Clinical pathologist in Korea--training program and its roles in laboratories.

A rapid development of practice of laboratory medicine in Korea owes its success to the clinical pathologists (CP), who have played a role of a pathfinder for laboratories. The Korean CP postgraduate education (residency) program is unique in that it is exclusively for laboratory medicine. The training program for clinical pathologists includes diagnostic hematology, diagnostic immunology, clinical microbiology, clinical chemistry, blood bank, diagnostic genetics, informatics and laboratory management. The program has produced a strong group of about 600 laboratory physicians, officially clinical pathologists since 1963. Most of Korean clinical pathologists work as laboratory directors, directors of university hospital laboratories or teaching faculty members in medical schools. The roles of clinical pathologists are laboratory management, interpretation of laboratory test results, clinical consulting services to clinicians and patients, ordering secondary tests after reviews of requested test results and utilization management. The clinical pathologists have developed clinical laboratories to be a main contributor for improved medical practice. During the last 40 years under the turbulent healthcare system, clinical pathologists have significantly contributed to safeguard the laboratory interests. The education program and the role of clinical pathologists are described.

Three-year experience in using total laboratory automation system.

We implemented a total laboratory automation (TLA) system, currently used in Chungnam National University Hospital (CNUH), designed around the A&T Corporation to perform the general and specific laboratory testing throughout the system in a timely and cost-effective manner. The system consists of two major lines: chemistry and hematology. The analyzers attached to the hematology line include one SE 9000 hematology analyzer (Sysmex Corporation, Kobe, Japan), one SP-100 slide maker (Sysmex), and one R9000 reticulocyte counter (Sysmex). The chemistry line consists of preanalytic system and linked analyzers. The analyzers attached to chemistry line are one Hitachi 747 chemistry analyzer (Hitachi, Ltd., Tokyo, Japan), one A&T 502X analyzer (A&T Corporation, Tokyo, Japan) and one Architect i2000 immunochemistry analyzer (Abbott Diagnostics Division, Santa Clara, USA). The preanaytic system including start stocker, centrifuge, de-cap unit and aliquoting unit were connected with analyzers. The turn around time (TAT) of all tests was shortened in comparison to manual systems. Consequently it makes feasible one-day care clinic and makes reduced inherent errors in sample identification, dispensing, and reporting. In addition, real-time re-run can make test quality more reliable. As many as 12 departments can be reduced to 7 departments. The subsidiary advantages of smaller size were incorporated into reduced working steps facilitating workflow. Overall, better qualified and quicker results can be provided to the clinicians, and proper cost-effectiveness and better quality services can be anticipated as a result of much easier system management and higher reliability. In conclusion, the TLA has been successful within our laboratory.