Lab professionals
This article was last reviewed on
This article waslast modified on
January 5, 2018.

Your health practitioner would like to run some tests and so you've had your blood drawn and your sample has been sent "off to the lab." (Follow a Sample to find out what happens next.) You met the phlebotomist who drew your blood sample, but have you ever wondered who will actually receive your sample and conduct the tests?

There are a variety of skilled and educated laboratory professionals who, as a patient, you may never see face-to-face. However, these individuals play a very important role in your health care. People working in the clinical laboratory are responsible for conducting tests that provide crucial information for detecting, diagnosing, treating, and monitoring disease. 

These professionals use specialized instrumentation and techniques to analyze patients' samples, such as blood, urine, body fluids and tissue, and stool. They may be working in the lab located in the hospital, clinic, or physician's office where you are being treated or they may be at a reference laboratory located hundreds or perhaps thousands of miles away. (See Where Lab Tests Are Performed for more information on the different laboratories and how they serve you and your health practitioner.)

Because they produce the results that impact the health care you receive, laboratory professionals are specially educated and trained for the functions they perform and, in most cases, have certification for their position. Those in supervisory roles, with extensive training and many years of experience, oversee the testing being performed in the laboratory. They also ensure that strict quality control and quality management systems are followed.

Clinical laboratories in the United States are regulated by the federal government under the Clinical Laboratory Improvement Amendments (CLIA). Passed by Congress in 1988, the regulations for the CLIA amendments established quality standards for laboratory testing to ensure that results are accurate, reliable, and timely. They include standards for the education and training of laboratory personnel so that you can be confident in their ability to process your specimen, perform the tests, and report accurate results.

The following pages provide an overview of the field of laboratory medicine, from the current outlook for professionals in the field or looking to join it to a summary of many of the types of professionals who work in the lab. Links to various resources on educational programs and job databases can be found at the end of the article.

Accordion Title
About Lab Professionals
  • Positions In the Lab

    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. Below is a description of these and other positions as well as a table summarizing the training and roles associated with each.

    Laboratory Director
    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.

    Technical and General Supervisors
    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, or a bachelor's degree and experience. 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.

    Medical Laboratory Scientist (MLS) or Medical Technologist (MT) 
    Medical laboratory scientists (MLSs) or Medical technologists (MTs) play an important role in the clinical laboratory. They 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 may train other laboratory personnel, perform quality control checks, evaluate new instruments, and implement new test procedures. MLSs/MTs also may assume managerial roles, including supervising laboratory personnel as the general and/or technical supervisor.

    Many MLSs/MTs specialize in one particular area, such as in clinical chemistry, immunology, molecular pathology, microbiology, or transfusion medicine. MLSs/MTs have 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 MLSs/MTs be certified to demonstrate their competence to conduct their job functions. MLSs/MTs are 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).

    Medical Laboratory Technician (MLT) 
    A medical laboratory technician (MLT) performs routine tests in all areas of the clinical laboratory. Usually, MLTs have an associate degree and have completed an accredited MLT or certificate program. MLTs will use microscopes as well as other laboratory equipment and techniques to perform tests. Like MLSs/MTs, they may specialize in certain areas of the lab, such as clinical chemistry, and may be certified by the BOC or AMT.

    There may be other personnel within the laboratory as well, including several with very specific functions. These include:

    • Pathology Assistant (PA): Pathologists' assistants are usually responsible for the gross examination and dissection of tissue samples sent to the anatomic pathology lab and may perform or assist pathologists with autopsies (the postmortem examination of a body). They usually have a Master's degree and are certified by the ASCP BOC. They prepare tissue for complex tests such as frozen section, flow cytometry, and immunohistochemical staining. PAs may also supervise others in the anatomic pathology lab.
    • Cytogeneticist (CG). Cytogenetics is a subspecialty of medical genetics. Clinical cytogeneticists are usually MDs or PhDs who have been certified by the American Board of Medical Genetics. They perform and interpret cytogenetic analyses in order to diagnose chromosomal abnormalities and help manage genetic disorders. They are assisted by cytogenetic technologists, who usually have a bachelor's degree in the sciences or clinical/medical laboratory science and CG certification from an approved organization like the BOC. Technologists prepare biological specimens for genetic studies and perform cell culture and microscopic analyses as part of cytogenetic studies.
    • Cytotechnologist (CT). CTs are specialized laboratory technologists whose job it is to prepare and examine samples of cells from body tissue and fluids under a microscope to look for signs of cancer or other diseases by recognizing changes in the cells, such as their color, size, or shape. They may assist in performing fine needle aspirations (using a needle to remove cells from a cyst, an enlarged lymph node, or abnormal tissue masses or fluids) and examine the sample removed during the procedure for abnormal cells. They assist pathologists in making a diagnosis. Usually, CTs have a bachelor degree and have completed an accredited CT program.
    • Histotechnologist (HTL). Also known as histologists, these technologists work in the pathology lab and are trained in the preparation of tissue samples used to diagnose disease. They help the pathologist to analyze small sections of body tissue that have been removed from a patient. The tissue sample undergoes special preparation before being examined under a microscope to look for evidence of disease, such as cancer. HTLs perform more complex procedures than histologic technicians (HTs; see below) and may supervise their work. They usually have a bachelor degree and have completed an accredited HTL program.
    • Histologic technician (HT). HTs perform routine specimen preparation, a task that usually involves slicing thin pieces of human tissue and mounting them on glass slides for examination under the microscope by the pathologist. Usually, HTs have completed high school and an accredited histology program.
    • Phlebotomist (PBT): Phlebotomists, also called phlebotomy technicians, work directly with you, the patient, to draw your blood for laboratory tests using venipuncture or skin puncture. Usually, PBTs have completed high school and have received phlebotomy training, either through a program or on the job experience. Some may be certified.

    In addition, laboratories have people who manage the operations. While these professionals may not be performing tests on your samples, they are an important element in ensuring that the laboratory runs efficiently. Many labs are looking for laboratory professionals with advanced degrees and experience.

  • Summary of Roles and Responsibilities

    The following table summarizes the key positions in the lab, the education required for the position, and the responsibilities of the position. 

    Roles & Responsibilities in the Lab
    Position Education & Training Responsibilities
    Laboratory Director

    Doctoral degree (e.g., MD or PhD); sometimes a medical laboratory scientist

    Board certification recommended

    Directs and manages all lab operations and ensures quality patient care; Interprets test results, with consulting pathologist
    Technical Supervisor Doctoral degree (e.g., MD or PhD); may be Master's or bachelor's degree with experience 

    Board certification recommended

    May be the same person as the lab director
    Provides oversight of technical and scientific functions of the lab
    General Supervisor May be the same person as the lab director or technical supervisor

    Depending on lab and experience, MLS/MT or MLT may qualify
    Provides oversight of day-to-day functions of the lab
    Medical Laboratory Scientist (MLS) or Medical Technologist (MT) Bachelor degree in clinical/medical laboratory science or life sciences and completion of accredited MLS/MT program

    Licensure/certification may be required by employers
    Performs routine tests;develops new test methods under supervision; performs quality control tests; becomes group or team leader; supervises, teaches, delegates
    Medical Laboratory Technician (MLT) Associate degree and completion of accredited MLT or certificate program

    Licensure/certification may be required by employers
    Performs routine tests and quality control tests under supervision on MLS/MT
    Specialized Fields
    Pathology Assistant Master's degree and board certification Gross examination and dissection of tissue samples sent to anatomic pathology lab; assist with autopsies
    Cytogeneticist Doctoral degree (e.g., MD or PhD) and board certification Performs cytogenetic analyses to diagnose chromosomal abnormalities in human genetic diseases
    Cytogenetic Technologist Bachelor degree (B.A. or B.S) in the sciences or clinical/medical laboratory science

    CG certification recommended
    Prepares biological specimens for cell culture and microscopic analyses as part of cytogenetic studies; assists the cytogeneticist
    Cytotechnologist (CT) Bachelor degree and completion of accredited CT program Examines human cells under microscope for signs of pathology (e.g., Pap smears for signs of cancer); with appropriate experience, may supervise a cytology laboratory
    Histotechnologist (HTL) or Histologist Bachelor degree and completion of accredited HTL program Prepares tissue samples for microscopic examination by pathologist and performs complex procedures; can supervise histologic technicians and, with appropriate experience, may supervise histology laboratory
    Histologic technician (HT) High school degree and completion of accredited histology program Prepares sections of body tissues for microscopic examination by pathologist, processes tissue biopsies, assists histotechnologists
    Phlebotomist (PBT) High school degree and training or work experience Collects blood samples from patients for lab tests

    * Compiled from "Careers in Medical Laboratory Technology," published by the American Society for Clinical Pathology; "Clinical Chemistry: Partnerships in Healthcare" by the American Association for Clinical Chemistry; the Association of Genetic Technologists; and Laboratory General: CAP Checklist 1 (April 1998). The specific name for many of these positions varies by location.

    Each laboratory must have on staff a sufficient number of personnel who meet the qualification requirements to perform the functions needed for the volume and complexity of testing performed at that lab. For this reason, the make-up of each lab differs in terms of the number and type of personnel that are on staff. Other people who might work in the laboratory include assistants, students in training, medical residents, pathology residents, and research fellows. However, the people holding the positions described above are the key people who will be handling your sample, performing the tests, and ensuring that the results they provide to your doctor are accurate, reliable, and timely. You may never meet them, but they are a crucial part of the health care team that cares for your health.

  • Outlook for Lab Professionals

    Clinical scientists accounted for 325,800 jobs in 2012. 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 22% between 2012 and 2022. 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 a survey performed each year by the American Society for Clinical Pathology, laboratory professions are seeing an average vacancy rate of 5-6%. The number of working lab personnel has declined for a number of reasons, including retirement. 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.

  • Resources

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

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

    Another educational and career resource is AACC's Clinical Chemistry Trainee Council.

    To search for an education program, visit the National Accrediting Agency for Clinical Laboratory Sciences' web site: www.naacls.org.

    For a comprehensive list of aids to guide and inform you whether you are exploring the field of clinical lab medicine or looking to advance your career, visit the AACC web site's Career Guidance page.

View Sources

NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.

Sources Used in Current Review

American Association of Pathologists' Assistants. What is a Pathologists' Assistant? Available online at http://www.pathassist.org/?page=AboutUs_WhatIsAPA through http://www.pathassist.org. Accessed May 2014.

Bureau of Labor Statistics. Medical and Clinical Laboratory Technologists and Technicians. Available online at http://www.bls.gov/ooh/healthcare/medical-and-clinical-laboratory-technologists-and-technicians.htm through http://www.bls.gov. Accessed May 2014.

Help wanted: lab workers [Commentary]. By Douglas A. Beigel. April 22, 2014. The Baltimore Sun. Available online at http://www.baltimoresun.com/news/opinion/oped/bs-ed-lab-worker-shortage-20140422,0,2689380.story through http://www.baltimoresun.com. Accessed May 2014.

Sources Used in Previous Reviews

American Board of Medical Genetics, Inc. Available online at http://genetics.faseb.org/genetics/abmg/abmgmenu.htm through http://genetics.faseb.org.

American Society for Clinical Pathology. "Careers in Medical Laboratory Technology" and "Medical Lab Careers" pages. Available online through http://www.ascp.org.

American Society for Clinical Laboratory Science

Association of Genetic Technologists: Jobline. Available online at http://www.agt-info.org/Jobdesbod.html through http://www.agt-info.org.

Bureau of Labor Statistics. Available online at http://stats.bls.gov/oco/ocos096.html through http://stats.bls.gov.

Center for Health Careers: Clinical Laboratory Scientist/Medical Technologist. Available online at http://chc.hcwp.org/occbull.asp?id=1 through http://chc.hcwp.org.

Clinical Chemistry, Partnership in Healthcare. American Association for Clinical Chemistry, brochure.

Clinical Laboratory Improvement Amendments. Available online at http://www.cms.hhs.gov/clia/.

Laboratory General: CAP Checklist 1 (April 1998)

National Registry of Microbiologists. Available online at http://www.asm.org/Admin/Index.asp?downloadid=1133 through http://www.asm.org.

Silver, Sheryl. Career Wise Advice: Shortage of Clinical Laboratory Personnel Grows More Severe. MLive.com. Available online at http://www.mlive.com/careerwise/index.ssf?/careerwise/html/articles/clinicianshortage.html through http://www.mlive.com.

SOAHEC Careers in Health Manual – Clinical Lab Sciences. Available online at http://www.nmsu.edu/~soahec/manual/clinlab.html through http://www.nmsu.edu.

Ward-Cook K, Tatum DS, Jones G. Medical technologist core job tasks still reign. Laboratory Medicine 31 (7): 375-379, July 2000.

United States Department of Labor, Bureau of Labor Statistics. Clinical Laboratory Technologists and Technicians. Available online at http://stats.bls.gov/oco/ocos096.htm through http://stats.bls.gov.

Bureau of Labor Statistics. Occupational Outlook Handbook, 2010-11 Edition: Clinical Laboratory Technologists and Technicians.