Principles of Medical Laboratory Science PDF

OPPORTUNITIES, CHALLENGES, PROBLEMS OF MT Clinical Areas AND PROFESSIONALS WITHIN THE CLINICAL LABORATORY Medical laboratory technologists have the...

OPPORTUNITIES, CHALLENGES, PROBLEMS OF MT Clinical Areas AND PROFESSIONALS WITHIN THE CLINICAL LABORATORY Medical laboratory technologists have the opportunity to be employed in drug testing centers as long as they have received proper I. OPPORTUNITIES FOR AND CHALLENGES FACED BY training in drug testing at a duly accredited MEDICAL TECHNOLOGISTS (MTs) drug testing training center. A center employing biogenetics or stem cell center, especially a cord blood center, would A. OPPORTUNITIES FOR MTs probably be the best center for medical technologists since we are highly skilled and trained professionals Laboratories A medical laboratory technologist may be Business and Industrial Areas employed in the following fields Immunology and Serology These include the offering of services such as ○ Study of the immune system, deals ○ product development and design with antibody reactions ○ marketing and sales Cell Marker Technology ○ quality control and assurance ○ A specialized technology in clinical ○ environmental health laboratory wherein cell markers are ○ insurance identified, monitored, and examined ○ Cell Markers serve monograms that help identify and classify cells Academic Areas Bioengineering ○ A promising field that deals with the The most noble job opportunities for medical use of genetic technologies in laboratory technologists are those in teaching evaluating and diagnosing genetic and research. disorders However, these job opportunities may require Cancer Research higher education attainment and experience, In CVGH laboratory, the different such as a Masteral and Doctoral Degrees departments, i.e., hematology, clinical chemistry, microbiology, are separated into different rooms In other hospital-based laboratories, some departments are all located in the same room and floor 1  B. CHALLENGES FACED BY MTs In the Philippines, wages are low. This is the main reason why so many Filipinos opt to go abroad to work once they graduate. Future Challenges Due to the nature of work, technologists may spend the whole day on duty. Some clinics Medical technologists are in extremely high only hire one medical technologist with no day demand, but laboratory activities involve off and 10-hour work days; which affect the some sophisticated techniques that require efficiency and even the health of the medical special training. technologist. Technology continues to advance, therefore, Medical schools are raising their requirement laboratories will be equipped with highly for advanced training facilities including specialized machines which might be programs and new advances in the ever accompanied with complex procedures changing healthcare environment in order to Thus, medical technologist have to undergo create the best clinical environment for special medical training in order to maximize students to master the principles and theories the full use of the equipment of medicine. Taking up Medical Technology in the Philippines is one great advantage because Current Challenges the Philippine health system is patterned after the United States health system, i.e., passing The vacancy rate or being understaffed for the American Society for Clinical Pathology medical technologists among all laboratory (ASCP) examination gives additional careers is the highest at 10.4%, especially in credentials to the applicant. those careers that require involvement in high Health professionals permanently migrate to risk laboratory activities. developed countries. Emigration of High risk lab activities include Handling: professional manpower in 1982, had a total of ○ COVID samples or COVID positive 14,000 medical doctors and about 89,000 patients nurses who moved from the Philippines to ○ HIV blood samples other countries (mainly the United States). More students are opting for BSMT as a preparatory course to medicine, resulting in a II. PROBLEMS, NEEDS, AND DEMANDS OF MEDICAL noticeable increase in enrollment in Medical TECHNOLOGY SERVICES Technology courses. Nursing program has decreased tremendously due to freeze hiring of nurses overseas; thus students have Medical technology students often dream of transferred to BSMT courses. pursuing studies abroad after completing their With the increase in population, there is also a degrees. considerable increase in the demand for their The high cost of college education, especially services. for those who go to medical schools, makes them very eager to seek a high-paying job that is internationally recognized. 2 III. MEDICAL TECHNOLOGY / CLINICAL LABORATORY Their role is only to perform lab tests and PROFESSION provide data They do not give diagnosis or treatment to the patient, as that is the role of the physicians Constitutes one area of medical and health profession A dynamic medical profession at the Clinical Laboratory Scientist (CLS) forefront of medical science discovery Medical Technologist (MT) Constantly changing and advancing as new technology evolves In the Philippines, practicing medical ○ This could pose as a future challenge technologists work under the supervision of a for MTs, but it also has its benefits pathologist in a hospital-based or Profession in high demand free-standing laboratory Considered one of the “best jobs” Free-Standing Laboratory Positions available are Master’s degree and ○ Independent lab that is not part of a PhD level practitioners hospital or hospital-based facility Unlimited choice of practice settings, including ○ Performs lesser or more common test ○ Hospital compared to hospital-based labs ○ Reference Laboratory ○ e.g. Hi-Precision and LH Prime ○ Physician’s Office Hospital-Based Laboratory ○ Research ○ Lab found inside the hospital ○ Industry ○ e.g. labs in CVGH and Chong Hua ○ Sales Whether freestanding or hospital-based there ○ Biotechnology will always be the presence of a pathologist to supervise the medtechs Classification of CLS/MT in Other Countries IV. PROFESSIONALS WITHIN THE CLINICAL ○ Medical Laboratory Technologist 1: LABORATORY for a resident of that country ○ Medical Laboratory Technologist 2: for a non-resident who has experience A. CLINICAL LABORATORY PRACTITIONERS and a license from other countries, such as the Philippines In the Philippines, practicing MT/CLS are Perform tests that analyze blood, urine, tissue licensed and registered with the PRC or other body specimens, such as ○ Professional Regulation Commission: cerebrospinal fluid, synovial fluid, sputum, and administer the board exam they give other body fluids the license after passing Use complex instrumentation and sophisticated knowledge to provide critical data for diagnosis, treatment planning, and preventative healthcare 3  Perform duties and responsibilities, including Clinical Laboratory Technician (CLT) but not limited to: Medical Laboratory Technician (MLT) ○ Examination of laboratory specimen e.g. blood, urine, and other In the Philippines, MLT/CLT are either those: body fluids ○ who did NOT satisfactorily pass the Must be well-collected and licensure examination for Medical viable for testing to produce Technologists administered by the PRC accurate results ○ students who unsatisfactorily ○ Setting and implementing a quality completed the BSMT program control program In other countries, they are called laboratory ○ Setting and implementing laboratory assistants safety measures Usually work under the supervision of the ○ Regular calibration of instruments and MT/CLS or a laboratory manager equipment They can only be promoted into full-fledged Done to produce accurate medical technologist if they satisfactorily pass results since the doctors rely the licensure examination administered by on these data for the proper PRC, but subject to CHED memorandum order diagnosis and treatment of They have limited functions in the laboratory patients which include: ○ Operation of laboratory instruments ○ Perform less complex tests and ranging from a simple microscope to a laboratory procedures complex automated equipment ○ Carrying out an inventory of ○ Conducting of research activities and laboratory materials exploration of new discoveries in the ○ Preparation of patients for laboratory field of science and biotechnology examination ○ Collection of laboratory specimens for Perform routine testing on specimens, quality examination control tasks, calibrate instruments May handle routine testing and tasks that a Perform preventative maintenance MLT/CLT does but are also capable of Report normal test results handling abnormal samples or more difficult and complex tests Responsible for supervision the MLT/CLT MT/CLS MLT/CLT May also work with other health care professionals to provide information for Supervised by a Supervised by a MT/CLS or pathologist laboratory manager establishing appropriate, cost-effective testing protocols for suspected diagnosis Passed the board exam Did not pass the board exam or Did not complete the BSMT program Can handle abnormal Has limited functions samples Performs less complex tests Do more difficult tests Only performs routine testing and reports normal test results 4  B. OTHER LABORATORY PRACTITIONERS Cytotechnologist Prepares and examines slides of cells Pathologist Microscopically examines human cell samples for early signs of cancer and other diseases Medical doctor who studies the cause and Best known for the performance of development of disease Papanicolaou Smear Examination (PAP’s Clinical Pathologists smear) as a routine screening procedure to ○ Mainly examine body fluids, including detect cervical cancer, but they examine blood, urine, and bone marrow many other types of specimens as well Anatomical Pathologists Performs special chemical stains and ○ Analyze samples of tissue and cells to techniques as well as determine differences aid in determining the diagnosis and among inflammatory, viral, and malignant cause of diseases changes in cells A pathologist usually examines biopsy ○ Malignant: abnormal cells divide samples or fluid aspirates under the without control and invade nearby microscope and check for abnormalities tissues Other countries hold a doctor of medicine degree with laboratory pathology Phlebotomist/Phlebotomy Technologist specialization Specially trained person who is responsible for drawing blood from patients Collects quality samples from the patient to produce quality laboratory results ○ Blood samples collected should not be hemolyzed or insufficient so that the Figure 1. Stained Cell Samples prepared and sample would be viable for testing and examined by Cytotechnologists, Microscopic Results the results produced would be of a PAP’s Smear Examination accurate Drawing blood from patients is not the job of the MTs, but the phlebotomists as they are Histologic Technician specially trained for that, while MTs are supposed to be working only inside the lab Routinely prepares, processes, and stains However, in the Philippines, most of the time, biopsy and tissue specimens for microscopic the MTs would serve as the phlebotomists as examination by a pathologist well Biopsy: sample of tissue taken from any organ in the body to examine it more closely 5  Steps in Obtaining a Tissue Sample Categorical Practitioner ○ Biopsy is collected and processed ○ It is sliced into thin sections Educated and trained in only one laboratory ○ Small portions are placed on a slide discipline and therefore can only work in that and stained particular area of the clinical or reference ○ Pathologist examines it under the laboratory microscope Specialist Works for a number of years in a specific discipline and who has extensive knowledge and experience in this area They must take and pass an exam to Figure 2. Histology Samples demonstrate expertise in the discipline Histotechnologist Cytogenetic Technologist Performs all aspects of a job that histologic Cultures cells from tissue and body fluid in technicians do but also perform more order to obtain chromosomes for analysis complex processing, staining, or identification procedures Prepares solid tissue, such as biopsy samples Blood Bank Technologist and tumors, for microscopic examination Main Focus: to determine any abnormalities in They specialize in the process of testing and tissues, which can be determined by the preparing of blood for transfusion pathologist Only does the drawing of blood into the blood Staining Process: Multiple slides can be bag and processing of the blood to check the placed on a rack and dipped into different compatibility of the blood from the donor to solutions within a corresponding time interval the recipient and testing for possible or with a specific number of dips per container transfusion transmissible diseases, such as HIV from the first solution until the last one and Hepatitis B, to ensure that the blood is safe for transfusion However, the blood transfusion itself to the recipient of patient is done by the nurses Basically only does the drawing of blood and all the necessary preparations of the blood to ensure the safety of the blood transfusion Figure 3. Staining Slides 6 Nuclear Medical Technologist IV. CHARACTERISTICS OF CLINICAL/MEDICAL LABORATORY PRACTITIONERS They are highly specialized health care professionals who look at how the body functions Problem Solvers This is to help in diagnosis and treatment of a Focused: ability to work with precision and range of conditions and diseases accuracy They prepare and administer small amounts ○ Precision: how close the results are to of radioactive substances that are called each other radiopharmaceuticals to patients for ○ Accuracy: how close the results are to diagnosis and treatments a certain standard value Good Communication Skills Trustworthy Toxicologist Efficient and Self-reliant Dignified and Respectable They perform tests on samples collected by Role Models crime scene investigators Self-motivated The samples tested could be gasses (e.g. carbon monoxide), illicit drugs, prescription drugs, poisons, alcohol, metals, and other substances/poisons when poisoning or drug overdoses are expected Deal with toxic substances or poisons 7  V. EMPLOYMENT OPPORTUNITIES FOR MEDICAL B. NONTRADITIONAL ROLES TECHNOLOGISTS/CLT Infection Control A medical technologist plays both traditional POC Testing and non-traditional roles in laboratory Quality Assurance medicine Special Laboratories ○ Fertility ○ Cytogenetics A. TRADITIONAL ROLES ○ Transplant/Antigen Matching ○ Forensics ○ Flow Cytometry Hospital Clinical Laboratory Veterinary Laboratory Traditional Disciplines Industrial Laboratory Infection Control Corporate Research and Development POC (Point of Care) Testing New Product Development ○ Small devices usually brought to the Consultant to Physician Office Laboratories patient’s bedside Laboratory Inspector ○ e.g. portable glucometer for blood Public Health Laboratory glucose determination Laboratory Marketing and Sales Research Hospital Administration ○ e.g. hospital medical center Manager of Group Practice Laboratory Reference Laboratory Lab/Hospital Information Systems ○ e.g. RITM, HIV laboratory Patient Educator Sales/Technician Representative Patient Care Manager Laboratory Administration Medtech Educator 8