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Cervical cytology and histology laboratory health professionals

There are three different health professional groups that make up the team that provides laboratory services for cytology and histology laboratories that process cervical smears and cervical biopsies for the NCSP. They have protected titles and are registered with New Zealand registration authorities under the Health Practitioners' Competency Assurance Act (HPCA):

  • Medical Laboratory Technicians (MLT) are required to undergo a minimum two years practical training in-house, and at the conclusion sit the NZ Institute of Medical Laboratory Science (NZIMLS) Qualified Medical Laboratory Technicians examination (QMLT) in Medical Cytology. The examination consists of a theory paper and a practical screening exam. MLT's are registered with the Medical Laboratory Science Board (MLSB).
  • Medical Laboratory Scientists (MLS). There are two health professional groups that are registered with the MLSB as MLS.
    • Medical laboratory scientists that undertake a four-year BMLSc degree. The fourth year is laboratory based and cytology may be taken as one of two major papers. A logbook and theory examination is sat for each major. Once the degree is completed and the MLS is registered, they are issued with an interim practicing certificate (IPC) and are supervised working in a laboratory (e.g. cytology) for a minimum of six months until they are signed off for a number of core competencies. The practitioner is then granted an annual practicing certificate (APC).
    • Scientific officers are mostly hospital based and required to hold post-graduate qualifications e.g. MSc, PhD. They are often involved in research.
  • Pathologists (cyto and histopathologists) are medical doctors who have specialised in anatomical pathology and sat specialist examinations after a minumim of five years post-graduate training. They are registered with the NZ Medical Council (MCNZ).

Pathologists and MLS's are required to participate in CPD/CME programmes provided by professional bodies, and external quality assurance programmes.  Laboratory assistants (LA) are not registered and do not require any particular qualifications. LA's are not involved in specimen testing but undertake support roles mainly associated with sample preparation.

A newly qualified health professional registered as a MLS and wanting to practice cytology, is required to undertake and pass the Vocational Registration Programme in Cervical Cytology (VRPCC). A minimum number of smears have to be screened along with slide test sets, theory questions, and completion of a logbook and workbook. The VRPCC will take up to 12 months to complete and may be used to gain an APC. The VRPCC is administered by the National Gynae Cytology Training School based at Canterbury Health Laboratories, Christchurch.

All registered cytology staff have a major role in the screening and reporting of cervical smears. A pathologist reports abnormal cervical smears. Histology processing of tissue samples is complex and prepared by technicians and scientists for reporting by pathologists. Scientists and pathologists are also responsible for quality assurance, teaching, management and other laboratory and multidisciplinary activities. MLT’s work under supervision by MLS and pathologist staff. The cytologist screen detects abnormal pre-cancerous cell changes, which are then confirmed and graded by histology, for treatment by colposcopy, preventing the development of cancer.

Standards in medical laboratories

NZ cervical cytology and histology medical laboratories are accredited with International Accreditation New Zealand (IANZ). Every threee to four years IANZ along with the NCSP will visit the laboratory for a full accreditation along with interim annual surveillance visits. Accreditation is ISO15189 in conjunction with standards in Chaper five, Providing a Laboratory Service, of the NCSP Operational Policy and Quality Standards.

Responsibilities for cytology and histology laboratory health professionals

There are currently 22 NCSP OPQS standards for cervical cytology and histology laboratories, which cover activities for:

  • specimen preparation and processing
  • screening and reporting of cervical smears
  • reporting of cervical smears and histology cervical biopsies
  • minimum and maximum cervical smear volumes for laboratories and individual practitioners
  • internal quality control and external quality assurance
  • staff qualifications, experience, educational activities and ongoing competencies.

The following websites provide information on registration authorities, professional bodies, accreditation bodies and educational insititutes:

Registration bodies:

Professional bodies:

Accreditation bodies:

Educational institutions: