What Does a Medical Laboratory Technologist Actually Do? A Day in My Life as an MLT in Canada

 If you tell someone you're a Medical Laboratory Technologist, there's a good chance they'll ask you what exactly you do.

Most people know that we work in a hospital laboratory, but beyond that, the job is surprisingly unfamiliar to people outside healthcare.

If you've never worked in a hospital laboratory, you might imagine that an MLT spends the entire day putting blood tubes into machines and releasing results.

That's not really how it works.

I've been working as a Medical Laboratory Technologist in a Canadian hospital for about 9 years, and I work primarily in hematology and coagulation. One thing I actually like about my job is that I'm not necessarily doing the same thing every day.

We rotate between different benches, so what I work on can be quite different depending on the day.

One day I might be responsible for CBC (Complete Blood Count) testing, another day I'm working in routine coagulation, and another day I might be doing investigative coagulation, morphology, or even bone marrow work.

So what does that actually look like? 👀

On a 🩸CBC bench, a large part of the work involves running and reviewing complete blood counts. The analyzer generates results, but the MLT isn't simply looking at the numbers and pressing "release."

We review analyzer flags, look for results that require further investigation, and determine whether additional testing or a peripheral smear is needed.

For 🧪routine coagulation, I am responsible for releasing 

• PT/INR
• aPTT
• fibrinogen
• D-dimer
• anti-Xa tests
• Mixing studies

Coagulation is particularly interesting because pre-analytical factors can have a major impact on results. Something as simple as an incorrectly filled citrate tube can affect testing. I won't bore you with the details.

🔬 Investigative Coagulation 

Investigative coagulation is where things become much more detective-like.

When routine coagulation results don't make sense or suggest a more complicated problem, additional testing may be performed to investigate what's happening.

One example would be investigating why a patient would have a prolonged aPTT result. Is it the factor deficiency? Specific or non-specific inhibitor? It could be many different things!

The tests include factor assays, lupus anticoagulants, VWD screen, HIT (Heparin induced thrombocytopenia) assays, and many more.

🔬 Morphology

We review peripheral blood smears as well as body fluids (CSFs, peritoneal fluid, synovial fluid, and many more!) under the microscope and send the abnormal slides for hematopathologist's review.

I love looking under the microscope and seeing different RBC and WBC morphology.

Unfortunately, there are many sick patients in my hospital and we often see blasts, lymphoma cells, sickle cells, and even malarial parasites sometimes.

🦴 Bone Marrow

Another area I rotate is bone marrow bench. As an MLT, I do NOT examine bone marrow slides but instead prepare them for hematopathologist's review. This involves setting up the stainer, spreading and staining bone marrow aspirate and biopsy slides, then physically delivering the slides to the doctor.

One job, but very different kinds of work 😉

This is probably one of the things I appreciate most about working in hematology.
I can spend one day reviewing hundreds of CBC results, another day troubleshooting coagulation results, and another day spending much more time looking at individual cells under the microscope.

The work can be repetitive at times, but the actual problems you're solving can be very different from one day to the next.