist Consultant
The scope of the curriculum in Medical Laboratory Science ranges from a certificate to an academic credential, B.Sc., MSc. and/or Ph.D. This education allows Medical Laboratory Technologists to practice independently as health professionals, taking complete responsibility for their own work. In their work they
Present a professional image and fully support an independent profession that has unique skills useful to the physician, the patient, and other healthcare professionals when relating to the public. Emphasise the unique knowledge of medical laboratory scientists in the performance of clinical laboratory procedures; pre-analytical, analytical and post-analytical, utilising unique clinical correlation skills. Promote the application of knowledge, performance of technical skills and correlation of results in a clinical environment. Prepare Medical Laboratory Scientists to develop and assess new techniques and put them to proper clinical use. Reflect on current as well as anticipated needs for the delivery of health care as perceived by the profession, react appropriately and collaborate with other health care professionals. Educate practitioners to be professionally responsible for all aspects of the clinical laboratory related to the clinical laboratory science profession.
QUALIFICATION OF MEDICAL TECHNOLOGISTS
Policy statements on qualification of Medical Laboratory Technologists were adopted by the General Assembly of Delegates (GAD) at the 19th and the 20th World Congress of the International Association of Medical Laboratory Technologists (IAMLT):
In 1990 (19th World Congress):
"The medical laboratory work done by our members throughout the world is closely associated with human life. Irrespective of different standards of medical technology practised among our member countries, a policy on Qualification has been adopted:
To ensure the patient's life and health IAMLT strongly recommend clinical laboratory test service and the important diagnostic work both in private and public clinics be done by fully qualified Medical Laboratory Technologists. "
In 1992 (20th World Congress) the following statement was adopted:
"The General Assembly of Delegates (GAD) of the International Association of Medical Laboratory Technologists held in Dublin on 29 July 1992 agreed to request governments to set in place the necessary mechanisms to give effect to these statements."