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While cytotechnologists are professionals who are trained to perform cytodiagnosis as well as screening, they spend most of their effort screening cytological preparations. While cytopathologists are physicians who are trained to perform screening as well as diagnosis, they spend most of their efforts in cytopathology making or confirming diagnoses. The ill-advised Final Rule, which revises laboratory regulations for the Clinical Laboratory Improvement Act of 1967 regarding cytology proficiency testing of individuals, which was issued by the Health Care Financing Administration in March 1990, groups cytotechnologists and cytopathologists together for testing purposes. I believe that proficiency testing (if required) should test individuals primarily on what they do. To hold cytotechnologists to the same standard as cytopathologists in the Bethesda system of diagnosis with a potential of "sudden death" loss of their livelihood following a single, unannounced, on-site cytology proficiency test by some government bureaucrat poses yet another severe
Lundberg GD. Cytotechnologists' Proficiency and Laboratory Regulations-Reply. JAMA. 1990;264(15):1946. doi:10.1001/jama.1990.03450150043018