The Doctor of Medical Laboratory Science (DMLS) program known in other parts of the world as Doctor of Clinical Laboratory Science (DCLS) remained in the pipeline for a long time. It was anticipated that the program would be implemented sooner when the West African Health Organisation first conceptualised it in 2009. There have been lots of questions about the program is about. Why DMLS?
This article takes a look at where the medical laboratory profession came from in Ghana, how it is doing now and where it is headed with the introduction of the Doctor of Medical Laboratory Science in light of the global context.
Where the Profession came from
Regulation of the profession was first discussed somewhere in 1968. On 28th May 1971, the Secretary of the Association of Ghana Medical Laboratory Technologists, Mr. E. K. Addo, was mandated to write a memorandum to the Ministry of Health requesting among other things;
- The establishment of a medical laboratory board to control and regulate the practice of medical laboratory technology in Ghana.
- School for the training of medical laboratory technologists and
- Review the salaries of technologists to befit their status as professionals.
On 25th July 1973, the Association of Ghana Medical Laboratory Technologists (AGMLT) was registered in accordance with the Professional Bodies Registration Decree, NRCD 143 of 1973 with a membership of fifty (50) Technologists and was inaugurated by Major A.H. Selormey, the commissioner for Health on Saturday, 13th October 1973. Read more on the history from GAMLS’ official site.
The events that followed from the registration of this profession to the establishment of training programs for the professionals is available here. However, below is the summary of where the association came from;
- THE CERTIFICATE PROGRAM (LABASS)
- THE DIPLOMA PROGRAM(1994)
- THE BACCALAUREATE DEGREE PROGRAM
- MSc MEDICAL LABORATORY SCIENCES (OFFERED IN UNIVERSITY OF GHANA, LEGON)
The Global View
In the USA, the National Accreditation Agency for Clinical Laboratory Sciences (NAACLS) held its Futures Conference of stakeholders, according to Randall S. Lambrecht, PhD, FASAHP, MT(ASCP), dean and professor, UW Milwaukee College of Health Sciences, and chair of the NAACLS Doctoral Review Committee.
“The purpose of the conference was to look into the future and imagine the possible roles laboratory professionals would have”. “It was clear clinical laboratory science as a professional discipline needed to emerge as having a significant role as part of the future healthcare team.” Dr Lambrecht said.
A task force was formed and their report suggested considering a clinical or advanced practice doctorate in the field of clinical laboratory science. Later, a multi-organizational task force was formed among members of ASCLS, NAACLS and the American Society for Clinical Pathology (ASCP) to discuss what the doctorate would look like, what the curriculum would be and how to develop and implement the programs in schools. There was one conclusion all the tasks forces and committees agreed on:
- A position needed to be created to act as a liaison between the laboratory and the rest of the hospital.
- The fact that a huge gap existed in the healthcare information continuum, for patients and providers alike who didn’t fully understand the implications of laboratory test results.
Dr Kenimer-Leibach added that some laboratorians have been stepping up to become the liaison, but without the needed formal training.
“Some of us are filling that role on an informal basis, but with experiential training and not formal training,” she said. “What we are setting up to do with the DCLS is to formalize that education, giving them the skills and training they need. They would also be salaried to do this job.”
What exactly would a person holding a DCLS do? “A clinical laboratory professional with a DCLS will have the knowledge and stature to develop, implement and oversee protocols for the appropriate ordering of laboratory tests and the use of laboratory information,” Dr Lambrecht explained.
Additionally, this laboratorian will aid in the diagnosis and treatment of the patient by providing knowledge to other healthcare practitioners.
Institute of Medicine (USA) View
In its recommendations for the transformation of the health care system, the institute of medicine (IOM) in its report crossing the quality chasm emphasized:
- patient-centered care
- evidence based practice
- information technology
One approach to accomplishing these goals is to restructure the training of health professionals.
Echoed in a subsequent report, health professions education: a bridge to quality which kept the emphasis on educating all health professionals with the goal to applying evidence-based practice and quality improvement in an interdisciplinary approach to patient-centred care. These demands directly impact and highlight the clinical laboratorians’ role in diagnostics, health and treatment monitoring, and disease prevention and early detection hence the DCLS program
Elizabeth is a Professor at the School of Health Professions at Rutgers University – Newark.
according to her, given that as much as 93% of the objective data in the clinical record is contributed by the laboratory (Source), 50%-60% of all laboratory orders may be inappropriate.
Most (68%-87%) of laboratory errors are non-analytical (Source) inefficiencies involving the generation of orders (pre-analytical processing) and utilization of laboratory data (post-analytical processing) further increase the possibility of inappropriate resource utilization.
The responsibility of quality oversight will require education of clinical laboratory scientists at the doctoral level resulting in the conferral of the Doctor of Clinical Laboratory Science the course is offered at the Rutgers university school of health-related professions.
West African Health Organisation’s (WAHO) view
WAHO also used very similar approach to arrive at the same conclusion. Their main objective for DMLS program was to produce medical laboratory scientists with professional and scientific competence and sufficient management ability, who can:
- Perform effectively in-hospital diagnostic services, public health services, research and academics.
- Function independently or in collaboration with other members of health team.
- Be the vanguard for the production of biological and diagnostic reagents and can design and fabricate laboratory equipment
The task was then left on the individual professional bodies to undertake the development by themselves across the sub-region and that was when the fight began.
Doctor of Medical Laboratory Science in Ghana
The university for development studies (UDS) is the only university currently running the MLS.D programme in Ghana and in Africa. The first batch of students was admitted to the 2014/2015 academic year. There have since been four batches of Doctor of Medical Laboratory Scientists produced.
The programme at UDS was designed inline with the outline by the WAHO which was meant to train professionals to be;
- complementary to pathologists, doctoral scientists.
- consultant to physicians and caregivers on test selection, test result interpretation and patient educator.
- researcher on improvements to patient care. and
- cost reduction derived from laboratory services.
Admission requirements for the MLS.D programme
- SSCE/WASSCE graduates enter at level 100 after an assessment exam and interview.
- Holders of Medical Laboratory Technician (MLT) certificate/diploma may enter at level 200 subject to an interview process.
- Graduates of allied disciplines such as biochemistry, microbiology etc enter at level 200.
- Graduates with a bachelor of medical laboratory science or B.Sc. in medical laboratory science or associateship certificate may enter the programme in level 500 (2 years duration)
What is new with the MLS.D programme
Doctors of medical laboratory science are accorded with the doctor title but it is not equivalent to a PhD. Doctor of Medical Laboratory Science is an undergraduate professional doctorate programme like Doctor of Medicine, Doctor of Pharmacy, Doctor of Optometrist etc.
Graduates who aim for further specialisation in the professional cadre need to go for a fellowship with the West African Post-Graduate College of Medical Laboratory Scientist (WAPCMLS) headquartered in Abuja, Nigeria.
However, graduates who prefer to further in the academic cadre ought to go through either a masters program through to PhD or PhD direct.