Clinical laboratory testing plays a crucial role in the detection, diagnosis, and treatment of disease. Clinical laboratory technologists and technicians, also known as medical technologists and technicians, perform most of these tests.
Clinical laboratory personnel examine and analyze body fluids, tissues, and cells. They look for bacteria, parasites, or other micro-organisms; analyze the chemical content of fluids; match blood for transfusions, and test for drug levels in the blood to show how a patient is responding to treatment. They also prepare specimens for examination, count cells, and look for abnormal cells. They use automated equipment and instruments that perform a number of tests simultaneously, as well as microscopes, cell counters, and other kinds of sophisticated laboratory equipment to perform tests. Then they analyze the results and relay them to physicians.
The complexity of tests performed, the level of judgment needed, and the amount of responsibility workers assume depend largely on the amount of education and experience they have.
Medical technologists generally have a bachelor's degree in medical technology or in one of the life sciences, or have a combination of formal training and work experience. They perform complex chemical, biological, hematological, immunologic, microscopic, and bacteriological tests. Technologists microscopically examine blood, tissue, and other body substances; make cultures of body fluid or tissue samples to determine the presence of bacteria, fungi, parasites, or other micro-organisms; analyze samples for chemical content or reaction; and determine blood glucose or cholesterol levels. They also type and cross-match blood samples for transfusions.
They may evaluate the effects a patient's condition has on test results, develop and modify procedures, and establish and monitor programs to insure the accuracy of tests. Some medical technologists supervise medical laboratory technicians.
Technologists in small laboratories perform many types of tests, while those in specialty laboratories or large laboratories generally specialize. Technologists who prepare specimens and analyze the chemical and hormonal contents of body fluids are clinical chemistry technologists. Those who examine and identify bacteria and other micro-organisms are microbiology technologists. Blood bank technologists collect, type, and prepare blood and its components for transfusions; immunology technologists examine elements and responses of the human immune system to foreign bodies.
Cytotechnologists, who have specialized training, prepare slides of body cells and microscopically examine these cells for abnormalities which may signal the beginning of a cancerous growth.
Medical laboratory technicians generally have an associate degree from a community or junior college, or a diploma or certificate from a vocational or technical school. They perform routine tests and laboratory procedures. Technicians may prepare specimens and operate automatic analyzers, for example, or they may perform manual tests following detailed instructions. Like technologists, they may work in several areas of the clinical laboratory or specialize in just one. Histology technicians cut and stain tissue specimens for microscopic examination by pathologists and phlebotomists draw and test blood. They usually work under the supervision of medical technologists or laboratory managers.
Experienced clinical technologists may advance to supervisory positions.
Hours and other working conditions vary according to the size and type of employment setting. In large hospitals or in independent laboratories that operate continuously, personnel usually work the day, evening, or night shift, and may work weekends and holidays. Laboratory personnel in small facilities may work on rotating shifts rather than on a regular shift. In some facilities, laboratory personnel are on call (available in case of emergency) several nights a week or on weekends.
Clinical laboratory personnel are trained to work with infectious specimens. When proper methods of infection control and sterilization are followed, few hazards exist.
Laboratories generally are well lighted and clean; however, specimens, solutions, and reagents used in the laboratory sometimes produce odors. Laboratory workers may spend a great deal of time on their feet.
Clinical laboratory technologists and technicians held about 268,000 jobs in 1992. More than half worked in hospitals. Most others worked in medical laboratories and offices and clinics of physicians. Some worked in blood banks, research and testing laboratories, and in the Federal Government for Department of Veterans Affairs hospitals and the U.S. Public Health Service.
About 1 laboratory worker in 6 worked part time.
The usual requirement for an entry level position as a medical technologist is a bachelor's degree with a major in medical technology or in one of the life sciences. Universities and hospitals offer medical technology programs. It is also possible to qualify through a combination of on-the-job and specialized training.
Bachelor's degree programs in medical technology include courses in chemistry, biological sciences, microbiology, and mathematics, and specialized courses devoted to knowledge and skills used in the clinical laboratory. Many programs also offer or require courses in management, business, and computer applications.
Masters degrees in medical technology and related clinical laboratory sciences provide training for specialized areas of laboratory work or teaching, administration, or research. Two universities offer doctorates in clinical laboratory technology.
Medical laboratory technician training is offered in community and junior colleges, hospitals, vocational and technical schools, and in the Armed Forces. A few technicians learn on the job. Community and junior college programs last 2 years and lead to an associate degree. Others are shorter and lead to a certificate in medical laboratory technology.
Nationally recognized accrediting agencies in the allied health field include the American Medical Association's Committee on Allied Health Education and Accreditation (CAHEA), and the Accrediting Bureau of Health Education Schools (ABHES). CAHEA accredits over 800 programs that provide education for medical technologists, cytotechnologists, histologic technicians, specialists in blood bank technology, and medical laboratory technicians. ABHES accredits training programs for medical laboratory technicians.
Licensure and certification are methods of assuring the skill and competence of workers. Licensure refers to the process by which a government agency authorizes individuals to engage in a given occupation and use a particular job title. Some States require laboratory personnel to be licensed or registered. (Information on licensure is available from State departments of health, boards of occupational licensing, or occupational information coordinating committees.)
Certification is a voluntary process by which a nongovernmental organization such as a professional society or certifying agency grants recognition to an individual whose professional competence meets prescribed standards. Widely accepted by employers in the health industry, certification is a prerequisite for most jobs and often is necessary for advancement. Agencies that certify medical laboratory technologists and technicians include the Board of Registry of the American Society of Clinical Pathologists, the American Medical Technologists, the National Certification Agency for Medical Laboratory Personnel, and the Credentialing Commission of the International Society for Clinical Laboratory Technology. These agencies have different requirements for certification and different organizational sponsors.
Clinical laboratory personnel need analytical judgment and the ability to work under pressure. Close attention to detail is essential because small differences or changes in test substances or numerical readouts can be crucial for patient care. Manual dexterity and normal color vision are highly desirable. With the widespread use of automated laboratory equipment, computer skills are important. In addition, technologists in particular are expected to be good at problem solving and to have strong interpersonal and communications skills.
Technologists may advance to supervisory positions in laboratory work or become chief medical technologists or laboratory managers in hospitals. Manufacturers of home diagnostic testing kits and laboratory equipment and supplies seek experienced technologists to work in product development, marketing, and sales. Graduate education in medical technology, one of the biological sciences, chemistry, management, or education usually speeds advancement. A doctorate is needed to become a laboratory director. Technicians can become technologists through additional education and experience.
As in most occupations, replacement needs will be the main source of job openings. Employment of clinical laboratory workers is expected to grow about as fast as the average for all occupations through the year 2005 creating additional job openings. The rapidly growing older population will spur demand, since older people generally have more medical problems. Technological changes will have two opposite effects on employment. New, more powerful diagnostic tests will encourage more testing and spur employment. However, advances in laboratory automation and simpler tests, which make it possible for each worker to perform more tests, should slow growth. Research and development efforts are targeted at simplifying routine testing procedures so that nonlaboratory personnel physicians and patients in particular can perform tests now done in laboratories. Also, robots may prepare specimens, a job now done by technologists and technicians.
Fastest growth is expected in independent medical laboratories, as hospitals continue to send them a greater share of their testing. Rapid growth is also expected in offices and clinics of physicians. Slower growth is expected in hospitals.
Median annual earnings of full time, salaried clinical laboratory technologists and technicians were $26,312 in 1992. Half earned between $19,136 and $32,864. The lowest 10 percent earned less than $14,664 and the top 10 percent more than $39,000.
According to a University of Texas Medical Branch national survey of hospitals and medical centers, the median annual salary of medical technologists, based on a 40 hour week and excluding shift or area differentials, was $31,202 in October 1992. The average minimum salary was $24,888 and the average maximum was $36,844. For medical laboratory technicians, the median was $23,340; for histology technicians, the median was $25,605; for cytotechnologists, the median was $34,414; and for phlebotomists, the median was $16,209.
Clinical laboratory technologists and technicians analyze body fluids, tissue, and other substances using a variety of tests. Similiar or related procedures are performed by analytical, water purification, and other chemists; science technicians; crime laboratory analysts; food testers; and veterinary laboratory technicians.
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Reprinted with Permission of U. S. Department of Labor