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Frequently Asked Questions about regulating medical laboratory technicians and assistants



Why is the CMLTO pursuing the regulation of medical laboratory assistants and technicians?
Over the last six years, the CMLTO has repeatedly heard from medical laboratory technologists (MLTs) about changes in the laboratory practice environment. A recurring theme is the increased effect medical laboratory assistants and technicians have on the provision of medical laboratory services.

Understanding the effect medical laboratory test results have on patient care underscores the importance of incorporating the professionals involved in the key phases of clinical laboratory testing under the same legislative framework that protects the public via regulating MLTs.

In 2009, CMLTO Council made regulating medical laboratory assistants and technicians one of its strategic priorities, based on member feedback. MLT feedback points to five clear reasons for regulating medical laboratory assistants and technicians:
  • impact of medical laboratory assistants and technicians on patient care
  • increased reliance on medical laboratory assistants and technicians in clinical laboratory testing
  • expanded roles of medical laboratory assistants and technicians
  • need for standardized educational preparation
  • impact of changes in the health care system on MLT professional practice.
Each of these points is elaborated on in the 2010 CMLTO Position Paper (PDF) on the Regulation of Medical Laboratory Assistants and Medical Laboratory Technicians.

Who informed and influenced Council’s decision to make regulating medical laboratory assistants and technicians a priority?
In the 2008 CMLTO Member Survey, approximately 1000 MLTs responded to the two questions related to medical laboratory assistants and technicians. Overall, MLTs supported regulating medical laboratory assistants and technicians.

In the 2015 CMLTO Member Survey, approximately 1300 MLTs responded to a question regarding the impact of a Voluntary Roster on public protection and 68% of them believe the impact will be positive. An additional 10% believe that the CMLTO should be pursuing regulation directly and bypassing developing a Voluntary Roster. Only 9% of respondents did not believe the Voluntary Roster would improve public safety and the quality of health care in Ontario, and the majority of them felt that current employer-based competency processes ensure medical laboratory assistants and technicians practise safely.

In addition to feedback received by Council and CMLTO staff members during formal linkage sessions, CMLTO continues to receive informal feedback from MLTs regularly via discussions with MLTs, emails and phone calls.

Is the CMLTO aware of any opposition to the regulation of medical laboratory assistants and medical laboratory technicians?
The CMLTO is aware that some MLTs, medical laboratory assistants and technicians, and other stakeholder organizations are opposed to regulating medical laboratory assistants and technicians for a variety of reasons.

CMLTO acknowledges the differing views but is convinced that regulating medical laboratory assistants and technicians is in the public’s best interest.

The CMLTO welcomes the opportunity to discuss its reasons for pursuing the regulation of medical laboratory assistants and technicians with any individual or organization, in an open and transparent manner.

How is the CMLTO working with stakeholders who have an interest in the regulation of medical laboratory assistants and technicians?
Throughout the process, CMLTO has engaged a wide variety of stakeholders through surveys, face-to-face meetings, presentations and electronic communications. The CMLTO will continue with these outreach initiatives to receive stakeholder opinions and input.

The CMLTO welcomes the opportunity to discuss the regulation of medical laboratory assistants and technicians with any individuals or organizations in an open and transparent manner.

Why does the CMLTO not distinguish between medical laboratory assistants and medical laboratory technicians?
The CMLTO has heard from MLTs and medical laboratory assistants and technicians that these are two separate issues.

The first is related to nomenclature. We have met medical laboratory professionals who are referred to as ‘technicians’, ‘assistants’, and ‘attendants’ in their workplaces. Currently, to be inclusive, the CMLTO refers to this group of health professionals as medical laboratory assistants and technicians.

Secondly, MLTs and medical laboratory assistants and technicians report that regardless of the titles used in the workplace, there is a very broad range of responsibilities which are employer-specific. Therefore, ‘assistants’ in one laboratory may have more responsibilities assigned than ‘technicians’ in another laboratory, and vice-versa.

Working towards regulating medical laboratory assistants and technicians necessitates a clear and consistent nomenclature for these professionals, and a clearly defined scope of practice. This will enable clear interprofessional collaboration between MLTs and medical laboratory assistants and technicians as there will be less need for interpretation of scopes of practice.

The CMLTO sees the need for clarity and consistency in nomenclature and scope of practice as a fundamental enabler to the regulation of medical laboratory assistants and technicians.

On whose authority has the CMLTO expanded its jurisdiction to include medical laboratory assistants and medical laboratory technicians?
The CMLTO, like every other health regulatory College, has certain legislated requirements assigned to it under the Regulated Health Professions Act, 1991. Two specific objects of health regulatory Colleges are particularly important to the regulation of medical laboratory assistants and medical laboratory technicians.

The CMLTO has a legislated requirement to engage stakeholders to meet its obligations regarding interprofessional collaboration. Via linkage with CMLTO, MLTs have discussed the important relationship between them and medical laboratory assistants and medical laboratory technicians and many reasons for undertaking their regulation.

The CMLTO also has a legislated requirement to promote the ability of members to respond to changes in practice environments. The increased impact and participation of medical laboratory assistants and medical laboratory technicians in clinical laboratories affect the provision of safe and effective medical laboratory services.

Interpretation of these requirements, along with MLT feedback, clearly indicates the need to pursue the regulation of medical laboratory assistants and medical laboratory technicians.

Does the CMLTO suggest that medical laboratory assistants and medical laboratory technicians are not practising in a safe manner?
As integral members of the health care team in the clinical laboratory, medical laboratory assistants and medical laboratory technicians affect patient care. In many cases, they are the primary source of contact between the laboratory and patients, as they perform phlebotomy and many of the pre-analytical functions for the laboratory.

Published research reports suggest a high proportion of medical errors occur during the pre-analytical phase of medical laboratory testing. The CMLTO recognizes that other factors, external to the participation of medical laboratory assistants and medical laboratory technicians in the pre-analytical phase of laboratory testing, may contribute to these results. However, it is clear that medical laboratory assistants and technicians play a very important role in this process.

Based on feedback from MLTs, medical laboratory assistants and technicians, the CMLTO believes the regulation of medical laboratory assistants and technicians will contribute to the provision of safe and effective medical laboratory services.

Why do medical laboratory assistants and technicians need to be regulated when the Institute for Quality Management in Healthcare standards contain criteria for entry to practice?
Under the Institute for Quality Management in Healthcare (IQMH) standards, as well as the Laboratory and Specimen Collection Centre Licensing Act, 1990, the onus is on the Laboratory Director to ensure medical laboratory assistants and medical laboratory technicians have the appropriate education and preparation to practice.

The CMLTO believes that applying the current legislative framework to all regulated health professionals whose practice could have a detrimental effect on patient care is an acceptable, effective process and mechanism for public protection. The CMLTO also believes self-regulation of health professionals ensures they are accountable to the public.

The regulation of medical laboratory assistants and technicians will be a multi-year initiative. The process and criteria for regulating a new health professional is clearly outlined by the Health Professional Regulatory Advisory Council (HPRAC). This information can be found on the Laws and legislation page.

Individuals who register for updates will be notified as any information on the regulation of medical laboratory assistants and technicians is added or updated on this website.

What are some of the anticipated impacts of regulation?
The legislative process that will lead to the regulation of medical laboratory assistants and medical laboratory technicians is a multi-step process, involving the CMLTO, the Ontario Ministry of Health and Long-Term Care (MOHLTC), the Health Professionals Regulatory Advisory Council (HPRAC), and many other stakeholders. The basis for demonstrating the need for regulation of a new health profession is determined by HPRAC, then recommended to the Minister of Health and Long-Term Care. The HPRAC criteria for regulation of a new health profession serve as the guiding framework for the operational and project planning documents to move this initiative forward.

Some of the potential anticipated impacts of regulation relate to the HPRAC criteria. For example, one of the current HPRAC criteria for the regulation of a new health profession requires registrants to have graduated from an educational program accredited by the Canadian Medical Association's Conjoint Accreditation process.

Why is the CMLTO creating a Voluntary Roster of Registered Medical Laboratory Technicians?
The CMLTO Voluntary Roster will enable non-regulated medical laboratory practitioners who meet certain criteria, to demonstrate adherence to a set of clear guidelines. This will establish, for the first time, a standardized way to classify medical laboratory assistants and technicians. Until the time that medical laboratory assistants and technicians are regulated health professionals in Ontario, the Voluntary Roster will serve the public interest by confirming that they meet a certain level of educational and professional practice criteria.

Those individuals who successfully meet the criteria for acceptance to the Voluntary Roster will be granted access to the designation of "Registered Medical Laboratory Technician." 


What are the criteria for inclusion on the Voluntary Roster?
 1. 1950 hours of general clinical laboratory and/or phlebotomy work experience over the last five (5) years

OR
2. Graduation from a medical laboratory technician or assistant program that is:
accredited by the Canadian Medical Association, orapproved by the Ontario Ministry of Training, Colleges and Universities, orapproved by the Ontario Society for Medical Technologists.

OR
3. Current certification with the Canadian Society for Medical Laboratory Science (CSMLS) or the Ontario Society for Medical Technologists (OSMT), and 900 hours of general clinical laboratory and/or phlebotomy work experience within the last three (3) years

For more detailed information about the Voluntary Roster criteria, please click here



What are the steps involved in applying to the Voluntary Roster?

To apply to the Voluntary Roster, you will be required to: 
1. Complete an online application form.
2. Submit the assessment application fee of $100.00+ $13.00 HST.
3. Submit supporting documentation. 

Once CMLTO receives your completed application form, payment and supporting documentation, the application will be processed.   

Upon inclusion on the Voluntary Roster, you will be required to pay a Voluntary Roster fee of $56.50 ($50.00 + 6.50 HST) to be included on the Voluntary Roster until March 31, 2018. 

The CMLTO Voluntary Roster of Registered Medical Laboratory Technicians is now accepting applications! Click here to get started.


What should I expect if I am successful in applying to the Voluntary Roster?

Successful inclusion on the Voluntary Roster provides you with recognition that you have met the required level of skills and knowledge. Once you are included on the Voluntary Roster you can expect: 
• to use the designation, “ Registered Medical Laboratory Technician”
• a welcome letter and special pin to be mailed to you
• your name to appear on a Voluntary Roster which will be available to the public and employers
• a Certificate of Acceptance to the Voluntary Roster to be sent to you
• to be included on the mailing list for FOCUS, CMLTO’s quarterly newsletter
• access to professional practice resources
• access to professional conduct and quality assurance guides
• direct communication with the CMLTO for professional practice advice. 

Does inclusion on the Voluntary Roster automatically ensure registration with the CMLTO in the future?
The entry to practice requirements for medical laboratory assistants and technicians will be described through the process of regulation, and will include criteria relating to education, experience and certification examinations.

Until the time that the regulation of medical laboratory assistants and technicians is legislated, the CMLTO Council's shorter term goal is to establish a Voluntary Roster of Registered Medical Laboratory Technicians. Those individuals who successfully meet the criteria for registration on the Voluntary Roster should not expect to automatically become registered with the CMLTO in the future. As registration requirements become developed, so will options to bridge from the Voluntary Roster to registration with the CMLTO.


How will the establishment of the Voluntary Roster affect medical laboratory employers?
The CMLTO has developed an FAQ for employers (PDF). Employers with further questions are invited to contact This e-mail address is being protected from spambots. You need JavaScript enabled to view it for more information or to request a presentation. 

Which certification exam will be accepted as one of the criteria for registration with the CMLTO in the future?
The entry to practice requirements for medical laboratory assistants and technicians will be described through the process of regulation, and will include criteria relating to education, experience and certification examinations. 


Sign up to be notified about news regarding this initiative.
Search the Voluntary Roster here.