Medical laboratory scientist

The most 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. Because medical laboratory scientists have many transferable technical skills, employment outside of the medical laboratory is common. Many medical laboratory scientists are employed in government positions such as the FDA, USDA, non-medical industrial laboratories, and manufacturing.


In the United Kingdom and the United States, senior laboratory scientists, who are typically post-doctoral scientists, take on significantly greater clinical responsibilities in the laboratory. In the United States these scientists may function in the role of clinical laboratory directors, while in the United Kingdom they are known as consultant clinical scientists.


Though clinical scientists have existed in the UK National Health Service for ≈60 years, the introduction of formally-trained and accredited consultant-level clinical scientists is relatively new, and was introduced as part of the new Modernizing Scientific Careers framework developed in 2008.


Consultant clinical scientists are expected to provide expert scientific and clinical leadership alongside and, at the same level as, medical consultant colleagues. While specialists in healthcare science will follow protocols, procedures and clinical guidelines, consultant clinical scientists will help shape future guidelines and the implementation of new and emerging technologies to help advance patient care.


In the United Kingdom, healthcare scientists including clinical scientists may intervene throughout entire care pathways from diagnostic tests to therapeutic treatments and rehabilitation. Although this workforce comprises approximately 5% of the healthcare workforce in the UK, their work underpins 80% of all diagnoses and clinical decisions made.^[3]

Specialty areas[edit]

Many Medical Laboratory Scientists are generalists, skilled in most areas of the clinical laboratory. However, some 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), "SM" (Specialist in Microbiology), "SC" (Specialist in Chemistry), or "SH" (Specialist in Hematology) from the American Society for Clinical Pathology (ASCP). These additional notations may be appended to the base credential, for example, "MLS(ASCP), SBB(ASCP)".^[4] Additional information can be found in the ASCP Procedures for Examination & Certification.^[5]


Andrology Laboratory Scientist, Embryology Laboratory Scientist, and Molecular Diagnostics Technologist certifications are provided by the American Association of Bioanalysts; those with the certifications are classified as ALS(AAB), ELS(AAB), and MDxT(AAB) respectively.^[6] Certified Histocompatibility Associate, Certified Histocompatibility Technologist, Certified Histocompatibility Specialist, and Diplomate of the ABHI are titles granted by the American Board of Hisocompatibility and Immunogenetics after meeting education and experience requirements and passing the required examination; those individuals would hold the credentials CHA(ABHI), CHT(ABHI), CHS(AHBI), and D(ABHI) upon passing the corresponding examination.^[6][7]


In the United States, Medical Laboratory Scientists can be certified and employed in infection control. These professionals monitor and report infectious disease findings to help limit iatrogenic and nosocomial infections. They may also educate other healthcare workers about such problems and ways to minimize them.^[8]


In the United Kingdom the number of Clinical Scientists in a pathology discipline are typically greater, where less medically qualified pathologists train as consultants. Clinical Biochemistry, Clinical Immunology and Genomic Medicine are specialities with an abundance of UK Clinical Scientists, and where the role is well established. Infection services in the United Kingdom are generally undertaken by medically qualified Microbiologists, who may have overall responsibility for laboratory services in addition to Infection Prevention and Control responsibilities, and may be required to contribute to ward rounds and patient clinics. Therefore, the Royal College of Pathologists and Royal College of Physicians have developed Combined Infection Training[10], that medical trainees gain a much more patient focused experience, and undertake Physician examinations in addition to Pathology training. The result of this is that several regional medical deaneries no longer permit Medical Doctors to train in Microbiology or Virology as single disciplines, and instead advocate dual-specialisation as Infectious Disease/Microbiology or Infectious Disease/Virology [11]. Simultaneously the expansion of higher specialist scientist trainees in microbiology mean that many of the laboratory and scientific responsibilities of medical doctors may be taken on by Clinical Scientists, and medical doctors will instead be expected to perform a much more patient facing role. The exception in Microbiology is the sub-discipline of Virology, which is well suited to the expertise of clinical scientists due to reliance on cutting-edge scientific methods, increasing use of specialised genetic technologies, and a technical understanding of virus biology, with a reduced emphasis on patient management compared with Microbiology as a whole[12].

Labor shortage[edit]

Medical facilities throughout the United States have gradually been experiencing a shortage in medical laboratory science professionals. The current projectory of medical laboratory personnel through 2030 is not sufficient enough to serve medical services effectively.^[45] Reasons for the shortage include current professionals retiring, a modern increase in medical laboratory scientist and technician demand, changes in the practice caused by new technological advances (which need training to learn to use), and vacancy and retirement rates being greater than the number of graduates from medical laboratory programs. Lack of funding, low salaries, lack of a developed career ladder, and a lack of clear job requirements has made recruitment and the hiring process difficult.^[46]


Newer recruiting attempts have increased the number of graduated professionals in the last five years, but not enough to meet the growing demand. Some clinical organizations suggest that professional-development programs for the allied health fields should be improved to cultivate interest in younger professionals and students.^[47] The Institute of Medicine is actively working on re-viewing policy reforms and new plans and recommendations to increase medical professional turnout among younger people.^[45] The COVID-19 pandemic has highlighted the medical laboratory shortage in the medical field and organizations such as the American Society for Clinical Laboratory Science and The American Society for Clinical Pathology are pushing for new ways to reduce this shortage and meet the demands of the public.^[46]