The Doctor of Medical Laboratory science (MLS.D) program known in other parts of the world as Doctor of Clinical Laboratory Science (DCLS) was in the pipeline for a long time. It was anticipated that the program would be implemented sooner than it did when the West African Health Organisation conceptualise it in 2009. Now many people are asking what the program is about. What difference does the Doctor of Medical Laboratory Science bring? 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 summery 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 Doctor of Medical Laboratory Science (MLS.D)
The West African Health Organisation was the focal figure in the events leading to the establishment of this program. WAHO is the specialized health institution of the Economic Community of West African states (ECOWAS) with the sole responsibility;
- To provide leadership in all health care matters in the region.
- To facilitate education of health professionals that is responsive to essential health problems, as well as availability and mobility of human resources for health in the ECOWAS sub region, the following resolutions and protocols were put in place by the heads of states and governments of ECOWAS to promote the rationale and basis for curriculum harmonization and to ensure its implementation.
Why Doctor of Medical Laboratory Science (MLS.D) –WAHO View
The leadership of WAHO considered the following points in line with the growing global requirement for evidence based medical practice. They aimed to;
- stop quasi specialization at the first degree level
- introduce new areas that are deficient in the current programme To provide an in-depth scientific background to enrich the practice of medical laboratory science.
- train graduates that will meet the peculiar needs of medical laboratories at all tiers of healthcare in the sub region as well as serve other relevant public utilities department.
- 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. To be the vanguard for the production of biological and diagnostic reagents and can design and fabricate laboratory equipment.
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.
More from the Global View
In an article published in the the journal of the International Federation of Clinical Chemistry and Laboratory Medicine; the development of the doctorate in clinical laboratory science in the U.S teresa s. nadder, phd, mls(ascp)cm stipulates that;
- Due to the explosion of technology the need for professionals with an advanced base knowledge of the sciences and clinical practice is essential.
- The increase in complexity of testing and laboratory services also prompted the need for consultation services for test result interpretation, test utilization, and informatics.
Institute of Medicine (USA) View
In its recommendations for 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 emphasis on educating all health professionals to be trained in applying evidence-based practice and quality improvement in an interdisciplinary approach to patient-centered care was stated
- 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 Kenimer Leibach’s View (ASSOCIATE PROF. MEDICAL COLLEGE OF GEORGIA)
According to her,
- given that as much as 93% of the objective data in the clinical record is contributed by the laboratory,
- 50%-60% of all laboratory orders may be inappropriate,
- most (68%-87%) of laboratory errors are non-analytical and
- inefficiencies involving the generation of orders (pre-analytical processing) and utilization of laboratory data 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 was started in the USA at the Rutgers University School of Health Related Professions but currently ran in many other reputable institutions.
The program is not a PhD neither is it a masters program, it is a professional doctorate program analogous to;
- DOCTOR OF PHARMACY (PharmD)
- DOCTOR OF OPTOMETRY
- DOCTOR OF MEDICINE
- DOCTOR OF VETERINARY
Doctor of Medical Laboratory Science (MLS.D) in Ghana
In 2014, the University for Development Studies rolled out the MLS.D program. The program in trying to accommodate the need for capacity development among the professional leadership allowed a top up program for professionals already in practice.
Aside the original objectives by WAHO for the establishment of the Doctor of Medical Laboratory science, the University for Development Studies are training MLS.D students to be;
- complementary to pathologists and doctoral scientists
- consultant to physicians and care givers on test selection and results interpretation
- patient educators and
- researcher on improvements to patient care and cost reduction derived from laboratory services
The first batch of doctors of Medical Laboratory Science in Ghana graduated in 2016.
I have included the admission requirements for the purpose of professionals who may want to upgrade and for students looking forward to joining the profession. This is only available for the University for Development Studies as currently it remains the only training institution in Africa running this program.
- 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 INTERVIEW PROCESS.
- GRADUATES OF ALLIED DISCIPLINES SUCH AS BIOCHEMISTRY, MICROBIOLOGY ETC ENTER AT LEVEL 200 GRADUATES WITH 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).
This applies to both foreign and local students. You can find more on this on the UDS Official Website.
What is New with MLS.D in Terms of Course Content?
This are some f the new area of knowledge incorporated to streamline with the advanced knowledge of the basic sciences the program intends to impact. The new areas includes but not limited to;
- MEDICAL LAB SCIENCE ETHICS AND JURISPRUDENCE
- CLINICAL TOXICOLOGY
- MUSEUM TECHNIQUES
- EMBALMING TECHNIQUES
- PHARMACEUTICAL MICROBIOLOGY AND ADVANCED TECHNIQUES
- PRINCIPLES OF LABORATORY MANAGEMENT
- PUBLIC HEALTH EPIDEMIOLOGY
- HISTOPATHOLOGY SLIDE READING/REPORTING
For the purpose of specialization and development to consultant cadre, Doctor of medical Laboratory graduates would need to undertake further training at PhD and/or Professional Fellowship Levels. The West African Post Graduate College of Medical Laboratory Science (WAPCMLS) has been established in Abuja, Nigeria for the award of the sub-regional professional fellowship.
Contributor: The research in this article was originally conducted by Dr. Ken Osei Mensah