What's in a Name? Clarifying Laboratory Job Titles

Anyone working in the laboratory understands the frustration. People outside the lab think that everyone is a “lab tech” or a “med tech” and that it’s the same thing at “phlebotomist”. I worked as a lab assistant in the lab for years before learning that there was a difference between “technologist” and “technician” and my friends who are doctors literally still think I’m a phlebotomist.

There are essentially 4 levels in a lab:

1.      Doctoral = Laboratory Medical Director (LMD)

2.      Bachelor’s plus certification = Medical Technologist/Medical Laboratory

Scientist/Clinical Laboratory Scientist (MT/MLS/CLS)

3.      Associate’s = Medical Technician/Medical Laboratory Technician (MLT)

4.      High-school diploma = Lab assistant and phlebotomist

Let’s start at the top!

Medical Laboratory Director (LMD), often referred to as “the pathologist”

Education level:

Doctoral degree (MD, DO, or PhD), most often focused on pathology. This will take more than 6 years depending on path.

Responsibilities: A Medical Laboratory Director is a senior-level healthcare professional who oversees the operations of a clinical laboratory. This role is critical to ensuring that the laboratory functions effectively, providing accurate and reliable diagnostic information that is essential for patient care. The responsibilities and qualifications of a Medical Laboratory Director are extensive and require a deep understanding of both clinical and administrative aspects of laboratory operations.

Communication and Collaboration: The director acts as a liaison between the laboratory and other healthcare providers, including physicians, hospital administrators, and external partners. Effective communication is crucial for coordinating patient care and ensuring that the laboratory meets the needs of the healthcare community it serves.

Developing Diagnostic and Reporting Procedures: The lab runs on procedures. The laboratory medical director ensures that these are of high quality and up-to-date and that they are adhered to.

Regulatory Compliance: The director ensures that the laboratory complies with all relevant regulations, including those set by accrediting bodies such as the College of American Pathologists (CAP), Clinical Laboratory Improvement Amendments (CLIA), and other local, state, and federal agencies. This includes ensuring that all laboratory personnel are properly certified and that the laboratory meets all safety and ethical standards.

Research and Development: In some settings, the Laboratory Director may be involved in research activities, including the development of new diagnostic tests or participation in clinical trials. This aspect of the role requires staying up-to-date with the latest advancements in laboratory science.

Document Approval: A laboratory medical director needs to sign off on any documentation pertaining to changes in testing and any problem remediation such as corrective actions for failed proficiency testing.

Medical Technologist, also known as Medical Laboratory Scientist or Clinical Laboratory Scientist  (MT/MLS/CLS). THEY ALL MEAN THE SAME THING. MLS/CLS is the newer terminology.

Education level: Bachelor’s degree plus an ASCP-accredited program including internship. This typically takes between 4 and 6 years.

Responsibilities: Medical Technologists (MT), also known as Clinical Laboratory Scientists (CLS) or Medical Laboratory Scientists (MLS), typically hold a bachelor’s degree in medical technology, clinical laboratory science, or a related field such as microbiology. MTs are trained to perform complex laboratory tests that are crucial for diagnosing and treating diseases. Their responsibilities include analyzing bodily fluids, tissues, and cells; interpreting test results; and ensuring the accuracy and precision of laboratory tests. MTs are often involved in more advanced laboratory procedures, such as molecular diagnostics, immunology, and microbiology. They may also take on supervisory roles, overseeing the work of MLTs and other lab personnel, ensuring compliance with quality control procedures, and maintaining laboratory equipment. Due to their higher level of education and expertise, MTs often have more autonomy in their work and may be involved in the development and implementation of new testing methods. It is typically MT-level employees that become the leadership in the lab.

Performing laboratory testing: This part of being a medical technologist does not differ greatly from a medical laboratory technician. Get the tests run. Make sure the results are correct.

Supervise the laboratory and personnel: The MT-level employee is more likely to lead a department or a laboratory as a laboratory manager. They are qualified to perform training and evaluate the competencies of employees on a yearly basis.

Be delegated responsibilities by the laboratory medical director: The ability to perform high-level managerial work can be delegated to MT-level employees by the laboratory medical director.

Medical Laboratory Technician (MLT)

Education: Associate’s degree with an internship. This typically is done in 2 years.

Medical Laboratory Technicians typically hold an associate degree in medical laboratory technology. MLTs perform routine laboratory tests under the supervision of MTs or other laboratory professionals. Their work includes preparing samples, operating laboratory equipment, conducting basic tests, and recording results. MLTs play a crucial role in the day-to-day functioning of the lab by carrying out the essential tests that help diagnose and treat patients. However, their scope of practice is generally more limited compared to MTs, and they usually perform lower-complexity tests. MLTs are responsible for following established protocols and ensuring that tests are conducted accurately, but they generally do not interpret results or make clinical decisions based on those results.

Responsibilities:

Laboratory testing: This should come as no surprise.

Supervising: MLT-level employees can supervise moderate complexity work. This includes basic hematology and chemistry but does not include high-complexity part of a lab such as blood banking and microbiology.

Laboratory Assistant (LA)

Education: High school diploma (or equivalent). Many employers prefer candidates who have completed a certificate program in laboratory assisting, which can often be obtained from community colleges or vocational schools. These programs usually take several months to a year to complete and cover basic laboratory procedures, safety protocols, and medical terminology.

Responsibilities:

Specimen preparation: Lab Assistants are responsible for preparing specimens for testing. This may include labeling samples, processing them according to protocol, and ensuring that they are properly stored.

Supporting laboratory technologists and technicians: Lab Assistants provide support to Medical Laboratory Technicians (MLTs) and Medical Technologists (MTs). This might involve setting up equipment for tests, assisting with the execution of tests, and performing routine tasks under supervision. This may include duties such as plating microbiology specimens or staining slides.

Data entry: Lab Assistants often enter patient information and test results into databases. They must ensure accuracy when recording data, as this information is critical for patient diagnosis and treatment.

Inventory management: Managing laboratory supplies is another key responsibility. Lab Assistants monitor inventory levels, order supplies when needed, and ensure that all materials are stored correctly.

Phlebotomist

Education: High school diploma or equivalent. They must also typically complete a phlebotomy training program, which can last from a few months to a year. These programs are often offered by community colleges, vocational schools, or through hospital-based programs. The training includes classroom instruction on anatomy, blood collection techniques, and patient interaction, as well as hands-on practice. Requirements vary by state.

Responsibilities:

Blood collection: The primary responsibility of a phlebotomist is to collect blood samples from patients. This involves selecting the appropriate tools, locating veins, and drawing blood safely and efficiently.

Collaboration with healthcare professionals: Phlebotomists work closely with nurses, doctors, and laboratory personnel to ensure that samples are collected and processed correctly. Their role is essential in the continuum of care, providing the necessary specimens for diagnostic testing.