The need to establish and recognize the field of clinical laboratory science (CLS) as an essential field in advancing clinical goals
Clinical laboratory science (CLS) must be addressed in the current world of new diseases. Although it is important to maintain academic integrity, it is even more important to implement a standardized curriculum to accurately diagnose the clinical objective. In today's society, a medical diagnostic laboratory relies on three critical elements: advanced equipment, essential materials, and most importantly, a human employee capable of monitoring performance and quality, interpreting and reporting results; phone call regarding critical values. The CLS plays an important role in the education and training of scientists and other Healthcare professionals.1, 2 Another point is medical/healthcare professionals depend on the CLS with laboratory equipment and technology to ensure rapid access to results for patients.3 CLS is an important axis of modern health care for fast, correct, accurate, and timely disease diagnosis; innovative medical research; and ensuring the safety and effectiveness of medical treatments.4-6
The COVID-19 pandemic has emphasized the overarching role of the CLSs. The rapid development of diagnostic tests for diseases ranging from diabetes, and metabolic syndrome to rheumatism, and cancer, viral mutation tracking, point-of-care tests, and vaccine research depends on the expertise of laboratory scientists7-12 (Table 1). To attain the best benefits of laboratory science, we propose a comprehensive and multifaceted academic program that should be designed and implemented as the knowledge and its applications are beyond the defined geographical barriers (Table 2). The program should include a bachelor's degrees in laboratory science, master's degrees in laboratory science, and the doctorate or professional doctorate in CLS. In addition, a two-tiered system, consisting of a PhD in Clinical Laboratory Science and a Bachelor of Laboratory Science, has undergone a clear career progression. Individuals can start with a bachelor's degree, gain practical experience, and gradually progress to achieve a laboratory science doctorate. This structure has been successful in countries such as Iran, where laboratory science programs have thrived.
Laboratory science field | Associated diseases | Diagnostic tests | Clinical indications | Sample types | Diagnostics/monitoring importance |
---|---|---|---|---|---|
Hematology | Hematologic malignancies, and anemia hemoglobinopathies | Complete blood count (CBC), hemoglobin electrophoresis, peripheral blood smear, molecular tests, and flowcytometery | Unexplained fatigue, pale, weakness, respiratory complications, bleeding, chronic infections, and fever | Blood (EDTA/citrate) and body fluid | Blood disorders, pre/postsurgery monitoring, coagulopathy, ESR, and histopathology |
Immunology | Autoimmune diseases, infertility, and immunodeficiency | Antinuclear antibody (ANA) test, rheumatoid factor (RF) test, infertility tests, molecular tests, and flowcytometery | Joint pain and pregnancy | Blood, serum and body fluid | Immune system disease and pregnancy |
Biochemistry | Diabetes, liver or kidney disease | Blood glucose test, serum creatinine test, lipid profile, and liver function tests | Diabetes, kidney dysfunction, and digestive complications | Blood, urine, and body fluid | Metabolic and renal health |
Genetics | Genetic disorders | Genetic DNA testing and genetic counseling | Congenital defects | Blood, tissue, and body fluid | Genetic mutations |
Parasitology | Malaria and giardiasis | Microscopic examination of blood, and serology | Travel history and diarrhea | Blood and stool | Parasitic infections |
Virology | HIV, influenza, HBV, HCV, HEV, HTLV, and CMV | HIV viral load test, influenza rapid test, molecular tests, flowcytometery, and serology | High-risk behavior and flu symptoms | Blood and nasal swab | Viral infections |
Mycology | Candidiasis and aspergillosis | Fungal culture and microscopic examination | Persistent infections | Tissue and swabs | Fungal pathogens |
Bacteriology | Tuberculosis and staph infections | Tuberculosis culture and Gram stain test | Cough and skin infections | Sputum and tissue | Bacterial infection |
Microbiology | Various infections | Bacterial culture and microscopic examination | General infections | Body fluid, blood, urine, sputum, stool, animal tissues, and plant tissues | Various bacterial pathogens |
- Abbreviations: CMV, cytomegalovirus; ESR, erythrocyte sedimentation rate; HBV, hepatitis B virus; HCV, hepatitis C virus; HEV, hepatitis E virus; HIV, human immunodeficiency virus; HTLV, human T-lymphotropic virus type 1.
Country | University | Program name | Duration (years) | Curriculum highlights | Clinical internships* |
---|---|---|---|---|---|
United States | XYZ | Bachelor of Science in Medical Laboratory Science | 4 | Clinical rotations in various laboratory departments Hematology, Microbiology, Immunology | Yes (12 months) |
United Kingdom | UVW | BSc Biomedical Science | 3–4 | Pathology studies | Yes (You can choose a 4-year sandwich pathway or traditional 3-year pathway in internship program) |
Canada | LMN | Bachelor of Medical Laboratory Science | 4 | Diagnostic testing - Laboratory management | Yes (clinical practicum) |
Australia | PQR | Bachelor of Laboratory Medicine | 4 | Clinical microbiology - Molecular diagnostics | Yes |
Iran | Ahvaz Jundishapur | Bachelor of Laboratory Sciences | 4 | Core courses in Hematology, Microbiology, Immunology | 16 Units (hospital) |
Germany | GHI | Master of Science in Medical Biotechnology | 2 | Biotechnology applications - Research projects | No |
India | Jai Prakash Narayan Trauma Centre | MD Laboratory Medicine | 3–4 | Clinical pathology, hematology microbiology, biochemistry, and laboratory medicine | 3 Years in the main Department of MD Laboratory Medicine |
- * Clinical internships in laboratory science courses often involve students working in diagnostic or clinical laboratories under the supervision of experienced laboratory professionals. This hands-on experience allows students to gain valuable skills, apply their theoretical knowledge, and become familiar with the daily operations of a clinical laboratory. The internship is an essential part of their education and prepares them for a future career in laboratory science.
In addition, the All India Institute of Medical Sciences, New Delhi, is the initiator and provider of a postgraduate course in laboratory medicine for holders of a Bachelor of Medicine and Bachelor of Surgery (MBBS) degree in India. The 3-year residency program in a specialty following the MBBS leads to a corresponding postgraduate MD degree. A DM/MCh degree can then be obtained through a 3-year residency program. Pathology, microbiology, biochemistry, and laboratory medicine are among the specialization courses in CLS offered in India.13-16
CLS differs significantly from traditional medical training paradigms. Unlike medicinal chemistry, which focuses on theoretical principles, clinical biochemistry in CLS emphasizes practical applications in diagnostic and prognostic testing and patient care. Specialized training is essential for CLS and requires specific programs. In CLS, the curriculum is tailored to bridge the gap between laboratory testing and clinical practice, with an emphasis on the seamless translation of laboratory results to bedside treatment. While traditional degree programs suggest continuity from general biology to specialized fields, CLS emphasizes the importance of the clinical perspective in laboratory analysis for effective patient outcomes. While both fields aim to improve patient outcomes, clinical laboratory scientists specialize in bridging the gap between laboratory and patient care. Laboratory scientists participate in clinical work focusing on the practical aspects of health care. This approach expedites communication between the laboratory and healthcare providers, facilitating faster diagnosis and treatment decisions.
Just as nurses are trained in the fundamentals of health care, laboratory scientists must have basic knowledge of key disciplines, including hematology, immunology, microbiology, parasitology, virology, mycology, and biochemistry. In addition, they should be trained in quality control and quality assurance. To cultivate a workforce of clinical laboratory scientists, we propose to offer an additional 5-year study period for those who have completed their bachelor's degree. This culminates in a Ph.D in Clinical Laboratory Science, further strengthening their expertise and allowing them to take on laboratory leadership roles.
Therefore, the recognition and establishment of laboratory science as a core discipline in healthcare has long been important. Clinical Laboratory professionals, as described in Table 1&2, play a crucial role in healthcare innovation through their extensive training programs and career paths. They not only play a role in diagnosis and research, but also contribute significantly to the overall health care system. Their expertise and knowledge is invaluable in guiding healthcare professionals, including physicians, through the complexities of modern medicine. It is time to recognize their importance and maneuver them to the forefront of healthcare innovation.
AUTHOR CONTRIBUTIONS
Mojtaba Aghaei: Investigation; writing—review and editing. Reyhane Khademi: Writing—review and editing. Seyed Sobhan Bahreiny: Writing—review and editing. Najmaldin Saki: Supervision; validation.
ACKNOWLEDGMENTS
We wish to thank all our colleagues at Ahvaz Jundishapur University of Medical Sciences.
CONFLICT OF INTEREST STATEMENT
The authors declare no conflict of interest.
ETHICS STATEMENT
This article does not contain any studies with human participants or animals performed by any of the authors.
TRANSPARENCY STATEMENT
The lead author, Najmaldin Saki, affirms that this manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained.
Open Research
DATA AVAILABILITY STATEMENT
Data sharing is not applicable to this article as no new data were created or analyzed in this study.