Clinical Microbiologists, also known as Medical Microbiologists, now form part of the set-up of most clinical microbiology laboratories in the developed world. They are generally very well qualified people, most possessing a medical degree as well as post-graduate clinical and pathology fellowships. Thus they are not stupid, eccentric maybe, but not completely daft.

Their job description is sometimes difficult to define (I should know…). They are generally not clinicians, although they have a lot of clinical knowledge, nor are they technicians although again they know a lot about what happens on the benches.

They are essentially “inbetweeners”.

So what exactly is the role of a clinical/medical microbiologist?

This of course varies depending on the type of laboratory and/or hospital you work in but I think the following should apply to and define all clinical/medical microbiologists:

• Interfacing: Being able to form and strengthen the critical link between the laboratory and the clinician. This is not just about being a “result messenger”, but more importantly being able to communicate the importance/non-importance of specific results to the clinicians and along the same lines, being able to highlight the importance of particular samples to the scientists, so that time and energy can be focused.
• Optimise use of antibiotics and the control of microbes within institutions: Better known as anti-microbial stewardship and infection control, which most clinical/medical microbiologists get involved with to a greater or lesser extent.
• Ensure clinical appropriateness of testing: Ensuring that the tests being offered by the microbiology laboratory are the best that can be offered within the given budget, are the most clinically appropriate, and are utilised sensibly and appropriately by requestors. Clinical/medical microbiologists should also be responsible for filling in gaps in the microbiology testing profile of a laboratory and for getting rid of tests that are no longer current or best practice.
• Guide the future direction of laboratory: Being able to outline where the microbiology laboratory needs to be in the future in terms of equipment, testing strategy and profiles offered, expected turnaround times etc.

Unlike clinicians with a list of patients, or microbiology scientists with a batch of tests, clinical/medical microbiologists may not have a lot of pre-determined tasks sitting waiting for them when they arrive at work in the morning. Thus a high degree of self motivation is necessary to address some of the “less than concrete” objectives above on a daily basis. This can be difficult when you are tired or under the weather, and at such times it can be easier when your day is mapped out for you….

Clinical/medical microbiologists overlap considerably with Infectious Diseases physicians in terms of their knowledge, but at the same time it is important to acknowledge that each group also possess distinctive skill sets. Will the “inbetweener” speciality of clinical/medical microbiology survive the automation of the microbiology laboratory? For my sake, I hope so, but it is important that the profession is able to accurately define itself, so that it can continue to fill a niche, and to serve a useful purpose.

Michael