IS CLINICAL BIOLOGY MORE IMPORTANT OR DIFFICULT THAN DENTISTRY?

http://www.ifcc.org/index.asp?cat=Publications&scat=eNewsletter&suba=September/October_2006&subx=IS_CLINICAL_BIOLOGY_MORE_IMPORTANT_OR_DIFFICULT_THAN_DENTISTRY_&zip=1&dove=1&zona=full&numero=&aq=1

Contributed by Xavier Fuentes-Arderiu, Member IFCC News Working Group and President of the Catalan Association of Clinical Laboratory Sciences.

The European Communities of Clinical Chemistry (EC4) states that the training to be a specialist in clinical chemistry and laboratory medicine must involve at least 4 years dedicated post-graduate study, following a comprehensive and appropriate university education of at least 5 years in biochemistry, biology, chemistry, medicine or pharmacy (1).

Looking to another university health professions, in the case of dentistry the European Parliament and the Council of the European Union states that the basic training to be dental practitioner shall comprise a total of at least five years of full-time theoretical and practical study given in a university or under the supervision of a university (2).

The paragraphs above suggest that clinical chemistry and laboratory medicine is more important (or difficult) than dentistry. I wonder who of us − the university professionals of clinical laboratory − really thinks that our work is more difficult or more important that the work of a dentist?

In my opinion, dentistry is a good example of a well-designed university degree within the health sciences and, regarding duration, it might be taken as model for the training in clinical biology.

The above short digression is just a preamble to the following comment about the current EC4 recommendation on educational standards required to enter the professional field of clinical chemistry and laboratory medicine in the European Union.

In order to avoid misunderstandings, I will define the two disciplines corresponding to the two professional activities I am going to comment:

clinical biology: branch of health sciences that is concerned with the in vitro examination of biological properties of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, treatment of disease in, or the assessment of the health of, human beings, by means of chemical or biological techniques (3)

NOTE 1: The term clinical biology is used in this text because it is the "stateless" English designation given in the Council Directive 93/16/EEC (4) for this discipline and speciality.

NOTE 2: The literal translation to English of the official designation of this speciality in the different European Union countries having it is (4): clinical analyses (Spain), clinical biology (Belgium and Luxembourg), clinical pathology (Italy and Portugal), diagnostic laboratory (Poland), laboratory medicine (Estonia and Lithuania), medical biology (Austria and France), and medical laboratory diagnostics (Hungary).

NOTE 3: Clinical biology is called clinical laboratory science(s) in many universities and scientific publications, especially in, but not restricted to, the United States of America (5).
biological chemistry: branch of clinical biology that is concerned with the in vitro examination of chemical and biochemical properties of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, treatment of disease in, or the assessment of the health of human beings, by means of chemical or biological techniques

NOTE 1: The term biological chemistry is used in this text because it is the "stateless" English designation given in the Council Directive 93/16/EEC (4) for this discipline and speciality, although the term clinical chemistry is worldwide used.

NOTE 2: The literal translation to English of the official designation of the medical speciality in the different European Union countries having it is (4): biological chemistry (Luxembourg), clinical chemistry (Finland, Netherlands and Sweden), chemical pathology (Ireland, Malta and United Kingdom), clinical biochemistry (Czech Republic, Denmark, Italy, Slovakia and Spain), medical biochemistry (Slovenia) and medical and chemical diagnostic laboratory (Austria).

Also it is advisable to define the generic job I will write about:

professional [of clinical laboratory]: person working in a clinical laboratory and who have legal capacity for sign out clinical laboratory reports and who is eligible to act as director of a clinical laboratory

NOTE 1: "Professional" is the generic name used in the standard for accreditation ISO 15189:2003 (6). This term is applicable as much for the generalist (polyvalent) professionals dealing with any type of clinical laboratory examination as for the specialised ones (clinical biochemist, clinical microbiologist, etc.).

NOTE 2: Depending on the country, the generalist (polyvalent) professional has different names: clinical analyst, clinical biologist, clinical laboratory scientist, clinical pathologist, etc.

.....

I do not doubt that the postgraduate system of education is good for medical and surgical specialities, but I am convinced that it is not the most appropriate system of education for the field of clinical biology and related disciplines. Thus, I conclude that clinical biology should be an independent university degree at the same academic level as biology, chemistry, dentistry, medicine or pharmacy, and biological chemistry (clinical biochemistry) should be a PhD degree awarded after the degree in clinical biology.

As clinical biology is simultaneously a branch of biology, chemistry, medicine and pharmacy, in order to avoid discriminations and other conflicts, it is better to classify it as a branch of health sciences rather than a branch of medicine.