Demystifying the DCLS degree

It’s been a little over a decade since the first student was accepted into a Doctor of Clinical Laboratory Science (DCLS) program in 2014. Although the DCLS is still relatively new, graduates with this unique degree already are making an impact in clinical laboratories, healthcare settings, and private industry.

“One of ADLM’s organizational values is to enable diverse laboratory teams and empower them to improve population health,” said Association for Diagnostics & Laboratory Medicine (ADLM) President Paul Jannetto, PhD, DABCC, FADLM, MT(ASCP). “Laboratory scientists play an important role, including graduates of DCLS programs. These professionals really exemplify the highest ideals of laboratory medicine.”

What is a DCLS?

The DCLS is a doctoral-level degree that focuses on increasing the value of diagnostics. Healthcare professionals with a DCLS are qualified both to conduct research and serve on interprofessional healthcare teams. As of 2024, DCLS degree-holders also are board-eligible and qualified as CLIA high-complexity laboratory directors.

The key difference between a DCLS and other advanced laboratory degrees is that DCLS graduates don’t solely work in laboratories. They’re also part of patient care teams that collaborate closely with clinicians to order and interpret tests, thereby accelerating and enhancing clinical practice.

As part of their training, DCLS students complete a residency in which they participate in clinical rounds in healthcare settings. “As a result, they gain a holistic view of multidisciplinary care teams within the healthcare system,” said Jannetto. The experience enables them to help bridge the gap between laboratory science and clinical practice.

Four institutions now offer DCLS programs: Rutgers University (the first to offer the degree), the University of Texas Medical Branch, the University of Kansas, and the University of Cincinnati. More universities are working toward adding them in the future.

Why was the DCLS created?

The degree was created with two goals in mind: to reduce medical errors and to address critical laboratory personnel shortages.

According to the National Academy of Medicine, between 210,000 and 400,000 preventable patient deaths occur in United States hospitals each year, many of which are caused by laboratory errors. A 2023 study in the Journal of Patient Safety found that 77.1% of diagnostic-testing errors happen in the preanalytical phase, 13.5% in the analytics phase, and 8% in the postanalytical phase. Human error is the most frequent cause, playing a role in 58.7% of cases.

The DCLS degree gives non-physician laboratory scientists a valuable opportunity to directly impact patient care, particularly by giving them more influence over the preanalytical phase. “They can update clinicians in real time as to why a test got rejected, or guide them in collecting samples properly, so they’re not hemolyzed," said Jannetto. They also can counsel clinicians on the right test to use in the first place to prevent inappropriate assays from being ordered, rejected, and then reordered because clinicians didn’t understand the reason behind the initial rejection. “Now a DCLS can be right there to prevent the delay of patient care,” Jannetto added. “These graduates are having immediate impact and value.”

Michael Laposata, MD, PhD, professor of pathology at the University of Texas Medical Branch, helped launch his institution’s DCLS program after observing a need for high-level professionals who were cross-trained in laboratory medicine and patient care. DCLS students get that hands-on experience through their residencies. “We needed people who were clinically trained,” he said. “You wouldn't graduate a surgeon without experience doing surgeries. How are you going to help in the clinical setting if you don't have any training?”

Staffing shortages remain a critical problem for clinical laboratories. Moreover, because older workers — and lab leaders — are retiring without enough staff to replace them, the impact of these deficits reaches even the highest levels. DCLS degrees offer a new pathway to cultivate lab professionals with the experience to take over those jobs.

Amitava Dasgupta, PhD, professor of pathology and laboratory medicine at the University of Kansas Medical Center, sees this as a natural progression in the understanding of who can run a clinical laboratory. He sees a parallel from when he was coming up in his own career. Back then, he was told that medical directors needed to have an MD. However, eventually that changed, and PhDs were considered satisfactory credentials. “Now the Centers for Medicare & Medicaid Services is doing the same thing for DCLS degrees,” Dasgupta said.

What are recent DCLS graduates doing now?

As more DCLS graduates enter the field, they bring their distinctive skills to healthcare settings and industry.

Melody Nelson, DCLS, CC(NRCC), MS, MLS(ASCP), is a clinical assistant professor of pathology and laboratory medicine at the University of Kansas Medical Center and assistant director of the core laboratory at the University of Kansas Health System. Before starting the DCLS program at the University of Kansas, she was a laboratory scientist for about 10 years, and her experience included working as a manager in a core lab that supported a primary healthcare system. She went on to receive her DCLS degree in 2023.

“I saw the value of a consultation-type model where the lab is always within reach,” she said. She had an open-door policy, which led to clinicians coming to her with their ordering questions. That made her realize there “really was an appetite” for someone with a DCLS-level degree.

Nelson’s positive residency experience reinforced to her that she’d made the right decision in pursuing a DCLS, especially when clinicians would consult her during rounds. “I was able to do problem-solving work and liaise between the laboratory and interdisciplinary teams,” she said. She cultivated a deeper understanding of where the lab intersects with patient-care models. “We care about patients, but the way that we care is different than [clinicians] do, and we have to intersect at the right point to not make it a challenge,” she said.

LaShanta Brice, DCLS, MLS (ASCP)SH, graduated with her DCLS from the University of Texas Medical Branch in 2021. She entered the DCLS program after realizing that a traditional doctorate was not the right fit for her. It was a risk, but one that paid off. After working in the clinical laboratory setting for 15 years, she moved to industry. Brice now serves as the scientific engagement and clinical education scientist for Diagnostica Stago.

Much like those in clinical practice, DCLS graduates who go into industry jobs bridge two worlds. “When you look at scientific affairs or clinical affairs roles, oftentimes they don’t have the voice of the laboratorian,” Brice said. “What works in theory may not work in practice.” She too credits doing clinical rounds as part of her education for giving her a unique perspective on laboratory medicine and patient care as a whole.

Brice believes that she was the only candidate with a DCLS when she first began talking to industry employers about job opportunities. In the time since, however, she has noticed other in vitro diagnostic companies listing the DCLS as a qualifying degree for open positions.

How do DCLS graduates contribute to healthcare?

Although there are hurdles for any new degree to overcome before gaining wide acceptance, DCLS graduates have been proving their value with immediate impact in healthcare. “ADLM will continue to support all of our MLS professionals, including DCLS graduates, as we adapt to today’s complex healthcare challenges,” Jannetto said.

In 2024, ADLM formed a DCLS task force to develop strategies to support the integration, advancement, and success of DCLS professionals in laboratory medicine. Kacy Peterson, DCLS, MBA, MLS(ASCP), DLM (ASCP), is currently serving as chair of the task force. “We are one laboratory community, and the task force is working to bring additional visibility to the unique value DCLS add to the laboratory medicine team,” Peterson said.

Brice doesn’t see the DCLS and PhD as competing degrees. Rather, she views them as working together like a seesaw. For example, her colleague, a PhD biochemist, does a lot of laboratory theory, which complements Brice’s practical focus. “My job on the seesaw is to balance some of that theory and say ‘that works in theory, but not in practice’ or ‘this does not work in theory and we need to tweak it before we commercialize it,’” she said.

As more DCLS graduates enter the field, they forge connections that are greatly needed right now, said Laposata. For example, when analyzing results, they can look beyond simple measures such as blood count, electrolytes, and common proteins to assess how those values fit together and inform the bigger picture. “We need people who can look at those lab test values and say, ‘Whoa, this cancer patient has congestive heart failure,’” Laposata said. “That link has been missing for 40 years.”

Jen A. Miller is a freelance writer who works in Audubon, New Jersey. +bluesky: @byjenamiller.bsky.social