This portion of the website contains information about the legislative framework that directs medical laboratory technologists’ (MLT) practice. Ontario laws related to the regulation of health professions are administered by the Ministry of Health (MOH) and apply to all regulated health professions. The regulatory Colleges, such as the CMLTO, are statutory entities developed under provincial law. These laws direct the College to develop and maintain other legal requirements including By-laws and Standards of Practice. 

Provincial laws & legislation governing medical laboratory technologist

The Regulated Health Professions Act, 1991 (RHPA) and Medical Laboratory Technology Act, 1991

As one of Ontario’s self-regulated health professionals, MLTs are governed by the Regulated Health Professions Act, 1991 (RHPA). The RHPA protects the public’s right to safe, competent, and ethical health care. A College’s role and their authority, is set out in this act, along with the Health Professions Procedural Code, which is Schedule 2 to the RHPA. To access the RHPA, click here: Regulated Health Professions Act, 1991 (RHPA) 

For more information consult the College of Physiotherapists of Ontario’s videos about the RHPA: Understanding the Regulated Health Professions Act

Each profession also has its own statute, which for MLTs is the Medical Laboratory Technology Act, 1991 (MLT Act). The profession-specific act defines a profession’s scope of practice and the controlled acts that are authorized to the profession. For access to the Medical Laboratory Technology Act, 1991, click here: Medical Laboratory Technology Act, 1991, S.O. 1991, c. 28 (ontario.ca).


Requirements

Also, there are regulations made under the RHPA and the MLT Act. These regulations include the requirements for:

  • annual registration renewal
  • entry to practice, 
  • quality assurance, and 
  • professional misconduct. 

Also, there are regulations made under the RHPA and the MLT Act. These regulations include the requirements for:

Regulations ensure that a health profession’s unique needs and circumstances are addressed, while being regulated under the same statutory framework as all other regulated health professions. The MLT Act defines an MLT’s scope of practice, restricted title, and access to authorized acts. Please see below for further information on each: 

MLT Scope of Practice

The MLT Act defines the scope of practice for a MLT as follows:

  1. The practice of medical laboratory technology is the performance of laboratory investigations on the human body or on specimens taken from the human body and the evaluation of the technical sufficiency of the investigations and their results. 1991, c. 28, s. 3.
Controlled Acts

Health professionals may be authorized to perform one or more controlled act(s). Under the RHPA, no profession has a monopoly over any of the controlled acts. This regulatory structure allows for evolution in professional scopes of practice, and is emulated in other provinces in Canada and other jurisdictions around the world. In the Medical Laboratory Technology Act, 1991, the controlled act authorized to MLTs is:

  1. In the course of engaging in the practice of medical laboratory technology, a member is authorized, subject to the terms, conditions and limitations imposed on his or her certificate of registration, to take blood samples from veins or by skin pricking. 1991, c. 28, s. 4. 

Also, its important to note that MLTs may only complete the controlled act in certain conditions. The MLT Act states:

  1. (1) A member shall not perform a procedure under the authority of section 4 unless the procedure is ordered by a member of the College of Physicians and Surgeons of Ontario or the Royal College of Dental Surgeons of Ontario or by a prescribed person. 1991, c. 28, s. 5 (1); 1997, c. 9, s. 5.

Controlled acts may only be performed by health professionals in their practice if its authorized to them, if the controlled act is delegated to them by a health professional who is authorized to perform it, or if an exemption exists. Delegation of controlled acts and medical directives are often discussed together because they are both tools used to facilitate interprofessional care. MLTs could be asked to implement medical directives, such as for reflex testing, or be delegated the authority to perform a controlled act, such as releasing test results to a patient. MLTs could also potentially delegate the controlled act of phlebotomy, which is authorized to them. For more information about delegation consult CMLTO’s guidelines webpage here

Restricted Title

The Medical Laboratory Technology Act, 1991 defines the restricted title of a MLT as follows:

  1. (1) No person other than a member shall use the title “medical laboratory technologist”, a variation or abbreviation or an equivalent in another language. 1991, c. 28, s. 9 (1)

“As of Right” Applicants

In accordance with Ontario Regulation 198/23 of theMedical Laboratory Technology Act, 1991 (MLT Act), a person registered as a Medical Laboratory Technologist (MLT) with a regulatory authority in a Canadian jurisdiction other than Ontario is exempt from subsection 9 (1) and (2), Restricted titles, if they meet all the conditions outlined in the regulation.

For more information on the “As of Right” registration pathway, please refer to Registration Committee Policy 23: Applicants Registered in a Canadian-Regulated Jurisdiction available here

MLTs are expected to understand and comply with the professional, legal, and ethical requirements governing their practice. This includes all applicable Provincial statutes and regulations, such as:

Federal statutes and agreements, such as:

Personal Information and Protection of Electronic Documents Act, 2000 – Canada’s federal privacy legislation, applies to personal information

CMLTO DIRECTIVES GOVERNING MEDICAL LABORATORY TECHNOLOGISTS 

The CMLTO has developed extensive directives intended to guide and support the MLT practice. Please consult the resources below for more information. 

  • The CMLTO By-Law: Under the regulatory authority from the Regulated Health Professions Act, 1991 and the Medical Laboratory Technology Act, 1991, the CMLTO is empowered to make by-laws relating to the administrative and internal affairs of the College
  • The CMLTO Standards of Practice: the CMLTO Standards of Practice defines professionalism in the practice of medical laboratory technology and an ethical registrant shall adhere strictly not only to the guidelines, but also to the underlying spirit and precepts. To access the CMLTO Standards of Practice, click here: Standards of Practice (PDF)
  • The CMLTO Code of Ethics: the Code of Ethics defines the professional and personal expectations of all MLTs. To access the CMLTO Code of Ethics, click here: The Code of Ethics / Code de déontologie des technologistes de laboratoire médical (PDF) 

Have any further questions about an MLTs legal obligations? Please consult our most commonly asked FAQs below: 

Frequently asked questions

What is the scope of practice for a cytotechnologist?

Medical laboratory technologists (MLTs) share a common scope of practice and are individually accountable both to the employer and to the CMLTO for their conduct and for ensuring that they have the knowledge, skill and judgment to practice safely. Employers may provide an MLT with education and training to enable an MLT to practice in areas that fall outside the speciality(ies) included on the MLT certificate of registration. MLTs are accountable to their employer and the College for their conduct and professional practice. The employer is also accountable for an MLT practising outside the speciality(ies) listed on their certificate of registration.

If a new molecular technique is being introduced in a microbiology laboratory, can an MLT with microbiology on his/her registration perform the test?

An MLT may do this provided they have the necessary knowledge, skills, and judgement. 
Specific laboratory techniques, and as such, an individual MLT’s ability to perform them are independent from the speciality on their certificate of registration. Under the Medical Laboratory Technology Act, 1991, all MLTs have the same scope of practice. If an MLT has the knowledge, skills, and judgement to perform a new technique safely and competently, then there is nothing inhibiting them from doing so.  However, facility policies and training need to be considered and supervision of the individual would be a facility-specific management/staff decision based on the individual MLT’s knowledge, skills, and judgement in the area they are working in.

As a patient process improvement initiative, my facility has asked if an MLT could take vital signs along with drawing blood from a patient.

An MLT may do this provided they have the necessary knowledge, skills, and judgement.
The legislative and regulatory framework in Ontario enables MLTs to learn and perform new tasks if certain conditions are first met. For tasks involving legislative authority (such as ordering laboratory tests) or authorized acts (such as communicating a diagnosis), medical directives and delegation need to be used. Please refer to the medical directives and delegation (link to appropriate page) section of the CMLTO website for further information.

For tasks that do not involve legislative authority and do not pose a risk of serious bodily harm, such as taking vital signs, an MLT must ensure they have and maintain the necessary knowledge, skills, and judgement to perform the task safely and comply with relevant facility policies prior to undertaking the task. 

What can or needs to be done to enable reflex testing in the laboratory?
While ordering laboratory tests is not an authorized act in Ontario, and hence does not require a formal delegation, it is a legislated authority restricted to certain regulated health professionals. Authority for ordering laboratory tests is described by the Laboratory and Specimen Collection Centre Licensing Act, 1990. For an MLT to perform reflex testing in the laboratory, which involves automatically performing specified additional tests in defined circumstances, a medical directive needs to be developed following established institutional policies and protocols.

Can an MLT release results directly to a patient?

Communicating a diagnosis is an authorized act under the Regulated Health Professions Act, 1991 (RHPA). Releasing test results directly to a patient is a form of communicating a diagnosis, an act which is not authorized to MLTs. Under the RHPA, it is possible to delegate a controlled act. To delegate a controlled act, a whole series of activities need to be undertaken including, but not limited to:

  1. Having a regulated health professional who does have access to the specific controlled act (as defined by their discipline specific act) agree to delegate this act, following their own Colleges guidelines and/or regulations related to delegation (if there are any), and most importantly to take responsibility for the delegation. 
  2. Developing, usually through the local institutions (in the case of hospitals this is often done through the Medical Advisory Committee (MAC)), specific policies related to delegations and medical directives. An excellent resource to understand this process better has been developed by the Health Profession Regulators of Ontario (HPRO) can be accessed at Home | HPRO (regulatedhealthprofessions.on.ca)
  3. Having an individual (regulated or not) who accepts the delegation, and through the process of training, education and assessment develops and maintains the knowledge, skills and judgement to perform the specific procedure safely. In the case of a regulated health professional, this must be done in accordance with any regulations and guidelines developed by their regulatory body. 

The CMLTO supports the underlying precepts of the RHPA, including the ability to safely delegate the performance of a controlled act so that patients receive the most appropriate care, from the most appropriate health professional.