Advancing standards in laboratory medicine and pathology through professional credentials

Healthcare is experiencing a dire need for medical laboratory professionals. The shortage in the workforce is particularly concerning given their essential role in healthcare: Laboratory professionals are responsible for conducting a wide range of tests that inform 70% of medical decisions, from the diagnosis of diseases to the determination of treatment plans.1 The lack of sufficient and competent laboratory professionals leads to delays in diagnosis and treatment, impacting patient care and outcomes.2

Due in part to the ongoing impacts of the COVID-19 pandemic, an aging workforce, recruitment and retention challenges, evolving technological advancements in laboratory medicine, a combination of these and other factors has led to the significant shortage of personnel in the global medical laboratory workforce,2 and is becoming increasingly prominent. 

As challenging as these delays and impacts on care and outcomes are, they also present prospects for growth and innovation in laboratory medicine and pathology. As decision-makers at all levels seek and implement multi-faceted solutions, leveraging credentials such as those offered by the American Society for Clinical Pathology, Board of Certification (ASCP BOC) is emerging as a key strategy.3 This strategy not only enhances professional skills but opens new avenues for recruitment and retention.

Using professional credentials as a solution to these issues ensures the maintenance of high standards in laboratory medicine and aids in enhancing the profession's appeal and recognition. As the healthcare landscape continues to evolve, addressing this shortage is imperative for maintaining the efficacy and quality of global health systems. 

The role of the ASCP BOC

The ASCP BOC is a laboratory professional credentialing agency with nearly a century's legacy, having been established in 1928. Over this period, the ASCP BOC has credentialed more than 625,000 laboratory professionals worldwide, upholding its mission to provide excellence in certification of laboratory professionals on behalf of patients globally. The credentialing portfolio offered by the ASCP BOC spans 26 unique examinations for laboratory leaders at all levels, supporting phlebotomists who have direct interactions with patients through PhD scientists who lead high complexity laboratories. In 2006, the ASCP BOC began certifying laboratory professionals with an international “ASCPi” designation. The ASCPi initiative has seen widespread adoption, with applicants spanning 130 countries and, to date, more than 22,000 individuals from 117 countries earning ASCPi credentials.4

The importance of credentials for medical laboratory professionals 

Credentials for medical laboratory professionals are a testament to their competence and proficiency. They demonstrate that individuals have undergone rigorous education, training, and experiential assessments and have met established standards of knowledge and skills. This is particularly crucial in a field where precision and accuracy are paramount. Laboratory errors can have dire consequences on patient diagnosis and treatment, making the role of credentialed professionals indispensable.5 Credentialed laboratory professionals ensure that laboratory tests, which form the basis of a significant portion of clinical decisions, are accurate and reliable.

Moreover, in the realm of healthcare, trust is a vital commodity. When medical staff and patients are aware that laboratory professionals are credentialed, it instills confidence in the test results and diagnoses derived from these laboratories. This trust is not only essential for patient care but also for the smooth functioning of the entire healthcare system.6

Another aspect where credentials play a pivotal role is in regulatory compliance and quality assurance. Many healthcare regulations and standards mandate that individuals performing laboratory tests be properly credentialed. This compliance is critical for laboratories not just to operate legally but also to participate in insurance programs, including those funded by the government.3

Furthermore, credentialing can significantly impact dynamics of the medical laboratory professional workforce. It provides a clear pathway for career advancement and professional growth, which is crucial for attracting and retaining talent in the field. It also mandates continuous education and professional development, ensuring that laboratory professionals stay abreast of the latest technologies and procedures.3 This continuous learning environment fosters professional pride and job satisfaction, which are essential in reducing turnover rates.

U.S. & global workforce challenges

According to the ASCP BOC’s 2022 ASCPi Survey, many laboratories around the world report difficulties in filling open positions.7 In the United States, the Bureau of Labor Statistics of the Department of Labor forecasts an 11% growth in employment for medical and clinical laboratory technologists and technicians from 2020 to 2030, surpassing the average growth rate for all occupations.2 Despite this optimistic job outlook, a recent report by the ASCP and the University of Washington Center for Health Workforce Studies warns of an impending increase in laboratory workforce shortages.2 This anticipated rise is attributed to growing demand for laboratory services, limited opportunities for education and training, and challenges in recruiting and retaining laboratory personnel.2

Challenges such as these impact the overall quality of patient care and the effectiveness of laboratory operations. These credential examinations are a cost-effective way to ensure that laboratory professionals who pass are competent, knowledgeable, and focused on delivering high-quality, safe patient care. The ASCP BOC’s examinations are constantly being reviewed by ASCP BOC team members to ensure examination content reflects the rigor of current practice and is fair for all test takers.

To address the shortage in the United States and globally, the article “Severe Shortages of Qualified Medical Laboratory Professionals” suggests that hiring qualified, board-certified laboratory professionals is crucial.8 For emerging U.S. laboratory professionals, this involves taking a credential examination upon graduation to achieve board certification. Many medical and pathology laboratory employers also provide on-the-job training, which enhances the formal credentialing process. This blend of practical experience and credentials offers a solid foundation for career success, improving skills, knowledge, and contributing to the expansion of the laboratory workforce.

The contribution of professional credentials to the laboratory field is further evidenced by a 2019 survey by the Institute for Credentialing Excellence (ICE). This extensive survey, involving more than 12,000 credential holders from six organizations, aimed to assess attitudes and experiences regarding certification examinations and credentialing.3 The findings revealed that the respondents view certification (i.e., credentials) as highly valuable to their profession, with certification requirements seen as appropriate, and the ethics and code of conduct set by certifying bodies as beneficial. Moreover, credentialing is considered crucial for enhancing competence and performance in the profession.3

Internationally, the ASCP BOC also champions competency-based exams by recognized credentialing bodies. Its credentials are acknowledged in various regions, including the Middle East & North Africa, Latin America, and Asia.9 Developing global standards in credentialing helps guarantee that laboratory practices meet international safety and accuracy benchmarks, which is essential for effective disease diagnosis and management. It also aids in responding to global health workforce shortages by ensuring the availability and distribution of highly skilled professionals across various geographical regions, thereby contributing significantly to maintaining global health standards and effectively delivering healthcare services.

Inclusion, diversity, equity, and access (IDEA)

In the medical laboratory and pathology professions, sustainability transcends mere ecological considerations. It crucially includes the dimension of social sustainability, which is central to cultivating a resilient, competent workforce amidst prevalent challenges such as workforce migration and talent deficits. Effective laboratories are those that integrate strategies such as continual professional development, career progression pathways anchored in specialist or additional qualifications, the nurturing of a positive workplace culture, and the encouragement of a harmonious work-life balance.10 These strategies are instrumental in not only retaining adept personnel but also in attracting new talent, thereby enhancing overall employee contentment.

The pillars of inclusion, diversity, equity, and access (IDEA) are imperative for the cultivation of a sustainable workforce in laboratories. By fostering an environment that embraces diversity and ensures accessibility, laboratories can access a wider spectrum of talent, reflective of the diverse communities and patient populations they serve. The implementation of equitable practices, such as equal remuneration for comparable work and equal opportunities for career progression, is pivotal in maintaining a diverse and talented workforce.

Credentials play an indispensable role in advancing IDEA within the laboratory workforce. By offering a uniform assessment of professional skills and knowledge, these credentials ensure that all practitioners are evaluated solely on their expertise, irrespective of their background. This system of objective evaluation upholds the principles of equity, accessibility, and fairness within the workplace, fostering a more inclusive and equitable environment.

Moving forward

Laboratory professional credentials provided by the ASCP BOC play a pivotal role in addressing the global workforce shortage in medical and pathology laboratories. Through its credentials, the ASCP BOC not only standardizes and enhances the professional skills of laboratory workers but also opens new avenues for recruitment and retention. 

Key strategies for effective laboratory operations include continuous professional development and clear career progression paths linked to credentials, such as those offered by the ASCP BOC. Stacking, or gaining additional credentials, including becoming certified as a specialist in a particular area, can lend to these clear pathways. These strategies help foster a positive workplace culture and promote a work-life balance and are essential for retaining skilled staff and attracting new talent, ultimately leading to greater employee satisfaction.

Additionally, the principles of IDEA are integral to creating a sustainable, resilient workforce. By providing a uniform assessment of skills and knowledge, the ASCP BOC's credentials promote fairness and equity in the laboratory profession, ensuring that professionals are evaluated based on their expertise, irrespective of their background. In summary, the advancement of standards in laboratory medicine and pathology through professional credentials not only addresses immediate workforce challenges but also sets the foundation for a globally competent, diverse, and sustainable healthcare system in the future.


1. Strengthening clinical laboratories. Published November 15, 2018. Accessed December 20, 2023.

2. Garcia E, Kundu I, Fong K. The American Society for Clinical Pathology's 2021 Wage Survey of Medical Laboratories in the United States. Am J Clin Pathol. 2022;1;158(6):702-722. doi:10.1093/ajcp/aqac116.

3. Value of Certification: Multi-Organization Survey of Credential Holders. Institute for Credentialing Excellence.; 2019.

4. Spiczka A, Sreckovic A. Biannual Report on Examinees and Certifications for ASCPi. American Society for Clinical Pathology; 2023.

5. Mrazek C, Lippi G, Keppel MH, et al. Errors within the total laboratory testing process, from test selection to medical decision-making - A review of causes, consequences, surveillance and solutions. Biochem Med (Zagreb). 2020;15;30(2):020502. doi:10.11613/BM.2020.020502.

6. Cope EL, Khan M, Millender S. Trust In Health Care: Insights From Ongoing Research. Health Affairs Published. Published online 2022.

7. Baker J, Spiczka A. ASCPi Survey. American Society for Clinical Pathology. 

8. Robinson AT. Healthcare: Severe shortages of qualified medical laboratory professionals. Biomed J Sci Tech Res. 2023;48(3):39710-39713. doi:10.26717/bjstr.2023.48.007651.

9. Board of Certification. Countries with ASCP BOC Government Recognition. American Society for Clinical Pathology; 2023.

10. Garcia E, Kundu I, Kelly M, et al. The American Society for Clinical Pathology's Job Satisfaction, Well-Being, and Burnout Survey of Laboratory Professionals. Am J Clin Pathol. 2020;9;153(4):470-486. doi:10.1093/ajcp/aqaa008.