Classification: Position Paper
Replaces “Levels of Practice Position Paper” and “Model Career Ladder”, which were retired on June 30, 2022
Status: Approved June 30, 2022

Introduction / Background

The provision of clinical laboratory services requires the coordinated efforts of a variety of personnel. These personnel span the education continuum from high school through medical school and acquire degrees and certifications with which to appropriately deliver services. Many clinical laboratories lack a well-defined career ladder or appropriate defined practice levels that consider education, experience, and performance expectations for all levels of the continuum. With the ongoing challenges of a limited workforce, it is important to provide options for laboratory practitioners to grow and advance in their workplace to encourage retention in the profession and to ensure that appropriate skill levels are utilized in providing high quality, cost-effective services. The following models are recommendations for consideration by educators, practitioners, and laboratory leaders.


The Levels of Practice Model (Appendix A) The development of this model by an inter-organizational task force is described in the Levels of Practice White Paper1. The model focuses on and clarifies the levels of practice to ensure effective and efficient utilization of available personnel (e.g., associate degree practice skills in blood bank and microbiology).

Key components of the Levels of Practice model include:

  • Clear differentiation of levels of practice based on education, certification, and experience.
  • Affirmation of the importance of certification and verified competency at all levels of practice.
  • Definitions of the practice skills that should be taught and can be expected of practitioners at each level. In settings where practice levels are not well differentiated, the model provides descriptions of specific practice skills to better differentiate the levels.
  • A practice level-based career ladder from entry level positions through the clinical doctorate utilizing technical practice skills, education, and certification.

The Model Career Ladder (Appendix B) provides laboratory leaders and their supporting human resource departments the framework for implementing a career advancement program appropriate for the setting, size, and scope of the specific laboratory. In addition, the model career ladder provides current and prospective medical laboratory professionals specific criteria for how they can advance or move laterally to expand their knowledge and experience in their chosen profession. The use of a defined career ladder within the laboratory setting improves practitioner engagement, recruitment, and retention. A defined career ladder also supports succession planning and promotes fairness in how open positions or promotions are awarded.

Key components of the Model Career Ladder include:

  • Clear differentiation of professional roles based on education, certification, and performance characteristics.
  • Affirmation of the importance of education, certification, and verified competency at all levels of practice.
  • Career advancement program that includes emphasis on performance characteristics (e.g., service, professional involvement, and leadership skills).

While the two models share many similarities, they can be distinguished with the use of behavioral traits in the career ladder and the use of technical skills in the levels of practice.

Position Statements

  1. Personnel standards should be defined and prescribed for all levels of practice to ensure the validity of laboratory tests and the safety of patients.
  2. Levels of practice should be defined and differentiated to guide educational curricula and employment decisions.
  3. A career ladder for laboratory professionals should be supported and promoted.
  4. Every position included in the model career ladder contributes to quality patient care.
  5. Mentoring and ongoing education are important elements in supporting professional growth.
  6. National certification should be required.


  1. Levels of Practice White Paper

Related Documents

  1. ASCLS Scope of Practice and Personnel Standards position paper
  2. Standardizing the Professional Title of Medical Laboratory Professionals position paper
  3. ASCLS Body of Knowledge
  4. ASCLS Entry Level Curriculum


Appendix A: Levels of Practice (PDF)

Appendix B: Career Ladder (PDF)