How to Become a Phlebotomist

By: Andrew Colucci, MD

Last Updated: December 14, 2018

No one loves a needle stick, but the skillful touch of a good phlebotomist can make the process quicker and a lot less painful. Phlebotomists, also known as phlebotomy technicians, specialize in the crucial duty of drawing blood samples from patients for use in medical testing, transfusions, research, and donation. Many phlebotomists say that it’s their interactions with patients that make the job so fulfilling. They enjoy helping people through distress and providing comfortable testing and donation experiences.

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A phlebotomist’s most important job is to protect patients’ health and safety. Failing to verify a person’s identity or mislabeling a blood sample can lead to serious health consequences. It’s also extremely important that the phlebotomist choose an appropriate site for the puncture as well as the best equipment for the job.

Phlebotomists are important players on the healthcare team who work closely with physicians, technicians, nurses and other professionals to care for patients.

Workplace Details

Most phlebotomists - about 40 percent - work in hospitals. Commercial medical laboratories, physicians’ offices, and blood banks also employ many phlebotomists. “Mobile” phlebotomists (those who travel to different labs and offices as needed) are becoming more common.

Most phlebotomists work full time. Hours are generally regular, but those in hospitals may cover some evening, weekend, and holiday shifts.

Phlebotomy careers require a great deal of human interaction. A phlebotomist may be the only person the patient meets when visiting the lab, so it’s important to provide great service. Phlebotomists are also in near-constant contact with physicians, nurses and lab technicians.

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According to the U.S. Bureau of Labor Statistics, the median annual wage for all phlebotomists is $31,630, or $15.21 per hour. The highest-paid ten percent earn a median $45,190, and the lowest paid ten percent earn a median $22,850.

Work setting has a significant impact on earnings. The highest-paid phlebotomists work for insurance carriers and specialty hospitals (although there are relatively few positions in these industries), while those in general hospitals tend to earn less.

Phlebotomist wages also vary significantly by geographic area. Pay is highest on the West Coast, in Alaska, and on the East Coast between New Hampshire and Virginia.

Phlebotomists should be in excellent demand for the next decade. According to the Bureau of Labor Statistics, employment is expected to grow by 25 percent between 2014 and 2024.

One reason for this trend is that more people are seeking health care services. The Affordable Care Act expanded insurance coverage, giving more people access to doctors and hospitals. Growth of the elderly population and growth in the number of people with chronic conditions are also driving demand for services.

One of the best ways that phlebotomists can increase their job prospects is to obtain voluntary certification.

The websites of local hospitals and labs often list open phlebotomist positions. Other job-hunting resources include the ASCP job board and the Phlebotek website.

About a third of phlebotomists enter the job with a high school diploma and train on the job. But the rest of them follow up their high school education with additional coursework before becoming a phlebotomist.

The majority of phlebotomists complete a post-secondary certificate program through a community college, vocational school, or technical school. These programs typically take less than a year to complete and have both classroom and clinical components. Subjects covered include anatomy, physiology, medical terminology, and practical skills. Students practice blood draws on mannequins before trying them on real patients.

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Phlebotomy education is not well regulated in most states, so it’s important to be discerning when choosing a program. To find the best training:

• Ask local employers who provide high-quality programs in your area
• Consult the websites of reputable certification organizations (see the certification section below for more information)
• Look for a program that follows the quality standards of the Clinical and Laboratory Standards Institute (CLSI)
• The clinical experience should take place in a government-certified laboratory (look for the acronym CLIA)

Phlebotomy certification is mandatory in California, Louisiana, and Nevada, and is strongly preferred by employers across the country. Certification is offered by many organizations, but not all are credible or recognized by employers.

If your state has mandatory certification, it will maintain a list of recognized certification organizations. For more information, click the state links above.

For candidates seeking voluntary certification, the Center for Phlebotomy Education recommends the following organizations:

• National Center for Competency Testing
• American Society for Clinical Pathology
• American Medical Technologists

Certification varies by organization, but most require completion of an accredited training program or equivalent work experience with an accredited laboratory. Candidates must also pass a knowledge exam (and, in the case of the American Certification Agency, an additional practical exam).

Certified phlebotomists must participate in regular continuing education to maintain their credentials.

Phlebotomists with several years experience may move into supervisory roles. Those with an associate or bachelor’s degree may be qualified to instruct within phlebotomy training programs. Phlebotomy can also serve as a springboard to other health careers, including nursing, medicine, or laboratory science.

Many phlebotomists enter the profession with no formal education in phlebotomy and get their training on the job. The military also trains recruits in phlebotomy.

Many employers prefer to hire phlebotomists who have completed a certificate program in phlebotomy. Having some formal education makes it easier to change employers, move to new states, and pursue formal licensure and certification. (Note that holding a phlebotomy certificate is not the same as certification, which requires you to meet additional requirements and pass an exam.)

Community colleges, technical schools, teaching hospitals and health systems all offer phlebotomy programs. It’s also possible to obtain a phlebotomy certificate in the course of earning an associate degree (for example, as part of some medical laboratory technology programs).

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Be cautious and do your homework when choosing a training program. The phlebotomy education field is poorly regulated in many states. Some tips:

• The National Accrediting Agency for Clinical Laboratory Sciences (NAACLS), a respected accrediting organization, maintains a searchable list of approved phlebotomy programs on its website. Graduating from NAACLS often makes it easier to get certified. However, it’s worth noting that there are relatively few NAACLS-approved programs.
• If you plan to pursue state licensure and/or national certification, check the eligibility requirements for your desired credentials. Will you need to complete a minimum number of educational hours and supervised venipunctures? Ensure that your chosen educational program will provide these.
• Phlebotomy employers can also be a great resource when evaluating certificate programs. Ask which programs in your area are respected and produce well-qualified graduates.
• Finally, your certificate program should include a phlebotomy practicum. Verify that your clinical experience will be completed in a government-certified lab that meets the standards of the Clinical and Laboratory Standards Institute (CLSI).

Subjects you’re likely cover during your phlebotomy training include:

For working phlebotomists who have some experience in a specialized or related field, ASCP offers a few advanced certifications:

• Donor phlebotomy technician - collects blood that may ultimately be used in transfusions or stored at a blood bank
• Medical laboratory assistant - assists with a variety of lab tests and functions

Candidates must meet education and work experience requirements and pass a knowledge exam.