THE PROFESSION OF MEDICAL LABORATORY SCIENCE

Medical Technology
- Also known as laboratory medicine, clinical laboratory science, and medical laboratory science

Definitions of Medical Technology

- Fagelson (1961)
 Branch of medicine concerned with the performance of laboratory determinations and analyses used in the
diagnosis and treatment of disease and the maintenance of health

- Walters (1966)
 The health profession concerned with performing laboratory analyses in view of obtaining information
necessary in the diagnosis and treatment of diseases as well as in the maintenance of good health

- Heinemann (1963)
 Application of the principles of natural, physical, and biological sciences in laboratory procedures to aid in the
diagnosis and treatment of diseases

- R.A. 5527 (The Philippine Medical Technology Act of 1969):

 Auxiliary branch of medicine which deals with examinations using various chemical, microscopic, bacteriologic,
and other medical laboratory procedures or techniques that will aid the physician in diagnosis, study, and
treatment of disease and in the promotion of health in general

The Medical Technologists and Other Allied Health Professionals

Medical Technologist (as defined in R.A. 5527)

- A person who engages in the work of medical technology under the supervision of a pathologist (or licensed physician
authorized by the Department of Health in places where there is no pathologist)
- Have passed the prescribed course, Bachelor of Science in Medical Technology or Bachelor of Science in Hygiene
(nowadays Bachelor of Science in Public Health)
- Have passed the Board Examinations for Medical Technologists

Pathologist (as defined in R.A. 5527)

- A duly registered physician who is specially trained in methods of laboratory medicine, or the gross and microscopic
study and interpretation of tissues, secretions, and excretions of the human body and its functions in order to diagnose
disease, follow its course, determine the effectivity of treatment, ascertain cause of death and advance medicine by
means of research.

Medical Laboratory Technician (as defined in R.A. 5527)

- A person certified and registered with the Board of Medical Technology as qualified to assist a medical technologist
and/or qualified pathologist in the practice of medical technology

Phlebotomist
- An individual trained to draw blood either for laboratory tests or for blood donations.
- In the Philippines, a medical technologist is required to be skilled in phlebotomy. Nowadays, phlebotomy is a skill
confined not only to medical technologists but also to other health care practitioners as well, provided that they were
given certification by a reputed certifying or training body.

Blood Bank Technologists

- Medical technologists who are specialized in the process of testing and preparing of blood for transfusion

Cytotechnologist
- Laboratory practitioners specialized in the preparation of cell slides for microscopic study and detection of cellular
abnormalities

Histotechnologists
- Medical technologists who are specialized in preparation of solid tissue samples for examination under the microscope

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 HISTORY OF THE MEDICAL TECHNOLOGY PROFESSION

Early Beginnings

Vivian Herrick traces the beginning of medical technology to as early as 1550 BC when the first documented records of
parasites and parasitic infections were made.
a. Ebers papyrus (1500 BC)
 The oldest preserved Egyptian compilation of medical texts.
 Contains the first accounted records of intestinal parasitic infection caused by Ascaris lumbricoides and Taenia
species

b. Sushruta (600 BC)

 A Hindu physician who described diabetes as characterized by passage of large amount of urine. He further noted
that the madhumeha (‘honey urine’) from diabetes patients is sweet in taste and can attract black ants.

c. Hippocrates (300 BC)

 A Greek physician considered as the “father of medicine” and author of the Hippocratic oath
 Described four humors (body fluids) in the human body
 He associated the four humors to certain human behaviours and further concluded that all diseases were
due to imbalance of these four humors.
 Four humors:
 Blood (sanguis)
o Sanguine: Courageous, hopeful, playful, carefree
 Yellow bile (khole)
o Choleric: Ambitious, leader-like, restless, easily angered
 Black bile (melaina khole)
o Melancholic: Despondent, quiet, analytical, serious
 Phlegm (phlegma)
o Phlegmatic: Calm, thoughtful, patient, peaceful
 Concluded that the appearance of bubbles, blood, and pus in urine indicated kidney disease and chronic illnesses
 Adopted a triad of drugs, surgery, and bloodletting in treating diseases and infection

d. Galen (180 AD)

 Described diabetes as “diarrhea of urine” and established the relationship between fluid intake and urine volume

Ruth Williams believe that medical technology began from the medieval period.
e. Medieval Period (1098-1438)
 Diagnosis by ‘water casting’ (uroscopy) was widely practiced.
 Urinalysis became commonplace and was a practice that was followed with exaggerated zeal. Patients submitted
their urine specimen in decorative flasks.
 Physicians who failed to examine the urine samples were subjected to public beatings.

Anna Fagelson prefers to date the beginnings of medical technology in the 14th century
f. Alessandra Gillani (14th century)
 Was hired at the University of Bologna by Mondino de’ Liuzzi, an Italian doctor, to perform some tests and other tasks
in the laboratory
 Unfortunately, Gillani died from a laboratory-acquired disease in 1326

Onset of Modern Medical Technology

a. Marcello Malphigi
 Described as the ‘greatest’ of the early microscopists
 Became renowned for his exploration of embryology and physiology of the glands and the viscera.
 Regarded as the founding father of modern anatomic pathology

b. Rudolf Virchow
 Recognized as the father of microscopic pathology and is credited to have established the world’s first pathology
laboratory
 Was the first scientist/ physician of the time who emphasized the study of the manifestation of diseases and
infections, which are visible at the cellular level by means of a microscope.

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 c. Von Ziemssen (1886)
 Established the first hospital-attached clinical laboratory in Munich, Germany
 The clinical laboratory he established was described to be well-conceived with a chemical , a physical, and a
bacteriological department, a working library, and rooms for practical courses and the examination of patients.

Medical Technology in its Modern Onset in the United States

a. Massachusetts General Hospital (MassGen, Training hospital of Harvard Medical School)
 1847: Established the position of “Chemist-Microscopist” whose duties included assisting at autopsies
 1854: John Bacon Jr. was employed as the Chemist- Microscopist. However, he later suggested to separate the
duties of the hospital microscopist and the hospital chemist.
 1855: Dr. Calvin Ellis became the hospital microscopist. He is the first in the hospital to significantly utilize the
microscope in examination of specimens leading to a diagnosis.

b. Dr. William Welch

 1878: Opened a teaching laboratory at Bellevue Medical College (New York University Medical School) after studying
several German laboratories.
 He gave the first laboratory course in pathology offered in an American Medical School
 Became the first physician recruited to be a professor at the Johns Hopkins University in 1886

c. William Pepper Laboratory of Clinical Medicine (1895)

 Established by the Hospital of the University of Pennsylvania
 Considered by many as the first legitimate clinical science laboratory in the United States

d. University of Michigan Hospital

 Opened the first well-equipped chemical laboratory related to medicine, where Dr. Douglas (unspecified) was the first
to give laboratory instructions.
*Note: Cardona et al. (2015) reports this laboratory as the first clinical laboratory set-up in the U.S.

e. Johns Hopkins Hospital

 Opened its clinical laboratory in 1896
 1898: Dr. William Osler, a Canadian physician and professor, established ward laboratories at the Johns Hopkins
Hospital where routine tests were performed by attending physicians.

f. Rockefeller Institute (1903)

 Located in New York; Established its own clinical laboratory headed by Dr. Simon Flexner

g. James Campbell Todd (1908)

 Wrote a book entitled Clinical Diagnosis: A Manual of Laboratory Methods, which described the techniques and
procedures of the laboratory tests available then

h. John Bernard Henry

 Edited the book authored by Todd. The said book was later named as Henry’s Clinical Diagnosis and Management
by Laboratory Methods. This book then became the fundamental source in the practice of laboratory medicine.

i. Pennsylvania State Legislature (1915)

 Passed a law requiring all hospitals and institutions to have complete laboratory facilities with full-time technicians,
which gave laboratory services a chance to be fully recognized and widely utilized.

j. World War I (1914-1918)

 Produced a great demand for technicians
 Physicians with knowledge on laboratory works began to teach their assistants to do some tests for them
 Faced with reductions in medical staff because of America’s entry into World War I, hospitals started hiring and
training women to become laboratory technicians.

k. John Kolmer (1918)

 Called for the development of a method that would certify medical technologists on a national scale
 Published The Demand for and Training of Laboratory Technicians that included a description of the first formal
training course in Medical Technology

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 Despite the training of many technicians by the Army during the war and the laboratory courses offered by several medical schools,
the demand for reliable, well-trained technicians greatly exceeded their availability.

l. R.B.H Gradwohl (1920)

 Proposed the establishment of schools for the proper training of laboratory technicians and for the organization of
a laboratory examining board to pass on their qualifications for employment

m. American Society for Clinical Pathology

 Founded in 1922 with the objective of encouraging the maintenance of status of clinical pathologists
 Also established the code of ethics for technicians and technologists stating that these allied health professionals
should work under the supervision of a physician and refrain from making oral or written diagnosis and advising
physicians on how patients should be treated.
 American Society for Clinical Laboratory Science: Originally formed as a subgroup of ASCP, helped in the
recognition of nonphysician clinical laboratory scientists as autonomous professionals.

n. University of Minnesota
 Was the first to offer a degree program on medical technology in 1923

o. 1950’s
 Medical technologists in the United States sought professional recognition from the government of their educational
qualifications through licensure laws

Medical Technology in the Philippines

a. 1944
 During the onslaught of World War II, U.S. bases were set up in Leyte
 Members of the U.S. healthcare team were brought to the country to serve their wounded soldiers and civilians.
 26th Medical Laboratory of the 6th Infantry of the US Army
 The first clinical laboratory in the Philippines; Established on Quiricada Street, Sta. Cruz, Manila
 Now known as Manila Public Health Laboratory
 By February 1944, it provided a one-year training program to high school graduated to work as laboratory
technicians

b. June 1945
 Staff of the 6th US Army left the facility after endorsing the newly established clinical laboratory to the National
Department of Health. However, the laboratory facilities were not fully utilized and was later non-operational.

c. Dr. Pio de Roda

 Filipino doctor who was a former staff of the 26th Medical Laboratory and a well-known bacteriologist
 Preserved the remains of the laboratory with the help of Dr. Mariano Icasiano, who was the first City Health Officer of
Manila
 October 1, 1945: Dr. de Roda, with the help of Dr. Prudencio Sta. Ana, formally re-established the laboratory
 1947: Dr. de Roda and Dr. Sta. Ana offered a training program to high school and paramedical graduates who were
interested in working as medical technicians
 The training program was initially unsuccessful because no certificates were issued to the trainees and the
duration of the training was not set.
 Dr. de Roda recognized the problems and instructed Dr. Sta. Ana to prepare a formal syllabus

d. Dr. de Roda, Dr. Sta. Ana, and Dr. Tirso Briones (1954)
 Conducted a six-month training course with certification. (However, the project did not last long since formal
education began in the same year)

Formal Medical Technology Education in the Philippines

a. Philippine Union College (now the Adventist University of the Philippines) and Manila Sanitarium Hospital (now the Manila
Adventist Medical Center)
 1954: Offered the first four-year Bachelor of Science in Medical Technology program in the Philippines
 Founders credited for development of the first Medical Technology program include:
 Dr. Willa Hilgert Hedrick:
 “Founder of medical technology education in the Philippines”
 With the help of Mrs. Antoinette McKelvey, prepared the course curriculum and established the first
complete laboratory in microbiology, parasitology, and histopathology at the Manila Sanitarium
Hospital
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  Dr. Reuben Magsaysay: The then president of the Philippine Union College
 Rev. Warren: President of the North Philippine Mission of Seventh Day Adventist and director of the Bureau
of Education
 Dr. Jesse Umali
 First student to graduate Medical Technology from the Philippine Union College in 1956
 Later pursued a career in medicine (OB-Gyne)

b. University of Santo Tomas

 1957: Started offering medical technology as an elective subject to pharmacy students
 1961: Medical technology was recognized as an official program in UST with the first three years as a three-year
academic course and the fourth year as an internship program

c. Centro Escolar University

 1960: Began offering the Medical technology program, which was later granted a recognition permit by the Bureau of
Education

d. Far Eastern University

 1961: Started its School of Medical Technology, which was later formally approved by the Bureau of Education

e. Saint Louis University

 1966: SLU started offering Bachelor of Science in Medical Technology
 1970: The Imelda R. Marcos Clinical Laboratory (now SLU Clinical Laboratories opened to offer training for SLU
medical technology interns
 1971: BSMT was recognized and approved by MECS (Ministry of Education, Culture, and Sports)

THE MODERN FILIPINO MEDICAL TECHNOLOGIST

Roles and Responsibilities of Medical Technology Professionals

1. Perform clinical laboratory testing
2. Perform special procedures
3. Ensure accuracy and precision of results
4. Be honest in practice
5. Ensure timely delivery of results
6. Demonstrate professionalism
7. Uphold confidentiality
8. Collaborate with other health care professionals
9. Conduct research
10. Involvement in health promotion programs

In the Philippines, a licensed medical technologist’s roles, responsibilities, and expected conduct are governed by the Medical
Technology Code of Ethics.
Medical Technology Code of Ethics

As I enter into the practice of Medical Technology, I shall accept the responsibilities inherent to being a professional; I shall uphold the
law and shall not engage in illegal work nor cooperate with anyone so engaged; I shall avoid associating or being identified with any
enterprise of questionable character;

I shall work and act in a strict spirit of fairness to employer, clients, contractors, employees and in a spirit of personal helpfulness and
fraternity toward other members of the profession;

I shall use only honorable means of competition for professional employment or services and shall refrain from unfairly injuring, directly
or indirectly, the professional reputation, projects or business of a fellow medical technologist; I shall accept employment from more than
one employer only when there is no conflict of interest;

I shall perform professional work in a manner that merits full confidence and trust carried out with absolute reliability, accuracy, fairness
and honesty; I shall review the professional work of other medical technologists, when requested, fairly and in confidence whether they
are subordinates or employees, authors of proposals for grants or contracts, authors of technical papers or other publications or involved
in litigation;

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I shall advance the profession by exchanging general information and experience with fellow medical technologists and other
professionals and by contributing to the work of professional organizations;

I shall restrict my praises, criticisms, views and opinions within constructive limits and shall not use the knowledge I know for selfish ends;
I shall treat any information I acquired about individuals in the course of my work as strictly confidential, and may be divulged only to
authorized persons or entities or with consent of the individual when necessary;

I shall report any infractions of these principles of professional conduct to the authorities responsible of enforcement of applicable laws
or regulations, or to the Ethics Committee of the Philippine Association of Medical Technologists as may be appropriate.

To these principles, I hereby subscribe and pledge to conduct myself at all times in a manner befitting the dignity of my profession.

References:
Suba, S., & Florida, J. (2014) . Introduction to Medical Technology with Science, Technology, and Society. Pasig: Cengage Learnng
Asia Pte Ltd
Cardona, C., Garcia-Meim, R., & Martin, G. (2015). Introduction to Medical technology Practice in the Philippine Setting. Quezon City:
C&E Publishing, Inc.
Benitez, P., Dumaoal, O., Estrella, F., & Mortel, F., Nava, M.R. (2019). Principles of Medical Laboratory Science 1. Quezon City: C&E
Publishing, Inc.
Sunderman Sr., F.W. (1993). Evolution of Clinical Science: An Overview. Annals of Clinical and Laboratory Science, 23(4), pp. 231-248

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