MLT Exam

The MLT exam is a computer-based exam delivered at Pearson Professional Centers. You may take it after you meet one of the ASCP BOC eligibility routes, submit your application and fee, and receive your Admission Notification.

Key Facts About the MLT Exam

The ASCP BOC offers three eligibility routes for US candidates. You must meet all of the requirements of one route.

Route 2 has been discontinued. International candidates apply for the MLT(ASCPi) credential under their own routes and take an exam built on the same content guideline.

Create an ASCP account, complete the MLT application for your route, upload or request the required documentation (transcripts, program completion verification or experience documentation) and pay the fee. When your application is approved, the BOC sends an Admission Notification with your eligibility period. Schedule your appointment at a Pearson Professional Center inside that period; it will not be extended. Bring valid, government-issued photo identification that exactly matches the name on your application. If you need a state license (for example in California, Florida, New York or another licensure state), apply to the state separately after you pass.

The content guideline divides the exam into seven subtests. Questions fall into three kinds: theoretical questions that ask you to apply knowledge, calculate results and correlate results with disease; procedural questions about laboratory technique and quality assurance; and regulatory questions drawn from US sources such as AABB, the FDA and CLIA.

Official Subtests

Donors and blood products, component preparation and storage, blood group systems, antibody detection and identification, compatibility testing, hemolytic disease of the fetus and newborn, immune hemolysis and transfusion practice including transfusion reactions. Covered in Sections 1 and 2.

Physical, chemical and microscopic urinalysis with renal physiology and disease, plus cerebrospinal, serous, synovial, amniotic and seminal fluids and feces. Covered in Section 3.

Carbohydrates, lipids, proteins and nitrogen compounds, enzymes, heme derivatives, electrolytes, blood gases and acid-base balance, endocrinology, vitamins, therapeutic drug monitoring and toxicology. Covered in Sections 4 and 5.

Blood cell production and function, red cell, white cell and platelet disorders, manual and automated testing, morphology, special stains, flow cytometry and molecular markers, and hemostasis with coagulation testing. Covered in Sections 6 and 7.

Immune system principles, autoimmune disease, hypersensitivity, immunodeficiency, transplantation, infectious disease serology and serologic test methods. Covered in Section 8.

Specimen collection and processing, stains and media, bacteriology by body site, identification methods including MALDI-TOF and molecular panels, susceptibility testing and resistance, mycobacteriology, mycology, parasitology, virology, biosafety and reporting. Covered in Sections 9 and 10.

Quality assessment and quality control, safety, laboratory mathematics, and manual and automated methods and instrumentation. Covered in Section 11, with lab math also practiced throughout the guide.

The content guideline expects you to calculate transferrin saturation, indirect bilirubin, LDL by the Friedewald formula and non-HDL cholesterol, the albumin/globulin ratio, timed urine collections and creatinine clearance, Beer's law, the WBC count corrected for nucleated red cells, manual hemocytometer counts, red cell indices and absolute counts from relative values. Expect dilution, statistics and blood bank calculations as well. Every one of these is worked step by step in the content sections.

Reference ranges are not provided during the exam. The content guideline publishes composite adult ranges for exam preparation, and this guide teaches the common values you need to recognize a high, low or critical result. When a practice question depends on a borderline value, the reference interval is given in the question.

The exam is a criterion-referenced computer adaptive test. Every candidate answers 100 questions. When you answer correctly, the next question is slightly harder; when you answer incorrectly, it is slightly easier. After each answer the computer re-estimates your ability, and your final score reflects the difficulty of the questions you answered correctly, not a simple count. Because the questions adjust to you, most candidates feel the test is hard the whole way through. That is the design, not a sign of failure. Some questions are unscored field-test items that look exactly like the scored ones, so treat every question as if it counts.

• Every question is multiple choice with four options and one best answer. This is also the format of the practice tests in this guide.
• Many questions include an image: a blood smear, a Gram stain, a colony on agar, urine sediment, an antibody panel, an electrophoresis pattern or a Levey-Jennings chart. In this guide those images are described in words so you can practice the same reasoning.
• Questions range from knowledge and comprehension to application and analysis. The most common pattern is a set of results followed by "What is the most likely cause?", "What should the technician do next?" or "Which result is expected?"
• You cannot skip a question, but you can flag it and return to it if time remains at the end.

Scores are reported on a scale from 100 to 999, and the minimum passing score is 400. There is no fixed number or percentage of questions you must answer correctly. A preliminary pass or fail result appears on the screen when you finish. Within four business days you receive an email telling you to log in and view your official score report, provided the BOC has received and processed your transcripts. If you pass, the report shows your pass result and scaled score. If you do not pass, it also shows your performance in each subtest, which tells you where to focus before your next attempt.

You may take the exam up to five times under one eligibility route. Each attempt requires a new application and fee. After five unsuccessful attempts, you must qualify under a different eligibility route before you can test again.

Your certification appears in your ASCP account and can be verified by employers. If you work in a state that licenses laboratory personnel, apply for your state license and follow its rules. Many MLTs later complete a bachelor's degree and sit for the Medical Laboratory Scientist (MLS) exam.

ASCP BOC certification is maintained through the Credential Maintenance Program (CMP). Every three years you document continuing education points in laboratory or patient safety and the major content areas for your credential, then complete the CMP declaration and pay the maintenance fee. Check the current point requirements for the MLT credential on the ASCP BOC website.

American Medical Technologists (AMT) also certifies medical laboratory technicians as MLT(AMT). The AMT exam covers the same core disciplines: blood banking, chemistry, hematology, immunology, microbiology, urinalysis and laboratory operations. This guide's content review applies to both exams; check the AMT candidate handbook for that exam's format and eligibility rules.