Medical Laboratory Technologists and Pathologists' Assistants - What They Do

Medical laboratory technologists conduct medical laboratory tests, experiments and analyses to assist in the diagnosis, treatment and prevention of disease. They are employed in medical laboratories in hospitals, blood banks, community and private clinics, research facilities and post-secondary educational institutions. Medical laboratory technologists who are supervisors are included in this unit group.

Job duties

This group performs some or all of the following duties:

Set up, operate and maintain laboratory equipment
Conduct and interpret chemical analyses of blood, urine, and cerebrospinal and other body fluids
Study blood cells and other tissues to determine their relation to various physiological and pathological conditions
Prepare tissue sections for microscopic examinations using techniques to demonstrate special cellular tissue elements or other characteristics
Perform and interpret blood group, type and compatibility tests for transfusion purposes
Establish procedures for the analysis of specimens and for medical laboratory experiments
Conduct quality control assessment of testing techniques
May supervise and train other medical laboratory technical staff, students and helpers
May assist pathologists during autopsies.
Medical laboratory technologists may specialize in areas such as clinical chemistry, clinical microbiology, hematology, histotechnology, immunohematology, cytotechnology and cytogenetics.

Job titles

cytogenetics technologist - medical laboratory
medical laboratory supervisor
histology technologist
immunohematology technologist
medical technologist - medical laboratory
clinical immunology technologist
medical laboratory technologist

Employment Requirements

This is what you typically need for the job:

A two- or three-year college program in medical laboratory technology is required and A period of supervised practical training may be required.
Registration with a regulatory body is required in Nova Scotia, New Brunswick, Quebec, Ontario, Manitoba, Saskatchewan and Alberta.
Certification by the Canadian Society for Medical Laboratory Science is usually required by employers.

Essential Skills

Reading

Read handling and storage instructions on the labels of laboratory materials such as reagents, dyes, preservatives and cleaners. (1)
Read e-mail on a variety of topics from supervisors, co-workers and colleagues. For example, they may read e-mail from supervisors requesting assistance, describing laboratory equipment status and notifying of changes to work or maintenance schedules. (2)
Read trade publications such as Industrial News Room and BloodLine to stay abreast of industry trends and learn about new laboratory technologies, equipment and supplies. (3)
Read user manuals to ensure familiarity with the functioning of laboratory equipment. For example, they may refer to user manuals to review steps needed to run quality control procedures or to troubleshoot equipment. (3)
Refer to standards of practice, laboratory policies and procedures, health and safety guidelines and other regulations and standards to ensure processes, procedures and practices are compliant with industry standards and institutional requirements. For example, they may review the regulations governing the preservation of biological specimens, or procedures for disposing of files and other records that may contain confidential information about patients. (3)
May read manuals and internal reports to evaluate their accuracy and quality. For example, they may read laboratory operating manuals to assess whether they reflect changes to standard operating procedures. (4)
May read patients' hospital care records or medical files for information which validates or explains test results. They pay close attention to factors such as age, gender, results of previous laboratory investigations, history of diagnosed and undiagnosed diseases and pharmacological treatments. They may be required to summarize this information for specialist physicians. (4)
May read articles in scientific journals such as the New England Journal of Medicine, the Journal of Infectious Diseases, Frontiers in HematOncology and Cytopathology to further their medical knowledge, gain continuing education credits and maintain professional certification. For example, they may read about topics such as discoveries made from analysing plaques in the brain tissue of Alzheimer patients, or the relationship between blood pH levels and the human body's biochemical functions. These articles contain specialized terminology intended for an expert audience. (4)

Document use

Read lists of names and addresses of laboratory product suppliers. (1)
Refer to laboratory requisition forms completed by physicians to identify tests needed and reasons for testing. (1)
Refer to daily, weekly and monthly work schedules to determine work assignments and responsibilities. (2)
Interpret a variety of icons to identify hazardous substances on containers or navigate websites for information about pathologies, medical diagnoses, testing technologies and laboratory supplies. (2)
May read tables generated by analyser equipment to obtain information about quality control procedures, reagent levels required, analyses being performed and acceptable ranges for test results. (2)
Enter data into equipment maintenance logs when they encounter malfunctions with laboratory equipment. They enter details such as the pieces of equipment involved, their locations and when service technicians were contacted. (2)
Review specimen identification labels to ensure they contain accurate and complete data. They study labels to check that information such as the patients' names and identification numbers and the names of the referring physicians have been entered correctly. (2)
Complete test result forms. They use these forms to track collection, preparation and analysis of specimens. They also fill in forms to record the quality of specimen preparation, the normality of testing procedures and the final test results. (3)
Refer to graphs contained in medical journals, textbooks, trade publications and web sites to learn about pathologies. They may have to locate and retrieve data from a number of graphs and accompanying texts to fully distinguish between health and disease. (3)
Read schematic drawings to troubleshoot and maintain laboratory equipment. For example, medical laboratory technologists may review schematic drawings to replace probes in chemistry and haematology analyzers. (3)
May interpret pictures and x-ray images included in patients' care records to aid in the validation of test results. For example, genetics technologists may interpret an autoradiograph to analyze nucleic acids. (4)

Writing

Write short descriptions of laboratory equipment malfunctions into maintenance logs. (1)
Write e-mail to supervisors, co-workers and colleagues on a variety of topics. For example, they may respond to service requests and administrative queries. (2)
May write letters. For example, medical laboratory supervisors may write letters of reprimand to laboratory workers who consistently deviate from acceptable laboratory protocols. These letters use an established format and describe the facts surrounding the breach. (2)
Write reports to present lab results and describe the analysis of specimens. In these reports, technologists may present and discuss test results, describe the architecture, morphology and condition of specimens that have been collected and give overviews of testing procedures. By completing these reports accurately and quickly, medical laboratory technologists contribute to the early diagnosis and treatment of diseases in living patients. (3)
Prepare comprehensive, unambiguous procedures and protocols for the collection, identification, transportation, preparation, storage and analysis of specimens. For example, a medical laboratory technologist may write procedures for the staining of the organism Helicobacter pylori in paraffin sections. In the procedures, the technologist establishes the protocol that all laboratory workers must follow when carrying out this task. (3)
Draft reports recommending the purchase of new laboratory equipment and submit them to management for approval. In these documents, they generally include analyses of various equipment deficiencies, descriptions of troubleshooting and maintenance work done over time and justifications for replacement. For example, an assistant chief technologist may prepare a document recommending the purchase of a new immunohistochemistry stainer. (4)

Numeracy

Money Math

May calculate line amounts, taxes and totals on purchase orders for antibody and specimen diluents, dilution buffers, reagents, test tubes, electronic pipettes, analysers, laboratory analysis software and other laboratory supplies. (2)

Scheduling, Budgeting & Accounting Math

May determine shift staffing requirements and develop work and vacation schedules for co-workers. Medical laboratory supervisors and assistant chief technologists preparing laboratory schedules take into account several complicating factors including collective agreements governing overtime, the requirement to assign hours based on seniority and the need to rotate assignments for analysers and other laboratory equipment. They frequently adjust schedules to accommodate sick leaves or other unexpected occurrences. (3)
May prepare and monitor laboratory budgets. Medical laboratory supervisors and assistant chief technologists ensure that expenditures incurred for equipment, materials and labour remain within budgeted amounts. They frequently adjust line items because of equipment breakdown, loss of staff or other unexpected events. (3)

Measurement and Calculation Math

Determine quantities of laboratory supplies. For example, a technologist may determine the quantities of slides, coversheets, stains and paraffin needed to run a series of tests. (2)
May measure various body and organ dimensions to complete autopsies or surgical dissections. For example, during autopsies pathology assistants may weigh the heart and lungs; measure the diameter of nodules; and measure the length, width and thickness of other organs. (2)
May calculate quantities of materials for mixtures and solutions. They perform these calculations using ratios, rates and percentages. For example, they may calculate the volumes of crystallized buffer needed for specified volumes of stain. (2)
Use specialized instruments and methods to measure the values of various parameters during laboratory analyses. For example, they may take precise measurements of antibodies found in blood specimens using analyser equipment. They may take precise measurements of pH levels prevailing in their solutions using pH meters. They may also measure a patient's creatinine clearance by inserting creatinine level, weight, sex and age into a mathematical equation and solving the equation. (3)

Data Analysis Math

Compare test results to reference ranges and critical ranges to verify their validity and aid in diagnoses. (2)
Analyse quality control and performance data to ensure the effectiveness and efficiency of laboratory equipment and services. For example, they may assess means and standard deviations against quality requirements per time period to compare with client specifications. (3)

Numerical Estimation

Estimate the length of time needed to analyse specimens using past experience as a guide. (1)
Estimate certain quantities by eyeballing. For example, microbiology technologists may make qualitative visual estimates of quantities of pathogen bacteria on plates to determine the presence of infections. Pathology assistants may make qualitative visual estimates of quantities of blood in pleural cavities during autopsies. (1)

Oral communication

Talk to suppliers about technical specifications, price quotes, service options and delivery times for new laboratory materials, equipment and supplies. (1)
Interact with outgoing shift workers to discuss events such as equipment breakdowns that have happened during their shifts. They also discuss outstanding laboratory tests which have to be performed and indicate which tests have highest priorities. (2)
Talk to referring physicians to advise them of critical test results and to explain delays in their delivery. They may need to reassure impatient doctors that test results will be available shortly. (2)
Interact with other technologists and medical laboratory workers to coordinate the delivery of laboratory services and the operation and maintenance of laboratory equipment. They may assign new tasks, review completed tasks, discuss the status of ongoing work and resolve conflicts. (2)
Meet with supervisors or directors to obtain guidance and approvals, to review quality control data and to discuss work performance, unique test results, laboratory schedules and other administrative issues. They may also meet with supervisors or directors to present their analyses and recommendations for new equipment. (3)
Participate in and may facilitate staff meetings with other laboratory workers and health professionals to discuss patient cases, current issues with laboratory services, policy and procedure changes and upcoming equipment repairs. At these meetings, they may be asked to present laboratory procedures they have developed. (3)
May counsel patients and their representatives about specimen collection procedures. Technologists must be able to clearly explain the purposes of specimen collection, the steps involved in preparation procedures and the importance of following procedures as directed. They must also identify food, beverages and drugs which should be avoided in the hours preceding testing. (3)
Train health care workers assigned to the collection, identification, transportation, preparation, storage and analysis of specimens. They teach the protocols these workers have to follow when carrying out their tasks. They present case scenarios, explain applicable procedures, demonstrate tasks and facilitate discussions. They question trainees to ascertain the understanding of procedures. They have to establish trust and encourage trainees' active involvement in the learning process. (4)

Thinking

Problem Solving

Encounter situations where information on specimen collection containers does not match that on requisition forms. They then call referral sources to clarify, requesting new samples if necessary. (1)
Face equipment failures which may adversely affect the timely delivery of laboratory analyses. They refer to user manuals to troubleshoot equipment and describe the failures and repairs into maintenance logs. If they are unable to repair equipment, they call service technicians for assistance. (2)
Realize that specimens received are unsuitable for analysis. For example, blood specimens may have been subject to clotting or hemolysis. They contact referral sources, report the nature of inadequacies and request that new specimens be collected where possible. (2)
Observe practices which constitute hazards to the safety of laboratory workers. They identify safe alternatives to these practices and discuss them with their supervisors or directors. For example, when staff is required to handle hazardous materials, they may suggest the purchase of masks, gloves, aprons, gowns, face shields or other personal protective equipment. (3)
May discover that quality control data suggest a high degree of analytical deficiencies. They identify the source of the errors and develop appropriate strategies for improvement. For example, medical laboratory supervisors may link errors to particular technologists. They work with these employees to assess the reasons for the deficiencies and to guide them in the proper direction. They monitor work closely to verify if the workers improve on their analyses and they evaluate the need for retraining. (3)

Decision Making

May decide which laboratory supplies to order. They use their professional knowledge and take into consideration such factors as budgets and the types of anticipated demand for laboratory analyses. (2)
Decide whether specimens should be kept in storage or sent to other laboratories for processing when there are equipment failures. To help them decide, they verify how soon doctors need results and when equipment is expected to be repaired. (2)
May decide which tasks to assign to junior technologists and other medical laboratory workers on their teams. They consider junior staff's individual strengths and weaknesses, work experiences and abilities to meet deadlines. If they choose the wrong people, the delivery of laboratory services may be delayed. (2)
Decide which procedures to follow when carrying out their tasks. For example, during the course of autopsies, pathology assistants must decide which specimens to remove for further microscopic examination based on their observations and knowledge of the patient's clinical chart. There are standard procedures, but they often leave significant scope for interpretation. Lack of appropriate specimens may preclude accurate diagnoses of cause of death and reflect badly on the assistants' reputation for competence. (3)
May choose the methods, times, locations and durations to train health care workers assigned to the collection, identification, transportation, preparation, storage and analysis of specimens. They may have to study the cost and feasibility of several different options for each. They may also have to consider the need to replace laboratory workers who are taking training. Past training decisions provide only limited guidance since laboratory procedures and equipment keep changing. (3)

Critical Thinking

Evaluate the completeness of patient data received prior to the collection of specimens. They review laboratory requisition forms to ensure they contain all information which is relevant to tests needed. (2)
Assess the suitability of specimens collected for analysis. They verify that adequate amounts or volumes have been collected and that specimens' integrity has been maintained through adequate preparation, transportation and storage. (2)
Evaluate the completeness and clarity of procedures they have just written for the collection, identification, transportation, preparation, storage and analysis of specimens. They ensure that crucial information has not been omitted and wording is not open to misinterpretation. (3)
May evaluate the performance of other technologists and laboratory employees. As part of the assessments, they determine the extent to which employees have met the various work objectives and adhered to laboratory policies and procedures. Their conclusions may lead to recommendations for new job assignments and further training. (3)
Evaluate the effectiveness, efficiency and quality of laboratory services on an ongoing basis. They verify that all necessary specimens have been collected, that all requested analyses have been performed and that all test results have been delivered to referral sources in due time. They monitor quality control data to rapidly identify analytical deficiencies. They document errors and note the remedial actions they have taken. (3)

Job Task Planning and Organizing

Own Job Planning and Organizing

Medical laboratory technologists and pathologists' assistants have to complete a set of routine tasks each day to ensure the timely delivery of laboratory test results. They have some scope to order tasks, but this discretion is usually limited by written 'prioritization protocols.' Urgent requests from doctors for critically ill patients, equipment failures, shortages of service technicians, delays in repairs and other unexpected events frequently force them to reorganize job tasks. (2)

Planning and Organizing for Others

Medical laboratory technologists and pathologists' assistants play a central role in organizing, planning and scheduling day-to-day laboratory operations and may contribute to long-term and strategic planning for their organizations.

Significant Use of Memory

Remember various diagnostic and specimen adequacy codes to speed up the writing of result reports.
Remember the acceptable range of values for several parameters measured during laboratory analyses.
Remember formulations to prepare regularly used mixtures.
Remember typical shapes and morphology of a wide range of cells, bacteria and other microbes, as well as subcellular structures to aid in microscopic analysis.

Finding Information

Find historical information on patients' test results by searching databases and, in some cases, medical records. (2)
Search a wide range of sources including medical dictionaries, textbooks, trade press, medical journals and websites to find information about pathologies with which they are not familiar. They also consult with co-workers, peers and other health professionals. (3)

Digital technology

Use word processing. For example, they may use software such as Word and WordPerfect to write, edit and format text. (2)
Use databases. For example, they may use hospital and laboratory databases to enter and view information on patients' test results. They may also use databases to access procedure descriptions and forms as well as equipment troubleshooting steps and service requests. (2)
Use spreadsheets. For example, they may enter data into existing Excel spreadsheet templates to prepare budgets, manage laboratory supply inventories, track work schedules and workload data or compare test results to quality control data. (2)
Use communication software. For example, they exchange e-mail and attached documents with specialist physicians, technologists who are working on other shifts and colleagues from other departments or laboratories. (2)
Use the Internet. For example, they perform keyboard searches to get information about pathologies, medical diagnoses, testing technologies and laboratory supplies. (2)
Use graphics software. For example, they may create slide shows for trainees using presentation software such as PowerPoint. In order to develop effective presentations, they may import digital photographs processed with image editing programs such as PhotoShop. (3)
Use computer-assisted design, manufacturing and machining. For example, they may use supervisory control and data acquisition (SCADA) systems incorporated to laboratory equipment to generate quality control data. (3)
Use other software. For example, they may use genetic imaging and analysis software such as CytoVision to classify chromosomes. (4)

Other Essential Skills:

Working with Others

Medical laboratory technologists and pathologists' assistants perform some tasks independently but generally work with teams of specialist physicians, medical laboratory workers and other health professionals. They may work independently to prepare tissue sections for microscopic examinations and to conduct analyses of blood, urine, cerebro-spinal and other body fluids, but most other tasks are carried out with team members. They collaborate with other medical laboratory workers to design laboratory procedures, procure specimens, share equipment, run diagnostic tests and get the results out quickly. They also coordinate their work with that of pathologists, biochemistry physicians and other health professionals to discuss tests needed and analyse specimens. They may supervise and train junior technologists and other medical laboratory workers in the implementation of laboratory procedures and in the operation and maintenance of laboratory equipment. They may be responsible for assigning tasks to junior technologists and other medical laboratory workers who assist them in the collection, identification, transportation, preparation, storage and analysis of specimens. (3)

Continuous Learning

Continuous learning is an integral part of the job for medical laboratory technologists and pathologists' assistants. They are expected to further their medical knowledge and to keep abreast of changes in laboratory technologies, equipment, procedures, regulations and standards. On a day-to-day basis, they acquire new learning by discussing with co-workers, browsing the Internet and reading laboratory policies and procedures, standards of practice, equipment manuals, health and safety guidelines, regulations, trade publications, textbooks, scientific journals and other documents. They also attend conferences, seminars, symposia, workshops and courses on topics such as the use of digital photography in autopsies, the West Nile Virus, health care management and the interpretation of clinical chemistry.

Medical laboratory technologists are governed by the regulatory body in the province in which they practice. They may be required to develop their own learning plans and engage in continuous learning to maintain professional certification. (3)