Medical Laboratory Professionals: Who's Who in the Lab - Testing.com (2024)

There are a variety of positions within a clinical laboratory, and roles are based on a career ladder of academic and technical milestones. Although terminology has changed slightly over time and may vary from location to location, the main elements to a clinical laboratory team include the laboratory director, technical and general supervisors, scientists/technologists, and technicians.

In addition, laboratories have people who manage the operations. While these professionals may not be performing tests on your samples, most have had training and experience in the technical aspects of the laboratory, and are an important element in ensuring that the laboratory runs efficiently.

The director of a clinical laboratory is usually a board-certified medical doctor, PhD scientist, or in some cases, a medical laboratory scientist. He or she must meet the requirements of CLIA, the federal law governing U.S. laboratories, and/or the College of American Pathologists (CAP), The Joint Commission (TJC), COLA, or the American Association for Laboratory Accreditation (A2LA) if the lab is to be accredited by one of these private organizations.

Many are pathologists, physicians who specialize in the science of identifying the nature and cause of disease and who are specially trained to interpret biopsy results, Pap tests, and other cytologic samples. If the laboratory director is not a pathologist, a consulting pathologist may be retained to provide services that require their expertise, including interpreting test results.

Regardless of the qualifications of the director, CLIA states that the director is responsible for managing overall operations within the laboratory, including maintaining the standards of agencies that inspect and accredit the lab and ensuring that all technical, clinical, and administrative functions of the lab are performed.

Pathologists are medical doctors who diagnose and characterize disease by examining a patient’s tissues, blood, and other body fluids. They are specially trained to interpret biopsy results, Pap tests, and other biological samples. Sometimes called a ‘doctor’s doctor’, pathologists work with primary care physicians as well as specialists, and use laboratory testing to identify or rule out diseases and conditions. A laboratory may employ one or more pathologists depending on the requirements of the lab.

Pathologists work in two broad areas:

• Anatomic pathology is the examination of the physical appearance and microscopic structure of tissues. Anatomic pathologists look at biopsies and organs removed at surgery (surgical pathology) as well as cells that are collected from brushings or body fluids (cytopathology). They also perform autopsies to investigate the cause of death (autopsy/forensic pathology).Some pathologists sub-specialize based on organ systems: neuropathologists (nerves/brain), renal pathologists (kidney), hematopathologists (blood and bone marrow), and dermatopathologists (skin).
• Clinical pathology deals with the measurement of chemical constituents of blood and other body fluids (clinical chemistry), analysis of blood cells (hematology), identification of microbes (microbiology/parasitology/mycology), and the collection, preparation and use of blood for transfusion (transfusion medicine). Clinical pathologists direct the laboratories that perform these tests and provide consultation to other doctors on the significance of test results.

Clinical laboratories may also have technical or general supervisors, although the position title may be different in certain organizational structures. The lab director may serve as the technical supervisor as well. The technical supervisor may be a medical doctor (MD) or doctor of osteopathy (DO) with certification in anatomic and/or clinical pathology or other specialty, depending on the area s/he is responsible for, or has qualifications that meet the standards of board certification. The technical supervisor may also be a scientist with a PhD, a Master’s degree, or a bachelor’s degree in addition to acquiring theappropriate laboratoryexperience(s). S/he is responsible for the technical and scientific oversight of the lab.

A general supervisor, sometimes referred to as the laboratory manager, may have the same qualifications as the technical supervisor, but an individual with a bachelor’s or associate’s degree in the sciences and appropriate experience may qualify as well. A general supervisor is responsible for oversight of the day-to-day laboratory operations as well as the personnel conducting the tests and reporting results.

These laboratory professionals are responsible for performing routine as well as highly specialized tests to diagnose and/or aid in the treatment of disease, troubleshooting (preventing and solving problems with results, specimens, or instruments), and communicating test results to the pathologist or treating health practitioner. They may examine blood or body fluid specimens under the microscope for bacteria, parasites, fungus, or cells that might indicate cancer or other diseases. They perform quality control checks, evaluate new instruments, and implement new test procedures. Scientists/Technologistsalso may assume managerial roles, including supervising laboratory personnel as the general and/or technical supervisor.

Many Scientists/Technologistsspecialize in one particular area, such as in hematology, clinical chemistry, immunology, molecular pathology, cytogenetics, microbiology, ortransfusion medicine. Scientists/Technologistshave a bachelor’s degree in clinical/medical laboratory science or the life sciences that included three or four years of academic course work and one year of clinical experience. Most labs require that theybe certified to demonstrate their competence to conduct their job functions. Scientists/Technologistsare certified by organizations such as the American Medical Technologists (AMT), the American Society for Clinical Pathology (ASCP) Board of Certification (BOC), or the National Registry of Microbiologists (NRM).Some states require Scientists/Technologists to obtain a license from the Department of Health or the Board of Education.

Clinical scientists accounted for 335,700 jobs in 2016. About half of these jobs were in hospitals; the remainder were in clinics, doctor’s offices, blood banks, and independent clinical, forensic, and research laboratories, or with the government (such as the Public Health Service). Despite changes in the field, including technological advances that can automate some tasks, the need for laboratory professionals is expected to grow much faster than the average employment, by 13% between 2016 and 2026. The National Center for Health Workforce Analysis has estimated a 24% increase in the demand for laboratory professionals by the year 2025.With population growth and aging, increased coverage of screening tests resulting from federal health care reform, and the development of new tests, the volume of laboratory tests is expected to increase.

However, there is a documented shortage of working laboratory professionals in the U.S. According to the latest bi-annual survey performed by the American Society for Clinical Pathology, laboratory professions are seeing a range of vacancy rates, from about 5% for anatomic pathology departments to roughly 9% for chemistry departments, for example. The number of working lab personnel has and continues to decline primarily due to retirements. At the same time, many educational programs are at capacity and cannot expand, limiting the number of new graduates each year.

Some state educational systems as well as other organizations with an interest in promoting the lab profession are responding with efforts to combat this shortage, such as through scholarships and endowments. For information on job opportunities and educational programs, see the Resources section.

For information on job opportunities, there are several web sites with job banks, such as:

• AACC’s Clin Lab Job Center
• Clinical Laboratory Management Association’s Career Center

In addition, hospitals and labs in your area may have job databases on their web sites.