# American Society for Clinical Pathology

The American Society for Clinical Pathology (ASCP), formerly known as the American Society of Clinical Pathologists, is a professional association based in Chicago, Illinois, encompassing 130,000 pathologists and laboratory professionals.
Founded in 1922, the ASCP provides programs in education, certification and advocacy on behalf of patients, pathologists and lab professionals. In addition, the ASCP publishes numerous textbooks, newsletters and other manuals, and publishes two industry journals: American Journal of Clinical Pathology (AJCP) and LabMedicine.
The current CEO since 2010 is Ervin Blair Holladay, Ph.D., MASCP, SCT(ASCP)$^{CM}$ who collects an annual salary of US$1 million.

## Acquisitions

In February 2006, ASCP acquired the cytology product line of the Midwest Institute for Medical Education (MIME). At the time, it was the only national cytology proficiency testing provider.
In 2009, ASCP acquired the medical technologist led National Credentialing Agency for Laboratory Personnel (NCA). The baccalaureate-level certification designations Medical Technologist (MT) and Clinical Laboratory Scientist (CLS) were replaced by Medical Laboratory Scientist, MLS(ASCP)$^{CM}$. The BOC Board of Governors will be composed of five ASCP Fellows (pathologists), five ASCP laboratory professionals, four representatives of ASCLS, two representatives of the Association of Genetic Technologists, eight representatives from the eight participating societies respectively, and one public representative. The acquisition was criticized by AMT as doing little to further the standing of laboratory professionals.
In 2021, ASCP acquired the Clinical Laboratory Management Association (CMLA). CMLA had advocated against laboratory personnel licensure as an unnecessary cost.

## Board of Registry (BOR)

   [MT ASCP] is becoming increasingly important and will serve in to place trained laboratory technicians in a more secure competition with those whose training has been more superficial.
The ASCP Board of Registry (BOR) was established in 1928 as the "Registration Bureau for Technicians" as the first certification agency for clinical laboratory personnel in the US. ASCP was the first professional medical organization to set standards for laboratory professionals, which initially only required a recommendation from a member. Those recommended were subsequently registered with ASCP, hence name the Board of Registry. In 1931, there were two classifications for registrants: Laboratory Technician (L.T.) and Medical Technologist (M.T.). The L.T. designation was granted to all technicians who met the minimum requirements without the examination. The M.T. designations was issued to applicants who met rigid requirement of the Board and were individually elected at each annual meeting. The first certification was issued in 1930 to Paul H. Adams of Fort Wayne, Indiana. In 1933, ASCP began to assess individuals for academic and clinical prerequisites, and those who passed a board examination were granted certification. The initial certifications included a written and practical component. In 1935 the title Medical Technologist (MT) automatically to those certified Laboratory Technicians with college degrees. In 1936, the "Laboratory Technician" designation is retired and subsequent registrants are designated Medical Technologists and the academic requirements were raised to two years of college. In 1938, the Registry was renamed from the Registry of Technicians to the Registry of Medical Technologists. As Canadian pathology society did not have a registry, interested Canadian medical technologists sat for the Amereican ASCP MT certification instead. In 1939, the BOR publishes the first book outlining the educational curriculum for medical technologists entitled Curriculum for Schools of Medical Technology. In 1940, as other organizations began using the same designations, the initials MT(ASCP) were used. In 1944, due to travel wartime restrictions from World War II, the practical component of the certification was discontinued. In 1948, the written essay portion of the certification was deemed too cumbersome to assess, and the certification was switched to a multiple choice and true-false assessment that could be graded on a machine and provide exam statistics. In 1949, the BOR changed the exam format to a 200 multiple choice question exam as the multiple choice questions were found to be a more reliable indicator than true-false questions. In 1949, the BOR also created the Board of Schools (BOS) for registering schools. In 1958, BoR and ASMT assisted with the reclassification of medical technologists, putting them at the professional level in the Civil Service and allowing medical technologists to gain commission status in the US military.
In 1962, the BoR began requiring 3 years of college for the MT certification. In 1972, the BoR began requiring a Bachelor's degree for the MT certification.
There were 100,000 certificates issued by 1975, 200,000 by 1980, 300,000 by 1991, 400,000 by 2005, and 500,000 by 2014.
In July 1991, BOR administered their first Computer adaptive tests the ASCP headquarters for the Medical Technologist (MT), Medical Laboratory Technician (MLT), Phlebotomy Technician (PBT), Cytotechnologist (CT), and Histologic Technician (HT) certification examinations.
In 1994, BOR changed their examination format to Computerized adaptive testing (CAT).
In 2004, the BOR implemented the Certification Maintenance Program (CMP) requiring continuing education every three years to remain certified.

### Controversy

   Through its efforts to standardize the training of medical technologists, the Registry has come to be recognized by the leading medical and hospital groups as the only authoritative qualifying body for this field...The Registry, therefore, while purely voluntary and non-coercive, is universally accepted as the authoritative organization for qualifying the medical technologists in the United States.
In the 1960s, the BOR Code of Ethics and Standards of Conduct placed professional limitations on medical technologists requiring "A medical technologist will work at all times under the direction or supervision of a pathologist or other duly qualified and licensed doctor of medicine, such qualifications being determined on the basis of accepted medical ethics" and that "A medical technologist will not act as owner, co-owner, advisor or employee, or by means of any subterfuge, participate in an arrangement whereby an individual not regularly licensed to practice medicine is enabled to own or operate a laboratory of clinical pathology." In 1965, Janet Higgins, an ASCP certified medical technologist, was removed from the Board of Registry (BOR) because she was employed at a New Jersey laboratory where the director was a state-licensed bio-analytical laboratory director, but not a physician. Though New Jersey has never required the certification for employment, the technologist successfully sued ASCP under monopolistic restraint of trade to be reinstated to the registry with the Supreme Court of New Jersey finding that the "professional status conferred on plaintiff by her certificate is an interest of sufficient substance to warrant the protection of the court." The lawsuit, and the focus on pathologists over medical technologists spurred other medical technologist societies, such as the American Society for Medical Technology (ASMT) to promote the creation of their own certifying boards.
The BOR bylaws were updated following the transition from the American Society of Clinical Pathologists to American Society for Clinical Pathology.

## Board of Schools (BOS)

In 1949, ASCP stablished the Board of Schools (BOS) for accrediting medical technologist programs and published the Essentials of an Acceptable MT School. In 1973, following antitrust litigation by the United States Department of Education, the ASCP Board of Schools became the independent National Accrediting Agency for Clinical Laboratory Sciences.

## Initiatives

In 2022 ASCP received a multi-year grant over $1M to promote the CDC OneLab initiative, a network of laboratory professionals and testers to support rapid, large-scale responses to public health emergencies.

## Certifications

ASCP offers a number of certifications. International certifications taken outside the United States are denoted as ASCP$^i$. As of 2022, there were 580,000 ASCP and 20,800 ASCP$^i$ certificates awarded. In 2023, the number of MLS ASCPi applicants exceeded the number of MLS ASCP applicants.
Outside the US, the Philippines is largest ASCP$^i$ market with a third of eligible Filipino graduates applying for the MLS (ASCP$^i$) certification annually. The credential is not required for practice in the Philippines, but is appealing for its international work eligibility, primarily immigration to the United States.
| Name | Abbreviation | Level | First Offered | Discontinued | Notes |
| Technologist in Blood Banking | BB | Technologist | 1983 | | |
| Technologist in Chemistry | C | Technologist | 1948 | | |
| Technologist in Cytogenetics | CG | Technologist | 2010 | | |
| Cytologist | CT | Technologist | 1957 | | Formerly Cytotechnologist |
| Histotechnologist | HTL | Technologist | 1980 | | |
| Technologist in Immunology | I | Technologist | 1980 | | |
| Technologist in Microbiology | M | Technologist | 1948 | | Formerly Bacteriologist, changed in 1953 |
| Medical Laboratory Scientist | MLS | Technologist | 1933 | | Formerly Medical Technologist (MT) |
| Technologist in Molecular Biology | MB | Technologist | 2003 | | Formerly Technologist in Molecular Pathology (MP) |
| Hemapheresis Practitioner | HP | Specialist | 1993 | 2009 | Superseded by Qualification in Apheresis (QIA) |
| Specialist in Blood Banking | SBB | Specialist | 1954 | | |
| Specialist in Chemistry | SC | Specialist | 1954 | | |
| Specialist in Cytology | SCT | Specialist | 1959 | | Formerly Specialist in Cytotechnology |
| Specialist in Cytometry | SCYM | Specialist | 2017 | | |
| Specialist in Hematology | SH | Specialist | 1968 | | |
| Specialist in Laboratory Safety | SLS | Specialist | 2000 | 2011 | Superseded by Qualification in Laboratory Safety (QLS) |
| Specialist in Immunology | SI | Specialist | 1982 | | |
| Specialist in Microbiology | SM | Specialist | 1953 | | |
| Specialist in Virology | SV | Specialist | 1988 | | |
| Specialist in Molecular Biology | SMB | Specialist | 2018 | | |
| Diplomate in Laboratory Management | DLM | Other | 1989 | | |
| Diplomate in Medical Laboratory Immunology | DLMI | Other | 2023 | | |
| Pathologists' Assistant | PA | Other | 2005 | | |
| Apheresis Technician | AT | Technician | 2003 | 2009 | Superseded by Qualification in Apheresis (QIA) |
| Donor Phlebotomy Technician | DPT | Technician | 2003 | | |
| Histotechnician | HT | Technician | 1948 | | Formerly Histologic Technician |
| Laboratory Aide | LA | Technician | 1948 | 1964 | Replaced by Clinical Laboratory Assistant (CLA) |
| Clinical Laboratory Assistant | CLA | Technician | 1963 | 1982 | |
| Medical Laboratory Assistant | MLA | Technician | 2015 | | |
| Medical Laboratory Technician | MLT | Technician | | | |
| Phlebotomy Technician | PBT | Technician | 1990 | | |
| Gynecologic Cytologist | CTgyn | Technologist | | | |
| Qualification in Biorepository Science | QBRS | Qualification | 2020 | | |
| Qualification in Donor Phlebotomy | QDP | Qualification | | | |
| Qualification in Apheresis | QIA | Qualification | | | |
| Qualification in Cytometry | QCYM | Qualification | 1993 | 2017 | |
| Qualification in Immunohistochemistry | QIHC | Qualification | 1994 | | |
| Qualification in Lab Informatics | QLI | Qualification | 2003 | 2017 | |
| Qualification in Laboratory Safety | QLS | Qualification | | | |
| Qualification in Laboratory Compliance | QLC | Qualification | 2003 | Yes | |
| Qualification in Point of Care Testing Evaluator | QPOCTE | Qualification | 1997 | Yes | |

### Accreditation agencies

The following lists the eligible programs under accreditation agencies
* National Accrediting Agency for Clinical Laboratory Sciences (NAACLS)
** Medical Laboratory Technician/Medical Laboratory Scientist
** Histotechnician/Histotechnologist
** Cytogenetics
** Diagnostic Molecular Science (can sit for the Technologist in Molecular Biology exam)
** Pathologists' Assistant
** Phlebotomy
** Clinical Assistant (can sit for the Medical Laboratory Assistant exam)
* Commission on Accreditation of Allied Health Education Programs (CAAHEP)
** Cytotechnologist
** Specialist in Blood Banking
* Accrediting Bureau of Health Education Schools (ABHES)
** Medical Laboratory Technician