On May 28-29, 2009, a number of medical laboratory opinion leaders, pathologists and biochemists met in Sitges, Spain to discuss issues of interest to medical laboratory professionals. The meeting was sponsored by Bio-Rad Laboratories Inc. (Hercules, CA). Over 40 persons representing Austria, Belgium, Czech Republic, Finland, Germany, Great Britain, Israel, Italy, Netherlands, Portugal, South Africa, Spain, Sweden and the US participated in the 1.5 days meeting. The intended purpose of the convocation was to give medical laboratory professionals from different countries and backgrounds an opportunity to share ideas, concerns and experiences in five areas of interest of the sponsor. These areas of interest included: * a requirement for medical laboratory accreditation across Europe * uncertainty of measurement in a clinical laboratory setting * application of Six Sigma values to characterize laboratory quality * effects of analytical errors on patient care and outcomes * harmonization of allowable total error (TEa) specifications The convocation began with a keynote speech by Dr. James Westgard on "Managing quality vs. measuring uncertainty in the medical laboratory". Dr. Westgard's presentation was thought provoking and called into question the utility and practicality of using uncertainty in a medical laboratory setting. This journal contains a companion article written by Dr. Westgard on this topic. After the keynote speech, the meeting adjourned into five discussion groups and reconvened the next day to hear the outcomes of the discussions by each of the working groups. This article provides a synopsis of the reports from each working group.