Lesson 9
Surgical Technologists and Perfusionists
WORK DESCRIPTION OF SURGICAL TECHNOLOGISTS
The term operating room conjures up the image of two principal characters: the surgeon and the
patient. Most operations involve more people than this, however, and during a major procedure
such as open-heart surgery, the operating room may be crowded with as many as 20 doctors,
nurses, and technicians. Among these are surgical or operating room technicians. Surgical
technicians work with, and under the supervision of, surgeons or registered nurses. They help set
up the operating room with surgical instruments, equipment, sterile linens, and fluids such as
saline (a salt solution), or glucose (a sugar solution). Surgical technicians may prepare patients
for surgery by washing, shaving, and disinfecting the body area where the surgeon may operate.
They may transport patients to the operating room and help drape them and position them on the
operating table. During surgery, they pass instruments and other sterile supplies to the surgeons
and the surgeon's assistants. They may hold retractors, cut sutures, and help count the sponges,
needles, supplies, and instruments used during the operation. Surgical technicians help prepare,
care for, and dispose of specimens taken for laboratory analysis during the operation of diagnostic
equipment.
WORKING CONDITIONS
Surgical technicians work in clean, well lighted, cool environments. They need stamina to be on
their feet the whole time they are on duty and must pay close attention to detail during operations.
Most surgery is performed during the day, but some workplaces, such as an emergency surgical
unit, require 24-hour coverage. A 40-hour, 5-day workweek is normal for surgical technicians,
although many are required at times to be on call.
EMPLOYMENT OPPORTUNITIES
Surgical technicians hold about 57,000 jobs. In some regions of the country, technicians known
as private scrubs are employed directly by surgeons. Most, however, are employed by hospitals
and other places that have operating rooms, delivery rooms, and emergency room facilities.
TRAINING, OTHER QUALIFICATIONS, AND ADVANCEMENT
Nearly all technicians receive their training in formal programs offered by community and junior
colleges, vocational technical schools, or hospitals. There are approximately 650 training
programs for surgical technicians, of which 450 are accredited by the Committee on Allied
Health Education and Accreditation of the American Medical Association. High school
graduation normally is required for admission. Although most programs last from nine to 10
months, some community college programs last two years and lead to an associate degree.
Accredited programs provide classroom training as well as supervised clinical experience.
Required courses include anatomy, physiology, and microbiology. Other courses cover such
topics as the care and safety of patients during surgery, proper use of anesthesia, and surgical care
procedures. Students learn how to sterilize instruments, prevent and control infection, and handle
special drugs, solutions, supplies, and equipment.
Some surgical technicians receive their training in hospital-based programs that last from six
months to one year, depending on the program's admission requirements. The shorter programs
are designed for licensed practical nurses that already have some background in anatomy,
physiology, and clinical practice. The longer programs, from nine months to a year, are for
individuals with no background in health care.
Some surgical technicians are trained in the armed forces. Regardless of where they are educated
and trained, surgical technicians are expected to keep abreast of new developments in the field.
With additional training, they can work with new equipment such as is used in open-heart
surgery.
Obtaining professional credentials for this occupation is voluntary; the Liaison Council on
Certification certifies technicians who demonstrate entry-level knowledge by successfully passing
a national certification examination. Continuing education or reexamination is required to
maintain certification, which must be renewed every six years.
Manual dexterity is a necessity for surgical technicians because they must handle instruments
quickly; often having to anticipate which instrument is needed. They must be conscientious,
orderly, and emotionally stable. In surgery there is little margin for error. High school students
interested in careers in this occupation are advised to take courses in health, biology, chemistry,
and mathematics.
Technologists may advance by specializing in a particular area of surgery, such as neurosurgery
or open heart surgery. They may also work as circulating technologists. A circulating
technologist is the person during the procedure that monitors the patient's circulatory function.
They interview the patient before surgery; keep a written account of the surgical procedure; and
answer the surgeon's questions about the patient during the surgery. With additional training,
some technologists advance to first assistants who help with retracting, sponging, suturing,
cauterizing bleeders, and closing and treating wounds.
Career advancement for surgical technicians often involves leaving the occupation in order to
take sales, consumer relations, or management positions with insurance companies, sterile supply
services, or operating equipment firms. Some technicians advance by becoming instructors in
surgical technology training programs.
JOB OUTLOOK
Employment in this field is expected to grow faster than the average for all occupations through
the year 2010. As in other occupations, most job openings will result from the need to replace
experienced workers who transfer to other occupations or stop working all together. The volume
of surgery, surgical practice patterns, and the availability of operating room nurses will affect
future prospects for surgical technicians. The number of surgical procedures is expected to rise
due to projected changes in the size and age structure of the population, technological advances
that permit surgical intervention for more conditions than ever before, and widespread insurance
coverage for surgical care.
The rate of surgery has climbed steadily among persons 65 years of age and above. Elderly
patients typically undergo surgery for cataracts, hip replacements, hernia repair, or prostate
removal, for example. As new procedures and improvement in technology continue to make
surgery less risky and more successful, the potential benefits to elderly patients increasingly
outweigh the risks. Rapid growth of the 65-and-older population in the years ahead is certain to
sustain a high level of demand for surgery.
Surgical practice patterns are changing, however; the dominant trend is a shift to outpatient or
ambulatory surgery. Advances in anesthesia, fiber optics, and laser technology have made it
possible for many procedures to be performed on an outpatient basis, and cost-control
considerations furnish a powerful stimulus for choosing outpatient rather than inpatient surgery.
Some health insurance plans cover the full cost of outpatient surgery but only pay part of the cost
if the same procedure entails a hospital stay.
The growing popularity of outpatient surgery is especially evident in the hospital sector.
Explosive growth is occurring in the number of surgical procedures performed in hospital
outpatient departments, which employ surgical technicians as assistants. If hospitals continue to
dominate the rapidly expanding outpatient surgery market, demand for surgical technicians is
likely to remain strong. Nonetheless, the shift to outpatient or ambulatory surgery will create
faster growth for technologists in offices and clinics of physicians, including surgicenter.
Shortages or surpluses in the supply of operating room nurses are quite likely to affect demand
for surgical technicians, however. Hospitals unable to locate sufficient numbers of suitably
trained surgical nurses may alter operation room staffing patterns, increasing their utilization of
surgical technicians. Thus, in areas experiencing a nursing shortage, opportunities for surgical
technicians should be even more favorable.
Because so many factors are at work, the job market for surgical technicians will vary from one
community to another, depending on local hiring needs and the supply of qualified applicants.
Employment prospects for top graduates of accredited programs in surgical technology are
expected to be very good, overall. Employers tend to view graduates of accredited training
programs more favorably than those without such preparation--with the important exception of
applicants with very strong clinical backgrounds such as foreign medical school graduates who
have not yet passed the licensing examination that is necessary to enter residency training.
EARNINGS
The average starting salary for surgical technicians is $21,741 a year, according to a national
survey by the University of Texas Medical Branch. Experienced technicians earn an average
annual salary of $30,540. Surgical technicians employed by the Federal government are
classified as nursing assistants. Their starting salaries range from about $18,885 to $29,740,
depending on education and experience.
Salaries vary widely by geographic location, with those on the East and West Coasts generally
higher. Surgical technicians employed by surgeons tend to earn more than those employed by
hospitals and similar institutions.
Questions:
Describe what Surgical Technologists do in a surgical unit.
How do Surgical Technologists receive their training?
What are the requirements to get into a Surgical Technologist program?
What are the physical requirements for becoming a Surgical Technologist?
What is the job outlook for a Surgical Technologist?
What is the average starting salary for a Surgical Technologist?
RELATED OCCUPATIONS
Other workers who perform medical activities under supervision are chiropractor assistants,
dental assistants, electrocardiograph technicians, electroencephalographic technologists, licensed
practical nurses, medical assistants, nursing assistants, occupational therapy assistants, orderlies,
and physical therapy aides.
ADDITIONAL INFORMATION
Additional information on a career as a surgical technician, on training schools for the
occupation, and on certification is available from: American Medical Association, Division of
Allied Health Education and Accreditation, 535 N. Dearborn St., Chicago, IL 60610.
Perfusionists
WORK DESCRIPTION OF PERFUSIONISTS
A perfusionist is a skilled person, qualified by academic and clinical education, who operates
extra corporeal circulation and auto transfusion equipment during any medical situation where it
is necessary to support or temporarily replace the patient's circulatory or respiratory function.
The perfusionist is knowledgeable concerning the variety of equipment available to perform extra
corporeal circulations functions and is responsible, in consultation with the physician, for
selecting the appropriate equipment and techniques to be used.
Perfusion (extra corporeal circulation) procedures involve specialized instrumentation and/or
advanced life-support techniques and may include a variety of related functions. During a
cardiopulmonary bypass, the perfusionist may administer blood products, anesthetic agents, or
drugs through the extra corporeal circuit on prescription and/or appropriate protocol. The
perfusionist is responsible for the monitoring of blood gasses and the adequate anticoagulation of
the patient, induction of hypothermia, hemodilution, and other duties, when prescribed.
Perfusionists may be administratively responsible for purchasing supplies and equipment, as well
as for personnel and departmental management. Final medical responsibility for extra corporeal
perfusion rests with the surgeon-in-charge.
EMPLOYMENT OPPORTUNITIES
Perfusionists may be employed in hospitals, by surgeons, and as employees of a group practice.
They typically work during the week and are frequently on call for emergency procedures on
weekends and nights. They may work in an on-call system, depending on the number of
perfusionists employed by the institution.
TRAINING, OTHER QUALIFICATION, AND ADVANCEMENT
Programs are generally one to four years in length, depending on the program design, objectives,
prerequisites, and student qualifications. Certificate programs require that applicants have a
bachelor's degree. Prerequisites vary depending on the length and design of the program. Most
programs require college-level science and mathematics. A background in medical terminology,
respiratory therapy, or nursing is suggested for some programs.
Curricula of accredited programs include courses covering heart-lung bypass for adult, pediatric,
and infant patients undergoing heart surgery; long-term supportive extra corporeal circulation;
monitoring of the patient undergoing extra corporeal circulation; auto transfusion; and special
applications of technology. Curricula include clinical experience that incorporates and requires
performance of an adequate number and variety of circulation procedures.
Standards are minimum educational standards adopted by the AACP, AATS, ABCP, AMA,
AmSECT, Perfusion Program Directors Council, Society of Cardiovascular Anesthesiologists,
Society of Thoracic Surgeons, and Commission on Accreditation of Allied Health Education
Programs. Each new program is assessed in accordance with the Standards, and accredited
programs are periodically reviewed to determine whether they remain in substantial compliance.
The Standards and Guidelines are available on written request from the AC-PE.
EARNINGS
According to the AmSECT, the average base salary for a recently graduated perfusionist is about
$50,000; for a certified perfusionist with two to five years experience, $55,000 to $69,000; 5 to
10 years experience, $65,000 to $72,000; and chief perfusionist, $70,000 to $90,000.
Questions:
What does a Perfusionist do?
How do Perfusionists receive their training?
The minimum education standards for Perfusionists are adopted by what agencies?
What are the starting salaries for Perfusionists?
ADDITIONAL INFORMATION
For inquiries regarding accreditation, contact:
Accreditation Committee Perfusion Education, 7108-C S. Alton Way, Englewood, CO 801122106
Careers/Curriculum, AmSECT National Office, 503 Carlisle Dr., Herdon, VA 20170
American Academy of Cardiovascular Perfusion, P.O. Box 468, Pell City, AL, 35125
Certification, American Board of Cardiovascular Perfusion, 207 N. 25th Ave., Hattiesburg, MS,
39401
Medical Assistants
WORK DESCRIPTION
Medical Assistants assist physicians in their offices or other medical settings, performing
administrative and/or clinical duties delegated by the physician in relation to the degree of
training and in accordance with respective State laws governing such actions and activities.
Medical assistants have a wide range of duties in many aspects of the physician's practice.
Business administrative duties include scheduling and receiving patients; obtaining patients' data;
maintaining medical records; typing medical transcriptions; handling telephone calls,
correspondence, reports, and manuscripts; and assuming responsibility for office care, insurance
matters, office accounts, fees, and collections. Clinical duties include preparing the patient for
examinations, obtaining vital signs, taking medical histories, assisting with examinations and
treatments, performing routine office laboratory procedures, such as, electrocardiograms,
sterilizing instruments and equipment for office procedures, and instructing patients in
preparation for x-ray and laboratory examinations.
Both administrative and clinical duties involve purchasing and maintain supplies and equipment.
A medical assistant who is sufficiently qualified by education and/or experience may be
responsible for personnel and office management.
WORKING CONDITIONS
Medical assistants are usually employed in physicians' offices where they work in pleasant, well
lighted, surroundings. They constantly interact with other people, and may have to handle several
responsibilities at once. A 5-day, 40-hour workweek is normal, although some physicians may
require some work evenings and weekends. Their responsibilities and hours will vary depending
on whether they work in a clinic, hospital, large group practice, or private office.
EMPLOYMENT OPPORTUNITIES
Medical assistants hold about 200,000 jobs. More than 70 percent are employed in physicians'
offices, and about 12 percent work in offices of other health practitioners such as chiropractors,
optometrists, and podiatrists. Others work in hospitals, nursing homes, and other health care
facilities.
TRAINING, OTHER QUALIFICATIONS, AND ADVANCEMENTS
Medical assisting is one of the few health occupations open to individuals with no formal
training. Although formal training in medical assisting is available, such training, while generally
preferred, is not always required. Some medical assistants are trained on the job. Applicants
usually need a high school diploma or the equivalent. Volunteer experience in the health care
field may be helpful.
Formal programs in medical assisting are offered in vocational-technical high schools, post
secondary vocational schools, community and junior colleges, and in colleges and universities.
Programs are either two years, resulting in an associate degree; or one year, resulting in a
certificate or diploma. The curricula of accredited programs are required to include anatomy and
physiology; medical terminology; medical law and ethics; psychology, communications (oral and
written); medical assisting administrative procedures, including office procedures, business
correspondence, bookkeeping, and insurance; and medical assisting clinical procedures, including
examination room techniques, aseptic practices and techniques, care of equipment and supplies;
first aid and cardiopulmonary resuscitation, laboratory orientation, and principles of
pharmacology. Programs must include an internship that provides practical experience in
qualified physicians' offices, accredited hospitals, or other health care facilities.
Two agencies recognized by the U.S. Department of Education accredit programs in medical
assisting: The American Medical Association's Committee on Allied Health Education and
Accreditation (CAHEA) and the Accrediting Bureau of Health Education Schools (ABHES).
There are 207 medical assisting programs accredited by CAHEA and 136 accredited by ABHES.
The Joint Review Committee for Opthalmic Medical Personnel has approved 13 programs in
ophthalmic medical assisting.
Although there is no licensing for medical assistants, some States require them to take a test or a
short course before they can take x-rays, draw blood, or give injections. Employers prefer to hire
experienced workers or certified applicants who have passed a national examination, indicating
that the medical assistant meets certain standards of competence. The American Association of
Medical Assistants awards the Certified Medical Assistant credential; the American Medical
Technologists awards the Registered Medical Assistant credential; the American Society of
Podiatric Medical Assistants awards the Podiatric Medical Assistant Certified credential; and the
Joint Commission on Allied Health Personnel in Ophthalmology awards the Ophthalmic Medical
Assistant credential at three levels: Certified Ophthalmic Assistant, Certified Ophthalmic
Technician, and Certified Ophthalmic Medical Technologist.
Persons considering this career should have the ability to work with people of all ages,
temperaments, and personalities. They should have good communication skills and be friendly
and trustworthy. Medical assistants must be able to put patients at ease and explain physicians'
instructions. They must respect the confidential nature of medical information. Clinical duties
require a reasonable level of manual dexterity and visual acuity. Each patient views his or her
doctor by the first encounters with the medical assistant. Medical assistants may be able to
advance to office manager or become ward clerks, medical record clerks, phlebotomists, or EKG
technicians in hospitals. Medical assistants may qualify for a wide variety of administrative
support occupations, or may teach medical assisting. Some, with additional schooling, enter
other health occupations such as nursing and medical technology.
JOB OUTLOOK
Employment for medical assistants is expected to grow much faster than average for all
occupations through the year 2010. The medical settings may become more varied, with the shift
to HMOs and group practices. Job prospects are expected to remain favorable for graduates of
accredited programs, as the shift in the age of the population increases the need for medical care.
With a demand from more than 600,000 physicians, there are and will probably continue to be
almost unlimited opportunities for formally educated medical assistants. Physicians in private
practice employ more medical assistants than any other types of allied health personnel. The type
of administrative and clinical tasks they perform facilitates the work of the physician, and
qualified assistants are always in demand.
EARNINGS
A survey of medical directors indicated that the average entry-level salary for medical assistants
is $20,350. Entry-level salaries in 1998 averaged $23, 150, the lowest being $19,000 and the
highest $28,350. Salaries vary depending on the employer and geographic location.
Questions:
What are the main job functions of a Medical Assistant?
Where are Medical Assistants’ employed?
What are the training requirements to become a Medical Assistant?
What agencies accredit Medical Assisting programs?
What kind of State licensing do Medical Assistants require?
What abilities should a Medical Assistant possess?
What are the average beginning earnings of Medical Assistants?
RELATED OCCUPATIONS
Related occupations in supervised health care activities include occupational therapy assistants,
surgical technicians, physical therapy aides, psychiatric aides, and clinical laboratory technicians.
ADDITIONAL INFORMATION
Inquiries concerning careers and curriculum should be addressed to: American Association of
Medical Assistants, 20 N. Wacker Dr., Suite 1575, Chicago, IL 60606
Athletic Trainers
WORK DESCRIPTION
Athletic Trainers are professionally trained medical technicians who work in conjunction with
and under the supervision of a physician. Through preparation in both academic and practical
experience, the athletic trainer provides a variety of services including injury prevention,
recognition, immediate care, treatment, usually associated with competitive athletics, and
rehabilitation after physical trauma as prescribed by the team physician. They keep the team
coach informed of the injured athlete's condition.
The role of the athletic trainer includes, but may not be limited to, six domains: prevention,
recognition and evaluation, management and treatment, rehabilitation, organization and
administration, and education and counseling. Trainers' duties include taking care of minor
injuries such as cuts, scratches, abrasions, and blisters; making protective devices such as
mouthpieces and injury pads; and taping, wrapping, and padding injuries. Trainers must be
skilled in massage and corrective exercise techniques and be able to use therapeutic equipment
such as diathermy units, whirlpools, infrared lamps, and ultrasound machines. Athletic trainers
conduct conditioning and rehabilitation programs, plan menus and supervise diets, and aid in
purchasing and fitting equipment. Educational institutions employ some athletic trainers,
including secondary and high education facilities. They often teach classes in related or nonrelated subjects as part of their regular duties.
Some athletic trainer positions require individual trainers to serve a group of schools or an entire
school district. Under this arrangement, the trainer is usually located in a central place such as a
stadium, and has a small staff. In some cases, trainers take teaching positions in which they teach
the skills of the profession to other athletic trainers.
WORKING CONDITIONS
Most athletic trainers work in secondary schools, college or universities, and a limited number are
employed by professional athletic teams. The nature of the work requires long and irregular
hours. It is not uncommon for trainers to work 55 or more hours per week. Emergencies and
illnesses requiring their attention may come up at any time, and the regular schedule includes any
of the days and evenings of the week, often including holidays. Travel can be part of the job and
is a necessity for trainers who work with a professional team, which may be away from home for
long periods of time.
TRAINING, OTHER QUALIFICATIONS, AND ADVANCEMENT
The educational minimum for entry into this work is a bachelor's degree in athletic training that
includes appropriate course work and clinical experience, as specified by the institution. An
increasing number of candidates have graduate training. The certifying agency for programs in
athletic training is the national Athletic Trainers Association (ATA). Typical courses of study
include anatomy, physiology, physiology of exercise, kinesiology, physics, chemistry,
psychology, first aid, safety, nutrition, administration of health and physical education programs,
and techniques of athletic training. In addition, the program may lead to teaching certification in
health education.
Certification by NATA is not required to obtain employment, but it is considered a valuable
credential in this field. To become a certified athletic trainer, an individual must meet a number
of requirements, including having a college degree with specified courses and a teaching license.
The certification candidate must also have worked for two years under a NATA supervisor, have
been a member of NATA for one year, and pass the NATA certification examination. There are
colleges in 26 States that offer approved NATA curricula.
The employing institution or team regulates advancement in this career, and, although there are
no set patterns of advancement, a number of possibilities exist. One would be to start as an
assistant athletic trainer, progress to a trainer, and then to head trainer or director of training. A
trainer at an educational institution might work into an athletic administration position. The
athletic trainer's whole employment with a professional team is in a somewhat special
employment situation. Usually, the professional trainer only works with one sport. Although
most professional teams only operate approximately six months a year, they have an off-season
program and employ the trainer during the full year.
JOB OUTLOOK
At present, most opportunities exist in learning institutions. However, future demand in these
positions may be determined to a large extent by Federal legislation that, if introduced and
passed, will require each school to employ an athletic trainer. Currently, the trainers with the best
employment potential for these jobs are able to teach a subject or subjects for which there is a
demand. The more subjects a trainer is able to teach, the greater the chances for employment.
Competition is keenest for positions with professional athletic teams, and chances of starting a
career as a professional trainer are very slim.
EARNINGS
According to the NATA, entry-level salaries average $24,000.
Questions:
What do Athletic Trainers do for a sports team?
Where do most Athletic Trainers work?
What are the minimum education requirements for a Bachelor’s degree?
How does one become a certified Athletic Trainer?
What are the chances for advancement as an Athletic Trainer?
What is the current job outlook for Athletic Trainers?
ADDITIONAL INFORMATION
Requests for information on program accreditation, including Standards, contact:
JRC-AT, 7108-C Alton Way, Suite 150, Englewood, CO 80112,2106. For information on the
career of athletic trainer, contact: National Athletic Trainers' Association, Inc. 2952 Stemmons
Frwy, Suite 200, Dallas, TX, 75247. For information on certification, contact: NATA Board of
Certification, NATABOC Administration Offices, 1512 S. 60th St., Omaha, NE 68106-2102.