Talk to most medical laboratory professionals about their involvement in the patient care process, and you’re likely to hear them describe the need to increase the visibility of the vital role they play.
Dr. Melissa Bell, DCLS, MS, BS, MLS (ASCP)cm
For Dr. Melissa Bell, DCLS, MS, BS, MLS (ASCP)cm, that desire to move from behind the scenes to more of a bedside patient consulting role is what led her to pursue her Doctorate of Clinical Laboratory Sciences (DCLS) at the University of Texas Medical Branch at Galveston (UTMB) after working in the industry for 15 years, going from a med tech to laboratory director during that time.
“I wanted to have more patient interaction and I wanted to have more interaction with physicians, too because I noticed they sometimes struggled with new testing that was being introduced and how to best utilize and interpret those tests,” says Bell, who currently serves as a laboratory director and technical consultant for Lighthouse Lab Services (LLS) and was part of the first accredited class to graduate from the DCLS program at UTMB. “I really wanted to be part of improving that process and I thought this was the best way to do it.”
DCLS is an advanced professional doctorate intended for clinical lab scientists who are seeking to further their level of clinical expertise while also developing leadership and management skills. DCLS professionals aim to improve patient outcomes and increase cost effectiveness by working with pathologists to assist the primary care providers. This includes participating directly in patient care decisions, monitoring laboratory utilization, and conducting research on the diagnostic process.
Doctorate of Clinical Laboratory Sciences offers a new pathway for medical laboratory professionals
That being said, DCLS is a relatively new pathway only offered by three medical schools in the United States: Rutgers University, UTMB, and most recently, Kansas University. Bell, who says she always envisioned one day becoming a doctor, hopes that more DCLS graduates entering the workforce in the coming years will help these programs gain recognition and be offered more widely.
“This is a great career path for anybody who is in this field and really wants to be more patient facing, have more interaction with physicians, and wants to drive more testing platforms,” Bell says. “Anybody who really enjoys providing education to the care team would be a great candidate for this program.”
Another common refrain from across the industry is that there is a lack of generalist knowledge as clinical laboratory scientists become increasingly specialized. DCLS graduates may present a remedy to this problem, as Bell says the program greatly helped her gain more generalized knowledge in several fields. In fact, UTMB’s program requires a minimum of three years of clinical lab experience, with a preference for generalists.
“When I went through the program, we did rotations in basically every field there was,” says Bell, citing blood bank, microbiology, coagulation, hematology, and chemistry, to name a few. “We worked with the pathologists who oversaw those departments as well as the residents. The physicians would bring actual patient cases, show their history, and ask where we could go from there.”
The benefit of this approach, Bell says, is twofold: For one, it reduces unnecessary or blanket testing and reins in administrative waste. The second is that this more informed approach to testing improves patient care and generally reduces their length of stay, which is a benefit for both the patient and hospital.
“If you can get the correct test ordered on a patient, you can treat them quicker and get them home quicker,” says Bell, who intends to eventually transition to a Medical Director role with LLS. “I really wanted to be a part of improving that process, and so far, this has been a great way to do it.”
Looking forward to being a Lighthouse HCLD as a DCLS NRCC like Melissa! Great article and congrats to UTMB for achieving NAACLS accreditation!
Biz Fisher
Glad you enjoyed the article, Biz! We’re looking forward to you joining us as well!
Exciting news! Only have 5 years of experience, but mat take the DCLS route at some point. I like to hear that there is a preference for generalists in the program, sadly it is a struggle to find true generalists jobs nowadays.
Glad to hear this sparked some potential interest in you exploring a DCLS program! We can definitely attest to the overall lack of generalists in the field, so hopefully programs like this will help alleviate that issue as they gain prominence.
Great article by Dr. Bell. I just completed my DCLS degree at UTMB, as well. I am looking forward to using my degree and presenting the laboratory in a newer, more progressive way.
Thanks, Tiffany! We’re excited to see DCLS programs gaining more recognition and can’t wait to see what great things you and your classmates do to help promote the visibility of medical lab professionals. Don’t hesitate to reach out to us if you ever need assistance with placement or would like to explore new opportunities!
So a DCLS is qualified to be a CLIA high complexity laboratory director? I didn’t think there was any official guidance from CMS or CLIA regards to whether this degree is equivalent to PhD.
Hi, Jonston, thanks for the question. I reached out to Dr. Bell, and here was her response: “Currently under CFR 493.1443(b)(3)(i), the CMS/CLIA interpretative guidelines, with the correct board approved certification, the DCLS is qualified to be a high complexity lab director.”
Are there any DCLS graduates that are now HCLD? I thought that CLIA did not accept DCLS as equivalent to PhD.
Hi Cecil, someone asked a similar question below. Dr. Bell said that under CFR 493.1443(b)(3)(i), the CMS/CLIA interpretative guidelines, with board approved certification a DCLS is qualified to be a high complexity lab director.
This is misleading, incomplete, and incorrect information. I can see in future Lab getting in trouble. CMS/CLIA has not approved DCLS as an approved education requirement to be a high complexity lab director even if you have a certification from the approved board. Refer to this CLIA pubic comment publication. And lots of states do not recognize DCLS as an approved degree.
https://www.cdc.gov/cliac/docs/addenda/cliac0419/PC5_ABB_Personnel_Public_Comment.pdf
Hi Hitencha, while we understand your concern about readers potentially being misled, it should be noted that the document you link to only reflects the position/comments from the ABB in 2018. We understand ABB doesn’t recognize DCLS and CLIA has no say on which boards do recognize the DCLS degree. However, there are several DCLS graduates who have successfully sat for the NRCC exam and are CLIA directors. Our intent with this article was to bring attention to DCLS as an educational pathway, while also outlining what one graduate has gone on to do with her career.
CLIA does not recognize DCLS as an earned doctorate degree. I am not understanding how CLIA will reject the degree and approve the CLIA directorship at the same time. I have reached out to the state CQ evaluation department. They do not recognize DCLS as an earned doctorate degree based on CLIA interpretation. Refer to the email from the CMS specialist dated: Thursday, February 01, 2018. It clearly says DCLS is not a qualified degree. I am not aware of any other CLIA guidelines.
This is an interesting discussion. I am considering to pursue this degree and glad that Lighthouse is recognizing it. When I saw the potential hurdles and debates on whether a DCLS can serve as a CLIA Lab Director, my initial response was why is there even a debate. The law clearly states “doctorate degree in biological sciences or clinical lab science”. I had to ask how DCLS doesn’t meet that qualification. The answers I received from board certifying agencies like ABB, ASM, and ABCC are that the DCLS degree doesn’t require any wet lab based research in science that’s required in PhD programs. My question is, how does any PhD research in a very specialized topic of the science lead to someone being more qualified to become a clinical lab director? If anything DCLS courses are so heavily geared toward clinical aspects of the laboratory and its utility. It should provide better preparations for someone to take charge of a clinical lab than someone doing a research project in some random enzyme for four years in a PhD program. Having the ability to conduct independent research does not translate to how well you can manage/direct a clinical lab at all… If you really care about patient care, do you really want your lab to have a director who is fresh out of a PhD program with just one year of clinical lab experience or a very experienced mid-level or senior level lab manager who earns a Doctorate in Clinical Lab Science that just lacks a wet lab dissertation? It’s an easy choice for me. I think NRCC saw this, and hence, is allowing DCLS graduates to take its board certification.
Thanks for weighing in on this issue, Tom. I reached out to Dr. Bell for additional input, and here is her reply: “I agree with the discussion on this. I would argue that even though a DCLS does not have the same wet lab research experience that a PhD does, we still have wet lab experience. In fact, one of the prerequisites for the DCLS program is to have three years of clinical laboratory experience as a generalist. I would also argue that one of the graduation requirements from any Clinical Laboratory Science program is to do clinical rotations in either a hospital or large reference-based laboratory. In addition to PhD’s as Medical Directors, Pathologists are also Medical Directors, and they do not have the wet lab research experience that PhD’s do, unless they are MD, PhD’s. The experience can vary vastly between these three degrees, but I don’t believe that makes one more qualified over the other with the proper board certification, and I see the need for all three. Many Pathologists are spread very thin, especially in rural areas, and cannot dedicate a lot of time to the laboratory, so why not have a DCLS who has the knowledge and expertise in the clinical laboratory fill this role? A DCLS graduate has been trained to focus on proper utilization of laboratory testing and the interpretation of these results so that Physicians utilize the correct test(s) to provide the best patient care. I work with several PhD’s and the knowledge they have shared with me in different areas of advanced testing has been invaluable. I believe that the type of lab and the testing being performed may help decide what degree a Medical Director holds in regard to what best suits that lab, but again there is a need for all three-degree types. I must applaud the NRCC for allowing myself and other DCLS graduates to sit for their board exam. I believe that they are really paving the way for DCLS graduates and the betterment of laboratory medicine.”
This comment is vey misleading. MLS/CLS thinking of going to pursue DCLS program must be aware that DCLS graduates are not qualified/approved to be a HCLD and not going to be in near future.
Can an MLS generalist sit for the NRCC exam? I understand that in order to be eligible to sit for the board exam, you need to work in clinical chem for at least 3 years. Please correct me if I am wrong. Can any DCLS graduates with NRCC certification weigh in on this? Thanks!
Thanks for your question, Dalal. I reached out to Dr. Bell and will let you know when she has a chance to respond!
Dalal, here is the response from Dr. Bell: “Unfortunately no, an MLS generalist cannot sit for the exam without having an advanced degree (PhD or DCLS). You also have to have 3 years’ experience within the last 5 years in “broad clinical chemistry testing areas”. Interestingly enough, they will not consider research laboratory or experience as part of your degree program experience. I have attached the link to the specific requirements. I just went through the application process and got approval to sit for this exam this past Monday. I have loved working with the NRCC. https://nrcc6.org/clinical/
Thank you for the quick response. That was helpful. I meant to ask if rotating through clinical chemistry as a generalist will suffice (assuming one goes on to become a DCLS) or do the 3 yrs have to be spent in working in clinical chem?
I followed up with Dr. Bell and she encouraged you to reach out to NRCC with this question. Apologies for not being able to provide a direct answer, but she wasn’t 100% sure offhand and we don’t want to lead you astray.
Hello everyone,
Great conversation. I just wanted to point out the link Hitencha added is just a public comment from AAB to CLIAC, not law, nor the position of of CLIA, CLIAC, nor the CDC.
Biz
DCLS Student, Future NRCC HCLD
Biz
I am just pointing out the current CLIA guidelines. It is not final until approved. And not all NRCC certified can be HCLD. NRCC is the only board where non-doctorate can also apply and be certified. It is too early to tell if CLIA will approve DCLS to be HCLD. It is not a problem until it is a problem. Imagine having a CAP/JC survey and not recognizing your degree and certification. We were even questioned and investigated for having a Ph.D. HCLD.
CMS has what’s called “State Operations Manual Appendix C – Survey Procedures and Interpretive Guidelines for Laboratories and Laboratory Services”. It provides guidelines on how the CFRs related to clinical laboratory must be interpreted. According to the document’s Interpretive Guidelines §493.1443(b)(3) it states that for HCLD “an acceptable doctoral degree is a Doctor of Philosophy – Ph.D., Doctor of Science –D.Sc. If acceptable to the board, a Doctor of Dental Surgery – D.D.S., Doctor of
Veterinary Medicine – D.V.M., Doctor of Public Health – Dr.P.H.” With DCLS being a relatively new degree, CMS has to decide on whether a DCLS can be part of this list. D.Sc is quite different than DCLS. It’s funny that none of the agencies had a problem with DVM being on the list, yet they are so against “Doctor of Clinical Laboratory Science”. Probably because they know that DCLSs would be their competition in the job market.
I love this video. I am for a DCLS degree and I hope to attain this degree soon!
Thanks! Best of luck with continuing your education via the DCLS path.
Good new for everybody . CMS approved the DCLS degree.
It’s great to see this degree gaining more widespread recognition!