Educational requirements[edit]

Educational and licensing requirements vary by country due to differing scopes of practice and
legislative differences.

Australia[edit]
In Australia, medical laboratory scientists complete a four-year undergraduate degree program
in medical laboratory science or Master of Medical Laboratory science . These programs
should be accredited by the Australian Institute of Medical Scientists (AIMS).[1]

Canada[edit]
In Canada, three-year college or technical school programs are offered that include seven
semesters, two of them comprising an unpaid internship. The student graduates before taking
a standard examination (such as the Canadian Society for Medical Laboratory Science, or
CSMLS, exam) to be qualified as a medical laboratory technologist.[2] Many MLTs go on to
receive a bachelor of science degree after they are certified, but a few university programs
affiliated with a college MLT program to allow students to graduate with both MLT certification
and a degree such as the University of New Brunswick's Bachelor of Medical Laboratory
Sciences program.
Canada is currently experiencing an increasing problem with staffing shortages in medical
laboratories.[3]

New Zealand[edit]
In New Zealand, a medical laboratory scientist must complete a bachelor's degree in medical
laboratory science or biological or chemical science recognized by the Medical Sciences
Council of New Zealand. Once they graduate they must have worked at least six months under
supervision, be registered with the Medical Sciences Counsel of New Zealand, and hold a
current Annual Practicing Certificate.[4]

Ghana[edit]
In Ghana, a doctor of medical laboratory scientist (MLS.D) is a professional with a six (6) years
professional doctorate degree in medical laboratory science, the medical laboratory scientist
(MLS) has four (4) years bachelor's degree in medical laboratory science and the medical
laboratory technicians (MLT) has three (3) years diploma in medical laboratory science.
The curriculum for the programme include clinical rotations, where the students get hands-on
experiences in each discipline of the laboratory and performs diagnostic testing in a functioning
laboratory under supervision.

Pakistan[edit]
In Pakistan National Institute of Health (NIH) Islamabad is the pioneer in Laboratory Sciences,
College of Medical Lab Technology, (CMLT), NIH, Islamabad offers 2 years F.Sc in Medical
Lab Technology (MLT), Previously 2 Years B.Sc (MLT) that was discontinued and replaced by
4 years Bachelor Program in Medical Lab Sciences. University of Health Sciences, Lahore also
offering 4 year Bachelor program in Medical Lab Sciences through approved colleges.
University of Lahore, University of Faisalabad, University of Sargodha and Superior University
Lahore offering 5-years Doctor of Medical Lab Sciences (DMLS) Program; Eligibility criteria for
4 years BS Medical Lab Sciences and 5 years Doctor of Medical Lab Sciences (DMLS) is F.Sc
Pre-Medical. [5][6][7]
United States[edit]
In the United States, a medical laboratory scientist (MLS), medical technologist (MT), or a
clinical laboratory scientist (CLS) typically earns a bachelor's degree in medical laboratory
science, clinical laboratory science, or medical technology. Other routes include attaining a
degree in biomedical science or in a life / biological science (biology, biochemistry,
microbiology, etc.). Both routes typically requires the MLS/MT/CLS to obtain certification from a
national certifying board (AAB, AMT, or ASCP) as most laboratories exceed the federal
minimum requirements established by the Clinical Laboratory Improvement Amendments
(CLIA).
Common comprehensive Medical laboratory scientist degree programs are set up in a few
different ways.

 In 3+1 programs, the student attends classroom courses for three years and complete a
clinical rotation their final year of study.
 In 2+2 programs, students have already completed their lower division coursework and
return to complete their last two years of study in a CLS program.
 In 4+1 program, students who have already completed an undergraduate program return
to complete a year of medical laboratory training. The training is typically completed at a
clinical site rather than a college.
The core curriculum in medical technology generally comprises 20 credits in clinical chemistry,
20 credits in hematology, and 20 credits in clinical microbiology.
During clinical rotations, the student experiences hands-on learning in each discipline of the
laboratory and performs diagnostic testing in a functioning laboratory under supervision. With
limited or no compensation, a student in the clinical phase of training usually works 40 hours
per week for 20 to 52 weeks. Some programs in the United States have had the time students
spend completing their clinical rotation reduced due to staffing shortages. For example, in
2015, the MLS program at the University of Minnesota reduced the clinical rotation portion of
the program from 22 weeks to 12 weeks.[8]
In the United States, a two year academic program (associate's degree) qualifies the graduate
to work as a medical laboratory technician (MLT). MLTs receive training more exclusively in
laboratory sciences without the basic science coursework often required by MLS programs;
however, there are many MLT training programs that require substantial basic didactic science
course work prior to entry into a clinical practicum.[9] Although the didactic coursework may be
less for the MLT, the clinical practicum, in many cases, is similar to that of the MLS student's.
This equates to MLTs who are well equipped to enter the work force with relevant and
knowledge based practical application. The shorter training time may be attractive to many
students, but there are disadvantages to this route. MTs, MLSs and CLSs usually earn higher
salaries and have more responsibilities than MLTs. In 2018, medical laboratory technicians
earned an average salary of $51,219, while medical laboratory scientists earned a salary of
$67,888.[10] An added disadvantage for MLTs is that some institutions will only employ MLSs,
although that practice is starting to change due to recent efforts in cost reduction, and due to
staffing shortages.
In practice, the term medical laboratory technician may apply to persons who are trained to
operate equipment and perform tests, usually under the supervision of the certified medical
technologist or laboratory scientist. Depending on the state where employment is granted, the
job duties between MLSs and MLTs may or may not be similar. For example, in Florida, a MLT
may only perform highly complex testing while under the direct supervision of a clinical
laboratory technologist, a clinical laboratory supervisor, or a clinical laboratory director.[11] This
may make it impractical for a MLT to lawfully work in a Florida blood bank. California has
similar restrictions on MLTs. To accommodate California's restrictions, the American
Association of Bioanalysts (AAB) developed a separate certification examination for California
licensure. However, this exam does not include material covering the areas of
immunohematology or microscopy.[12] Although the typical entry-level academic requirement for
most MLTs is an associate degree, a 60 credit certificate program exists through military
training programs; such as the U.S. Army's 68K military occupational specialty.[13]
As in other countries, staffing shortages have become a major issue in many clinical
laboratories in the United States. Due to several factors, including boomer retirement, and
inadequate recruitment and retention efforts, the medical laboratory workforce is shrinking. For
the decade 2010-2020, workforce needs are expected to grow by 13%. This translates into
about 11,300 positions per year that will need to be filled, with only about 5000 new graduates
per year coming out of various programs. By 2025, it is estimated that the shortage of medical
laboratory professionals will reach 98,700 in the U.S.[14][15]

United Kingdom[edit]
In the United Kingdom (UK) there are two varieties of registered healthcare scientist in
hospitals - Clinical Scientists and Biomedical Scientists (BMS). There is a strict and formal post
graduate training programme for both careers followed by statutory registration for each with
the Health & Care Professions Council UK (HCPC):[1], for the safety and assurance of the
customers - the patients. They are two similar but distinct careers with parallel but different
training paths and different entry requirements.
The role of Clinical Scientists is to improve the health and well-being of patients and the public
by practising alongside doctors, nurses, and other health and social care professionals in the
delivery of healthcare. Their aim is to provide expert scientific and clinical advice to clinician
colleagues, to aid in the diagnosis, treatment and management of patient care.
Examples of the type of work they undertake include:

 Advising, diagnosing, interpreting, and treating patients.

 Advising health and social care professionals in the diagnosis and treatment of patients.
 Researching the science, technology, and practise used in healthcare to innovate and
improve services.
 Designing, building, and operating technology for diagnosing and treating patients.
 Ensuring the safety and reliability of tests and equipment used in healthcare.
Trainee Clinical Scientist posts are advertised nationally, usually between November and
February on the Clinical Scientists Recruitment webpages where application forms may be
obtained and electronic submission of applications can be made. These posts are for the
approved Pre-registration Training Programme, designed to prepare entrants for higher
professional qualifications, further clinical training and eventual Consultant responsibility.
Clinical Scientist training involves enrolment of graduates (1st or 2nd class honours degree or
better is essential due to the high competition for limited training places) into an intensive 3-
year training scheme leading to certification and eventual registration before starting the higher
career structure. The basic qualification for becoming a Clinical Biochemist, Clinical
Immunologist or Clinical Microbiologist is a good Honours degree in an appropriate subject: for
Clinical Biochemistry, that subject might be Biochemistry or Chemistry (or another life science
subject which contains a substantial Biochemistry component); for Clinical Immunology, that
subject might be any life science degree with an immunology component; for Clinical
Microbiology that subject might be any life science degree with a microbiology component.
Although not essential, some candidates will apply with higher degrees in an to attempt to
improve their chances of selection for training and several universities currently offer MSc
courses in Clinical Biochemistry, Immunology and Microbiology which have been approved by
the ACB or the AHCS. Full-time and 'sandwich' courses are available, and further information
may be obtained from individual programmes, although the level of financial support provided
varies, and should be clarified at interview. Some entrants to the profession will already have
obtained a PhD, and the training and research experience that this provides is invaluable to the
work of the Clinical Scientist. In larger Departments, there may be opportunities to study for a
research degree after entering the profession and acquiring registration, but since this has to
be fitted in with other responsibilities, it may take some years to complete. It should be clearly
understood that the major role of the profession is patient care and that research, management
and all the other aspects will come as side issues and not be the predominating factor in the
career path. The work of Biomedical Scientists and Clinical Scientists have impact on the
diagnosis and treatment of almost every patient admitted to hospitals in the United Kingdom.
The United Kingdom is facing a shortage of qualified Clinical and Biomedical Scientists. The
Royal College of Pathologists and the Royal College of Physicians have pointed out the need
for increased government funding for medical training programs to prevent diagnostic facilities
and medical infrastructure from being overwhelmed.[16]

Certification and licensing[edit]

A Lab tech uses a microscope for a cell count.

United States[edit]
There are currently three major certification agencies in the United States of America for
clinical laboratory scientists. They are the American Association of Bioanalysts (AAB), the
American Medical Technologists (AMT), and the American Society for Clinical Pathology
(ASCP). All three national accrediting agencies will certify scientists in the clinical laboratory as
generalist (chemistry, hematology, immunology, immunohematology/blood bank, and
microbiology).[17][18][19] The American Association of Bioanalysts and the American Medical
Technologists certifications continue to use the traditional designation Medical Technologist
(MT), while the American Society for Clinical Pathology has adopted the designation of Medical
Laboratory Scientist (MLS). Regardless of terminology, these highly qualified individuals serve
as scientists in the clinical laboratory.
There are two other organizations that have previously provided proficiency examinations to
clinical laboratory scientist. The first, is the US Department of Health and Human
Services.[20] The second, is the National Credentialing Agency for Laboratory Personnel (NCA).
The NCA was absorbed by the American Society for Clinical Pathology in 2009 and promptly
dissolved.[21]
In the United States, the Clinical Laboratory Improvement Amendments (CLIA '88) define the
level of qualification required to perform tests of various complexity.[22] Clinical Laboratory
Scientists, Medical Technologists and Medical Laboratory Scientists are near the highest level
of qualification among general testing personnel and are usually qualified to perform the most
complex clinical testing including HLA testing (also known as tissue typing) and blood type
reference testing. Provider Performed Microscopy, or PPM (doctorate or master's level health
provider) and Cytology have additional requirements.[23][24]
In addition to the national certification, 12 states (California, Florida, Georgia, Hawaii,
Louisiana, Montana, Nevada, North Dakota, Rhode Island, Tennessee, West Virginia and New
York) and Puerto Rico also require a state license. Puerto Rico, in order to provide the state
license, requires either a local board certification with a state examination, or any of both the
ASCP and the NCA.[25] Minnesota, Texas, Illinois, Massachusetts, Michigan, Vermont,
Washington, New Jersey, Iowa, Utah, Ohio, South Carolina, Wyoming, Pennsylvania, Virginia,
South Dakota, Delaware, Missouri, and Alaska are currently attempting to obtain licensure. All
states require documentation from a professional certification agency before issuing a state
certification. A person applying for state certification may also be expected to submit
fingerprints, education and training records, and competency certification. Some states also
require completion of a specified number of continuing education contact hours prior to issuing
or renewing a license. Licensing is somewhat controversial as it adds a bureaucratic layer in a
field that is severely understaffed. Simply requiring testing personnel to obtain and maintain
their national certification would help ensure competent testing personnel without increasing
costs to testing personnel.
Some states recognize another state's license if it is equal or more stringent, but currently
California does not recognize any other state license.[26]

United Kingdom[edit]
In the United Kingdom all clinical scientists and biomedical scientists have had to be registered
with the Health & Care Professions Council (HCPC) in order to work unsupervised, to develop
through the careers grades of their profession and to use the protected titles of "Clinical
Scientist" or "Biomedical Scientist". The HCPC registers nearly 200,000 healthcare
professionals[3] and while success in an approved degree course from an accredited
University is sufficient for all other professions, both clinical scientists and biomedical scientists
have post graduate training and no approved degree courses. Autonomous assessment of
applicants in these two professions with subsequent certification for successful ones, is the
only approved UK route to registration for them.
"Clinical Scientist", just as "Biomedical Scientist", is a protected title under the law (there is a
£5000 fine for transgressors who fraudulently use the title without being registered by the
state). The HCPC can strike people off the register for malpractice in just the same way as for
doctors with the General Medical Council (GMC).
Those who are working in "Trainee" positions in the profession are permitted to use the title
with an appropriate caveat, for example – "Pre-registration Clinical Scientist", Trainee Clinical
Scientist, etc. Alternatively some may use titles specific to the discipline they train in, such as
Trainee Clinical Biochemist", "Clinical Immunologist in Training" or “ Pre-Registrant Clinical
Microbiologist” which is also perfectly acceptable since it is not implying the protected "Clinical
Scientist" title of fully qualified and registered practitioners. It is against the law to formally work
with the title of “Clinical Scientist” without professional registration[4].

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, parasit
ology, 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) from the American Association of Blood Banks,
"SM" (Specialist in Microbiology) from the American Society for Microbiology, "SC" (Specialist
in Chemistry) from the American Association for Clinical 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".[27] Additional information can be found in the ASCP Procedures for
Examination & Certification.[28]
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.[29] 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.[30][31]
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.[32]
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 end
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 my 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].
It is therefore likely that many patients in UK hospitals may come into contact with Clinical
Scientists working in a patient facing speciality, who may be confused with medical doctors due
to the complex nature of their role.