Canadian Society for Medical
Laboratory Science (CSMLS)
Future of the Professions: Who has the
Crystal Ball?
Christine Nielsen BHA, MLT, CAE
Bessie Carydis M MSc, BHA, ART
www.csmls.org
Drivers of Change
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Evolving needs in healthcare
Co-dependent nature of lab (subservience)
Setting the standards
Unfinished journey of regulation for MLA
Meeting future patient’s needs – impact of Boomers
Crystal ball
www.csmls.org/www.scslm.org
Dynamic Health Care-Evolving
Landscape
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Regulation of MLT (PEI, BC and territories excluded)
Delegation of Controlled Act - phlebotomy
Employer Demand – lazy HR departments
Evolving Technology – lab on a chip? POCT
Aging Demographics
HHR
IPC
Global migration
Starved for clinical placements
Devolution of duties
www.csmls.org/www.scslm.org
HHR
• Are we actually in a health human resource crisis?
• Will the boomers ever retire?
• Will MLAs dominate the market place?
• Foreign Qualification recognition – we identify the gaps, WHO helps
the clients fill them? Role of higher education
www.csmls.org/www.scslm.org
Canadian Medical Association Accreditation
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CMA approves all CSMLS Competency Profiles for accreditation
MLT - since 1941
MLA - since 2007
Ensure integrity of ALL MLA programs – private and public
Certification exam offered to graduates of CMA accredited MLT and
MLA programs, or equivalent through PLA
• Certification accepted as entrance to practice for MLT/MLA in all
provinces except Quebec
• CSMLS Competency Profiles serve as scope of practice for MLT and
MLA in Canada
www.csmls.org/www.scslm.org
National Certification
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Creation of National Competency Profiles
Periodic competency profile review- consultative process
Standardization of MLT/MLA Profession
Eligibility Criteria for CSMLS Exam - Additional Eligibility Pathway PLA
• Competency Profile / blueprint for testing
• Creation and delivery of national certification exam – often enough?
www.csmls.org/www.scslm.org
Competency Profile Review
• Every 5 years or when major change to domain
• Taskforce composed of subject matter experts
• Consultative process – educators, members, non-members,
practitioners, regulators, employers etc
• Market demand - future competencies, emerging technologies
• Major themes identified (feedback via survey)
• Draft new competency profile
• Consultative validation process with all stakeholders
• If insufficient support – redrafted, validation cycle repeats
• Process takes 12-18 months to complete
www.csmls.org/www.scslm.org
Competency Profile Process
www.csmls.org/www.scslm.org
Unfinished Journey of Regulation
• PEI and BC are pursuing regulation of MLT
• MLA not regulated in any province
• Alberta, Ontario, Newfoundland, Saskatchewan,
Manitoba all requested MLA regulation but denied
• BC/PEI are pursuing MLT and MLA umbrella regulation
• No MLAs in Quebec
www.csmls.org/www.scslm.org
In Pursuit of the “Magic Bullet”
• Rapid changes in technology (slow uptake in Canada)
• Focus on molecular genetics, diagnostics and
targeted therapies
• What is funded depends on province – individual willing to pay?
www.csmls.org/www.scslm.org
Sweeping Changes in Diagnostic Cytology
• HPV molecular testing vaccines have made great strides in cervical
cancer
• Pap smear screening on a decline – change of screening matrix,
change in screening algorithm – less cytotechs needed
• 2014 – Competency Profile review outcome was to expand the scope
of practice to include histology, performing molecular techniques,
pathology assistant duties and screening of histology slides
www.csmls.org/www.scslm.org
Crystal Ball - Within 20 years
• MLTs MAY evolve into biomedical specialists – more in line with the
rest of the world
1. Core Lab Technologist (hematology, transfusion medicine &
microbiology)
2. Pathology Technologist (histology, cytology & pathology
assistant)
3. Clinical Genetics technologist (cytogenetic & molecular genetics)
• MLA perform (not interpret) most lab tasks – automation
www.csmls.org/www.scslm.org
Crystal Ball - Within 50 years
• Dark Daily – May 12 – Significant Numbers of Primary Care Doctors
Are Uncertain About the Correct Clinical Laboratory Tests to Order
• Will the NEW technologist become more involved in schedule of test,
referral patterns, advising on appropriateness? Will anyone LISTEN?
• Designer genes, diagnostics and therapies
• MLTs all involved in genetics??
• Full automation with larger numbers of MLAs
• What is the impact of global migration?
www.csmls.org/www.scslm.org
Champions of Patient-centred Care
• Molecular diagnostics – targeted therapies
• Point of Care testing – at patient bedside
and homes – QA crucial
• Changing roles – outside of the lab and in
the communities
www.csmls.org/www.scslm.org
Christine Nielsen, CEO
christinen@csmls.org
Bessie Carydis,
Director – Certification and PLA
bessiec@csmls.org
www.csmls.org
www.csmls.org/www.scslm.org