Training In Clinical Chemistry Research Articles

In Memoriam: Edward W. Bermes, Jr., PhD, FAACC (1932-2021).

Dr. Edward W. Bermes, Jr., PhD, FAACC, passed away peacefully at home on February 16, 2021, following a long-term illness. He was born in Chicago, Illinois on August 20, 1932. He received his BS in Chemistry from St. Mary’s College in Winona, MN, followed by a MS and Ph.D. in Biochemistry from Loyola University of Chicago (LUC). In 1958, he was appointed Chief Biochemist at Cook County Hospital. On receiving his doctoral degree in 1959, he was appointed Assistant Professor of Biochemistry in LUC’s Stritch School of Medicine (SSOM). During the 1960s, he served as Director of Biochemistry at St. Francis and West Suburban hospitals. In 1969, he was promoted to Associate Professor of Biochemistry and Pathology. Also at that time, he led the creation of a laboratory for a hospital opening on LUC’s new medical center campus (LUMC) in Maywood, IL. By then, Dr. Bermes had become an excellent teacher and welcomed more teaching opportunities. At St. Francis Hospital, he had developed a predoctoral clinical biochemistry program. He codirected it with Dr. Hugh McDonald, Chair of LUC’s Department of Biochemistry and Biophysics. Dr. McDonald was also a charter member and Past-President of AACC (1954). It was challenging to find sites to provide clinical experience for predoctoral trainees until the opening of LUMC, which also became the location for creation of a postdoctoral fellowship program in clinical chemistry. Initially funded through a NIH grant, the postdoctoral program was approved by the American Board of Clinical Chemistry in 1972. Dr. Bermes’ devotion to postdoctoral training led to his serving on the Commission on the Accreditation of Clinical Chemistry Training Programs Board of Directors, and as its president for 8 years. During his career, he trained thousands of students of medicine, graduate schools, medical technology, and clinical laboratory science as well as residents and fellows in pathology, clinical chemistry, and other disciplines. In 1983, his dedication to teaching was recognized with his receiving AACC’s Award for Outstanding Contributions in Education and Training.

Data Never Lie

Approximately 2 years ago, I started my training in clinical chemistry at Boston Children's Hospital. A colleague at the hospital once said something that will always stay with me: “let the data tell you.” With a steep learning curve ahead of me and a finite number of hours in a day, I found myself getting up at 5:30 am to go to the gym to have the only hour of sanity throughout my day. As an avid long distance runner, I use my FiBit HR to monitor my heart rate to obsessively assess my progress. After the morning respite, I usually have challenging days on the mass spectrometer …

Medical Biochemistry as Subdiscipline of Laboratory Medicine in Serbia.

SummaryMedical biochemistry is the usual name for clinical biochemistry or clinical chemistry in Serbia, and medical biochemist is the official name for the clinical chemist (or clinical biochemist). This is the largest sub-discipline of the laboratory medicine in Serbia. It includes all aspects of clinical chemistry, and also laboratory hematology with coagulation, immunology, etc. Medical biochemistry laboratories in Serbia and medical biochemists as a profession are part of Health Care System and their activities are regulated through: the Health Care Law and rules issued by the Chamber of Medical Biochemists of Serbia. The first continuous and organized education for Medical Biochemists (Clinical Chemists) in Serbia dates from 1945, when the Department of Medical Biochemistry was established at the Pharmaceutical Faculty in Belgrade. In 1987 at the same Faculty a five years undergraduate study program was established, educating Medical Biochemists under a special program. Since the academic year 2006/2007 the new five year undergraduate (according to Bologna Declaration) and four-year postgraduate program according to EC4 European Syllabus for Postgraduate Training in Clinical Chemistry and Laboratory Medicine has been established. The Ministry of Education and Ministry of Public Health accredited these programs. There are four requirements for practicing medical biochemistry in the Health Care System: University Diploma of the Faculty of Pharmacy (Study of Medical Biochemistry), successful completion of the professional exam at the Ministry of Health after completion of one additional year of obligatory practical training in the medical biochemistry laboratories, membership in the Serbian Chamber of Medical Biochemists and licence for skilled work issued by the Serbian Chamber of Medical Biochemists. In order to present laboratory medical biochemistry practice in Serbia this paper will be focused on the following: Serbian national legislation, healthcare services organization, sub-disciplines of laboratory medicine and medical biochemistry as the most significant, education in medical biochemistry, conditions for professional practice in medical biochemistry, continuous quality improvement, and accreditation. Serbian healthcare is based on fundamental principles of universal health coverage and solidarity between all citizens.

Clinical Chemistry Residency Training Program at the Oklahoma University Medical Center.

At the University of Oklahoma Health Sciences Center Department of Pathology, we view excellence in training in clinical chemistry as an important element of our highly regarded clinical pathology residency training program. Over the years, this program has evolved into essential components that overall have proven to be most effective in producing high-quality clinical pathologists. These components are described below. ### Clinical Chemistry Training Overview Our chemistry resident teaching rotation consists of 14-week blocks (Table 1) that span 3 separate months of training in chemistry as well as other areas of the automated core laboratory, including phlebotomy, specimen processing and receiving, point-of-care testing, toxicology, endocrinology, hematology, coagulation, urinalysis, and specimen referral testing. The 3 separate months include introductory training (first-year residents), intermediate training (second-year residents), and advanced training (third- and fourth-year residents) in an effort to make our program progressive and therefore consistent with Accreditation Council for Graduate Medical Education (ACGME) (1) accreditation requirements. This progressive training “journey” allows a resident to gradually assume the role of a fully competent Laboratory Director. View this table: Table 1. Topics covered in a 14-week clinical chemistry residency training. The textbooks used for the chemistry rotation are The Professional Practice in Clinical Chemistry: A Review (2), Contemporary Practice in Clinical …

A STAR-Document for those interested in evaluating diagnostic research studies.

First, let me disclose that the Standards for Reporting Diagnostic Accuracy Studies (STARD) 2003 statement was published and endorsed by Clinical Biochemistry (1). Second, I will also disclose that I was doing my training in clinical chemistry during that time and I did not truly appreciate the importance of this document. Quite the omission, considering the Editor-in-Chief of Clinical Biochemistry at that time was also my supervisor.

The EC4 European Syllabus for Post-Graduate Training in Clinical Chemistry and Laboratory Medicine: version 4 – 2012

Laboratory medicine's practitioners across the European community include medical, scientific and pharmacy trained specialists whose contributions to health and healthcare is in the application of diagnostic tests for screening and early detection of disease, differential diagnosis, monitoring, management and treatment of patients, and their prognostic assessment. In submitting a revised common syllabus for post-graduate education and training across the 27 member states an expectation is set for harmonised, high quality, safe practice. In this regard an extended 'Core knowledge, skills and competencies' division embracing all laboratory medicine disciplines is described. For the first time the syllabus identifies the competencies required to meet clinical leadership demands for defining, directing and assuring the efficiency and effectiveness of laboratory services as well as expectations in translating knowledge and skills into ability to practice. In a 'Specialist knowledge' division, the expectations from the individual disciplines of Clinical Chemistry/Immunology, Haematology/Blood Transfusion, Microbiology/ Virology, Genetics and In Vitro Fertilisation are described. Beyond providing a common platform of knowledge, skills and competency, the syllabus supports the aims of the European Commission in providing safeguards to increasing professional mobility across European borders at a time when demand for highly qualified professionals is increasing and the labour force is declining. It continues to act as a guide for the formulation of national programmes supplemented by the needs of individual country priorities.

Education and Recognition of Professional Qualifications in the Field of Medical Biochemistry in Serbia

Education and Recognition of Professional Qualifications in the Field of Medical Biochemistry in Serbia Medical biochemistry is the usual name for clinical biochemistry or clinical chemistry in Serbia, and medical biochemist is the official name for the clinical chemist (or clinical biochemist). This is the largest sub-discipline of the laboratory medicine in Serbia. It includes all aspects of clinical chemistry, and also laboratory hematology with coagulation, immunology, etc. Medical biochemistry laboratories in Serbia and medical biochemists as a profession are part of Health Care System and their activities are regulated through: the Health Care Law and rules issued by the Chamber of Medical Biochemists of Serbia. The first continuous and organized education for Medical Biochemists (Clinical Chemists) in Serbia dates from 1945, when the Department of Medical Biochemistry was established at the Pharmaceutical Faculty in Belgrade. In 1987 at the same Faculty a five years undergraduate branch was established, educating Medical Biochemists under a special program. Since school-year 2006/2007 the new five year undergraduate (according to Bologna Declaration) and postgraduate program of four-year specialization according to EC4 European Syllabus for Post-Gradate Training in Clinical Chemistry and Laboratory Medicine has been established. The Ministry of Education and Ministry of Public Health accredits the programs. There are four requirements for practicing medical biochemistry in the Health Care System: University Diploma of the Faculty of Pharmacy (Study of Medical Biochemistry), successful completion of the profession exam at the Ministry of Health after completion of one additional year of obligatory practical training in the medical biochemistry laboratories, membership in the Serbian Chamber of Medical Biochemists and licence for skilled work issued by the Serbian Chamber of Medical Biochemists. The process of recognition of a foreign higher education document for field of medical biochemistry is initiated on request by Candidate. The process of recognition of foreign higher education documents is performed by the University. In the process of recognition in Serbia national legislations are applied as well as international legal documents of varying legal importance.

The Greek way to the Register: the establishment and operation of the Register for Clinical Chemists-Clinical Biochemists in Greece

In Greece, there is no officially organized training in clinical chemistry for scientists. The Greek Society of Clinical Chemistry-Clinical Biochemistry (GSCC-CB), following the encouragement of the EC4/RC decided to organize a voluntary Register for specialists in clinical chemistry. The following criteria for registration were defined: 1) University degree in Chemistry, Biochemistry, Biology, Medicine, Pharmacy or other relevant subject. 2) A total of 9 years of university studies and postgraduate specialization in clinical chemistry-clinical biochemistry. 3) A minimum of 4 years of postgraduate specialization in clinical chemistry-clinical biochemistry on the job. 4) The candidate must be practicing clinical chemistry-clinical biochemistry in a laboratory in a medical environment in Greece. The postgraduate specialization in clinical chemistry-clinical biochemistry includes the laboratory training and the theoretical education. The laboratory training is organized by the GSCC-CB according to the Professional Training Dossier. The theoretical education was organized in a series of 18 "Seminars" which was the content of the "Educational program" of the GSCC-CB. Successful completion of the Educational program leads to a Certificate of Competence. The Greek Register has gained equivalence with the EC4 Register and it has 218 members, more than 80 of whom are European clinical chemists.

The organisation of an educational program for specialists in clinical chemistry by the Greek Society of Clinical Chemistry-Clinical Biochemistry

In Greece, there is no officially organized training in clinical chemistry for scientists. The Greek Society of Clinical Chemistry-Clinical Biochemistry decided to organize an intensive educational program of 18 seminars on clinical chemistry content as it is described in the EC4 Syllabus. The duration of each seminar was about 6 hours and consisted of 6 to 9 lectures. At the end of each seminar there was a voluntary written examination, comprised of 24 multiple choice questions. Successful completion of the Educational program was leading to a Certificate of Competence. Two cycles of the 18 seminars were performed: 1st cycle from October 2003 to December 2005 and 2nd cycle from March 2005 to October 2007. One hundred eighty nine colleagues was the mean attendance per seminar for the seminars of the 1st cycle and 38 colleagues for the seminars of the 2nd cycle. The mean participation to the examination for each seminar was almost 80% for the 1st cycle and 68% for the 2nd cycle. More than 80% of the participants performed Good or Very good in the examination in both cycles. It is estimated that more than 40% of the scientists who practice Clinical Chemistry in Greece, participated to this educational activity. This program is now provided as an e-learning application, and it is open for all scientists who want to follow the discipline of clinical chemistry.

Resident Training in Clinical Chemistry

Practicing clinical chemists responded to an anonymous, open-ended questionnaire designed to define the state of clinical chemistry education in pathology training programs in the United States. Survey respondents identified many ideas for educational improvements and offered criticism regarding aspects of clinical chemistry education that are not working particularly well. Many of these findings are generalizable to other subspecialties of clinical pathology. It is hoped that this analysis will allow readers to compare their programs with national trends and identify new ways of improving clinical chemistry training at their institutions.

Guidelines for resident training in veterinary clinical pathology. II. Hematology

The Education Committee of the American Society for Veterinary Clinical Pathology (ASVCP) identified a need for improved structure and guidance in training residents in clinical pathology. To begin to meet this need, guidelines for training in clinical chemistry were published in 2003. The goal of this report is to define learning objectives and competencies in hematology, including coagulation and immunohematology. These guidelines were developed and written with the input of ASVCP Education Committee members and peer experts. The primary objectives of training in hematology are: 1) to accrue a thorough, extensive, and relevant knowledge base of the types, principles, and properties of hematology tests and concepts of pathophysiology in animals; 2) to develop abilities to reason, think critically, communicate effectively, and exercise judgment in hematologic data interpretation and investigative problem-solving; and 3) to acquire technical and statistical skills important in hematology and laboratory operations. We also provide options and ideas for training activities and identify hematology resources useful for clinical pathology faculty and staff, training program coordinators, and residents. The guidelines define expected competencies that will help ensure proficiency, leadership, and the advancement of knowledge in veterinary hematology and provide a useful framework for didactic and clinical activities in resident-training programs. The learning objectives can readily be adapted to institutional and individual needs, interests, goals, and resources.

EC4 European Syllabus for Post-Graduate Training in Clinical Chemistry and Laboratory Medicine: version 3 – 2005

The EC4 Syllabus for Postgraduate Training is the basis for the European Register of Specialists in Clinical Chemistry and Laboratory Medicine. The syllabus: Indicates the level of requirements in postgraduate training to harmonise the postgraduate education in the European Union (EU); Indicates the level of content of national training programmes to obtain adequate knowledge and experience; Is approved by all EU societies for clinical chemistry and laboratory medicine. The syllabus is not primarily meant to be a training guide, but on the basis of the overview given (common minimal programme), national societies should formulate programmes that indicate where knowledge and experience is needed. The main points of this programme are: Indicates the level of requirements in postgraduate training to harmonise the postgraduate education in the European Union (EU); Indicates the level of content of national training programmes to obtain adequate knowledge and experience; Is approved by all EU societies for clinical chemistry and laboratory medicine. Knowledge in biochemistry, haematology, immunology, etc.; Pre-analytical conditions; Evaluation of results; Interpretations (post-analytical phase); Laboratory management; and Quality insurance management. The aim of this version of the syllabus is to be in accordance with the Directive of Professional Qualifications published on 30 September 2005. To prepare the common platforms planned in this directive, the disciplines are divided into four categories: Indicates the level of requirements in postgraduate training to harmonise the postgraduate education in the European Union (EU); Indicates the level of content of national training programmes to obtain adequate knowledge and experience; Is approved by all EU societies for clinical chemistry and laboratory medicine. Knowledge in biochemistry, haematology, immunology, etc.; Pre-analytical conditions; Evaluation of results; Interpretations (post-analytical phase); Laboratory management; and Quality insurance management. General chemistry, encompassing biochemistry, endocrinology, chemical (humoral), immunology, toxicology, and therapeutic drug monitoring; Haematology, covering cells, transfusion serology, coagulation, and cellular immunology; Microbiology, involving bacteriology, virology, parasitology, and mycology; Genetics and IVF.

Education and training in clinical chemistry in the EU: Lessons from the experiences

This paper describes the history of FESCC (Forum of the European Societies of Clinical Chemistry and Laboratory Medicine), the actual fields of major activities and the key issues in Europe. The mission of FESCC is to support and promote clinical chemistry in Europe, to aid interactions with IFCC (International Federation of Clinical Chemistry), to develop education and quality in the discipline and to encourage young scientists to take an active role in these activities. The total quality systems in medical and clinical laboratories and accreditation of these laboratories is gaining more and more interest. Laboratory specialists are confronted with a new way of thinking concerning the management and the daily practice of their laboratories. Particularly in the European Union (EU), harmonization of criteria for quality systems is desirable. The freedom of movement and goods within the EU has a large impact for the member states. FESCC launched surveys in Europe on accreditation of medical laboratories and training with special attentions to postgraduate education of the profession. A second survey was launched to gather more information about the managerial situation of the specialists in clinical chemistry in Europe. The harmonization of the profession in one of the challenges for the European specialists in clinical chemistry and for FESCC a major task. Factors defining the future of laboratory medicine are treated.

Postgraduate training programs in veterinary clinical pathology in the United States and Canada (1998 to 2002).

Residency and graduate programs in veterinary clinical pathology provide specialized training for board certification and are important pathways to careers in clinical pathology diagnostics, teaching, and research. Information about training opportunities is useful for assessing disciplinary needs, outcomes, and changes, garnering program support, and providing objective data for program evaluation by faculty, trainees, and prospective applicants. The goals of this study were to 1) compile detailed information on the number and types of postgraduate training programs in veterinary clinical pathology in the United States and Canada, 2) describe the goals, activities, strengths, and weaknesses of the programs, 3) assess the desirability of program accreditation and program standards, 4) identify supplemental training opportunities, and 5) evaluate changes in programs, trainees, and faculty 4 years later. In July 1998, the American Society for Veterinary Clinical Pathology Education Committee sent a survey to representatives at the 31 schools and colleges of veterinary medicine in the United States and Canada and 31 diagnostic laboratories, private hospitals, and pharmaceutical companies. Survey data were compared with updated information obtained from training program coordinators in November 2002. Survey response rate was 94% for universities, 39% for nonuniversity institutions, and 66% overall. In 1998, there were 20 clinical pathology training programs, including residencies (n=10) and graduate programs combined with residency training (n=10), with 36 total training positions. In 2002, there were 25 training programs (14 residencies, 11 combined), with 52 total positions. The median faculty:trainee ratio was 2.0 in both years. Of 67 faculty members involved in training in 1998, 57 (85.1%) were board-certified in clinical pathology and 53 (79.1%) had DVM/PhD degrees. Net faculty numbers increased by 17 (25.4%) but the median per institution remained at 3.0. Primary program goals were 1) eligibility for and successful achievement of board certification in clinical pathology by the American College of Veterinary Pathologists, 2) proficiency in laboratory diagnostics, and 3) contemporary basic or applied research training. Many programs cited research opportunities, caseloads, and training in hematology and cytology as strengths. Program weaknesses included insufficient funding, too few faculty, and limited training in clinical chemistry and laboratory operations/quality assurance. Trainees completing programs within the past 5 years (n=70) were employed in academia (28.6%), diagnostic laboratories (32.9%), and industry (18.6%). For trainees completing programs between 1999 and 2002 (n=38), these percentages were 52.6%, 21.1%, and 7.9%, respectively. Most (62.5%) respondents supported program standards and accreditation, and 76% supported board review sessions for trainees. Opportunities for postgraduate training in veterinary clinical pathology increased between 1998 and 2002, with 5 new programs and 16 new training positions. These additions and the increased emphasis on diagnostic proficiency, efforts to strengthen training in clinical chemistry and quality assurance, and continuation of combined PhD-residency programs will help address the perceived need for increased numbers of qualified clinical pathologists in academia, diagnostic laboratories, and industry.

The management of clinical laboratories in Europe: a FESCC survey. Forum of the European Societies of Clinical Chemistry and Laboratory Medicine.

The professional duties of the specialists in clinical chemistry differ from country to country in Europe. One of the main goals of the Strategic Plan of the Forum of the European Societies of Clinical Chemistry and Laboratory Medicine (FESCC; IFCC-Europe) is to promote a high scientific and professional standard in the field of clinical chemistry and laboratory medicine in Europe. This can be stimulated by the knowledge of the local conditions in each country and by striving towards a strong and harmonised position in all the European countries. In order to enhance the knowledge of the managerial situation of the specialists in clinical chemistry in Europe, FESCC launched a survey in September 2000. This survey provides information about the position of the specialists in clinical chemistry in the various disciplines in the medical laboratories and in hospitals, and about the advisory tasks and the managerial education during the post-graduate training in clinical chemistry. Of the 35 FESCC member countries 33 have participated in the survey (94%). The results show a rather heterogeneous situation in Europe caused by the local historical developments, the differences in academic background and the relative numbers of private and physicians' office laboratories. Large differences exist between the European countries in the disciplines of laboratory medicine that are headed by a specialist in clinical chemistry. In the different countries the clinical chemistry laboratories are headed by specialists in clinical chemistry in between 20% and 100% of the laboratories. The haematology, immunology, microbiology, therapeutic drug monitoring, molecular biology and haemostasis laboratories and departments of blood banking are headed by specialists in clinical chemistry in between 0% and 100% of the laboratories. The responsibilities for the various managerial tasks of the specialists in clinical chemistry show no uniformity in Europe. In the majority of the countries the general management, the purchase of equipment and reagents and the education of technicians are in >90% the responsibility of the specialists in clinical chemistry. In most countries the majority of the specialists in clinical chemistry are members of the medical staff of the hospitals and have a position equivalent to the position of specialists in other medical disciplines. In some countries, however, it only holds true for the specialists with a medical background. In 79% of the countries the law regulates the profession of the specialists in clinical chemistry and in 60% of the countries the law regulates their position in the medical staff of the hospital. The advisory tasks to physicians, general practitioners and other users of laboratory tests are practised by >90% of the laboratories in 64% of the countries. Information is given directly to the patients by >90% of the laboratories in 30% of the countries. Only in a few countries laboratories give information to the public. The post-graduate training in clinical chemistry includes a managerial training in 58% of the countries, the study of information technology in 61% of the countries and an economy and/or a business administration study in 15% of the countries. In 27% of the countries no managerial education forms part of the post-graduate study in clinical chemistry. Harmonisation of the managerial aspects of the profession is one of the challenges for the European specialists in clinical chemistry. A European syllabus for post-graduate training could be helpful.

FESCC survey on accreditation and post-graduate training in clinical chemistry in European countries. Federation of European Societies of Clinical Chemistry.

Promotion of the professional growth and development of specialists in the field of clinical chemistry in European countries, and harmonisation of quality assessment and accreditation procedures are listed among the main goals and activities of Federation of European Societies of Clinical Chemistry (FESCC), according to its 1999-2000 strategic plan. The European countries that are members of the European Union are in the process of establishing the "European Register for Clinical Chemists", based on minimum standards of education, training and experience as defined by the European Communities Confederation of Clinical Chemists (EC4). Many other European countries would like to adapt their system of professional education to this model. Data on post-graduate training in EC4 FESCC members have already been gathered in 1998. However, at the present time, there is no detailed knowledge of pre- and post-graduate professional education of specialists in clinical chemistry in the non-EC4 European countries. FESCC launched a survey in July 1998 in order to gather this information with the hope to start a database about existing systems. All FESCC members received the same questionnaire on accreditation (seven questions) and non-EC4 FESCC members received an additional questionnaire with 11 questions related to post-graduate training in clinical chemistry. The response rate of the 35 FESCC member countries was 93% from the 15 EC4 members (14 responses/15 countries) and 80% from the 20-non-EC4 (16 responses/20 countries). The heterogeneity of the data on post-graduate training in clinical chemistry indicates that a great effort will be needed before harmonisation is reached. These results, however, will provide an interesting basis for further discussion and promotion of post-graduate training in clinical chemistry. The data provided on accreditation show that the total number of accredited laboratories was relatively low in EC4 countries and even lower in non-EC4 members. It was not surprising to see that the number of accredited laboratories was the highest in the two countries which started accreditation the earliest (i.e. Sweden and UK, 1992). This situation, however, is changing at a fast rate in most countries and the number of the accredited sites is expected to increase rapidly in the next few years.

Changes in Academic Productivity: Implications for Clinical Laboratory Research and Development

A recent report from the Council of Scientific Affairs of the American Medical Association indicated that the introduction of managed healthcare had a substantially negative influence on the academic productivity of clinical faculty in academic health centers (1). Consistent with this finding is the observed change in the number of scientific abstracts presented during the Annual Meeting of the AACC (2). As can be seen, over the last 4 years there has been a substantial 30% decrease in the number of abstracts received and accepted from all sources, including academia and industry (Fig. 1⇓ , A and B). This decline does not correlate to a change in the abstract rejection rate, which has remained relatively constant (∼20%) since 1992 (Fig. 1C⇓ ). Figure 1. Indicators of AACC academic productivity from 1992 through 1999. Comparison of abstract volume ( A and B ) and abstract acceptance rate ( C ) for the AACC annual meetings with student participation ( D ), COMACC-approved clinical chemistry training programs …

EC4 European Syllabus for Post-Graduate Training in Clinical Chemistry. Version 2 – 1999

Abstract In modern medicine the undeniable value and indispensability of scientific investigations are now universally recognized both for diagnostic purposes and monitoring of disease and in basic epidemiology. The direct treatment of patients is an undeniable task of doctors in medicine. Progress in laboratory science is largely the result of contributions by scientists with an adequate education and specialisation in the field, i.e. by clinical chemists. Clinical laboratory science has developed on a broad front throughout the European Community, resulting in significant differences in what constitutes a national clinical chemistry service in each state. Clinical chemistry is the medical discipline devoted to obtain, explore and employ chemical knowledge and chemical methods of investigation, in order to procure knowledge about normal and abnormal chemical processes in man. These processes are studied on a general level, in order to get insight into human health and disease, and on a patient-specific level for diagnostic or monitoring purposes. The delimitation of clinical chemistry varies from country to country, since there is no sharp boundary to haematology, immunology, molecular biology and microbiology. One of the main tasks of the clinical chemist is direction and supervision of a laboratory department in a hospital or health service (public or private), where his role involves bridging the gap between rapidly developing laboratory science and technology and the growing knowledge on characteristics of disease. He must possess fundamental biochemical knowledge and have the ability to use this knowledge most appropriately as applied to clinical requirements, i.e. diagnosis of disease and planning and monitoring of therapy. Apart from providing a competent laboratory service, the clinical chemist must be able to function as a consultant to his clinical colleagues and liaise with them in the interpretation of laboratory results. His advice and professional consultation have at least three aspects, i.e. choosing the most appropriate laboratory investigation in a certain case, ensuring that the analyses are performed in the best possible way and correctly reported and, finally, providing information and (most important) interpretation on the significance and consequences of the laboratory data obtained. As the results of laboratory investigations and the consultation of the clinical chemist have a direct and important influence on the treatment of the patient, it is to the benefit of the public that the profession of the clinical chemist is duly regulated.

Clinical biochemistry education in Spain

Clinical biochemistry in Spain was first established in 1978 as an independent speciality. It is one of several clinical laboratory sciences specialities, together with haematology, microbiology, immunology and general laboratory (Clinical analysis, análisis clinicos). Graduates in Medicine, Pharmacy, Chemistry and Biological Sciences can enter post-graduate training in Clinical Chemistry after a nation-wide examination. Training in an accredited Clinical Chemistry department is 4 years. A national committee for medical and pharmacist specialities advises the government on the number of trainees, program and educational units accreditation criteria. Technical staff includes nurses and specifically trained technologists. Accreditation of laboratories is developed at different regional levels. The Spanish Society for Clinical Biochemistry and Molecular Pathology (SECQ), the national representative in the IFCC, has 1600 members, currently publishes a scientific journal ( Quimica Clinica) and a newsletter. It organises a continuous education program, a quality control program and an annual Congress.

External quality assessment of Jordanian clinical chemistry laboratories.

A two-year study using inter-laboratory surveys has been carried out to assess the analytical quality of Jordanian clinical chemistry laboratories. The study surveyed greater than 65% (60 laboratories) of Jordanian laboratories using 18 control specimens and covering a total of 15 analytes. Close agreement was obtained between the consensus values and the designated values for analytes which had mean values within the normal range, whereas significantly lower consensus values were obtained for glucose, creatinine, bilirubin and urea in the pathological range. Considerable interlaboratory variation was observed in Jordan relative to EQA schemes in other countries. This study highlighted several problems in Jordanian laboratories, and stressed the need for a national EQA scheme with an effective means of providing continuous advice, education and training in clinical chemistry.