IFCC Young Scientists
IFCC Young Scientists Clinical
Biology: an education program that needs adjustments
Contributed by Dr. Pierre-Alexandre Olivier, IFCC Young
Scientists Representative Belgium
These past twenty years,
laboratories accelerated their transformation by merging,
specialising and by internationalising to clinical rank as well as
private rank. The world of clinical biology is dynamizing and
modernising. Indeed, the future laboratories are appearing. These
are equipped with fully automated corelabs, with efficient
validation programs, competent organisation tools and, complex
procedures of quality norms.
Clinical biology is definitively
at a turning point in its history. Actually, the time where
clinical results were send only on paper, where no more than five
employees worked by laboratory, and where a whole afternoon was
needed to get ten TGO results is now obsolete. In the
21st century, everything has to be centralised,
computerised, categorised, controlled, and made secured and
archived. The clinical biologist's work must
therefore follow the move and improve. We can see appearing
publications or at least reflections about the requirements to
attain regarding to the three main orientations: clinical
chemistry, haematology and microbiology.
The physiopathology comprehension
and interpretation keep of course an essential position because our
work remains medical in the first place. The clinical biologist has
to go on with his first missions. This means advise and guide the
prescriber in his diagnosis approach, know the analytical methods
as well as their limits, be familiar with the treatments but also
interpret the biological results with the clinical context.
These medical qualifications are
an immutable basis to which new branches have been added such as
ISO norms knowledge, reimbursement criteria,
stocks management, informatics, human resources, automation. There
is a strong necessity to go deeper in these daily management
aspects but up to now, this is not accessible. Therewith, we could
hope to keep a chance to decide where the function in the
laboratory should go.
Our education program can't
escape adjustments to the new requirements. So far, there is not
any change foreseen but it is time to define the expected
requirements for each speciality in order to propose ambitious and
adjusted programs to the dynamism that knows the area. These
changes will have to go through new study schemes and through
meetings with the involved professionals.
To conclude, the role of a
specialist in laboratory medicine must be recalibrated in order to
allow an update in the education program. Nevertheless, we can't
forget that the goal is not to make accountants, bankers or
financiers but to give the specialist of tomorrow everything in his
power to be the masterpiece of the clinical biology laboratory.
Laboratory medicine in South Africa: A paradoxical state
Contributed by Verena
Gounden, IFCC Young Scientists Representative- South
Africa
Currently as a young laboratorian in South Africa you would
certainly be working in interesting times. The paradoxical
nature of South African society (the divide between rich and poor)
is nowhere more acutely represented than by the health care system.
Whilst health care at state facilities is free, there is an immense
burden on healthcare resources. South Africa has the largest
population of HIV positive individuals in the world and a growing
epidemic of lifestyle diseases (another paradox).
The laboratory services at state facilities are exclusively run
by a para-statal organisation -: the National Health Laboratory
Services (NHLS). The NHLS provides laboratory services to 80%
of the South African population. It is also responsible for
training of medical technicians, technologists, scientists and all
pathologists. Privately owned laboratories predominantly
service the other, smaller fraction of the population.
I work as a junior pathologist in the Department of Chemical
Pathology at the Inkosi Albert Luthuli Central Hospital in Durban,
South Africa. As a pathologist in the state sector one often
has to be a proverbial "jack of all trades". Often the daily
demands of managing and running a laboratory lead to research
efforts being sidelined. From what I understand and have heard the
working demands are quite different to what would be experienced by
chemical pathologists in the US or UK.
The challenges are many and varied in providing a pathology
service in South Africa. Many of the academic centres where
pathologists work have modern instrumentation and automation yet
pre- analytical problems such as inadequate transportation services
for samples are still an overwhelming concern. Pathologists and
scientists are also concentrated in the larger cities and academic
centres with very little influence or input into the running of
smaller, more "rural" laboratories. Developments in
information technology and the increased connectivity of our modern
age have opened the possibility of greater involvement of
pathologists with these labs. For example the opportunity to
view IQC real time from a remote location will be one of the tools
that enable a greater input by pathologists. Concepts such as
electronic gate keeping have been implemented in some centres and
are hoped to allow for better management of resources and education
of clinicians with regards to best practice principles of test
ordering. The rapidly developing point of care technologies
(particularly dry chemistry) will have a future role in providing
analytical services in laboratories/clinics and hospitals where
transportation of samples to a central laboratory is a constant
problem.
"Our history is the pathway to our future, our continual
evolution the pathway to our survival"