Case for the Clinical Doctorate in Laboratory Science, The

Clinical Laboratory Science, Summer 2005 by Doig, Kathy

ABBREVIATIONS: BS = bachelor of science; CLS = clinical laboratory scientist; CLT = clinical laboratory technician; DLS = clinical doctorate in laboratory science; DO = osteopathic doctorate; EdD = doctorate in education; MD = medical doctorate; MS = master's degree; OT = occupational therapy; PharmD = Doctor of Pharmacy; PT = physical therapy.

INDEX TERMS: clinical doctorate; doctorate in clinical laboratory science.

Clin Lab Sci 2005;18(3):132

One proposal to advance the clinical laboratory science (CLS) profession has been to mandate a master's degree (MS) as entry qualification for positions that currently require a bachelor's degree. Proponents have presented the following arguments:

* other health professions that command higher salaries have made the move to advanced degrees for job entry, e.g., physical therapy (PT) and occupational therapy (OT); thus, proponents argue, the advanced degree could be expected to achieve the same for laboratory professionals.

* there are tasks within the laboratory that demand additional education beyond what is incorporated into current bachelor's degree programs.

* bachelor of science (BS) curricula are so packed as is, that addition of new content will require time beyond the BS, thus an MS.

* nearly 35% of the students in BS programs and especially hospital-based programs already possess a BS degree.1 They would prefer to be earning an MS and this may make the profession more attractive to other such students.1

Opponents of the idea of mandating an MS at entry have presented the following arguments:

* the added time and expense will discourage many students from selecting laboratory careers at all.1

* some programs will close because they will be unable to provide MS-level education.1

* fewer students will enter these programs and the shortage of personnel will be exacerbated because there is no reason to believe that managers will pay MS graduates more than they pay BS graduates OR that they will use them differently.1

* there is no independent practice (as in physical therapy and occupational therapy) so salaries will not rise to compensate for the added time and expense involved in the master's degree education.

* managers value experience over academic credentials and the MS graduate is unlikely to be hired directly into a management level position.1

* students who select CLS as a career rarely do so due to an interest in management, rather it is the science that interests them; so an entry level job that is heavily weighted to management may discourage many students. Though this might argue for them to take the clinical laboratory technician (CLT) route, they may also quickly become bored with routine work and leave the laboratory profession anyway.

* most current managers do not hold advanced degrees and having been successful without one, they may not see the value for an entry-level master's degree.1,2

Proponents have not garnered the support to move the proposal forward and gain the endorsement of the professional organization.3 Yet there seems to be support for a next phase in the advancement of the clinical laboratory profession and perhaps correction of some weaknesses in the current career model.4

CURRENT CAREER PATHS

Figure 1 depicts the current career paths in the clinical laboratory and demonstrates the following. First, the entry-level job of a CLT has a high degree of overlap with that of a CLS and in some facilities is virtually the same.5 This similarity is demonstrated in job advertisements that ask for either CLS or CLT credentials for the same position. This overlap and similarity discourage both CLTs and CLSs; the former feeling that they are underpaid for the work they do while the latter feel under utilized. The dissatisfaction of CLSs then leads to high attrition within the first five years on the job as they seek careers where they can use their clinical knowledge and have more responsibility, e.g., medicine, physician assistant, dentist, etc.2

Also shown in Figure 1 is that the road to management is relatively distant for the BS-CLS despite substantial management education in the BS curriculum for the last 20 years. So once again, BS graduates are not permitted to use their education, thus contributing to their dissatisfaction.5 Many laboratory managers earned their credential before management became a standard part of the CLS curriculum, and thus may not know what current curricula include and how they could capitalize on the skills of new CLSs.2

The diagram depicts substantial routes to advancement in management and in research/education. These career paths seem to be well developed as is and there is little discussion at professional meetings about changes to these paths. But the most obvious feature of Figure 1 is the dead-end for individuals with an interest in advancing their clinical scientific knowledge and practice. Although they can take the path of graduate education in one of the sciences, they may be lost from the clinical laboratory as they then pursue advanced careers in research laboratories, or in the in vitro diagnostics or pharmaceutical industries. They will introduce themselves saying "I used to be a CLS", if they acknowledge it at all. The lack of opportunities for advancement in clinical practice contributes to the loss from the laboratory of many of the best and brightest who want more challenge, though not in management or research. They must look outside laboratory medicine for the opportunity to use what they know about laboratory testing and pathophysiology in a patient care context.