Distinguishing between certification, licensure and membership in a national professional society is a challenge that has been around probably as long as our profession has existed. With the merger of the Board of Registry (BOR) and the National Credentialing Agency (NCA) certification entities, there is more confusion than ever among the general lab professional community, and it's more critical than ever to understand the difference.

For years, many have believed that their certification or license also made them a member of the professional societies the American Society for Clinical Pathology (ASCP) or the American Society for Clinical Laboratory Science (ASCLS).

What Is Certification?
Certification for us as laboratory professionals is a voluntary process, meaning the person decides on their own to take some examination from some recognized national certification entity to put initials after their name, showing they've gone through a formal program of education and achieved a passing grade on the exam.

Some people use the term interchangeably with words like "licensed" and "member." It is not a license or a membership; it is a credential.

There is nothing, legally, that requires an employer to hire only those individuals who are certified. Thankfully, most clinical lab employers recognize that doing what we do requires more than just a warm body at the bench, and do, as a company policy, require someone to have proof of having passed a national certification exam before hiring them.

It nonetheless becomes very evident to my own students, who at their clinical rotation sites, never took the exam and yet are still employed, sometimes even at the same salary level as certified personnel. It has become a previously never-imagined scenario that I have to convince my seniors to crown their years of study by getting those initials after their names. Employers are not helping matters by hiring them as "certification-eligible", but then not imposing a deadline and/or firing them if they do not comply.

In the United States, there are three entities which provide national certification exams. Largest is the Board of Certification (BOC), formed through the 2009 merger of the Board of Registry and the National Certification Agency (NCA).

The American Medical Technologists and the American Association of Bioanalysts also offer exams to medical technologists. The latter two automatically make anyone they certify become members of their professional society. This is not the case with the BOC. For BOC certificants, professional society membership is not automatic, and your certification is never tied to society membership. When you pay for certification, you are paying for that alone. BOC certification does not equal membership in any professional society.

What Is a License?
A license is a mandatory requirement imposed by a state. Think of it in terms of those licenses with which you are already familiar: driving a car, getting married, going hunting/fishing. These are all state-controlled processes. There is no such thing as a national license as this is not allowed by our U.S. Constitution. Limiting the ability of individuals to work by requiring a license is a states' rights issue.

As of this writing, the only states where it is illegal to work as a lab professional without a state license include California, Florida, Nevada, Tennessee, Georgia, Hawai'i, Louisiana, North Dakota, Rhode Island, Montana, West Virginia and New York. In addition, the Commonwealth of Puerto Rico has a licensure requirement.

If you do not work in one of those states, you cannot say you have a license, as no such personnel law exists in your state. All of these licensure states require you to pass some type of examination before being granted a license. That examination may be the "national certification" one, accepted in lieu of the state developing its own state licensure exam. But it's the license which gives you the right to work as a clinical lab professional in that state.

Professional Society Membership
There are three concepts that are central to understanding the difference between certification, licensure and membership.

1. Automatic: Nothing about professional society membership is automatic. Joining a professional society is a personal choice based not only on "what's in it for me," but "how can I influence the future of my profession?" Joining a professional society is like joining a club. You see what the group has to offer, see if you agree philosophically with the mission and vision of the group, envision eventually influencing the future of the group in a leadership capacity, and pay dues that will be used to attain the group's (and now your) goals.
   In the best clubs, your voice and desires for the group are represented at all meetings, you have the ability to choose who will lead the group, and you can aspire to be that leader, yourself. All of these things have to be considered when choosing to which national professional society you will send your hard-earned money.
   Notice that I have mentioned nothing about certification or licensure as a part of that choice. Obtaining certification/licensure through an exam or continuing education is completely and totally separate from being a member of a professional society. Becoming certified/licensed as a medical lab scientist/technician will never be automatically connected to professional society membership in ASCLS or ASCP. Certification/licensure is not a "membership benefit." Membership is not a "certification/licensure benefit."
2. Choices: There are about 30 different national clinical laboratory professional societies in the United States today. That number should not be surprising, given the vast variety inherent in our body of knowledge. As Americans, we shop around for what will "fit" us best. We do it for clothing, cars, entertainment and food. It is not realistic to expect anything less when it comes to something to support our career. Things to look for in choosing a national professional society would include:
   • Efforts focused primarily on the non-physician lab professional as an independent practitioner within our profession while also being at the forefront of collaboration with other healthcare professionals.
   • Governed by non-physician lab professionals, where each member (including students) gets a direct voice and a direct vote for his/her membership dues.
   • A governance structure in each state and region, including local communities, so as to maximize communication and professional interactions.
   • Focus on patient advocacy with legislators, towards needs of educators, and for the continuing education needs of its members.
3. Job Versus Career: Certification/licensure gives you the right to do your job. Professional society membership gives you the opportunity to build an independent career. So, the bottom line is:
   • You cannot be a member of the BOC since that entity is not a professional society.
   • It is not required to be a member of any professional society to maintain your BOC certification.
   • Being certified/licensed without being a member of a professional society is like having a cell phone but never being connected to a network. Choose a professional society that will give you the greatest value for the dues spent--advocacy, continuing education, and a direct vote. For my money, that is the American Society for Clinical Laboratory Science.

TABLE: DIFFERENCES BETWEEN CERTIFICATION AND LICENSURE