Medical technologist

Overview
A medical technologist (MT) is a healthcare professional who performs diagnostic analytic tests on human body fluids such as blood, urine, sputum, stool, cerebrospinal fluid (CSF), peritoneal fluid, pericardial fluid, and synovial fluid, as well as other specimens. Medical technologists work in clinical laboratories at hospitals, doctor's offices, reference labs, and within the biotechnology industry.

Educational requirements
In most four-year degree programs, the student attends classroom courses for 3 years and clinical rotations for 1 year. This combination is called a 3+1 program; there are also 2+2 and 4+1 programs. In clinical rotations, the student experiences hands-on learning in each discipline of the laboratory. Under supervision, the student performs diagnostic testing in a functioning laboratory. Although not compensated, the student usually works 40 hours a week for 20 to 26 weeks, experiencing work as a full-time employee. A medical technologist typically earns a bachelor's degree in Medical Technology (Clinical Laboratory Science) or in a life science, in which case certification from an accredited training program is also required.

In Canada, 3 year diploma college programs are offered with 7 semesters, two being an unpaid internship. The student graduates before taking their standards examination (example: CSMLS) to be qualified as a Medical Laboratory Technologist or MLT. Many MLT's go on to receive their Bachelor of Science after their diploma. There are a select number of university programs that affiliate with a college MLT program allowing the student to graduate with both their degree and diploma.

Certification and licensing
Medical technologists who are certified by and remain in good standing with the American Society for Clinical Pathology (ASCP) are entitled to use the credential "MT" after their names, as well as "MT" for those certified by the American Association of Bioanalysts (AAB). If credentialed by the National Credentialing Agency for Laboratory Personnel, the credential "CLS" (Clinical Laboratory Scientist) may be used. Another certifying agency for medical technologists is the American Medical Technologists located in Rosemont,Illinois. AMT has states societies which publish newsletters, and hold continue education credit seminars during the year with a national meeting in the summer.

In the United States, the Clinical Laboratory Improvement Amendments (CLIA) define the level of qualification required to perform tests of various complexity. A medical technologist holds the highest such qualification, and is in general qualified to perform the most complex clinical testing including HLA testing (tissue-typing) and blood type reference testing.

For most of the states, obtaining a license involves filling out paperwork, paying a fee, and showing proof of certification by a national accrediting agency. However in addition to the national certification, approximately 15 states also require a state license (e.g. California, Florida, Hawaii, Louisiana, Nevada, and New York.) California, Florida, and New York develop and administer their own examinations.

National certifications and most state licensures require annual continuing education credits for certification and license renewal.

Specialty areas
Most medical technologists are generalists, skilled in all areas of the lab. However some MTs are specialists, qualified from unique undergraduate education or additional training. Specialties include clinical biochemistry, haematology, coagulation, microbiology, bacteriology, virology, parasitology, mycology, immunology, immunohaematology (blood bank), histopathology, genetics, and cytogenetics. Medical technologists with a specialty may use additional credentials, such as "SBB" (Specialist in Blood Banking) from the American Association of Blood Banks, or "SH" (Specialist in Hematology) from the ASCP. These additional accolades may be appended to the base credential, for example, "MT(ASCP)SBB".

Job duties
A medical technologist analyzes human fluid samples using techniques available to the clinical laboratory, such as manual white blood cell differentials, bone marrow counts, analysis via microscopy and advanced analytical equipment. Medical technologists assist doctors and nurses in choosing the correct lab tests and collection methods; labeling and handling specimens; and interpreting the resulting analysis.

The technologist must recognize abnormalities and know how to correct them. They monitor, screen, and troubleshoot analytical devices including calibration, quality control, "on the fly" or run-by-run assessment, statistical control of observed data, and recording normal operations. To maintain the integrity of the laboratory process, the medical technologist recognizes factors that could introduce error and rejects contaminated or sub-standard specimens.

Common tests performed by medical technologists are complete blood count (CBC), comprehensive metabolic panel (CMP), electrolyte panel, liver function tests (LFT), urinalysis, prothrombin time (PT/INR), and activated partial thromboplastin time (PTT or APTT), blood type, semen analysis (for fertility and post vasectomy studies), and routine cultures.

Role in the healthcare process
A medical technologist's role is to provide accurate laboratory results in a timely manner. The results are used to confirm a diagnosis or to monitor treatment. Safeguards ensure accuracy. Safeguards include experimental controls, calibration of laboratory instruments, delta checks (changes within a normal series of results), and periodic surveys from the College of American Pathologists (CAP). Laboratory results are 80% of a doctor's diagnosis.

Nomenclature: Medical Technologist (MT) vs Medical Laboratory Technician (MLT)
The informal abbreviations of job titles may be a source of confusion. There are many "techs" in a hospital environment, including pharmacy techs, x-ray techs, and (formerly) respiratory techs, (now called Therapists). Medical technologists are called "lab techs" or "med techs." This shorthand term is occasionally used by other healthcare employees, including medical technologists. Where doubt exists, addressing an MT or MLT as a technologist demonstrates respect.

Formally, there is a distinction between a technician and a technologist. Technicians generally have no more than a two-year associates degree, and may have less training. A medical laboratory technician (MLT) has an associates degree and can be certified or registered by one or more nationally-recognized professional organizations, however, they may not be certified to perform tests of high complexity. A medical technologist (MT) has a baccalaureate degree, and can be certified or registered by one or more nationally-recognized professional organizations.

Regardless of formal definitions, a medical technologist is usually called a med tech and a medical laboratory technician is called an MLT.

Shortage
Currently, the United States is experiencing a labor shortage for medical technologists as well as virtually all other healthcare positions. Student enrollment in MT programs is steadily declining. Many universities cut budgets for Clinical Lab Science programs, or closed them altogether.

The primary reason for this decline is the vast disparity in salary, as compared to other healthcare workers. A typical medical technologist's salary is only 50 percent to 70 percent that of a registered nurse (RN), depending on geographical location. For instance, in Washington, D.C., the median MT salary is $37,378 compared to $67,695 for a Registered Nurse, assuming equivalent levels of experience. The 2005 data for the US Bureau of Labor Statistics lists the median annual income for a medical technologist in California as $64,540. That is the highest average in the nation.

The main reason for this is lack of public view for the profession, another being a clinical laboratory is a cost center for a hospital. Saving money for hospitals must begin where the patients can not directly see the effect.

This is a concern of most laboratory professionals in today's healthcare system.