Clinical Laboratory Technologists and Technicians

• Nature of the Work

  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 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 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, prepare slides of body cells and microscopically examine these cells for abnormalities which may signal the beginning of a cancerous growth.

  Medical laboratory technicians perform less complex tests and laboratory procedures than technologists. 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.

• Working Conditions

  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 an 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.

• Employment

  Clinical laboratory technologists and technicians held about 274,000 jobs in 1994. 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-at Department of Veterans Affairs hospitals and U.S. Public Health Service facilities.

  About 1 laboratory worker in 6 worked part-time.

• Training, Other Qualifications, and Advancement

  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.

  After September 1, 1997, the Clinical Laboratory Improvement Act (CLIA) will require technologists who perform certain highly complex tests to have at least an associate's degree. A grandfather clause will allow experienced workers to continue performing these tests.

  Medical laboratory technicians generally have an associate's degree from a community or junior college, or a certificate from a hospital, vocational or technical school, or from one of the Armed Forces. A few technicians learn on the job.

  Nationally recognized accrediting agencies in the clinical laboratory science include the National Accrediting Agency for Clinical Laboratory Sciences, and the Accrediting Bureau of Health Education Schools (ABHES). National Accrediting Agency for Clinical Laboratory Sciences accredits over 391 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.

  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.

• Job Outlook

  Overall, employment of clinical laboratory workers is expected to about as fast as the average for all occupations through the year 2005. 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. Because the Clinical Laboratory Improvement Act regulations that are to take effect will impose academic standards for persons conducting some evaluations, job opportunities will be best for technologists who have at least an associate's degree.

  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. Although significant, growth will not be primary source of opportunities. As in most occupations, most will result from the need to replace workers who transfer to other occupations, retire, or stop working for some other reason.

• Earnings

  Median annual earnings of full time, salaried clinical laboratory technologists and technicians were $26,988 in 1994. Half earned between $19,240 and $35,204. The lowest 10 percent earned less than $14,820 and the top 10 percent more than $44,304.

  Table 1 presents salary data for selected medical technology occupations from a University of Texas Medical Branch survey of hospitals and medical centers. The data are based on a 40 hour week and exclude shift and area differentials.

  Table 1:  Median annual salary, medical technology occupations, 1994
  
  Occupation	                  Minimum	                       Median	                     Maximum
  
  Cytotechnologist	          $29,772	                      $37,107	                      $43,477
  Histology technician 	           21,975	                       26,624	                       32,337
  Medical laboratory technician	   20,443	                       24,461                          30,414
  Medical technologist	           26,033	                       32,282	                       38,844
  Phlebotomist	                   15,344	                       17,166     	               22,339
  

  Source: National Survey of Hospitals and Medical Centers, University of Texas Medical Branch

• Related Occupations

  Clinical laboratory technologists and technicians analyze body fluids, tissue, and other substances using a variety of tests. Similar or related procedures are performed by analytical, water purification, and other chemists; science technicians; crime laboratory analysts; food testers; and veterinary laboratory technicians.

• Sources of Additional Information

  Career and certification information is available from:
  American Society of Clinical Pathologists, Board of Registry P.O. Box 12277, Chicago, IL 60612.

  American Medical Technologists, 710 Higgins Rd., Park Ridge, IL 60068.

  American Society of Cytopathology 400 West 9th St., Suite 201, Wilmington, DE 19801.

  National Certification Agency for Medical Laboratory Personnel 7910 Woodmont Ave., Suite 1301 Bethesda, MD 20814.

  International Society for Clinical Laboratory Technology 818 Olive St., Suite 918, St. Louis, MO 63101.

  For more career information, write to:
  American Association of Blood Banks 8101 Glenbrook Rd., Bethesda, MD 20814-2749.

  Clinical Ligand Assay Society, 3139 S. Wayne Rd., Wayne, MI 48184.

  For a list of educational programs accredited for clinical laboratory personnel, write to:
  National Accrediting Agency for Clinical Laboratory Sciences, 8410 W. Bryn Mawr Ave., Suite 670, Chicago, IL 60631.

  For a list of training programs for medical laboratory technicians accredited by the Accrediting Bureau of Health Education Schools, write to:
  Secretary-ABHES, 29089 U.S. 20 West, Elkhart, IN 46514.

  Information about employment opportunities in Department of Veterans Affairs medical centers is available from local medical centers and also from:
  Title 38 Employment Division (054D), Department of Veterans Affairs 810 Vermont Ave. NW., Washington, DC 20420.

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