Saturday, February 12, 2011

Quality Control: An analysis of the Velezian Med Tech - Yesterday, Today and the Future

Celestron 44104 500x Power Advanced Biological MicroscopeThis is a piece made by a fellow Velez College medical technology alumnus Keith Andrew Chan which I first read in the Velez College BSMT grads Facebook group which I decided to re-post with the author's permission of course. This is in response to a challenge question posed by Mr. Deogracias Delfin of what quality control means.

To the active contributors on the page, my sincerest and deepest thanks to you all for making us remember what truly matters - that a Velez Med tech is one by heart, that the ideals that we have learned and stand for will never leave us regardless of whether we work as med techs or have pursued other professions and that we are a symbol of the undying vision that we are scientists that are forever seeking the truth with utmost dignity, honor and pride- we are the Velez Med Tech.

My name is Keith Andrew Chan and I am from the (wonderfully "large") med tech batch of 2008 - a massive group of 39 graduates. Along with my sister, I am a second generation Velez Med Tech, after my father, the illustrious Edgar Chan, who graduated in 1977. Many years have passed since the pioneering batch of med techs walked the stage but i am led to believe that, apart from the many advances in automation and breakthroughs in science, not much has changed in the philosophy of the Velez Med. Tech.

I graduated high school in 2004 and applied for only one school: the nature filled park that is our alma mater, Velez college. When asked by my classmates why i didn't decide to go to one of the big 3 schools in Manila to try my hand at a pre - medical course like human biology or genetics, i would always have the right answer ready:

"...kay wala'y entrace exam sa Velez, bai."

Little did i know that Velez had a special entrace exam system of their own that went by it's own name: Third Year Med Tech.

I worked my way through first and second year without event, admittingly, even the dreaded "Human Anatomy and Physiology" course seemed managable in retrospect, given that it was only one of two majors in the ASE curriculum (a.k.a. the curriculum with Health Care for ALL paramedical courses).

By the time I got to 3rd year, everything was pretty much what everyone hyped it up to be: Sleepless nights. Praying you don't fail. Praying even harder you don't fall asleep. Watching groupmates pass out the first time you have that venipuncture exercise. Getting picric acid on your shirt only to explain to your mom that "it doesn't wash off" and eventually having a new uniform made in a week. Getting Hematoxylin and Eosin on it again and NOT telling your mom it doesn't wash off when she eventually finds out it's worse than picric acid and having to get ANOTHER pair. The lunch periods that aren't really lunch but cram fests. All of these may be a blur now, but it makes a lasting impression on you.

If there's anything i remember (fondly), it's the uniqueness of the way tests are conducted in Velez. First, you have the writtens. Then the practicals. Written exams are never made to get perfect on, they're made test if the aptly educated med tech really understands the principle. Or if s/he's simply a drone. An example:

Question 5 ( Clinical Chemistry): Write A if statement 1 is TRUE but 2 is FALSE. Write B if statement 1 is FALSE and 2 is TRUE. Write C if statements 1 and 2 are TRUE but not related by cause and effect. Write D if statements 1 and 2 are TRUE and ARE RELATED by cause and effect.

For the record,  i failed that exam miserably. Another example of the Velez species of exams:

Question 24 (Histopathology): In the boxes below, indicate the solutions that the unfixed tissue must go through and specify the name, concentration, solution class (i.e. mordant, fixative, etc.) and duration of exposure.

Screw up one and it cascades. Not only did we have to get this right, we'd hear the lines "Hoy! Mga students! Basta velez med tech ka, you know the TEST, PRINCIPLE, etc.... (if was too sleepy to listen to the whole thing).

Practical exams were a different story. Here, whatever you learned in lectures, you'd use them. Velez Med techs prided themselves with being able to function for long hours without the use of machines and still produce both precise and accurate results. Practicals expected nothing less of you. From those 10 months of drilling, these are some of the tests that i remember taking. Note that these problems are solved in UNDER 30 SECONDS.

(Hematology)... Load the cell counter WITHOUT overflowing AND do a wbc count.

(Blood bank)... (4 slides) determine blood groups and indicate whether minor or major mismatch

(Clinical Microscopy)... Indicate the principle in labtest strip square indicated AND color of negative and positive results.

(Clinical Chemistry)... (all you see is 3 bottles of reagents) Write full reaction formulas AND indicate wavelength of analysis AND expected color of reactant.

(Microbiology)... Identify organism. (the wonderful Doc Mesola pioneered way of identifying. Hehe)

By the time you blink you hear the God awful *DING*. Oh yeah. Not a moment to say "Darn it!" or any of your favorite four letter words.

Finally, after the entrance exam, you'd get a wonderful 365 days in the laboratory stuck with your friends, your superiors and the experiences you'd carry for a lifetime. Life in the lab was like no other experience you've had before... and before I get carried away with that (which would last me another billion words), I'd just like to share what I have remembered that would eventually change my perception of the Velez Med tech.

As the young (fine, I'll admit it) sometimes lazy individual, you dont really care for the higher principles in the running of a laboratory. Tests were boring. Tedious. Repetitive. No concept of QC would cross your mind. To you, it was all a blur. Plus, you'd wonder why they'd check if your pipettes were clean. If you set the centrifuge on the right speed. If the agar you made was good. The concentration of the saline. Why did they have to redo the long sero procedure? Why did i have to stand in front of an incubator for an hour monitoring the temperature? why did i have to check the refrigeration units every hour? Why did they HAVE to follow the full overnight schedule of manual processing tissue?

You couldn't care less. At least, not until you realize what I did. Someone (I can't seem to remember if it was Mr. Historillo or Dr. Panopio) told me that "... a medical laboratory can offer to the hospital 2 things, and 2 things only - a result and a reputation of integrity. These 2 are intrinsic to each other and go hand in hand. Trust the lab, you trust the result, you treat the patient. The minute a single result goes awry and a patient goes down, the lab goes with it. "

It dawned on me.

The Velez Med tech is skilled, knowledgable, adept and adaptable. We can recite procedures backwards and utter test principles while the test is incubating (Yes, don't tell me none of you mentioned "glucose oxidation", "protein error of indicators", "results lemon." at least ONCE while doing a dipstick test). But most importantly, our trade, our act, our art is dedicated to the integrity, honor and pride of the laboratory. What is quality control? It isn't the standard you run alongside the sample that determine the precision and accuracy of the test. My friends, it is the VELEZ MEDICAL TECHNOLOGIST running the test that makes it precise and accurate.


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