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Internal Proficiency Program for Wet Mount Microscopy

Michigan Regional Laboratory Wet Mount Proficiency Program 

The Michigan Regional Laboratory Program seeks to evaluate and document proficiency of practitioners in local health departments for the microscopic examination of vaginal discharge specimens (wet mount analysis). The primary vaginal infections identified during wet mount analysis are bacterial vaginosis (caused by a symbiotic overgrowth of Gardnerella vaginalis and Mobiluncas species), yeast infections (primarily caused by Candida albicans), and trichomoniasis (caused by Trichomonas vaginalis).

This proficiency testing program challenges the practitioner with 3 sets of photo-micrographs of cellular elements commonly observed in vaginal discharges specimens and asks the respondent/s to identify three separate elements per set. There are two challenges per year. Practitioners who perform microscopic examination of vaginal discharge specimens are expected to maintain a proficiency score of 80% or better on each challenge.

It is recognized that the clinical diagnosis of vaginal infections is based on multiple signs and symptoms. This proficiency testing program does not require the practitioner to make a diagnosis of disease since they are not provided with clinical information.   Instead, each challenge presents a set of microscopic cellular elements and requires the practitioner to identify each element. Thus, the proficiency program is based on object recognition and not clinical diagnosis.  The proficiency testing program also contains an ungraded educational component which provides examples of items commonly seen during wet mount analysis which may be confused with clinically relevant cellular elements.

We maintain a library of past and current proficiency challenges at this location. Each challenge is posted on this website in both Powerpoint format and as a Word document.    Each challenge is accompanied by a critique which provides the approved interpretation of each challenge micrograph.   In addition, we post microphotographs of examples of clinical material for both training and reference. By providing this material, it is our intention that previous challenges serve as training materials for individuals who need to examine and interpret clinical specimens of vaginal discharge.

Since 2006, the proficiency test challenges have been available in Powerpoint (*.ppt) format.   To view these challenges, first save the file to your hard drive.  You may then open the file in Powerpoint on your computer and view via "Slide Show".  Alternatively, you may print any of these documents by opening the file in Microsoft® Word.  You will need a photo quality inkjet printer and high quality matte photo paper - anything else will not give sufficient resolution to the documents for interpretation.

All proficiency test challenges and individual images on this website may be used by other individuals or institutions for educational and training purposes.   The Michigan Department of Health and Human Services, Bureau of Laboratories maintains and retains all rights to this material.  None of these images may be used to generate revenue. Duplication for publication in any form requires the permission of the MDHHS Laboratory Director.  Please recognize MDHHS whenever this material is used in training or education.

We welcome comments and would be pleased to accept micrographs from clinical professionals of clinical specimens of vaginal discharge. Submissions should be in '*.jpg' format and will be considered property of MDHHS upon receipt; submitters will be recognized by name and institution whenever a micrograph is used.  Please email comments and/or micrographs to  


The Quality Control Unit within the Michigan Department of Health and Human Services Bureau of Laboratories provides the Regional Laboratories with an inactivated (nonviable) yeast and bacterial suspension for use as a control for Wet Mount preparations. Agencies are limited to two vials of controls per testing site per order.   Your agency should limit its inventory to one opened vial and one unopened vial of wet mount control per testing site.   Controls are provided as part of our partnership in assisting the Regional Laboratories with their ongoing efforts to comply with CLIA '88.

Each vial contains a volume sufficient for 180 days of testing (the open vial expiration date).   Once the currently opened vial is depleted or reaches its assigned expiration date, please contact the Quality Assurance Section to place an order.

Orders are filled within 24 to 48 hours of the request.

MDHHS Bureau of Laboratories Quality Control Unit
Telephone 517-335-8074

The Safety Data Sheet (SDS) for the wet mount control suspension is available here


Wet Mount Proficiencies: Wet Mount Proficiency Critiques:
Proficiency 2024A Instruction and Score Sheet
Proficiency 2024A Challenge
2024A Expected Results
Proficiency 2023B Instruction and Score Sheet
Proficiency 2023B Challenge
2023B Expected Results
Proficiency 2023A Instruction and Score Sheet
Proficiency 2023A Challenge
2023A Expected Results
Proficiency 2022B Instruction and Score Sheet
Proficiency 2022B Challenge
2022B Expected Results
Proficiency 2022A Instruction and Score Sheet
Proficiency 2022A Challenge
2022A Expected Results
Proficiency 2021B Instruction and Score Sheet
Proficiency 2021B Challenge
2021B Expected Results
Proficiency 2021A Instruction and Score Sheet
Proficiency 2021A Challenge
2021A Expected Results
Proficiency 2020B Instruction and Score Sheet
Proficiency 2020B Challenge
2020B Expected Results
Proficiency 2020A Instruction and Score Sheet
Proficiency 2020A Challenge
2020A Expected Results
Proficiency 2019B Instruction and Score Sheet
Proficiency 2019B Challenge
2019B Expected Results
Proficiency 2019A Instruction and Score Sheet
Proficiency 2019A Challenge
2019A Expected Results
Proficiency 2018B Instruction and Score Sheet
Proficiency 2018B PowerPoint
2018B Expected Results
Proficiency 2018A Instruction and Score Sheet
Proficiency 2018A PowerPoint
2018A Expected Results

 Rev. 05/20/2024