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Professional nomenclature signifies destiny, visibility, and value. Consistency through recognizable professional terminology denotes a recognizable profession. As patient-centric contributors to the healthcare continuum, diagnoses, and treatment, the medical laboratory profession has diligently served in health-related settings for over a century. Additionally, many laboratory professionals are significant contributors in industry, public health, education, research, and beyond. The contributions of laboratory professionals continue to shine bright with emerging scopes of practice, guiding modernized technologies, and serving tirelessly as heroes during the COVID-19 pandemic.

Even with these positive attributes, the public, our patients, and other healthcare providers aren’t aware of who we collectively are, our strengths, the value of our credentials, the nature of our specialties, nor the significant influence of laboratory data to inform wellness vs. disease and treatment. As a professional community we have an opportunity to clarify our roles and responsibilities, including how we refer to ourselves and others by standardizing our professional nomenclature.

Unfortunately, lacking comprehension from the medical community and patients, as well as opportunities for cohesion within the laboratory workforce, brings collective challenges for unity and visibility.

Confusion exists within even one laboratory specialty when professionals use fractured or inconsistent nomenclature such as Medical Technologist (MT) or Clinical Laboratory Scientists (CLS) rather than Medical Laboratory Scientists (MLS). While contextually similar, these deviations are dependent on degrees, certifications, and job titles/descriptions. A unified designation is essential. The American Society for Clinical Pathology Board of Certification (ASCP BOC), and American Society of Clinical Laboratory Science (ASCLS), along with other Board of Governor (BOG) federated societies, and collaborators, have initiated a project for elevating medical laboratory professionals’ visibility through simplified, aligned, and consistent nomenclature so that the healthcare community and the public we serve understands our titles, aligned with value. The value of certification differentiates and elevates attainment of knowledge, skill, and competency, while also distinguishing academic preparation with unique scope of practice parameters. Ultimately, simplification of nomenclature not only brings cohesion, but it also aims to find consistency with state and federal regulations (primarily the Clinical Laboratory Improvement Amendments of 1988 [CLIA]).

For the highest volume laboratory professionals, the ASCP BOC is transitioning the Medical Technologist, MT(ASCP)/MT(ASCPⁱ) credential to Medical Laboratory Scientist, MLS(ASCP)/MLS(ASCPⁱ). This involves more than 185,000 laboratory professionals with the unification to Medical Laboratory Scientist being complete by the end of 2022.

Progressive improvements in standardizing professional titles were initiated for MLS in 2019, based on the lack of laboratory industry-wide standardization. An initial unified nomenclature was adopted through a joint position paper from the ASCP BOC and ASCLS titled “Standardizing the Professional Title of Medical Laboratory Professionals.” Beyond promoting unification of nomenclature for MLS, it also includes sunsetting use of outdated professional titles to include Medical Technologist and Clinical Laboratory Scientist. The paper also endorses efforts to find alternate job titles for those with variable education and training working in laboratory roles.

In 2022, further significant emphasis has been placed on alignment of nomenclature. The ASCP BOC Nomenclature Task Force published a second paper titled “Promoting the Medical Laboratory Science Profession through Standardized Titles.” This publication recommends incorporation of those with qualifying bachelor’s degrees within the MLS job title. The paper was widely endorsed, with support provided from ASCP and ASCLS along with the following societies and professional partners: American Association of Pathologists’ Assistants (AAPA); American Medical Technologists (AMT); American Society for Microbiology (ASM); American Society of Cytopathology (ASC); American Society of Hematology (ASH); Association for the Advancement of Blood & Biotherapies (AABB); Association of Genetic Technologists (AGT); and the National Society for Histotechnology (NSH).

Another effort to emphasize the title of MLS is the “I am MLS” campaign which was initiated as part of the ASCP 100th Anniversary Celebration and Annual Meeting. A resounding presence of “I am MLS” badges were visible throughout the venue. An “I am MLS” pledge is also well underway and has exceeded over 100 participants since being launched in September 2022. Through an online portal, participants pledge to:

• Refer to themselves as Medical Laboratory Scientist instead of Medical Technologist (Med Tech, MT) or Clinical Laboratory Scientist (CLS)
• Refer to self and colleagues as MLS, not a technologist or tech
• Work with managers, administrators, human resources (as applicable) at their organization to revise job titles and descriptions to MLS
• Tell at least one student, community member, or colleague about the role and value of MLS.

Moreover, FAQs (Frequently Asked Questions) to further promote and clarify the unified nomenclature of MLS have been developed and are available on the ASCP BOC website (see below). Job descriptions illuminating the roles and responsibilities of MLS and medical laboratory technician (MLT) are also being developed to benefit hiring managers and human resource professionals. Ultimately, this lends opportunity for collaborating with and supporting employers, providing potential for professional development and career ladders within the medical laboratory profession. Relating to the high-value work that has been put forward in support of the profession, Sue Johnson, MSTM, MLS(ASCP)SBB^CM, ASCP BOC BOG Past Chair and Current Nomenclature Task Force Chair indicated, “I have been fortunate to lead this task force of passionate, thought-provoking individuals as we worked through unification of nomenclature. This is arguably one of the most important things we have done as under-recognized laboratory professionals, ultimately standing up for ourselves with one unified name.”

In addition to medical laboratory scientist alignment, the ASCP BOC has likewise promoted other nomenclature optimizations. On October 30, 2021, the ASCP BOC BOG voted to approve “Cytologist” as the new credential nomenclature for the cytotechnologist certification and “Specialist in Cytology” for the specialist in cytotechnology certification. The new designations are intended to standardize naming conventions for these certifications to remove technologist or technology from the name. Also, effective in January 2022, the Molecular Pathology, MP (ASCP) credential changed to Molecular Biology, MB (ASCP). Based on lessons learned from the “I am MLS” campaign and related unification efforts, additional insights can be garnered for ongoing and future nomenclature unification.

The ASCP BOC recognizes additional progress and support is required to decrease complications and confusion. While inclusive criteria for changes are essential, so too are the opportunities to dissuade certain terms for medical laboratory professionals. Some examples include lab techs, bench techs, med tech or medical technologist, clinical laboratory technologist or clinical laboratory scientist, cytotech, or histotech, medical laboratorians, or lab rat.

To achieve the consistent use of standardized nomenclature, the ASCP BOC and its collaborators will continue working to:

• Elevate awareness of laboratory professionals by the patients we serve, the wider healthcare community, lawmakers and partners
• Guide employers in modernizing and unifying job titles for consistency across employers
• Engage educational organizations for consistency in program and degree titles
• Provide editors, authors, and journalists accurate titles of individuals and profession(s)
• Influence regulatory agencies including licensing authorities, Bureau of Labor Statistics (BLS), and Centers for Medicare/Medicaid Services (CMS) to adopt standardized nomenclature
• Persuade in vitro diagnostics manufacturers and their advertisers regarding the use of standardized professional titles.

For additional resources with comprehensive details, please see:

• The original position paper published in December 2020: Standardizing the Professional Title of Medical Laboratory Professionals A Position Paper of American Society for Clinical Laboratory Science (ASCLS) and the American Society for Clinical Pathology Board of ­Certification (ASCP BOC)
• The ASCP BOC Nomenclature Task Force collaborative publication, released in September 2022:Promoting the Medical Laboratory Science Profession through Standardized Titles
• Frequently Asked Questions (FAQs): Promoting the Medical Laboratory Science Profession through Standardized Titles FAQ

Have further questions or ideas? Please contact: BOCinfo@ascp.org.

Special thanks to the Nomenclature Task Force for the development and review of this article: Susan Johnson, MSTM, MLS(ASCP)SBB^CM, Chair of the Nomenclature Taskforce; Kathy Doig, PhD, MLS(ASCP)^CMSH^CM; William Finn, MD, MASCP; Kathleen Finnegan, MS, MLS(ASCP)SH^CM; Elaine Francis, EdD; Susan Harrington, PhD, D(ABMM), MLS(ASCP)^CM; Bonnie Rubin, MBA, MHA, MLS(ASCP); Clarke Sinclair; Linda Smith, PhD, MLS(ASCP)^CMBB^CM; Patricia Tanabe, MPA, MLS(ASCP)^CM