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TRAINING IN MEDICAL LABORATORY TECHNOLOGY
1365 i
I
i
Jalili, of Baghdad, and I1 investigated this effect by examining 200 blood-samples from patients and from control subjects. Each sample was divided into three portions; the first was kept at room-temperature 24-25°C (75-77°F), the second was placed in a water bath at 37-38°C (99-100°F), and the third in a bath at 44-46°C (111-115°P). All portions were kept at their respective temperatures for 30 minutes, then immediately cooled to room-temperature, and the test done at this
I
temperature. We found that increase in the ambient tempera-
’,
;
M.
ture was
invariably accompanied by an increase in the
E.S.R.
in
165 cases. In cases with low or very high rates the effect of temperature was small (of the order of 2-10 mm.), while in
slightly or moderately increased rates the effect was pronounced (10-35 mm.). With temperatures below 10°C (500F) or above 44°C (111°F) the effect became un-
cases
with
more
and there
was striking increase or decrease in the chart, constructed from these results, is shown in the accompanying figure.
predictable,
rate. A correction
The effect of heat
the E.s.R. should be emphasised in hot is being carried out in hot rooms, and/or the blood-samples are usually exposed to a hot environment during their transport to the laboratory. S. N. SALEM. Emerie Hospital, Kuwait. on
countries where the
test
TRAINING IN MEDICAL LABORATORY TECHNOLOGY on behalf of the Institute of Medical statement SiR,ŇThe Laboratory Technology (Oct. 28, p. 935) resulted in a variety of letters. Some correspondents suggested that the alignment of further education and vocational training for medical laboratory technicians in closer conformity with comparable professions was progressing too rapidly, while others, like Professor Hill and his colleagues and Mr. Gasser and Dr. Woolf (Nov. 11, p. 1044), thought that developments should be more rapid and uniform. The Institute believes that its policy reconciles to the best advantage what is practicable under present conditions in the medical laboratory services with what is recognised as desirable by those aware of the changes taking place in the practice of medical laboratory technology and in the broad area of technical education. Professor Crawford, in his letter (Nov. 11, p. 1043) on behalf of the College of Pathologists, one of the founder members of the joint committee for higher national certificates and diplomas in medical laboratory subjects, misquotes the title of the certificate as one in " medical sciences ". This error conceals the qualification’s emphasis on practical competence. Indeed, the Provisional Notes for the Guidance of Establishments of Further Education on the arrangement of courses for Higher National Certificates and Diplomas in Medical Laboratory Subjects, to which all member organisations of the joint committee subscribe, define the purpose of the new higher national certificates (H.N.C.S) as follows: "
The minimum aims
are to
give
the student
a
sufficient basis of
scientific principles and their applications to ensure that the holders of Higher National Certificates and Diplomas are able to use a wide range of existing medical laboratory techniques with discrimination and understanding, and to be instrumental in the development of new ones ".
The notes continue: Adequate and well planned laboratory work is a most important component of the course and generally the minimum ratio of practical to theoretical work should be 3:2. In the early stages particular attention should be paid to inculcating good laboratory techniques and clear understanding of the principles of quantitative procedures." "
Thus the proportion of practical work in the part-time day or block release courses is greater than the about half " recommended in the College of Pathologists’ " statement of June, 1965" which Professor Crawford quotes. Indeed, it is difficult to identify the points upon which the College differs from the Institute’s policy on H.N.C.S; that these are only minor is indicated 1.
by its wish to participate in the scheme from
Jalili, M. A., Salem, S. N. J. Fac. Med. Baghdad, 1959, 1, 158.
the outset. It is pleasing to note that the College subscribes the hope expressed in the Institute’s statement that " there will be the closest possible consultation and association between medical laboratories and the colleges offering courses for their technicians ". Mr. Kind (Nov. 11, p. 1044) misinterprets our statement in which we say that instruction to new employees in the techniques used in their laboratories "may be given more efficiently by those with pedagogic as well as scientific and technical training, and in 1966 the Institute obtained the collaboration of the Department of Education and Science to promote two pilot courses for laboratory tutors ". Thus there were no grounds for assuming that this laboratory instruction was intended to be given by " teachers in technical institutes ". Dr. Osborn (Nov. 25, p. 1144) invites the Institute to answer three questions. His first is whether " any medical college awards its membership or fellowship for examinations it does not conduct itself". If his intention was to question the Institute’s recognition of O.N.C.s and H.N.C.S for admission to its lower grades of membership and as a means of progress to its own examinations for fellowship, it should be noted that many national certificates were introduced specifically as a route to the higher qualifications of professional bodies. Dr. Osborn’s second question relates to the payment of registration fees as well as subscriptions to a professional institute: in medicine and allied professions there are many examples of this even when the professional society is not a qualifying body, as the Institute continues to be through its responsibilities for national certificate arrangements and its exclusive control of qualifications at the highest level. In his third question, Dr. Osborn asks whether a qualification should be devised for a new and important subject, like cytology, when it emerges. The Institute’s view is that the introduction of a new qualification for a subject is dependent not merely on whether the subject is important " but also on whether it embodies material requiring sufficient intellectual effort to place the qualification on a par with existing ones. The last paragraph of Dr. Osborn’s letter bears no relation to current needs, either within the profession or among schoolleavers of the calibre required in medical laboratories. Directors of laboratories proclaiming that " Instead of so much dayrelease we should have lectures in our laboratories for an hour on most days " are indeed likely to experience difficulty in maintaining the numbers of technicians on their staff and, like Dr. Osborn, may have to appoint those whose driving force fails to match their intellectual capacity and who prefer " to take an easier course at a teachers’ training college ". There seems to be every reason for confidence that the new courses will yield a standard of technical competence at least as good as before, as well as a high degree of versatility that could result only from a scientifically sound education. Doubtless this will be an important consideration for the Medical Laboratory Technicians Board of the Council for Professions Supplementary to Medicine when it considers the new qualifications in relation to statutory registration. to
"
T. S. LANSLEY Chairman, Institute of Medical Laboratory Technology.
PSYCHIATRIC REFERRALS SIR,-It is a custom for some psychiatric departments to ask patients on their first attendance to bring a relative or friend with them. It seems to me that this is often quite inappropriate and can cause a great deal of anxiety and difficulty for the patient. For personal reasons, the last people he wishes to inform that he is having a psychiatric consultation may be his relatives and friends. I am disputing not the value of an informant’s history as part of a psychiatric assessment but only the insensitivity of requesting this as a routine procedure at a first attendance. Student Health Association, University College London, C. J. LUCAS. London W.C.1.
I
i
Jalili, of Baghdad, and I1 investigated this effect by examining 200 blood-samples from patients and from control subjects. Each sample was divided into three portions; the first was kept at room-temperature 24-25°C (75-77°F), the second was placed in a water bath at 37-38°C (99-100°F), and the third in a bath at 44-46°C (111-115°P). All portions were kept at their respective temperatures for 30 minutes, then immediately cooled to room-temperature, and the test done at this
I
temperature. We found that increase in the ambient tempera-
’,
;
M.
ture was
invariably accompanied by an increase in the
E.S.R.
in
165 cases. In cases with low or very high rates the effect of temperature was small (of the order of 2-10 mm.), while in
slightly or moderately increased rates the effect was pronounced (10-35 mm.). With temperatures below 10°C (500F) or above 44°C (111°F) the effect became un-
cases
with
more
and there
was striking increase or decrease in the chart, constructed from these results, is shown in the accompanying figure.
predictable,
rate. A correction
The effect of heat
the E.s.R. should be emphasised in hot is being carried out in hot rooms, and/or the blood-samples are usually exposed to a hot environment during their transport to the laboratory. S. N. SALEM. Emerie Hospital, Kuwait. on
countries where the
test
TRAINING IN MEDICAL LABORATORY TECHNOLOGY on behalf of the Institute of Medical statement SiR,ŇThe Laboratory Technology (Oct. 28, p. 935) resulted in a variety of letters. Some correspondents suggested that the alignment of further education and vocational training for medical laboratory technicians in closer conformity with comparable professions was progressing too rapidly, while others, like Professor Hill and his colleagues and Mr. Gasser and Dr. Woolf (Nov. 11, p. 1044), thought that developments should be more rapid and uniform. The Institute believes that its policy reconciles to the best advantage what is practicable under present conditions in the medical laboratory services with what is recognised as desirable by those aware of the changes taking place in the practice of medical laboratory technology and in the broad area of technical education. Professor Crawford, in his letter (Nov. 11, p. 1043) on behalf of the College of Pathologists, one of the founder members of the joint committee for higher national certificates and diplomas in medical laboratory subjects, misquotes the title of the certificate as one in " medical sciences ". This error conceals the qualification’s emphasis on practical competence. Indeed, the Provisional Notes for the Guidance of Establishments of Further Education on the arrangement of courses for Higher National Certificates and Diplomas in Medical Laboratory Subjects, to which all member organisations of the joint committee subscribe, define the purpose of the new higher national certificates (H.N.C.S) as follows: "
The minimum aims
are to
give
the student
a
sufficient basis of
scientific principles and their applications to ensure that the holders of Higher National Certificates and Diplomas are able to use a wide range of existing medical laboratory techniques with discrimination and understanding, and to be instrumental in the development of new ones ".
The notes continue: Adequate and well planned laboratory work is a most important component of the course and generally the minimum ratio of practical to theoretical work should be 3:2. In the early stages particular attention should be paid to inculcating good laboratory techniques and clear understanding of the principles of quantitative procedures." "
Thus the proportion of practical work in the part-time day or block release courses is greater than the about half " recommended in the College of Pathologists’ " statement of June, 1965" which Professor Crawford quotes. Indeed, it is difficult to identify the points upon which the College differs from the Institute’s policy on H.N.C.S; that these are only minor is indicated 1.
by its wish to participate in the scheme from
Jalili, M. A., Salem, S. N. J. Fac. Med. Baghdad, 1959, 1, 158.
the outset. It is pleasing to note that the College subscribes the hope expressed in the Institute’s statement that " there will be the closest possible consultation and association between medical laboratories and the colleges offering courses for their technicians ". Mr. Kind (Nov. 11, p. 1044) misinterprets our statement in which we say that instruction to new employees in the techniques used in their laboratories "may be given more efficiently by those with pedagogic as well as scientific and technical training, and in 1966 the Institute obtained the collaboration of the Department of Education and Science to promote two pilot courses for laboratory tutors ". Thus there were no grounds for assuming that this laboratory instruction was intended to be given by " teachers in technical institutes ". Dr. Osborn (Nov. 25, p. 1144) invites the Institute to answer three questions. His first is whether " any medical college awards its membership or fellowship for examinations it does not conduct itself". If his intention was to question the Institute’s recognition of O.N.C.s and H.N.C.S for admission to its lower grades of membership and as a means of progress to its own examinations for fellowship, it should be noted that many national certificates were introduced specifically as a route to the higher qualifications of professional bodies. Dr. Osborn’s second question relates to the payment of registration fees as well as subscriptions to a professional institute: in medicine and allied professions there are many examples of this even when the professional society is not a qualifying body, as the Institute continues to be through its responsibilities for national certificate arrangements and its exclusive control of qualifications at the highest level. In his third question, Dr. Osborn asks whether a qualification should be devised for a new and important subject, like cytology, when it emerges. The Institute’s view is that the introduction of a new qualification for a subject is dependent not merely on whether the subject is important " but also on whether it embodies material requiring sufficient intellectual effort to place the qualification on a par with existing ones. The last paragraph of Dr. Osborn’s letter bears no relation to current needs, either within the profession or among schoolleavers of the calibre required in medical laboratories. Directors of laboratories proclaiming that " Instead of so much dayrelease we should have lectures in our laboratories for an hour on most days " are indeed likely to experience difficulty in maintaining the numbers of technicians on their staff and, like Dr. Osborn, may have to appoint those whose driving force fails to match their intellectual capacity and who prefer " to take an easier course at a teachers’ training college ". There seems to be every reason for confidence that the new courses will yield a standard of technical competence at least as good as before, as well as a high degree of versatility that could result only from a scientifically sound education. Doubtless this will be an important consideration for the Medical Laboratory Technicians Board of the Council for Professions Supplementary to Medicine when it considers the new qualifications in relation to statutory registration. to
"
T. S. LANSLEY Chairman, Institute of Medical Laboratory Technology.
PSYCHIATRIC REFERRALS SIR,-It is a custom for some psychiatric departments to ask patients on their first attendance to bring a relative or friend with them. It seems to me that this is often quite inappropriate and can cause a great deal of anxiety and difficulty for the patient. For personal reasons, the last people he wishes to inform that he is having a psychiatric consultation may be his relatives and friends. I am disputing not the value of an informant’s history as part of a psychiatric assessment but only the insensitivity of requesting this as a routine procedure at a first attendance. Student Health Association, University College London, C. J. LUCAS. London W.C.1.