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The hidden profession that saves livesMedical Laboratory Science (also called Clinical Laboratory Science) is one of themost under-recognized health professions with excellent job prospectsBy Rodney E. Rohde, PhD Posted on 11 February 2014Share story:

A Clinical Laboratory Science class at Texas State University (Photo by Chandler Prude)

As an undergraduate microbiology major and MS student in virology, I envisioned a career in the clinicallaboratory at some exciting hospital conducting microbiological testing to identify disease-causing microbes.

What is a Medical Laboratory Professional?Medical Laboratory Scientists (MLS) and Medical Laboratory Technicians (MLT) also known as ClinicalLaboratory Scientists (CLS) perform laboratory tests on patient samples to provide information needed todiagnose or monitor treatment. Examples of common laboratory tests include tests to detect anemia, diagnosediabetes and strep throat, and provide a transfusion to an accident victim.

Professional duties include:

Operating computerized instrumentsIdentifying abnormal cellsAssuring safe transfusion of blood productsCulturing and identifying bacteria and virusesCorrelating test results with patient's conditionSelecting and evaluating lab equipmentSelecting, orienting and evaluating employeesMonitoring the quality of testing

Source: NAACLS Standards for Accredited and Approved Programs

After graduating and starting my job search, I quickly learned that I was mistaken. To conduct diagnostic laboratory testing in a clinical environment, like a hospital laboratory and most referencelaboratories (which provide services for physicians), I needed to be certified or licensed as a medical laboratoryscientist (MLS) or medical laboratory technician (MLT).

After learning that I would be unable to work in a hospital laboratory, I decided to go to work for the TexasDepartment of State Health Services (DSHS) in the Bureau of Laboratories as a public health microbiologist. Iworked in a variety of areas, including newborn screening and virology.

Later, I was a molecular epidemiologist for the DSHS Zoonosis Control Division, where I became sort of a hybridemployee between the laboratory and in the field tracking zoonotic disease agents (for example, rabies,hantavirus and plague) as a molecular epidemiologist. It was a fantastic experience and provided a strongfoundation for the span of my career. I was one of the original members of the successful Oral Rabies VaccinationProgram in Texas that eliminated wildlife rabies from coyotes and foxes in the 1990s. I also worked with theCenters for Disease Control (CDC) to establish the DSHS Regional Rabies Typing Laboratory as the first statepublic health laboratory to provide rabies typing for other states and countries.

It was in the DSHS laboratory that I first became acquainted with a "med tech" and what his educationalbackground and profession involved.

Medical laboratory science involves diagnostic laboratory testing from A to Z. These professionals do everythingfrom providing your cancer testing results, to predicting the correct antibiotic to prescribe, to typing the correctblood for surgery. MLS professionals provide answers to life-and-death decisions every day.

I was fascinated and disappointed that I had not learned of this amazing career choice (and major) while I wasin college. In fact, I was right across the street from an MLS program while I was obtaining my microbiology andvirology degree.

This is an important thing to mention because MLS as a college major is often in an Allied Health program or theCollege of Health Professions, not in the College of Science where my microbiology courses were.

As MLS program chair, I have had so many students and alumni tell me: "If only I had known about the MLS majorsooner."

In our program, about 40 percent to 50 percent of students who apply to our major already have a BS, or even anMS or PhD, in another major (such as microbiology, biology or biomedical studies), but they are either unable tofind a job or they find out they can't work in a clinical laboratory without the degree and MLS certification.

Callie Megan Wright, MS, MLS, MB (ASCP)CM is a Texas StateUniversity alumna from 2009. She works at Clinical PathologyLaboratories in Austin, Texas, where she is responsible for settingup and evaluating molecular diagnostic tests and quality control.

In my case, I quickly became fascinated with the profession whileworking with so many wonderful medical lab scientists andmedical lab technologists at DSHS. I learned that I could use myvirology experience to get credit toward my certification, and wenton to obtain my Specialty in Virology (SV) from the Board ofCertification (BOC) of the American Society for Clinical Pathology(ASCP). The BOC is the primary certification agency for themedical laboratory profession. Eventually, after moving intoacademia, I acquired my Specialist in Microbiology (SM) andMolecular Biologist (MB) by the same route.

Have you ever wondered who conducts the detailed laboratorytesting for your annual exam, such as cholesterol and glucoselevels, and analyzes the results? Or who conducts specializedtesting for genetic disorders like sickle cell disease? How aboutthose who identify an antibiotic resistant infection like MethicillinResistant Staphylococcus aureus (MRSA) and determine whichantibiotic is required to save someone's life? Well, if you thought that it was your physician, or perhaps a nurse orsomeone else you see at your doctor's office or in the hospital, you would be incorrect.

MLS professionals provide up to 70 percent of patients' laboratory testing to physicians so they can provide anaccurate diagnosis and treatment plan, according to a 2002 study in Clinical Leadership and Management Reviewtitled "The Value of the Laboratory Professional in the Continuum of Care." In that study, author Rodney Forsman,Administrative Director Emeritus of the Mayo Clinic Medical Laboratories and President of the Clinical LaboratoryManagement Association, stated that 94 percent of the objective medical data in the patient record comes from thelaboratory professionals.

Doctors rely on laboratory test results to make informed patient diagnoses. Patient history along with physicalsigns and symptoms are vital, but most diagnoses need confirmation that only laboratory tests can provide. Thelaboratory professionals also contribute to wellness testing, guiding treatment, and monitoring patient progress.

Video: 'A Life Saved'This video by the American Society for Clinical Laboratory Science (ASCLS) tells the story of how medicallaboratorians save lives by assisting with patient diagnosis and treatment:

Is this profession right for you?Consider this profession if you:

Have a strong interest in scienceWant a career in health care with minimal patient contactLike challenge and responsibilityLike to solve problemsAre a team playerWork well under pressureAre self-motivated

Enjoy working with computersAre detail-orientedAre willing to persevere to find the right answer

What are the job prospects?The profession is growing "much faster than average," according to the US Bureau of Labor Statistics, with a 22percent increase in employment projected from 2012 to 2022 twice that of all other occupations. At Texas StateUniversity, the job placement rate for students has been 90 percent to 95 percent for the past decade, with most ofthe remaining students going to graduate school, according to Dr. Rohde. At the University of Delaware, Dr.McLane reports a similar scenario, with a job placement rate of 90 percent to 98 percent. They said studentstypically receive one or two job offers in their final semester while doing their clinical internships.

This situation is similar in may parts of the US, according to the American Society for Clinical Laboratory Science(ASCLS), which states: "Currently there is a shortage in many parts of the US,meaning that graduates can expectemployment and higher salaries."

How much can you earn?The salary for laboratory professionals varies according to their level and location. According to the AmericanSociety for Clinical Pathology (ASCP) 2013 Wage Survey of Clinical Laboratories in the United States, the stafflevel MT/MLS/CLS national average is $56,430 per year and $77,113 per year at the supervisory level. Salariesare higher for those who become lab directors or faculty members. The full ASCP report is here.

According to PayScale.com, which gathers its information from individual user reports: "A Mid-CareerMedical/Clinical Laboratory Technologist earns an average of $22.40 per hour. The skills that increase pay for thisjob the most are PCR Analysis and Molecular Biology."

Related resourcesASCLS Career CenterLaboratory Medicine a National Status Report , for the CDC

People often think their lab tests are done by their doctor, like it's done on House, or Dr. Kildare or Grey's Anatomy.In fact, you would probably not want your personal physician to do your lab tests because the specialized skillsrequired are not an integral part of the medical school curriculum.

In a 2008 report in the Annals of Clinical Biochemistry, authors Victoria Khromova and Trevor Gray of NorthernGeneral Hospital in Sheffield, UK, reported that the junior doctors they surveyed were more confident in theirknowledge of when to request tests than in their ability to interpret the results. In fact, 18 percent of them said theywould order a lab test without knowing how to interpret the result. The authors concluded that the elimination ofpathology and laboratory medicine from the curriculum in many medical schools is jeopardizing patient safety.

Ask your physician, nurse, pharmacist or biology graduate about Vitamin C acting as interference in glucose andtriglyceride testing, or causes of false positives in pregnancy testing, or World Health Organization (WHO)classifications for Hodgkin disease and diagnostic criteria, or ways to test for swine flu (H1N1) and avian flu(H5N1), or genetic testing modalities for cystic fibrosis, or who is most likely to show antibodies to Kell during aSTAT emergency test for life-saving blood in surgery, or any other critical laboratory test and its interpretation.These aspects of lab testing are generally not in the body of knowledge of any of these medical professionals, andyet it is completely in ours.

Formal coursework training in medical laboratory testing comprises a small portion of the curriculum forphysicians, nurses, pharmacists, physical therapists, occupational therapists, and biology graduates. However, forMLS and MLT students, medical laboratory theory for all 1,000+ available lab tests, sources of interference, andconnections between test results and diagnoses is the main focus of their studies.

My colleague Dr. Mary Ann McLane, Professor in the Medical Laboratory Sciences Department at the Universityof Delaware and Past President of the American Society for Clinical Laboratory Science (ASCLS) , emphasizedthe value of their expertise to the patients:

Medical laboratory scientists are on the cutting edge of determining by evidence-based practice the most useful, time-efficient, safest, least costly diagnostic tests to be used for your healthcare. They are involved in the research needed to bring the best that science and technology canoffer into the realm of diagnostic reality, all for the benefit of the patients we serve.

Professor Mary Ann McLane, PhD, MLS (ASCP)CM, works with Sarah Greenwood when she was a student in theMedical Laboratory Sciences Department at the University of Delaware. Greenwood has a BA in BiologicalSciences. (Photo by Kathy Atkinson).

To that end, over 50 MLS professionals from ASCLS volunteer to answer questions daily about lab test results forboth patients and clinicians through Lab Tests Online (labtestsonline.org), which has been has been run by theAmerican Association for Clinical Chemistry (AACC) since it was launched in 2001.

Through this service, Dr. McLane said, "over 140,000 questions have been answered, saving many lives, relievingconfusion about what such tests may mean, and offering follow-up questions for the next clinician visit."

"Lab Tests Online has given a public face to the practice of laboratory medicine," said Executive Producer GeorgeLinzer, "and with the support of ASCLS' consumer response network, it has begun to give more public recognitionto the valuable work of the laboratory professional."

About 7.25 billion laboratory tests are conducted annually in the US, according to the Centers for Medicare &Medicaid Services. And yet most in the general public have no understanding about our profession and the criticalservices we provide daily.

You can learn more about our profession and its importance for patients on the ASCLS page Promote theProfession.

For patients, be an advocate for your own health and wellbeing by making sure your laboratory testing is beingconducted by a qualified medical laboratory professional, by asking your health-care team about what yourlaboratory results mean and by visiting labtestsonline.org. You might just be surprised at how much you can learnby understanding your laboratory tests and the professionals who provides that expertise.

How do you become a Medical Laboratory Professional?

Medical laboratory scientists (also known as medical technologists or clinical laboratory scientists) must have aBS degree in medical technology or one of the life sciences.

Medical laboratory technicians must complete a two-year associate degree with similar courses and clinicalpracticum as the BS degree, but with less emphasis on highly complex laboratory techniques.

Rebecca Denham, MPH, MLS (ASCP), is a TexasState CLS alumna from 2008. She is currently workingat the Blood and Tissue Center of Central Texas inAustin, where she was recently promoted toLaboratory Manager. (Photo by Chandler Prude)To work as either a medical laboratory scientist (MLS)or technician (MLT), you need to be certified by theBoard of Certification (BOC) of the American Societyfor Clinical Pathology (ASCP) once you have adegree.

The best way to prepare for the certification exam is tocomplete an NAACLS accredited program or clinicalinternship in medical technology. These programsprepare students with a combination of lectures andclinical rotations in hematology, clinical chemistry,microbiology, mycology, parasitology, immunology, immunohematology (blood bank), and sometimes genetics.They are offered through hospitals and universities and take from two to four years to complete.

To work in some states (such as New York, Florida and California) you'll also need to be licensed. The license isusually obtained after sitting for the ASCP exam. Upon passing, you can then apply for the license. It's veryimportant to understand the requirements of a particular state you will work in versus where you obtain yourdegree. For example, once students in our CLS program at Texas State University finish our degree and pass theMLS (ASCP) exam, they are able to work in any clinical laboratory in Texas. However, if our students move toCalifornia, there may be restrictions on their scope of work until they satisfy the state's requirements to work in aclinical laboratory.

Learn moreThere are various categorical and specialty certifications from ASCP (and other certification agencies) that willallow different "routes" to obtaining these credentials. ASCP has a free procedures booklet with information on thedifferent routes to certification, how to register for certification, and how to maintain certification with continuingeducation. For a complete description of all the routes and requirements, visit the ASCP Board of Certificationwebsite.

You can learn about this profession and its importance for patients on the ASCLS page Promote the Profession.

Also, you can do a Web search for your area and "medical laboratory scientist" or "medical technologist" orcontact the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS) . It would also be helpful tovisit with an advisor at a local medical laboratory or college.

Sources: National Accrediting Agency for Clinical Laboratory Sciences (NAACLS) and American Society forClinical Pathology (ASCP)

Elsevier Connect ContributorDr.

Professor Rodney Rohde, PhD, MS, SV, SM(ASCP)MBRodney E. Rohde is Professor, Research Dean and ProgramChair and Director of the Clinical Laboratory Science programin the College of Health Professions of Texas State University,where he spends a great deal of time mentoring and coachingstudents in this sometimes mysterious and vague path.

Dr. Rohde's background is in public health and clinicalmicrobiology, and his PhD dissertation at Texas State wasaligned with his clinical background: MRSA knowledge,learning and adaptation. His research focuses on adulteducation and public health microbiology with respect to rabiesvirology, oral rabies wildlife vaccination, antibiotic resistantbacteria, and molecular diagnostics/biotechnology. He has published over 30 research articles, book chapters andabstracts and presented at more than 100 international, national and state conferences. He was awarded the2012 Distinguished Author Award and the 2007 ASCLS Scientific Research Award for his work with MRSA. Learnmore about his work here.

Elsevier's textbooks on Clinical Laboratory ScienceElsevier publishes many textbooks for Clinical Laboratory Science. Some of the most popular are:

Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics (7th Editioncoming in March), by Carl A. Burtis, PhD and David E. Bruns, MDLinne & Ringsrud's Clinical Laboratory Science: The Basics and RoutineTechniques, 6th Edition, by Mary Louise Turgeon, EdD, MT(ASCP), CLS(NCA)Textbook of Diagnostic Microbiology, 4th Edition, by Connie R. Mahon, MS,MT(ASCP), CLS, Donald C. Lehman, EdD, MT(ASCP), SM(NRM) and GeorgeManuselis Jr., MA, MT(ASCP)Hematology: Clinical Principles and Applications, 4th Edition , by Bernadette F.Rodak, MS, MLS, George A. Fritsma, MS, MLS and Elaine Keohane, PhD, MLS

See all of Elsevier's CLS textbooks.

The hidden profession that saves livesMedical Laboratory Science (also called Clinical Laboratory Science) is one of the most under-recognized health professions with excellent job prospectsBy Rodney E. Rohde, PhD Posted on 11 February 2014

What is a Medical Laboratory Professional?Video: 'A Life Saved'Is this profession right for you?What are the job prospects?How much can you earn?Related resources

How do you become a Medical Laboratory Professional?Learn moreElsevier Connect ContributorElsevier's textbooks on Clinical Laboratory Science