Becoming a Laboratory Professional

To become a laboratory professional requires intelligence, a commitment to working hard in school, a desire to help humankind, and a love of science. Use the following checklist to help you determine whether you may be suited to a career as a laboratory professional.

Personal Checklist

Yes No

1. It is important to me to have a career that involves helping others.
   
   
2. To my friends, family, and teachers, I am known to be a person of honesty and integrity.
   
   
3. I have good manual dexterity and can translate thinking skills into doing skills.
   
   
4. I like a certain amount of order or structure in the work that I do.
   
   
5. I am able to plan and carry out activities with little supervision,
   
   
6. It is important to me to have a sense of accomplish situations.
   
   
7. I am able to prioritize and carry out tasks when given several of them to do at the same time.
   
   
8. I have good communication skills.
   
   
9. I enjoy using various instruments (such as micro scopes), as well as computers.
   
   
10. I like to know why things happen and what causes certain biologic conditions to occur.
    
    
11. I enjoy learning new ways of doing things.
    
    
12. I wish to play a significant role in finding the causes of disease and in helping people to improve their lives.
    
    
13. I like and do well in science courses, especially biology.
    
    
14. I know that work in clinical laboratory science involves testing blood and other biological substances for their cellular, chemical, or biological components.
    
    
15. I understand that with a degree in laboratory science, I can work in laboratories in hospitals, clinics, research, veterinary medicine, industry, and a number of other areas.
    
    
16. I know that in laboratory science I will use the latest scientific discoveries in my work.
    
    
17. Following high school, I am willing to spend two to five years (depending on the program chosen) to pre pare for a profession in laboratory science.
    
    
18. Following high school, I would enjoy studying science and other courses needed to prepare for a profession in laboratory science.
    
    
19. In college, I understand that to enter a professional program in clinical laboratory science (medical technology), I will need to demonstrate my academic abilities by earning good grades.
    
    
20. I understand that a degree in laboratory science/medical technology can be the basis for graduate work in laboratory science as well as in the biological and physical sciences, medicine, dentistry, law, education, and administration.
    
    
21. I know that in some settings, laboratory personnel interact with patients with infectious diseases, together with biologic fluids from these patients, but that precautions for safety are well established.
    
    
22. I like medically related activities, but not one hundred percent direct patient contact.
    
    
23. I understand that laboratory science is a profession based on the team concept in which health care providers work together to achieve positive outcomes.
    
    
24. I understand that the starting salaries for clinical lab oratory personnel are usually comparable to those of other allied health professionals.
    
    
25. I recognize that in this profession, I may have to work evening, night, or weekend shifts, depending on the work setting I choose.
    
    
26. I am willing to treat all patients and their families equally and humanely-with respect and care.
    
    
27. As a health care professional, I will be able to keep all patient or client information in the strictest confidence.
    

To score this assessment instrument, give two points for a yes response to items 2, 3, 5, 8, 9, 10, 12, 16, 17, and 22. These items have been chosen by forty laboratory educators as the ten key statements for a potential student to become a successful laboratory scientist. Give one point to a yes response for each of the other twenty items. If your total score is 30 or more, you are an excellent candidate for becoming a successful clinical laboratory professional. If you score from 20-29, you are a good candidate. If you score 19 or less, you should probably investigate other career options.

The checklist also can be grouped in two ways: knowledge of self (items 1-16), and knowledge of the field (items 17-30). Both are important in choosing a career, especially one in laboratory science.

High School Highlights

The usual high school education consists of four years of secondary school studies beginning with the ninth grade and concluding with completion of the twelfth grade of study. Courses of instruction in a secondary (high school) school curriculum are usually measured in terms of units. A unit is defined as one year's work on a single subject. Most high school students will study the course of English during each of the four years in attendance, thereby accumulating four units in that subject.

For admission eligibility, community and junior colleges, four-year colleges, and universities often require applicants to complete eighteen to twenty-two units of acceptable high school work. Stu dents considering laboratory science as a career should not be enrolled in commercial, vocational, or nonacademic programs within high schools. Enrollment in college preparatory high school curriculums will enhance admission requirements to most institutions of higher education.

It is essential that the subject of English be included during each of the four years spent in high school. The ability to read, write, and speak intelligently is increasingly important in health care. Future laboratory science students must have a strong foundation in science; they are urged to include the basic sciences of chemistry, biology, and physics in a high school program. At least two courses in mathematics should be completed, and a student would do well to study the highest level math course consistent with individual ability. As the world grows smaller, knowledge of a foreign language is becoming increasingly important, and two to four units of a language would be helpful.

Completion of English, the sciences, and mathematics as described will yield a minimum of nine of the units needed for collegiate admission. Remaining units may be drawn from courses in social studies, history, and electives. A course in computer science could be considered as one of the elective courses.

What other elective subjects might a high school student select during the secondary school years? Programs in art and music will stimulate an interest in the beauty of sight and sound. A variety of elective courses is enriching; and the better informed one becomes, the better will be future personal decisions. Subjects such as social sciences, history, and philosophy provide some insights into human conduct and principles of being.

A minimum grade point average of 3.0 (B) should be maintained in high school to be successful in a college or university laboratory science program.

B.S. Program in Clinical Laboratory Science/Medical Technology

The curriculum for becoming a laboratory scientist will vary from institution to institution. However, key courses in college that usually do not change include those in inorganic and organic chemistry and biology.

For the B.S. degree, two sample laboratory science curricula are seen below: one from the University of Minnesota (curriculum A), which is an integrated program and uses the quarter system (eleven weeks = one quarter); the other (curriculum B) is from a 3 + 1 program, using the semester system (sixteen weeks = one semester).

Curriculum A: Clinical Laboratory Science

(Integrated program: suggested curriculum sequence using a quarter system; numbers of credits are in parentheses.)

One may switch from a quarter to semester system (or vice versa) easily. To convert credits from the quarter to semester system, divide the number of quarter credits by two-thirds. There-fore, a quarter course of six credits is equivalent to a semester course of four credits. To convert semester credits to quarter credits, multiply the number of semester credits by one and one-half, Therefore, a two-credit semester course is equivalent to a three-credit quarter course.

It can be seen in curriculum A that students have preclinical courses (year four, fall, winter, spring quarters) prior to their clinical experiences in hospital laboratories. The actual length of time spent in rotations in these hospital laboratories is therefore shortened to twenty-three weeks. In curriculum B, all of the laboratory science professional courses are taught in year four in an accredited hospital program. Total length is fifty to fifty-two weeks. In some programs, especially those in California, one may need to complete a baccalaureate degree prior to entering a one-year (fifty-week) professional program.

Students interested in laboratory science/medical technology are urged to consult with high-school and college advisors who are well-informed about various health science curricula, especially math and science prerequisites. If one switches majors while in college, completion of prerequisite course work also can be accomplished during evening or summer school sessions. A prospective student should check periodically with the director of the professional program he/she is interested in attending to find out whether changes in the curriculum have been made. Accredited program listings can be obtained by writing to the National Accrediting Agency for Clinical Laboratory Sciences, 8410 West Bryn Mawr Avenue, Suite 670, Chicago, IL 60631.

To gain entrance to the professional program in laboratory science/medical technology (for example, years three or four of curriculum

A or year four of curriculum B), one usually needs a collegiate grade point average (GPA) of close to 3.0 or better (A = 4.0). Some programs may accept a minimum grade point average of 2.5. Admission is usually determined by overall GPA and GPA in prerequisite (science and mathematics) courses. Other factors that may be used by an admissions committee include letters of recommendation, an interview, standardized test scores, and knowledge of the field as evidenced by a written essay or previous laboratory experience. Usually grade point average is considered as the primary determinant for admission.

The Professional Program

Students in laboratory science are expected to become competent professionals. To do so, they are provided with instruction in chemistry/urinalysis; microbiology; blood banking, including immunology/serology; and hematology/coagulation. Often student laboratories are used to provide introductory exercises. Other instruction makes use of case studies, computer-assisted programs, demonstrations, discussions, and research methodology.

"Clinical rotations" refer to the training period of practical experience (an internship) that a student undertakes in a productive laboratory, which is often located in a hospital. The student is under the supervision of practitioners. This experience is exciting, practical, and rewarding as knowledge and skills learned in the classroom and student laboratories are applied in the real world. During clinical rotations, students also interact with patients and other health care providers. Each day of the clinical rotation adds to the students' self-confidence and moves them closer to becoming real professionals.

Personal Attributes

The thirty-item checklist found earlier in this chapter includes some of the personal characteristics that will enhance one s chances of becoming a successful practitioner who enjoys his or her work. First, an interest in science is very important. Of all high school courses completed, biology is probably the most important. In fact, many professionals believe that an interest and success in biology is more important than an interest and success in chemistry, physics, or mathematics. Thus, one who is interested in biologic processes as well as medical phenomena will be well suited for this profession.

Second, one must have the highest personal integrity. Accurate laboratory information is crucial to the health and well-being of individuals; thus the mislabeling of tubes or specimens, careless work, or reporting erroneous results cannot-and will not-be tolerated. Professionals and students must be able to say, "I made a mistake," and go about correcting it before it can adversely affect a patient.

Third, one must be a good student-intelligent, hardworking, and motivated; one who does not put off studying. As in medicine, those in laboratory science want "the brightest and the best," and therefore, achieving a good grade point average is important. Fourth, one should have good manual dexterity-the ability to manipulate small tubes or microtiter plates, reagents, microscopes, and instruments such as balances or computers in a skillful manner. Usually one's manual dexterity will improve with experience and confidence, but if one cannot handle syringes, pipettes, or delicate instruments skillfully, success in laboratory science may be limited.

Fifth, one should be able to prioritize-to attend to matters that require immediate action, and to be able to decide upon other concerns that can be carried out later and in what order. Patient care is not predictable; often one can receive three STAT (emergency) requests simultaneously. Thus, the laboratorian who can sort out the importance of each and complete the work accurately and in a timely fashion is one of the most valued members of the health care team.

Similar to the ability to prioritize is the ability to work under stress-a person who is "turned on" by the immediacy of a STAT situation, who can remain calm and productive when physicians and nurses are being demanding, and who can communicate with others when they are less than courteous will find laboratory science exciting, meaningful, and very rewarding.

A person who is considering this profession also should be able to plan and carry out tasks with very little supervision. Laboratorians are known for their sense of independence-of being able to analyze a problem or demanding situation and, on their own, go about finishing what needs to be completed. Coupled with many of these attributes is an enjoyment of problem solving. If a person gains a sense of satisfaction in "fixing things," he or she will be much sought after in the laboratory; if able to troubleshoot various instruments, this person will be extremely valued.

Finally, when one considers that, for example, a ten-year span of work involves twenty thousand hours of employment, (usually two thousand hours each year) it is essential that the person interested in laboratory science understand the field, the course work, and personal characteristics required to complete a program, as well as the opportunities available upon graduation. Thus the inquisitive student who tours two or three laboratories, talks to a number of professionals, and visits several accredited educational programs will have an advantage over one who is somewhat interested but not as assertive.

One should note, however, that many laboratory professionals have started school in other majors, such as biology, microbiology, or chemistry. Once they have become knowledgeable about laboratory science, they then switch to it. That, too, is very acceptable, because most people find their career niche not in the first year of school, but later on.

The checklist provides information on other characteristics that are important for success in the profession: a desire to help others, to have a sense of accomplishment for work done well, to be curious, to enjoy learning new things, to enjoy using cutting-edge technologies, to be motivated, and to be able to follow through on projects undertaken.

The potential laboratory science student should understand the hands-on nature of laboratory work. Volunteering to assist in a laboratory will help one, gain knowledge of the field, as well as the atmosphere in which it is practiced. It is also important for a student to understand the varied settings, as well as the positive and negative aspects of working in these settings. Finally, one should obtain figures on salaries and benefits-which vary by city, area, region, and setting (such as research versus hospital setting)-so as to understand the financial rewards when one becomes a laboratory professional.

From the above, one might conclude that the laboratory science profession demands intelligent, trustworthy, and caring individuals. This is true, because as health care providers, laboratorians can be nothing less.

Listed next are one graduates ten rules for survival as a student enrolled in a clinical laboratory science program. These rules reinforce the necessity for character traits of honesty, integrity, and fair-mindedness.

Ten Rules for Survival in Laboratory Science Education

Written by Janice L. Putnam, B.S., a graduate of the University of Minnesota.

1. Be honest with yourself. The career you have chosen is one that requires personal integrity and absolute honesty. As a professional, you will be part of a patient care team. It will be your responsibility to perform accurate laboratory tests and interpret the results carefully, so that physicians and other health care workers can determine an appropriate course of patient treatment. If honest work is your policy while in school, it will carry over into your work as a practicing laboratorian. Cheating in school is, of course, dishonest, and may be grounds for dismissal. However, in this field, cheating is much more serious, because it will be harmful to the well-being of a patient. Make a commitment to give the same quality service to patients that you would expect to receive if you were a patient.
   
   
2. Practice respect for your fellow classmates. You and your classmates are pursuing a mutual goal-graduation in this profession. Along the way, you will spend numerous hours together in lectures, in laboratories, between classes, and in social events. Some of you will become close friends. Others will not share the same closeness. Every person, however, is unique, and differences among students should be respected. However competition, jealousy, or personal conflicts benefit no one. As a professional, you will have contact with people from varied backgrounds and personalities. If you learn to respect the differences among your classmates, you will be more-kind, gentle, and caring of both the patients and other health care providers you will work with as a professional.
   
   
3. Never hesitate to ask for help from your instructors. The information presented in lectures and practiced in the laboratory is sometimes intense. It may be difficult to comprehend the details, even when reviewing lecture notes and laboratory exercises after class. If you do not understand the material presented, make an appointment to see the instructor. No question is too trivial, and most instructors will gladly take the time to help you comprehend the many aspects of laboratory science.
   
   
4. Budget your time wisely. The high cost of a college education leaves most students with no choice but to work, in addition to attending classes and studying. Wise utilization of each day is important for successful completion of a program. If outside work is a financial necessity, try to find a job with some flexibility, so that as class schedules change, you can adjust a work schedule accordingly. Attending classes, finishing assigned homework, and studying should be your primary priority. Although it is important to be financially secure, do not allow outside employment to jeopardize your ultimate goal.
   
   
5. Take care of your health. The demands of college and professional course work can be exhausting. It is important to take care of your health in order to be able to function at the fullest capacity, A healthy diet, drinking plenty of water, regular exercise, and adequate rest will keep you alert and energetic enough to meet the challenges of a laboratory science program.
   
   
6. View new information with a questioning mind. A lab oratory professional is a scientist. A scientist who is learning new information should want to know not only what it means, but also how it came about and how it can be expanded upon. As a student, you will be presented with new material every day Rather than just memorizing the facts for an exam, question what you have learned. Discuss it with fellow students and with your instructors. Expand upon it. Ultimately, success and personal satisfaction in your career will come about when you learn to think as a scientist.
   
   
7. Listen to upper-class students, but use your own best judgment. Whether you choose to accept upper-classmens words as "sacred" should be determined by your own experiences. An unpleasant experience or encounter for one student is hardly reason for another student to form prejudices. Enter every class and meet every new instructor with an open mind. Then, based on your own experiences, decide to agree or disagree with the opinions of upper-class students.
   
   
8. Never stop learning. This is an evolving profession with changing methods, better technologies, and increasing responsibilities. It is imperative that as a student, and then as a graduate, you continue to learn so as to progress further in the profession. Continuing education may be the farthest thought from your mind while an undergraduate. However, think ahead toward directions that will enhance your future as a professional.
   
   
9. Take time for fun. The enjoyment of extracurricular activities is essential for everyone's mental and physical health. Although it is important to put forth a best effort as a student, it is impossible to learn every detail. You will need to take a break. Go to a movie, have dinner with a friend, engage in a hobby or sports activity that is enjoy able, or sit back and watch TV. Relax when the need arises. You will then be better able to enjoy learning. 10. Act as a professional. These rules are guides toward becoming a professional. Integrate them into your life.
   

Do not ignore laboratory test results that are out of the reference range or do not make sense. Learn how to resolve these and other problems. Keep up to date on the latest advances in diagnostic medicine. Practice the knowledge and skills you have acquired in order to ensure quality patient care. Always act as a professional, which includes keeping yourself well-groomed, well-mannered, and able to get along with others.

These rules represent one students imperatives to success in school and the profession. They also represent very sound guide lines to success in life,

Applying to a Laboratory Science Program

Once you have decided on a specific program in laboratory science, apply to that program and perhaps two or three others as well. The application means completing a specified form, submit ting a transcript, and often providing letters of recommendation. It is important that you fill in all forms neatly and completely, since these are the first pieces of information that members of an admissions committee will see and make judgments upon.

Most applications require submission of an application fee; be sure to include a check or money order in the correct amount and made payable to the institution. (Some organizations hold the application and will not act on it until the check is in receipt.) Follow these common sense directions: make the check payable to the institutions name (not to the name of the admissions officer); be sure the amount of the check equals the application fee; mail the check together with the application in the same envelope; and make certain your account has sufficient funds to cover the check. Once an admissions committee has received all materials, you may be invited for an interview. This provides the opportunity to visit the school and the laboratory directly. (Even if an interview is not required, visit a program prior to making a commitment.) The interview, although considered an evaluation tool by some, is an instrument of communication that permits direct transmission of information. Dress neatly for the interview, be as poised and confident as you can, and answer all questions truthfully.

In summary, evaluation tools available to an admissions committee include: transcripts, test scores, letters of recommendation, and sometimes interviews. Without question, the transcript is the most important and reliable source of information about an applicant. To an admissions committee, the transcript represents a total ity of grades earned by one student over a period of time and from many instructors. Thus it will be used as the primary resource to evaluate your potential.

Once you are accepted into a program, write the program direc tor promptly about your intent to attend. Thereafter, the program director will provide information about starting dates and orientation.

Educational Finances Required

The cost of a baccalaureate education in clinical laboratory science is similar to that in nursing or occupational therapy Often the first two-to-three pre-professional years are taken in a collegiate setting. In public institutions, tuition may range from $3,000 to $8,000 per year. In private colleges and universities, tuition is much the same as that for other science majors and may cost up to $30,000 per year.

Tuition for the professional component (one to two years) of laboratory sciences education is variable and may be the same as during the pre-professional period. During the professional component, tuition may increase due to the expense of offering laboratory courses.

A variety of scholarships are available to students, especially once they are in the professional program. Scholarships are provided by the American Society for Clinical Laboratory Science (ASCLS) and its state societies, as well as other organizations, such as the American Society of Clinical Pathologists. Loans and grants may be acquired, too; check with the financial aid office of the college or university that you will be attending. You can also research possible scholarships at your local library and on the Internet.

Licensure/Certification

Unlike physicians, nurses, pharmacists, and dentists, who enter their professions via licensure, most laboratory professionals enter their fields via certification. An explanation of each kind of credential is needed. The first credential (licensure) is required by law; the second (certification) is voluntary but strongly recommended and often required by employers. The purpose of each kind of credential is that of a gatekeeper, that is, to prevent incompetent persons from practicing. Licensure and certification are instituted to help protect the public health, safety, and welfare.

Dentists, nurses, pharmacists, and physicians are usually licensed to practice in the state in which they provide their services. Licensure is the process by which a government or agency grants permission to persons meeting predetermined qualifications to engage in a specific occupation. Usually these predetermined qualifications include completion of a professional program and passing of a state licensure examination. If one is not licensed, he or she cannot legally practice in that state.

In laboratory science, licensure is not the primary mode of gate keeping, except in several states. Personnel licensure exists in Florida, Georgia, Hawaii, Louisiana, Montana, Nevada, New York, North Dakota, Puerto Rico, Rhode Island, Tennessee, and West Virginia but may take the form of a license being granted for successfully passing a national certification examination. California has begun to rely more on national exams, although at the time of this writing the state-developed examination is required for the clinical laboratory scientist/medical technologist level practitioner.

In laboratory science most graduates take certification examinations. Certification is the process by which a nongovernmental agency or association grants recognition to an individual who has met predetermined qualifications-usually passing a certification examination-specified by that agency or association. Certification is voluntary; one does not legally need a certificate to practice.

However, most graduates of laboratory science programs take certification examinations, since employers strongly recommend that employees hold a certificate.

Certification in laboratory science is complex and confusing since there have been multiple agencies involved in providing certification examinations. Table 7 depicts the myriad accreditation agencies in this field. These agencies may certify generalists such as clinical laboratory scientists, or they may certify specialists such as clinical chemists. Some are more highly regarded than others. Thus students should know which employing organizations recognize and expect certain credentials. A brief review of major agencies certifying generalists is provided below.

Board of Registry of the American Society of Clinical Pathologists (ASCP)

In 1928 the American Society of Clinical Pathologists (ASCP) established the Registry of Technicians to register individuals who met certain requirements in training and education. The first certificates that were awarded required graduation from high school or a diploma from a school of nursing and one year of training. In 1933 applicants were required to pass an essay examination and an oral and practical (hands-on) examination before certification was granted. In 1934 educational requirements were increased to two years of college including science courses and one year of clinical training. Following is the actual examination given in 1933.

Registry Examination, October 1933

1. Name five divisions of the clinical laboratory in well organized work. In which divisions or division of the clinical laboratory has the applicant had the most training? Outline the nature of the practical training. In what division has the applicant had little or no training?
   
   
2. Define: meniscus, artifact, bacterial antigen, pyogenic, autolysis, hemolytic.
   
   
3. Define: metastasis, aspiration, Negribodies, pyrexia.
   
   
4. Define: pediatrics, otology, neurology, psychiatry, orthopedics, pathology, gynecology, radiography, gastroenterology, ophthalmology.
   
   
5. Define: cylindroid, hypychlorhydria, physiological leukocyto sis, hemoglobinuria, symbiosis.
   

Clinical

1. Define: endotoxin, chromogenic, anaerobic, attenuation symbiosis.
   
   
2. Name six organisms representing normal respiratory flora.
   

Hematology

1. Name the procedures included in the routine examination of the blood.
   
   
2. Distinguish by [drawing]: squamous epithelial cell, normal erythrocyte, normal lymphocyte, blood platelet, and pus cell.

Urinalysis

1. Name seven factors which should be included in the routine examination of the urine.
   

Serology

1. Name serological tests in the clinical diagnosis of syphilis, undulant fever, typhoid, and paratyphoid.
   

Tissue Technic

1. What is the most satisfactory fixing fluid for tissues?
   

The 2 + 1 (2 years college + 1 year training) pattern continued until 1962, when these requirements were replaced by a baccalaureate degree. The late 1960s and 1970s saw the rise of 2 + 2 baccalaureate programs, primarily in large colleges, universities, and medical centers, in addition to traditional 3+1 programs. In 1963 the Board of Registry of the ASCP began providing certification examinations for laboratory technicians. The Board of Registry has also certified individuals other than generalists: cytotechnologists, histotechnologists, histologic technicians, and phlebotomists; technologists in chemistry, cytotechnology, hematology, immunology, microbiology, and nuclear medicine, as well as specialists in blood banking, chemistry, cytotechnology, hemapheresis, hematology, immunology, and microbiology.

National Credentialing Agency for Laboratory Personnel (NCA)

In 1977 the American Society for Medical Technology helped to establish a new certification agency independent of control by any professional association. Prior to that time, the Board of Registry, under the auspices of the ASCP (a pathologist group), controlled the certification of the majority of laboratory personnel. Moreover, Board of Registry certificants had no voting rights under the ASCP. Many laboratory professionals chafed under these arrangements and initiated the National Credentialing Agency (NCA).

In 1978 NCA offered its first examinations for two generalist categories: the category of clinical laboratory scientist (CLS) and that of clinical laboratory technician (CLT). Other NCA examinations are now available, including those in management (for the clinical laboratory supervisor and clinical laboratory director), as well as in specialty areas such as cytogenetics, phlebotomy, and hematology

Many laboratory personnel believe that NCA best represents their interests as the preferred certifying body. NCA has a sound reputation, primarily because of the excellence of its examinations, which are based on competence statements of actual practice in the laboratory.

Moreover, NCA seeks recertification of its certificants either through completion of continuing education credits or through retesting. NCA is thus committed to continuing competence, not just initial certification. The NCA is known, therefore, for its excellent and comprehensive examinations, as well as for certificants' commitment to providing evidence of ongoing competence.

Other Agencies

Other agencies have provided certification examinations for laboratory generalists:

American Medical Technologists (AMT)

In 1939 a group of laboratory personnel founded AMT, a certification agency used mainly by graduates of proprietary schools. In addition, AMT approved laboratory education programs through the Accrediting Bureau of Health Education Schools. AMT certification requirements focus on technical training and work experience. Previously members of AMT tended to be graduates of one- or two-year proprietary schools who first qualified for the technician category and then, with work experience and passing of the AMT technologist's examination, gained medical technologist (MT) status.

American Association of Bioanalysts (AAB) formerly the International Society for Clinical Laboratory Technology (ISCLT).

Founded as a splinter group of AMT, ISCLT was a professional soci ety of laboratory personnel with a membership composed primarily of persons trained on the job (OJTs). ISCLT began providing a certification examination in 1962 through its credentialing commission; its efforts have been directed to the registered medical technologist (RMT) and registered laboratory technician (RLT) categories. ISCLT examinations are available to persons who have had experience in the laboratory and who are sponsored by a supervisor.

Department of Health, Education and Welfare (HEW)

To further complicate certification efforts, the federal government began providing proficiency examinations for supportive-level personnel in 1975. The intent of these examinations was to ensure that those independent laboratories that performed testing for Medicare patients had sufficient "properly qualified technical personnel." At that time, many independent laboratories employed numerous supportive-level personnel but fewer persons holding degrees. Since Medicare requirements for reimbursement were quite stringent-for example, that a supervisor be in attendance while supportive-level personnel were working-many independent laboratories, and some hospital laboratories as well, did not meet Medicare standards.

The Department of Health, Education and Welfare-now Health and Human Services (HHS)-tried to "upgrade" the status of workers employed through examination rather than "down grade" its original standards. Approximately fifty thousand laboratorians took the HEW examinations in an attempt to gain status and perhaps to prepare for further governmental regulations. Approximately one-half passed the exams and were certified by HEW as clinical laboratory technologists or cytotechnologists. (Contact the Department of Health and Human Services in Washington, D.C., for information on the status of the current HHS proficiency test for laboratory personnel.)

Other Certification Agencies

In addition to these agencies that have certified generalist laboratory personnel, there also exist a number of organizations that credential laboratory specialists. These organizations include the American Board of Bioanalysts, American Board of Clinical Chemistry, National Registry in Clinical Chemistry, International Academy of Cytology, American Society for Microbiology, American Society of Phlebotomy Technicians, International Academy of Phlebotomy Science, National Phlebotomy Association, American Registry of Radiologic Technologists, and Nuclear Medicine Technology Certification Board. Altogether at least fifteen different groups have provided or are providing certification examinations for various personnel in clinical laboratories.

The multiplicity of agencies and designations used have contributed to some of the confusion-especially for the public-regarding credentialed laboratorians. It also has prevented a united front in terms of the politics that concern laboratory personnel. Nonetheless, experienced employers know which credentials are meritorious and indicate competence of laboratorians.

Students may find areas of interest within other programs whose designated names may not always indicate graduate-level opportunities. Thus, a "specialization" in hematology may be found within a "department" such as anatomy. An "immunology" concentration might well be seen in pathobiology, or an "epidemiology" emphasis may be within a school of public health. Undergraduate (baccalaureate level) students who wish to obtain an advanced degree should take the Graduate Record Examination (GRE) close to the time of graduation, when course work is still very familiar. For those whose grade point average is below a 3.0 (A = 4.0), completion of additional courses is strongly advised because that GPA (B average) is a minimum for many graduate programs.

The American Society for Clinical Laboratory Science has published a Directory of Graduate Programs for Clinical Laboratory Practitioners, which includes information on U.S. masters- and doctoral-level programs in clinical laboratory science. Updated information can be found at the ASCLS website.

Finally, Petersons Guides (found in most medical libraries) list the programs and schools that offer advanced degrees. Take some time to do a little research so you can decide whether an investment in clinical laboratory science will be satisfying and meaningful.