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Registration

**LATEST NEWS: As of the second half of 2009 it has become evident that registration of medical scientists is either unlikely or will take some considerable time ie more than 10 years, to achieve. Scientific associations are now examining a self regulated certification system.

REGISTRATION OF MEDICAL SCIENTISTS

A background document to facilitate discussion written by Andrew St John & Tony Badrick, June 2006

What is Registration and What Does it Do?

Registration is a process that is designed to oversee the standards of a professional group. Currently across Australia there is no Registration of medical scientists, which contrasts with the situation in the UK, USA and NZ. In NZ, Registration was introduced following some significant errors in laboratories. The cost of Registration might be the order of $200 per annum.

Specifically the aim of Registration is as follows:

  • Protection of the public
  • Protection of title
  • Producing competent practitioners
  • Register of competent practitioners
  • Employment of registered practitioners

For an individual the benefits of Registration are the following:

  • A statement of competence
  • Validation of education and training
  • Continuing assessment of competence
  • Code of conduct

The public can see the benefits of Registration as the following:

  • Protection by ensuring health care is delivered by registrants in a professional, safe and competent way
  • Upholding the standards of practice within the profession
  • Maintain confidence in the profession

Why Consider Registration Now?

There are a number of issues which are prompting the profession to consider registration now of which four are briefly discussed below. This is not intended to be a complete list and the purpose of circulating this document widely is to obtain a more comprehensive view including those that are against the process of registration.

The first issue to prompt discussion of registration are staff shortages amongst the medical workforce. This has been discussed at various recent AACB and RCPA meetings and prompted the Productivity Commission report on the Healthcare Workforce. While it has focussed on the shortage of Pathologists there is also a concern about recruiting competent scientists in certain areas of the industry. The recent talk by Peter Flett on population demographics at the Cairns AACB meeting would suggest that these problems of recruitment are likely to get worse.

While the causes of a shortage of qualified and capable scientists within the industry include demographic ones but there is also the lack of a defined career path for non-medically qualified scientists when one compares it to that of medically-qualified personnel ie pathologists. As a consequence, medical science is seen as a career which is unattractive and inadequately recompensed. Of course, defining a better career path will have many steps of which Registration might just be one.

A second issue concerns the impact of accreditation and quality systems on laboratories. Until now the emphasis has been on ensuring that adequate equipment and systems are in place to ensure quality. There are limits to what can be achieved with the latter approach and future quality systems are likely to place greater emphasis on the capabilities of the staff of the laboratory ie whether they have the correct qualifications, appropriate experience and are enrolled in regular professional development. Such systems are largely in place for medically qualified staff but not for scientists, despite the fact that they produce the majority of the output. Once again Registration would involve scientists meeting all of the above requirements.

A third broad issue which needs to be debated in relation to Registration, relates to the role of the medical scientist in the future. This includes how scientists will interact with pathologists, particularly if there is a shortage of the latter. Will there be a need to define more clearly between the managerial responsibility, performed by the scientist, and clinical governance which will be the role of the pathologist? If that is the case then there are two possible consequences. One, there are likely to be fewer of such principal scientists in the future. Second, they will require more management skills and less of analytical chemistry (in the case of biochemists). While the projection of needing fewer “scientists” in the future might cause alarm, there will undoubtedly be benefits of having a more clearly defined management role than at present. If scientists are to achieve the latter they will clearly have to show they are fit for the task, of which Registration will again be one component.

A fourth factor is that there is the potential for change in the Registration process. Currently it is necessary for a profession to be registered in each jurisdiction throughout Australia which means lobbying each State and Territory government to have separate legislation. This is a long and tedious process. However the Productivity Commission on Medical Manpower has as one of its recommendations that there be one Registration Board for medical professionals across Australia. This may not be implemented but it is likely that there will be reform and Registration may be easier in the future.


How Do We Go About Obtaining Registration Now?

A consultant needs to be engaged to map a pathway through the bureaucratic maze. There have been recent successful registrations of sonographers and it is believed that currently radiation technologists and going through the process. So even if the Productivity Commission recommendations do not get accepted there is hope that medical scientists can obtain Registration.

It would be foolish to seek registration of clinical biochemists and therefore seeking registration of clinical or medical scientists should be done in association with AIMS. The process will be a long one and will include establishing a Registration Board and defining qualifications etc. Given the potential time involved it is essential that it is started as soon as possible but it is also important that the issues are widely understood by the profession.