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Health Technologists
and Technicians
ISBN 0-16-043056-9
Reprinted from the
Occupational Outlook Handbook, 1994-95 Edition
90000
U.S. Department of Labor
Bureau of Labor Statistics
9 780160 430565
Bulletin 2450-9
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Cardiovascular Technologists
and Technicians
In addition, they spend a lot of time walking and standing. Cardi
ology technologists may face stressful working conditions during
operating procedures and are in contact with patients who have seri
ous heart ailments.
(D.O.T. 078.264-010, .362-018, -030, -050, -062, .364-014, and .367-010)
Employment
Nature of the Work
Cardiovascular technologists and technicians assist physicians in di
agnosing and treating cardiac (heart) and peripheral vascular (blood
vessel) ailments.
Cardiovascular technicians who obtain electro (electrical)- cardio
(heart)- grams (record), abbreviated EKG’s or ECG’s, which trace
electrical impulses transmitted by the heart, are known as electro
cardiograph (ECG or EKG) technicians. To take a “basic” EKG,
technicians attach electrodes to the patient’s chest, arms, and legs,
then manipulate switches on a electrocardiograph machine to ob
tain the reading. The test is done before most kinds of surgery and as
part of a routine physical examination for persons who have passed
a certain age.
More skilled EKG technicians perform Holter monitor and stress
testing. For a Holter monitoring, technicians place electrodes on the
patient’s chest and attach a portable EKG monitor to the patient’s
belt. After 24-48 hours of normal routine for the patient, they re
move a tape from the monitor, place it in a scanner and read it for
electrical interference before sending it to a physician.
For a treadmill stress test, EKG technicians take a medical his
tory, explain the procedure, connect the patient to an EKG moni
tor, and obtain a baseline reading and resting blood pressure. They
then monitor the patient’s heart while on a treadmill, gradually in
creasing the speed of the treadmill to observe the effect of increased
exertion. Those who do EKG and stress tests are also known as
noninvasive technicians.
Cardiovascular technologists who specialize in cardiac catheteri
zation procedures, also known as invasive technology, are called
cardiology technologists. They assist a physician who winds a small
tube, or catheter, through a patient’s blood vessel, from a spot on the
patient’s leg into the heart to determine if a blockage exists and for
other diagnostic purposes. In balloon angioplasty, a procedure used
to treat blockages of blood vessels, technologists assist physicians
who insert a catheter with a balloon on the end to the point of the
obstruction. Technologists may prepare patients for these proce
dures by positioning them on an examining table, then shaving,
cleaning, and administering anesthesia to the top of the patient’s leg
near the groin. During the procedures, they monitor patients’ blood
gases and heart rate using EKG equipment and notify the physician
if something appears wrong. Technologists may also prepare and
monitor patients during open heart surgery and the implantation of
pacemakers.
Cardiovascular technologists and technicians may also specialize
in noninvasive peripheral vascular tests. They use ultrasound equip
ment that transmits sound waves, then collects the echoes to form
an image on a screen. Individuals who focus on blood flows and cir
culation problems are known as vascular technologists, while those
who use ultrasound on the heart are referred to as echocardiographers.
Some cardiovascular technologists and technicians schedule ap
pointments, type doctor’s interpretations, maintain patient’s files,
and care for equipment.
Cardiovascular technologists and technicians held about 31,000
jobs in 1992. Most worked in hospital cardiology departments,
while some worked in cardiologists’ offices, cardiac rehabilitation
centers, or health maintenance organizations. More than half were
EKG technicians.
Training, Other Qualifications, and Advancement
For basic EKGs, Holter monitoring, and stress testing, 1-year cer
tificate programs exist, although most EKG technicians are still
trained on the job by an EKG supervisor or a cardiologist. On-thejob training usually lasts about 8 to 16 weeks. Applicants must be
high school graduates. Most employers prefer to train people al
ready in the health care field, nursing aides, for example.
Most vascular technologists are trained on the job although some
have backgrounds in nursing and sonography.
Cardiology technologists need to complete a 2-year junior or
community college program. One year is dedicated to core courses
followed by a year of specialized instruction in either invasive,
noninvasive, or noninvasive peripheral cardiology. Those who are
kit
Working Conditions
Technologists and technicians generally work a 5-day, 40-hour
week, which may include Saturdays and Sundays. Those in cathe
terization labs tend to work longer hours and also may work eve
nings. They may also be on call during the night and on weekends.
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rW
EKG technicians operate machines that record electrical impulses
transmitted by the heart.
For sale by the U.S. Government Printing Office
Superintendent of Documents, Mail Stop: SSOP, Washington, DC 20402-9328
ISBN 0-16-043056-9
qualified in a related allied health profession only need to complete
the year of specialized instruction.
Cardiovascular technologists must be reliable, have mechanical
aptitude, and be able to follow detailed instructions. A pleasant, re
laxed manner for putting patients at ease is an asset.
Job Outlook
Overall employment in this field is expected to grow more slowly
than the average for all occupations through the year 2005, but tech
nicians and technologists will experience different patterns of em
ployment change. Employment of EKG technicians is expected to
decline. Although the number of cardiac tests and procedures per
formed is anticipated to grow, demand for EKG technicians is not
likely to keep pace because many hospitals are expected to train reg
istered nurses and others to perform basic EKG procedures. Indi
viduals trained in Holter monitoring and stress testing are expected
to have more favorable job prospects than those who can only per
form a basic EKG. Some openings will occur as EKG technicians
transfer to other jobs or leave the labor force.
Employment of cardiology technologists is expected to grow
faster than average for all occupations. Growth will occur as the
population ages, because older people have a higher incidence of
heart problems.
Earnings
According to a University of Texas Medical Branch national survey
of hospitals and medical centers, the median annual salary of EKG
technicians, based on a 40 hour week and excluding shift and area
differentials, was $17,222 in October 1992. The average minimum
salary was $15,223 and the average maximum was $21,868.
According to the American Society for Cardiovascular Profes
sionals, the average salary for cardiovascular technologists was
$28,756 in 1991.
Related Occupations
Cardiovascular technologists and technicians operate sophisticated
equipment to help physicians and other allied health practitioners
diagnose and treat patients, so do radiologic technologists, diagnos
tic medical sonographers, electroencephalographic technologists,
perfusionists, and respiratory therapists.
Sources of Additional Information
Local hospitals can supply information about employment opportu
nities.
For general information about a career in EKG and cardiovascu
lar technology contact:
W American Society for Cardiovascular Professionals, 10500 Wakeman
Dr., Fredericksburg, VA 22407.
For a list of accredited programs in cardiovascular technology,
contact:
W Division of Allied Health Education and Accreditation, American Medi
cal Association, 515 N. State St., Chicago, IL 60610.
For information on vascular technology, contact:
tw The Society of Vascular Technology, 1101 Connecticut Ave. NW., Suite
700, Washington, DC 20036.
For information on cardiovascular technology, contact:
ty American College of Cardiology, 9111 Old Georgetown Rd., Bethesda,
MD 20814-1699.
Clinical Laboratory Technologists
and Technicians
(D.O.T. 078.121-010, .221-010, .261-010, -014, -026, -030, and -038,
.281-010, .381-014, .687-010, and 559.361-010)
and technicians, also known as medical technologists and techni
cians, perform most of these tests.
Clinical laboratory personnel examine and analyze body fluids,
tissues, and cells. They look for bacteria, parasites, or other micro
organisms; analyze the chemical content of fluids; match blood for
transfusions, and test for drug levels in the blood to show how a pa
tient is responding to treatment. They also prepare specimens for ex
amination, count cells, and look for abnormal cells. They use auto
mated equipment and instruments that perform a number of tests
simultaneously, as well as microscopes, cell counters, and other
kinds of sophisticated laboratory equipment to perform tests. Then
they analyze the results and relay them to physicians.
The complexity of tests performed, the level of judgment needed,
and the amount of responsibility workers assume depend largely on
the amount of education and experience they have.
Medical technologists generally have a bachelor’s degree in medi
cal technology or in one of the life sciences, or have a combination of
formal training and work experience. They perform complex chemi
cal, biological, hematological, immunologic, microscopic, and bac
teriological tests. Technologists microscopically examine blood, tis
sue, and other body substances; make cultures of body fluid or tissue
samples to determine the presence of bacteria, fungi, parasites, or
other micro-organisms; analyze samples for chemical content or re
action; and determine blood glucose or cholesterol levels. They also
type and cross-match blood samples for transfusions.
They may evaluate the effects a patient’s condition has on test re
sults, develop and modify procedures, and establish and monitor
programs to insure the accuracy of tests. Some medical technolo
gists supervise medical laboratory technicians.
Technologists in small laboratories perform many types of tests,
while those in specialty laboratories or large laboratories generally
specialize. Technologists who prepare specimens and analyze the
chemical and hormonal contents of body fluids are clinical chemis
try technologists. Those who examine and identify bacteria and other
micro-organisms are microbiology technologists. Blood bank technol
ogists collect, type, and prepare blood and its components for trans
fusions; immunology technologists examine elements and responses
of the human immune system to foreign bodies. Cytotechnologists,
who have specialized training, prepare slides of body cells and mi
croscopically examine these cells for abnormalities which may sig
nal the beginning of a cancerous growth.
Medical laboratory technicians generally have an associate degree
from a community or junior college, or a diploma or certificate from
a vocational or technical school. They perform routine tests and lab
oratory procedures. Technicians may prepare specimens and oper
ate automatic analyzers, for example, or they may perform manual
tests following detailed instructions. Like technologists, they may
work in several areas of the clinical laboratory or specialize in just
one. Histology technicians cut and stain tissue specimens for micro
scopic examination by pathologists and phlebotomists draw and test
blood. They usually work under the supervision of medical technol
ogists or laboratory managers.
Working Conditions
Hours and other working conditions vary according to the size and
type of employment setting. In large hospitals or in independent lab
oratories that operate continuously, personnel usually work the day,
evening, or night shift, and may work weekends and holidays. Labo
ratory personnel in small facilities may work on rotating shifts
rather than on a regular shift. In some facilities, laboratory person
nel are on call (available in case of emergency) several nights a week
or on weekends.
Clinical laboratory personnel are trained to work with infectious
specimens. When proper methods of infection control and steriliza
tion are followed, few hazards exist.
Laboratories generally are well lighted and clean; however, speci
mens, solutions, and reagents used in the laboratory sometimes pro
duce odors. Laboratory workers may spend a great deal of time on
their feet.
Nature of the Work
Employment
Clinical laboratory testing plays a crucial role in the detection, diag
nosis, and treatment of disease. Clinical laboratory technologists
Clinical laboratory technologists and technicians held about
268,000 jobs in 1992. More than half worked in hospitals. Most
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Experienced clinical technologists may advance to supervisory
positions.
others worked in medical laboratories and offices and clinics of phy
sicians. Some worked in blood banks, research and testing laborato
ries, and in the Federal Government—for Department of Veterans
Affairs hospitals and the U.S. Public Health Service.
About 1 laboratory worker in 6 worked part time.
Training, Other Qualifications, and Advancement
The usual requirement for an entry level position as a medical tech
nologist is a bachelor’s degree with a major in medical technology or
in one of the life sciences. Universities and hospitals offer medical
technology programs. It is also possible to qualify through a combi
nation of on-the-job and specialized training.
Bachelor’s degree programs in medical technology include
courses in chemistry, biological sciences, microbiology, and mathe
matics, and specialized courses devoted to knowledge and skills
used in the clinical laboratory. Many programs also offer or require
courses in management, business, and computer applications.
Masters degrees in medical technology and related clinical labo
ratory sciences provide training for specialized areas of laboratory
work or teaching, administration, or research. Two universities of
fer doctorates in clinical laboratory technology.
Medical laboratory technician training is offered in community
and junior colleges, hospitals, vocational and technical schools, and
in the Armed Forces. A few technicians learn on the job. Commu
nity and junior college programs last 2 years and lead to an associate
degree. Others are shorter and lead to a certificate in medical labora
tory technology.
Nationally recognized accrediting agencies in the allied health
field include the American Medical Association’s Committee on Al
lied Health Education and Accreditation (CAHEA), and the Ac
crediting Bureau of Health Education Schools (ABHES). CAHEA
accredits over 800 programs that provide education for medical
technologists, cytotechnologists, histologic technicians, specialists
in blood bank technology, and medical laboratory technicians.
ABHES accredits training programs for medical laboratory techni
cians.
Licensure and certification are methods of assuring the skill and
competence of workers. Licensure refers to the process by which a
government agency authorizes individuals to engage in a given oc
cupation and use a particular job title. Some States require labora
tory personnel to be licensed or registered. (Information on licen
sure is available from State departments of health, boards of
occupational licensing, or occupational information coordinating
committees.)
Certification is a voluntary process by which a nongovernmental
organization such as a professional society or certifying agency
grants recognition to an individual whose professional competence
meets prescribed standards. Widely accepted by employers in the
health industry, certification is a prerequisite for most jobs and often
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is necessary for advancement. Agencies that certify medical labora
tory technologists and technicians include the Board of Registry of
the American Society of Clinical Pathologists, the American Medi
cal Technologists, the National Certification Agency for Medical
Laboratory Personnel, and the Credentialing Commission of the In
ternational Society for Clinical Laboratory Technology. These
agencies have different requirements for certification and different
organizational sponsors.
Clinical laboratory personnel need analytical judgment and the
ability to work under pressure. Close attention to detail is essential
because small differences or changes in test substances or numerical
readouts can be crucial for patient care. Manual dexterity and nor
mal color vision are highly desirable. With the widespread use of au
tomated laboratory equipment, computer skills are important. In
addition, technologists in particular are expected to be good at prob
lem solving and to have strong interpersonal and communications
skills.
Technologists may advance to supervisory positions in laboratory
work or become chief medical technologists or laboratory managers
in hospitals. Manufacturers of home diagnostic testing kits and lab
oratory equipment and supplies seek experienced technologists to
work in product development, marketing, and sales. Graduate edu
cation in medical technology, one of the biological sciences, chemis
try, management, or education usually speeds advancement. A doc
torate is needed to become a laboratory director. Technicians can
become technologists through additional education and experience.
Job Outlook
As in most occupations, replacement needs will be the main source
of job openings. Employment of clinical laboratory workers is ex
pected to grow about as fast as the average for all occupations
through the year 2005 creating additional job openings. The rapidly
growing older population will spur demand, since older people gen
erally have more medical problems. Technological changes will
have two opposite effects on employment. New, more powerful di
agnostic tests will encourage more testing and spur employment.
However, advances in laboratory automation and simpler tests,
which make it possible for each worker to perform more tests,
should slow growth. Research and development efforts are targeted
at simplifying routine testing procedures so that nonlaboratory per
sonnel—physicians and patients in particular—can perform tests
now done in laboratories. Also, robots may prepare specimens, a job
now done by technologists and technicians.
Fastest growth is expected in independent medical laboratories,
as hospitals continue to send them a greater share of their testing.
Rapid growth is also expected in offices and clinics of physicians.
Slower growth is expected in hospitals.
Earnings
Median annual earnings of full time, salaried clinical laboratory
technologists and technicians were $26,312 in 1992. Half earned be
tween $19,136 and $32,864. The lowest 10 percent earned less than
$14,664 and the top 10 percent more than $39,000.
According to a University of Texas Medical Branch national sur
vey of hospitals and medical centers, the median annual salary of
medical technologists, based on a 40 hour week and excluding shift
or area differentials, was $31,202 in October 1992. The average min
imum salary was $24,888 and the average maximum was $36,844.
For medical laboratory technicians, the median was $23,340; for
histology technicians, the median was $25,605; for cytotechnolo
gists, the median was $34,414; and for phlebotomists, the median
was $16,209.
Related Occupations
Clinical laboratory technologists and technicians analyze body
fluids, tissue, and other substances using a variety of tests. Similiar
or related procedures are performed by analytical, water purifica
tion, and other chemists; science technicians; crime laboratory ana
lysts; food testers; and veterinary laboratory technicians.
Sources of Additional Information
Career and certification information is available from:
fW American Society of Clinical Pathologists, Board of Registry, P.O. Box
12277, Chicago, IL 60612.
American Medical Technologists, 710 Higgins Rd., Park Ridge, IL
60068.
XW National Certification Agency for Medical Laboratory Personnel, 7910
Woodmont Ave., Suite 1301, Bethesda, MD 20814.
W International Society for Clinical Laboratory Technology, 818 Olive St.,
Suite 918, St. Louis, MO 63101.
For more career information, write to:
O" American Association of Blood Banks, 1117 N. 19th St., Suite 600, Ar
lington, VA 22209.
XS" American Society of Cytology, 1015 Chestnut St., Suite 1518, Philadel
phia, PA 19107.
XW American Society for Medical Technology, 7910 Woodmont Ave., Suite
1301, Bethesda, MD 20814.
For a list of educational programs accredited by CAHEA for
clinical laboratory personnel, write to:
tar Committee on Allied Health Education and Accreditation, 515 North
State St., Chicago, IL 60610.
For a list of training programs for medical laboratory technicians
accredited by the Accrediting Bureau of Health Education Schools,
write to:
Secretary-ABHES, 29089 U.S. 20 West, Elkhart, IN 46514.
Information about employment opportunities in Department of
Veterans Affairs medical centers is available from local medical cen
ters and also from:
Dental hygienists sometimes administer local anesthetic.
Employment
Dental Hygienists
Dental hygienists held about 108,000jobs in 1992. Because multiple
jobholding is common in this field, the number of jobs greatly ex
ceeds the number of hygienists. About half of all dental hygienists
usually worked part time—less than 35 hours a week.
Almost all dental hygienists work in private dental offices. Some
work in public health agencies, school systems, hospitals, and clin
ics.
(D.O.T. 078.361-010)
Training, Other Qualifications, and Advancement
Xg* Title 38 Employment Division (054D), Department of Veterans Affairs,
810 Vermont Ave. NW., Washington, DC 20420.
Nature of the Work
Dental hygienists provide preventive dental care and teach patients
how to practice good oral hygiene.
Hygienists examine patients’ teeth and gums, recording the pres
ence of diseases or abnormalities. They remove calculus, stain, and
plaque from teeth; apply caries-preventive agents such as fluorides
and pit and fissure sealants; take and develop dental x rays; place
temporary fillings and periodontal dressings; remove sutures; and
polish and recontour amalgam restorations. In some States, hygien
ists administer local anesthetics and nitrous oxide/oxygen analge
sia, and place and carve filling materials.
Dental hygienists also help patients develop and maintain good
oral health. For example, they may explain the relationship between
diet and oral health, inform patients how to select toothbrushes, and
show patients how to floss their teeth. Some hygienists develop and
promote community dental health programs which may include
teaching how to practice good oral hygiene.
Dental hygienists use hand and rotary instruments to clean teeth,
x-ray machines to take dental pictures, syringes with needles to ad
minister local anesthetics, and models of teeth to explain oral hy
giene.
Working Conditions
Flexible scheduling is a distinctive feature of this job. Full-time,
part-time, evening, and weekend work is widely available. Dentists
frequently hire hygienists to work only 2 or 3 days a week, so hy
gienists may hold jobs in more than one dental office.
Dental hygienists work in clean, well-lighted offices. Important
health safeguards include strict adherence to proper radiological
procedures, compliance with recommended aseptic technique, and
use of appropriate protective devices when administering nitrous
oxide/oxygen analgesia. Dental hygienists also wear safety glasses,
surgical masks and gloves to protect themselves from infectious dis
eases such as hepatitis and AIDS. The occupation is one of several
covered by the Consumer-Patient Radiation Health and Safety Act
of 1981, which encourages the States to adopt uniform standards for
the training and certification of individuals who perform medical
and dental radiological procedures.
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Dental hygienists must be licensed by the State in which they prac
tice. To qualify for licensure, a candidate must graduate from an ac
credited dental hygiene school and pass both a written and a clinical
examination. The American Dental Association Joint Commission
on National Dental Examinations administers the written examina
tion that is accepted by all States and the District of Columbia. State
or regional testing agencies administer the clinical examination. In
addition, examinations on legal aspects of dental hygiene practice
are required by most States. Alabama also allows candidates to take
its examination if they have been trained through a State-regulated
on-the-job program in a dentist’s office.
In 1993, 208 programs in dental hygiene were accredited by the
Commission on Dental Accreditation. Although some programs
lead to a bachelor’s degree, most grant an associate degree. Five uni
versities offer master’s degree programs in dental hygiene.
An associate degree is sufficient for practice in a private dental of
fice. A bachelor’s or master’s degree is usually required for research,
teaching, or clinical practice in public or school health programs.
About half of the dental hygiene programs prefer applicants who
have completed at least 1 year of college. Some of the bachelor’s de
gree programs require applicants to have completed 2 years. How
ever, requirements vary from school to school. These schools offer
laboratory, clinical, and classroom instruction in subjects such as
anatomy, physiology, chemistry, microbiology, pharmacology, nu
trition, radiography, histology (the study of tissue structure), periodontology (the study of gum diseases), pathology, dental materials,
clinical dental hygiene, and social and behavioral sciences.
Dental hygienists should work well with others, particularly pa
tients who may be under stress. Dental hygienists must have manual
dexterity because they use dental instruments with little room for er
ror within a patient’s mouth. Recommended high school courses for
aspiring dental hygienists include biology, chemistry, and mathe
matics.
Job Outlook
Employment of dental hygienists is expected to grow much faster
than the average for all occupations through the year 2005 in re
sponse to increasing demand for dental care. Demand will be stimu
lated by population growth, greater retention of natural teeth by
middle-aged and elderly people and rising real incomes. Additional
5
job openings will result from the need to replace workers who leave
the occupation.
Also, dentists are likely to employ more hygienists, for several
reasons. Older dentists, who are less likely to employ dental hygien
ists, will leave and be replaced by recent graduates, who are more
likely to do so. In addition, as dentists’ workloads increase, they are
expected to hire more hygienists to perform preventive dental care
such as cleaning, so they may use their own time more profitably.
Enrollments in dental hygiene programs have been on the rise re
cently after declining during the 1980’s. Unless the number in
creases sharply, however, opportunities are expected to remain very
good.
Earnings
Earnings of dental hygienists are affected by geographic location,
employment setting, and education and experience. Dental hygien
ists who work in private dental offices may be paid on an hourly,
daily, salary, or commission basis.
According to the American Dental Association, dental hygienists
who worked 32 hours a week or more averaged $609 a week in 1991;
the average hourly earnings for all dental hygienists was $18.50.
Benefits vary substantially by practice setting, and may be contin
gent upon full-time employment. Dental hygienists who work for
school systems, public health agencies, the Federal Government, or
State agencies usually have substantial benefits.
Related Occupations
Workers in other occupations supporting health practitioners in an
office setting include dental assistants, ophthalmic medical assist
ants, podiatric assistants, office nurses, medical assistants, and phy
sician assistants.
Sources of Additional Information
For information on a career in dental hygiene and the educational
requirements to enter this occupation, contact:
W Division of Professional Development, American Dental Hygienists’ As
sociation, 444 N. Michigan Ave., Suite 3400, Chicago, IL 60611.
t3° SELECT, American Dental Association, Department of Career Gui
dance, 211 E. Chicago Ave., Suite 1804, Chicago, IL 60611.
For information about accredited programs and educational re
quirements, contact:
Commission on Dental Accreditation, American Dental Association,
211 E. Chicago Ave., Suite 1814, Chicago, IL 60611.
The State Board of Dental Examiners in each State can supply in
formation on licensing requirements.
the surface of the metal to allow the metal and porcelain to bond.
They apply porcelain in layers to arrive at the precise shape and
color of a tooth. Technicians place the tooth in a porcelain furnace
to bake the porcelain onto the metal framework, then adjust the
shape and color with subsequent grinding and addition of porcelain
to achieve a sealed finish. The final product is an exact replica of the
lost tooth or teeth.
In some laboratories, technicians perform all stages of the work,
while in others, each does only a few. Dental laboratory technicians
also may specialize in one of five areas: Orthodontic appliances,
crown and bridge, complete dentures, partial dentures, or ceramics.
Job titles may reflect specialization in these areas. For example,
technicians who make porcelain and acrylic restorations are called
dental ceramists.
Working Conditions
Dental laboratory technicians generally work in clean, well-lighted,
and well-ventilated areas. Technicians usually have their own work
benches, which may be equipped with Bunsen burners, grinding and
polishing equipment, and hand instruments, such as wax spatulas
and wax carvers.
The work is extremely delicate and quite time consuming. Sala
ried technicians usually work 40 hours a week, but self-employed
technicians frequently work longer hours.
Employment
Dental laboratory technicians held about 48,000 jobs in 1992. Most
jobs were in commercial dental laboratories, which usually are
small, privately owned businesses with fewer than five employees.
However, some laboratories are larger; a few employ over 50 techni
cians.
Some dental laboratory technicians worked in dentists’ offices.
Others worked for hospitals that provide dental services, including
Department of Veterans Affairs hospitals. Some technicians work in
dental laboratories in their homes, in addition to their regular job.
Approximately 1 technician in 7 is self-employed, a higher propor
tion than in most other occupations.
Training, Other Qualifications, and Advancement
Most dental laboratory technicians learn their craft on the job. They
begin with simple tasks, such as pouring plaster into an impression,
and progress to more complex procedures, such as making porcelain
Dental Laboratory Technicians
(D.O.T. 712.381-014, -018, -022, -026, -030, -042, -046, and -050)
Nature of the Work
Dental laboratory technicians are like pharmacists: They fill pre
scriptions. But their prescriptions come from dentists, and their or
ders are for crowns, bridges, dentures, and other dental prosthetics.
Dentists send a specification of the item to be fabricated along with
an impression (mold) of the patient’s mouth or teeth to the techni
cians. Then dental laboratory technicians, also called dental techni
cians, create a model of the patient’s mouth by pouring plaster into
the impression and allowing it to set. They place the model on an ap
paratus which mimics the bite and movement of the patient’s jaw.
The model serves as the basis of the prosthetic device. Technicians
examine the model, noting the size and shape of the adjacent teeth
or gaps within the gumline. Based upon these observations and the
dentist’s specifications, technicians build and shape a wax tooth or
teeth using small hand instruments called wax spatulas and wax
carvers. They use this wax model to cast the metal framework for
the prosthetic device.
Once the wax tooth has been formed, dental technicians pour the
cast and form the metal. Using small hand-held tools, they prepare
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Many dental lab technicians are trained on the job.
crowns and bridges. Becoming a fully trained technician requires an
average of 3 to 4 years depending upon the individual’s aptitude and
ambition, but it may take a few more years to be recognized as an ac
complished technician.
Training in dental laboratory technology is also available through
community and junior colleges, vocational-technical institutes, and
the Armed Forces. Formal training programs vary greatly both in
length and the level of skill they impart.
In 1993, 42 programs in dental laboratory technology were ap
proved (accredited) by the Commission on Dental Accreditation in
conjunction with the American Dental Association (ADA). These
programs provide classroom instruction in dental materials science,
oral anatomy, fabrication procedures, ethics, and related subjects.
In addition, each student is given supervised practical experience in
the school or an associated dental laboratory. Accredited programs
generally take 2 years to complete and lead to an associate degree.
Graduates of 2-year training programs need additional hands-on
experience to become fully qualified. Each dental laboratory owner
operates in a different way, and classroom instruction does not nec
essarily expose students to techniques and procedures favored by in
dividual laboratory owners. Students who have taken enough
courses to learn the basics of the craft generally are considered good
candidates for training, regardless of whether they have completed
the formal program. Many employers will train someone without
any classroom experience.
Certification, which is voluntary, is offered by the National Board
for Certification in five specialty areas: Crown and bridge, ceramics,
partial dentures, complete dentures, and orthodontic appliances.
In larger dental laboratories, technicians may become supervisors
or managers. Experienced technicians may teach or take jobs with
dental suppliers in such areas as product development, marketing,
or sales. Still, for most technicians, opening one’s own laboratory is
the way toward advancement and higher earnings.
A high degree of manual dexterity, good vision, and the ability to
recognize very fine color shadings and variations in shape are neces
sary. An inclination for detailed and precise work also is important.
Useful high school courses are art, metal and wood shop, drafting,
and sciences. Courses in management and business may help those
wishing to operate their own laboratories.
Job Outlook
Job opportunities for dental laboratory technicians should be
favorable despite little growth in the occupation. Employers have
difficulty filling trainee positions, probably because of relatively low
entry level salaries and lack of familiarity with the occupation. Also,
experienced technicians who have built up a favorable reputation
with dentists should have good opportunities for establishing labo
ratories of their own.
Although job opportunities are favorable, employment of dental
laboratory technicians is not expected to grow through the year
2005, due to changes in dental care. The fluoridation of drinking
water, which has reduced the incidence of dental caries, and greater
emphasis on preventive dental care since the early 1960’s have im
proved the overall dental health of the population. As a result, peo
ple are keeping their teeth longer. Instead of full or partial dentures,
most people will need a bridge or crown. This means less work for
the dental laboratory technician, who may need to fabricate only
three or four teeth rather than a whole set of false teeth.
Office-based, computer-aided equipment, designed to measure a
patient’s mouth and fabricate the required prosthetic device, is cur
rently under development and testing in Europe. While not replac
ing the technicians completely, such equipment, when and if it
comes into widespread use in this country, could reduce the amount
of time required to produce dental prosthetics—and, therefore, the
demand for dental laboratory technicians.
Earnings
According to the American Dental Association, the average hourly
earnings for dental laboratory technicians in independent dental of
fices was $13.30 in 1991. According to limited data, trainees in den
tal laboratories average only a little over minimum wage. However,
earnings rise sharply with experience. In general, earnings of selfemployed technicians exceed those of salaried workers.
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Related Occupations
Dental laboratory technicians fabricate artificial teeth, crowns and
bridges, and orthodontic appliances following the specifications and
instructions provided by dentists. Other workers who make medical
devices include arch-support technicians, orthotics technicians
(braces and surgical supports), prosthetics technicians (artificial
limbs and appliances), opticians, and ophthalmic laboratory techni
cians.
Sources of Additional Information
For information about training and a list of approved schools, con
tact:
fir Commission on Dental Accreditation, American Dental Association,
211 E. Chicago Ave., Chicago, IL 60611.
General information on grants and scholarships is available from
dental technology schools.
For information on career opportunities in commercial laborato
ries, contact:
O" National Association of Dental Laboratories, 3801 Mt. Vernon Ave., Al
exandria, VA 22305.
For information on requirements for certification, contact:
XW National Board for Certification in Dental Technology, 3801 Mt. Vernon
Ave., Alexandria, VA 22305.
Dispensing Opticians
(D.O.T. 299.361-010 and -014)
Nature of Work
Dispensing opticians fit eyeglasses and contact lenses, following pre
scriptions written by ophthalmologists or optometrists. (The work
of optometrists is described in a statement elsewhere in the Hand
book. See the statement on physicians for information about oph
thalmologists.)
Dispensing opticians help customers select appropriate frames,
order the necessary ophthalmic laboratory work, and adjust the fin
ished eyeglasses. In some States, they fit contact lenses under the su
pervision of an optometrist or ophthalmologist.
Dispensing opticians examine written prescriptions to determine
lens specifications. They recommend eyeglass frames, lenses, and
lens coatings after considering the prescription and the customer’s
occupation, habits, and facial features. Dispensing opticians mea
sure clients for size of eyeglasses including the distance between the
centers of the pupils and the distance between the eye surface and
the lens. For customers without prescriptions, dispensing opticians
may use a lensometer to record the present eyeglass prescription.
Dispensing opticians may obtain a customer’s previous record,
or verify a prescription with the examining optometrist or ophthal
mologist.
Dispensing opticians prepare work orders that give ophthalmic
laboratory technicians information needed to grind and insert lenses
into a frame. The work order includes lens prescriptions and infor
mation on lens size, material, color, and style. Some dispensing opti
cians grind and insert lenses themselves. After the glasses are made,
dispensing opticians verify that the lenses have been ground to spec
ifications. Then they may reshape or bend the frame, by hand or us
ing pliers, so that the eyeglasses fit the customer properly and com
fortably. Dispensing opticians also fix, adjust, and refit broken
frames. They instruct clients about adapting to, wearing, or caring
for eyeglasses.
Some dispensing opticians specialize in fitting contacts, artificial
eyes, cosmetic shells to cover blemished eyes, or low vision aids. To
fit contact lenses, dispensing opticians measure eye shape and size,
select the type of contact lens material, and prepare work orders
specifying the prescription and lens size. Fitting contact lenses re
quires considerable skill, care, and patience. Dispensing opticians
observe customers’ eyes, corneas, lids, and contact lenses with spe
cial instruments and microscopes. During several visits, opticians
show customers how to insert, remove, and care for their contacts,
and make sure the fit is correct.
7
Dispensing opticians keep records on customer prescriptions,
work orders, and payments; track inventory and sales; and perform
other administrative duties.
Working Conditions
Dispensing opticians work indoors in attractive, well lighted, and
well ventilated surroundings. They may work in small stores where
customers are served one at a time, or in large stores where several
dispensing opticians serve a number of customers at once. Opticians
deal with customers most of the time and spend much time on their
feet. If they also prepare lenses, they need to take precautions
against the hazards associated with glass cutting, chemicals, and
machinery.
Most dispensing opticians work a 40-hour week, although some
work longer hours. Those in retailing may work evenings and week
ends. Some work part time.
Employment
Dispensing opticians held about 63,000 jobs in 1992. About half
work for ophthalmologists or optometrists who sell glasses directly
to patients. Many also work in optical shops, including “superoptical stores.” These stores offer one-stop shopping: Customers may
have their eyes examined, choose frames, and have glasses made on
the spot. Some work in optical departments of drug and department
stores.
Training, Other Qualifications, and Advancement
Some employers hire individuals with no background in opticianry
or those who have worked as ophthalmic laboratory technicians.
(See the statement on ophthalmic laboratory technicians elsewhere
in the Handbook.) Training may be informal, on-the-job or formal
apprenticeship. Others seek people with college level training in op
ticianry.
Knowledge of physics, basic anatomy, algebra, geometry, and
mechanical drawing is particularly valuable because training usu
ally includes instruction in optical mathematics, optical physics,
and the use of precision measuring instruments and other machin
ery and tools. Because dispensing opticians deal directly with the
public, they should be tactful and pleasant and communicate well.
Large employers generally offer structured apprenticeship pro
grams, and small employers provide more informal on-the-job train
ing. In the 21 States that license dispensing opticians, individuals
without formal college level training train from 2 to 4 years as ap
prentices. Apprenticeship or formal traineeship is offered in most of
the other States as well.
Apprentices receive technical training and are taught office man
agement and sales. Under the supervision of an experienced opti
cian, optometrist, or ophthamologist, apprentices work directly
with patients, fitting eyeglasses and contact lenses. In States requir
ing licensure, information about apprenticeships and licensing pro
cedures is available from the State board of occupational licensing.
Formal opticianry training is offered in community colleges and a
few colleges and universities. In 1993, there were about 40 pro
grams. Of these, 23 were accredited by the Commission on Op
ticianry Accreditation and awarded 2-year associate degrees in
ophthalmic dispensing or optometric technology. There are also
shorter programs, including some under 1 year. Some States that li
cense dispensing opticians allow graduates to take the licensure
exam immediately upon graduation; others require a few months to
a year of experience.
Dispensing opticians may also gain credentials through voluntary
certification or registration by the American Board of Opticianry
and by the National Contact Lens Examiners. Certification must be
renewed every 3 years through continuing education.
Many experienced dispensing opticians go into the opticianry
business for themselves. Others become managers of optical stores
or sales representatives for wholesalers or manufacturers of eye
glasses or lenses.
Job Outlook
Employment in this occupation is expected to increase faster than
the average for all occupations through the year 2005 in response to
rising demand for corrective lenses. The number of middle-aged and
elderly persons is projected to increase rapidly. Middle age is a time
when many people use corrective lenses for the first time, and eld
erly persons require more vision care, on the whole, than others.
Fashion, too, influences demand. Frames come in a growing vari
ety of styles and colors—encouraging people to buy more than one
pair. Finally, demand is expected to grow in response to products
such as special lens treatments; photochromic lenses (glasses that
become sunglasses in sunlight), now available in plastic as well as
glass; tinted lenses; and bifocal, extended wear, and disposable con
tact lenses.
This occupation is vulnerable to changes in the business cycle,
with employment falling somewhat during downturns. There will be
a relatively large number of job openings, both to replace those who
leave the occupation and due to growth. This is a young occupation
and like many other occupations in retail trade, many people trans
fer to other occupations.
Earnings
According to the Opticians Association of America, salaries for dis
pensing opticians in retail stores averaged about $26,000 in 1992.
The beginning average salary for licensed and certified opticians was
$20,971. Those with 3 to 5 years of experience averaged $21,875; 6
to 9 years, $25,876; and 10 years or more, $29,640. Noncertified op
ticians averaged about $6,000 less at each level of experience. Begin
ning apprentices averaged about $13,000 a year. Some opticians
earned well above $30,000 a year. Those who run their own stores
earned more than salaried workers. In addition to base salaries,
many employers provide commissions, bonuses, and profit-sharing.
Related Occupations
Other workers who deal with customers and perform delicate work
include jewelers, artificial eye makers, ophthalmic laboratory tech
nicians, orthodontic technicians, dental laboratory technicians,
prosthetics technicians, camera repairers, and watch repairers.
Sources of Additional Information
For general information about this occupation, contact:
^Opticians Association of America, 10341 Democracy Lane, Fairfax, VA
22030-2521.
For a list of accredited training programs, contact:
IS” Commission on Opticianry Accreditation, 10111 Martin Luther King,
Jr. Hwy., Suite 100, Bowie, MD 20720-4299.
For general information on opticianry and a list of home-study
programs, seminars, and review materials, contact:
Dispensing opticians help customers select appropriate frames.
8
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tsr National Academy of Opticianry, 10111 Martin Luther King, Jr. Hwy.,
Suite 112, Bowie, MD 20720-4299.
EEG Technologists
(D.O.T. 078.362-022)
Nature of the Work
“Brain waves” are electrical impulses which can be recorded by an
electroencephalograph (EEG) technologist using an EEG machine.
Since technologists often perform other related tests as well, they
may also be called electroneurodiagnostic or neurophysiologic tech
nologists. The tests performed by these technologists help neurolo
gists—physicians who study the brain—to diagnose brain tumors,
strokes, toxic/metabolic disorders, and epilepsy; to measure the ef
fects of infectious diseases on the brain; and to determine whether
individuals with mental or behavioral problems have an organic im
pairment such as Alzheimer’s disease. They are also used to deter
mine “cerebral” death, the absence of brain activity, and to assess
the probability of a recovery from a coma.
For basic, “resting” EEG’s, technologists take patients’ medical
histories and help them relax. Then they apply electrodes to desig
nated spots on the patient’s head and choose the most appropriate
combination of instrument controls and electrodes to produce the
kind of record needed. Technologists correct for electrical or
mechanical events that come from somewhere other than the brain,
such as eye movement or interference from electrical sources.
Increasingly, technologists perform EEG’s in the operating room,
which requires that they understand anesthesia’s effect on brain
waves.
For special procedure EEG’s, technologists may secure elec
trodes to the chest, arm, leg, or spinal column to record activity
from both the central and peripheral nervous systems.
In ambulatory monitoring, EEG technologists monitor the brain,
and sometimes the heart, while patients carry out normal activities
over a 24-hour period. Then they remove the small recorder carried
by the patients and obtain a readout. Technologists review the read
outs, a process which can take several hours, selecting sections for
the physician to examine.
Using “evoked potential” testing, technologists measure sensory
and physical responses to specific stimuli. After the electrodes have
been attached, technologists set the instrument for the type and in
tensity of the stimulus, increase the intensity until the patient reacts,
and note the sensation level. The tests may take from 1 to 4 hours.
For nerve conduction tests, used to diagnose muscle and nerve
problems, technologists place electrodes on the patient’s skin over a
nerve and over the muscle. Then they stimulate the nerve with an
electrical current and record how long it takes the nerve impulse to
reach the muscle.
Specialized electroneurodiagnostic technologists also administer
sleep studies and perform quantative EEG’s (sometimes called
“brain wave mapping”). For sleep studies, technologists monitor
respiration and heart activity in addition to brain wave activity.
They must know the various stages of sleep and the dynamics of the
neurologic and cardiopulmonary systems during each stage. Tech
nologists coordinate readings from several organ systems, separat
ing them according to the stages of sleep, and relay them to the phy
sician. For quantative EEG’s, technologists decide which sections of
the EEG should be transformed into color-coded pictures of brain
wave frequency and intensity, for interpretation by a physician.
They may also write technical reports summarizing test results.
Technologists also look for changes in the patient’s neurologic,
cardiac, and respiratory status, which may indicate an emergency,
such as a heart attack, and provide emergency care until help ar
rives.
EEG technologists may have supervisory or administrative re
sponsibilities. They may manage an EEG laboratory, arrange work
schedules, keep records, schedule appointments, order supplies, and
provide instruction in EEG techniques. Technologists may also be
responsible for the equipment’s upkeep.
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EEG technologists test for brain and nervous system disorders.
Working Conditions
EEG technologists usually work in clean, well-lighted surround
ings, and spend about half of their time on their feet. Bending and
lifting are necessary since they may work with patients who are very
ill and require assistance. EEG technologists in hospitals may do all
their work in a single room, or may push equipment to patients’ bed
sides and obtain recordings there.
Most technologists work a standard workweek, although those in
hospitals may be “on call” (ready to report to work at a moment’s
notice) evenings, weekends, and holidays. Those performing sleep
studies may work evenings and nights.
Employment
EEG technologists held more than 6,000 jobs in 1992. Most worked
in EEG or neurology laboratories of hospitals. Others worked in of
fices and clinics of neurologists and neurosurgeons, health mainte
nance organizations, and psychiatric facilities.
Training, Other Qualifications, and Advancement
EEG technologists generally learn their skills on the job, although
some complete formal training programs. Often, EEG trainees
transfer from other hospital jobs, such as licensed practical nurse.
Applicants for trainee positions in hospitals need at least a high
school diploma, while some hospitals require postsecondary train
ing.
Formal postsecondary training is offered in hospitals and com
munity colleges. In 1992, the Joint Review Committee on Education
in Electroneurodiagnostic Technology had approved 13 formal pro
grams. Programs usually last from 1 to 2 years and include labora
tory experience as well as classroom instruction in human anatomy
and physiology, neurology, neuroanatomy, neurophysiology, medi
cal terminology, computer technology, electronics and instrumenta
tion. Graduates receive associate degrees or certificates.
The American Board of Registration of Electroencephalographic
and Evoked Potential Technologists awards the credential “Regis
tered EEG Technologist” to qualified applicants. This board also
accredits technologists evoked potentials as “Registered Evoked Po
tential Technologist.” Although not generally required for staff
level jobs, registration indicates professional competence, and usu
ally is necessary for supervisory or teaching jobs.
Technologists should have manual dexterity, good vision, writing
skills, an aptitude for working with electronic equipment, and the
ability to work with patients as well as with other health personnel.
High school courses in health, biology, and mathematics are useful.
EEG technologists in large hospitals can advance to jobs perform
ing more difficult tests and then to chief EEG technologist, who
manages the EEG laboratory. Chief EEG technologists generally
are supervised by a physician—an electroencephalographer, neurol
ogist, or neurosurgeon. Technologists may also teach or go into re
search.
9
Job Outlook
Employment of EEG technologists is expected to grow much faster
than the average for all occupations through the year 2005, reflect
ing the increased numbers of neurodiagnostic tests performed.
There will be more testing as new tests and procedures are devel
oped, and as the older population, which requires more medical
care, grows rapidly. Most job openings will result from the need to
replace workers who transfer to other occupations or leave the labor
force.
Most jobs will still be found in hospitals; however, growth will be
fastest in offices and clinics of neurologists.
Earnings
According to a University of Texas Medical Branch national survey
of hospitals and medical centers, the median annual salary of EEG
technologists, based on a 40 hour week and excluding shift or area
differentials, was $23,369 in October 1992. The average minimum
salary was $19,695 and the average maximum was $28,736.
Related Occupations
Other health personnel who operate medical equipment include ra
diologic technologists, nuclear medicine technologists, perfusion
ists, and cardiovascular (EKG) technologists.
Sources of Additional Information
Local hospitals can supply information about employment opportu
nities.
For general information about a career in electroencepha
lography as well as a list of accredited training programs, contact:
EMT-Intermediates, or EMT-I’s, have more advanced training
and can perform such addtional procedures as administer intrave
nous fluids; and use defibrillators to give lifesaving shocks to a
stopped heart.
EMT-Paramedics provide the most extensive prehospital care. In
addition to the procedures already described, paramedics may ad
minister drugs orally and intravenously, interpret EKG’s, perform
endotracheal intubations, and use monitors and other complex
equipment.
Some conditions are simple enough to be handled following gen
eral rules and guidelines. More complicated problems can only be
carried out under the step-by-step direction of medical personnel
with whom the EMT’s are in radio contact.
When victims are trapped, as in the case of an automobile acci
dent, cave-in, or building collapse, EMT’s free them or provide
emergency care while others free them.
When transporting patients to a medical facility, EMT’s may use
special equipment such as backboards to immobilize them before
placing them on stretchers and securing them in the ambulance.
While one EMT drives, the other monitors the patient’s vital signs
and gives additional care as needed. Some EMT’s work for hospital
trauma centers or jurisdictions which use helicopters to transport
critically ill or injured patients.
At a medical facility, EMT’s transfer patients to the emergency
department, report to the staff their observations and the care they
provided, and may help provide emergency treatment.
After each run, EMT’s replace used supplies and check equip
ment. If patients have had a contagious disease, EMT’s decontami
nate the interior of the ambulance and report cases to the proper au
thorities.
W Executive Office, American Society of Electroneurodiagnostic Technolo
gists, Inc., 204 W. 7th, Carroll, IA 51401.
For information on work in sleep studies, contact:
O’ Association of Polysomnographic Technology, 1610 14th St. NW., Suite
300, Rochester, MN 55901.
Information about specific accredited training programs is also
available from:
is1 Joint Review Committee on Electroneurodiagnostic Technology, P.O.
Box 11434, Norfolk, VA 23517.
Information on becoming a registered EEG technologist is availa
ble from:
t3p American Board of Registration of Electroencephalgraphic and Evoked
Potential Technologists, P.O. Box 11434, Norfolk, VA 23517.
Working Conditions
EMT’s work both indoors and outdoors, in all kinds of weather.
Much of their time is spent standing, kneeling, bending, and lifting.
They may risk noise-induced hearing loss from ambulance sirens
and back injuries from lifting patients. EMT’s may be exposed to
diseases such as Hepatitis-B and AIDS, as well as violence from
drug overdose victims. The work is not only physically strenuous,
but stressful—not surprising in a job that involves life-or-death situ
ations. However, many people find the work exciting and challeng
ing.
Emergency Medical Technicians
(D.O.T. 079.364-026 and .374-010)
Nature of the Work
Automobile accident injuries, heart attacks, near drownings, un
scheduled childbirths, poisonings, and gunshot wounds all demand
urgent medical attention. Emergency medical technicians (EMT’s)
give immediate care and then transport the sick or injured to medi
cal facilities.
Following instructions from a dispatcher, EMT’s—who usually
work in teams of two—drive specially equipped emergency vehicles
to the scene of emergencies. If necessary, they request additional
help from police, fire, or electric company personnel, or they may
enlist bystanders to direct traffic or remove debris. They determine
the nature and extent of the patient’s injuries or illness while also
trying to determine whether the patient has epilepsy, diabetes, or
other preexisting medical conditions. EMT’s then give appropriate
emergency care following strict guidelines for which procedures
they may perform. All EMT’s, including those with basic skills, the
EMT-Basic, may open airways, restore breathing, control bleeding,
treat for shock, administer oxygen, immobilize fractures, bandage
wounds, assist in childbirth, manage emotionally disturbed patients,
treat and assist heart attack victims, give initial care to poison and
bum victims, and treat patients with anti-shock trousers, which pre
vent a person’s blood pressure from falling too low.
10
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Most job openings for EMT’s will result from people who leave the
field.
EMT’s employed by fire departments often have about a 50-hour
workweek. Those employed by hospitals frequently work between
45 and 58 hours a week and those in private between 48 and 51
hours. Some EMT’s, especially those in police and fire departments,
are on call for extended periods. Because most emergency services
function 24 hours a day, EMT’s have irregular working hours that
add to job stress.
Employment
In 1992, EMT’s held 114,000jobs. Two-fifths were in private ambu
lance services, about a third were in municipal fire, police, or rescue
squad departments, and a quarter were in hospitals. In addition,
there are many volunteer EMT’s.
Most paid EMT’s work in metropolitan areas. In many smaller
cities, towns, and rural areas, there are no paid EMT jobs. All ser
vices are provided by volunteers.
Training, Other Qualifications, and Advancement
Formal training is needed to become an EMT. EMT-Basic training
is 100 to 120 hours of classroom work plus 10 hours of internship in
a hospital emergency room. Training is available in 50 States and
the District of Columbia, and is offered by police, fire, and health
departments; in hospitals; and as a nondegree course in colleges and
universities.
The EMT basic program provides instruction and practice in
dealing with bleeding, fractures, airway obstruction, cardiac arrest,
and emergency childbirth. Students learn to use and care for com
mon emergency equipment, such as backboards, suction devices,
splints, oxygen delivery systems, and stretchers.
EMT-Intermediate training varies from State to State, but in
cludes 35-55 hours of additional instruction in patient assessment as
well as the use of esophageal airways, intravenous fluids, and an
tishock garments. Training programs for EMT-Paramedics gener
ally last between 750 and 2,000 hours. Refresher courses and contin
uing education are available for EMT’s at all levels.
Applicants to an EMT training course generally must be at least
18 years old and have a high school diploma or the equivalent and a
driver’s license. Recommended high school subjects for prospective
EMT’s are driver education, health, and science. Training in the
Armed Forces as a “medic” is also good preparation.
In addition to EMT training, EMT’s in fire and police depart
ments must be qualified as firefighters or police officers.
Graduates of approved EMT-Basic training programs who pass a
written and practical examination administered by the State certify
ing agency or the National Registry of Emergency Medical Techni
cians earn the title of Registered EMT-Basic. Prerequisites for tak
ing the EMT-Intermediate examination include registration as an
EMT-Basic, required classroom work, and a specified amount of
clinical experience and field internship. Registration for EMTParamedics by the National Registry of Emergency Medical Tech
nicians or a State emergency medical services agency requires cur
rent registration or State certification as an EMT-Basic, completion
of an EMT-Paramedic training program and required clinical and
field interships as well as passing of a written and practical examina
tion. Although not a general requirement for employment, registra
tion acknowledges an EMT’s qualifications and may make higher
paying jobs easier to obtain.
All 50 States have some kind of certification procedure. In 29
States and the District of Columbia, registration with the National
Registry is required at some or all levels of certification. Other
States require their own certification examination or provide the op
tion of taking the National Registry examination.
To maintain their certification, all EMT’s must reregister, usually
every 2 years. In order to reregister, an individual must be working
as an EMT and meet a continuing education requirement.
EMT’s should have emotional stability, good dexterity, agility,
physical coordination and be able to lift and carry heavy loads.
EMT’s need good eyesight (corrective lenses may be used) with ac
curate color vision.
Advancement beyond the EMT-Paramedic level usually means
leaving fieldwork. An EMT-Paramedic can become a supervisor,
operations manager, administrative director, or executive director
of emergency services. Some EMT’s become EMT instructors,
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firefighters, dispatchers, or police officers, or others move into sales
or marketing of emergency medical equipment. Finally, some be
come EMT’s to assess their interest in health care and then decide to
return to school and become R.N.’s, physicians, or other health
workers.
Job Outlook
Most job openings will occur because of this occupation’s substan
tial replacement needs. Turnover is quite high, reflecting this occu
pation’s stressful working conditions, limited advancement poten
tial, and the modest pay and benefits in the private sector.
Employment of EMT’s is expected to grow faster than average for
all occupations through the year 2005. Driving the growth will be an
expanding population. Also, the number of older people, who are
more likely to need emergency services, is increasing rapidly.
Opportunities for EMT’s are expected to be excellent in hospitals
and private ambulance services, where pay and benefits usually are
low. Competition for jobs will be keen in fire, police, and rescue
squad departments because of attractive pay and benefits and good
job security.
Earnings
Earnings of EMT’s depend on the employment setting and geo
graphic location as well as the individual’s training and experience.
According to a survey conducted by the Journal ofEmergency Med
ical Services (JEMS), average starting salaries in 1993 were $20,092
for EMT-Ambulance or Basic, $19,530 for EMT-Intermediate, and
$24,390 for EMT-Paramedic. EMT’s working in fire departments
command the highest salaries, as the accompanying table shows.
Table 1. Average annual salaries of emergency medical technicians, by type
of employer, 1993
Employer
Paramedic
EMT-I
All employers (mean)..............
$28,079
$22,682
$22,848
Private ambulance services__
Hospitals..................................
Fire departments......................
25,606
24,944
34,994
20,060
21,088
30,914
19,383
18,845
31,141
EMT-Basic
SOURCE: Journal of Emergency Medical Services
Those in emergency medical services which are part of fire or police
departments receive the same benefits as firefighters or police of
ficers.
Related Occupations
Other workers in occupations that require quick and level-headed
reactions to life-or-death situations are police officers, firefighters,
air traffic controllers, workers in other health occupations, and
members of the Armed Forces.
Sources of Additional Information
Information concerning training courses, registration, and job op
portunities for EMT’s can be obtained by writing to the State Emer
gency Medical Service Director.
General information about EMT’s is available from:
ty National Association of Emergency Medical Technicians, 9140 Ward
Pky., Kansas City, MO 64114.
Medical Record Technicians
(D.O.T. 079.362-014,-018)
Nature of the Work
When you enter a hospital, you see a whirl of white coats of physi
cians, nurses, radiologic technologists, and others. Every time these
11
health care personnel treat a patient, they record what they ob
served and did to the patient. This record includes information the
patient provides about their symptoms and medical history, and
also the results of examinations, reports of X ray and laboratory
tests, and diagnoses and treatment plans. Medical record techni
cians organize and evaluate these records for completeness and ac
curacy.
When assembling a patient’s medical record, technicians, who
may also be called medical record technicians, first make sure that
the medical chart is complete. They ensure that all forms are present
and properly identified and signed, and that all necessary informa
tion is on a computer file. Sometimes, they talk to physicians or
others to clarify diagnoses or get additional information.
Technicians assign a code to each diagnosis and procedure. They
consult a classification manual and rely, too, on their knowledge of
disease processes. Technicians may then use a software program to
assign the patient to one of several hundred “diagnosis-related
groups” or DRG’s. The DRG determines the amount the hospital
will be reimbursed if the patient is covered by Medicare or other in
surance programs that use the DRG system. Technicians who spe
cialize in coding are called medical record coders, coder/abstrac
tors, or coding specialists.
Technicians may also tabulate and analyze data to help improve
patient care, to control costs, to be used in legal actions, or to re
spond to surveys. Tumor registrars compile and maintain records of
patients who have cancer to provide information to physicians and
for research studies.
Medical record technicians’ duties vary with the size of the facil
ity. In large to medium facilities, technicians may specialize in one
aspect of medical records or supervise medical record clerks and
transcribers while a medical record administrator manages the de
partment (see the statement on health services managers elsewhere
in the Handbook). In small facilities an accredited record technician
may manage the department.
Working Conditions
Medical record technicians generally work a 40-hour week. Some
overtime may be required. In hospitals where medical record de
partments are open 18-24 hours a day, 7 days a week, they may
work on day, evening, and night shifts.
They work in pleasant and comfortable offices. Medical record
technician is one of the few health occupations in which there is lit
tle or no contact with patients. Accuracy is essential, and this de
mands concentration and close attention to detail. Medical record
technicians who work at video display terminals for prolonged peri
ods may experience eyestrain and muscle pain.
Employment
Medical record technicians held about 76,000 jobs in 1992. About
one half of jobs were in hospitals. Most of the remainder were in
nursing homes, medical group practices, health maintenance orga
nizations, and clinics.
In addition, insurance, accounting, and law firms that deal in
health matters employ medical record technicians to tabulate and
analyze data from medical records. Public health departments hire
technicians to supervise data collection from health care institutions
and to assist in research.
Some self-employed medical record technicians are consultants to
nursing homes and physicians’ offices.
Training, Other Qualifications, and Advancement
Medical record technicians entering the field usually have formal
training in a 2-year associate degree program offered at community
and junior colleges. Courses include medical terminology and dis
eases, anatomy and physiology, legal aspects of medical records,
coding and abstraction of data, statistics, databases, quality assur
ance methods, and computers as well as general education.
Technicians may also gain training through an Independent
Study Program in Medical Record Technology offered by the
American Health Information Management Association
(AHIMA). Hospitals sometimes advance promising medical record
clerks to jobs as medical record technicians, although this practice
may be less common in the future. Advancement generally requires
2-4 years ofjob experience and completion of the hospital’s in-house
training program.
Most employers prefer to hire Accredited Record Technicians
(ART). Accreditation is obtained by passing a written examination
offered by the AHIMA. To take the examination, a person must be a
graduate of a 2-year associate degree program accredited by the
Committee on Allied Health Education and Accreditation
(CAHEA) of the American Medical Association, or a graduate of
the Independent Study Program in Medical Record Technology
who has also obtained 30 semester hours of academic credit in pre
scribed areas. Technicians who have received training in nonCAHEA accredited programs or on the job are not eligible to take
the examination. In 1992, CAHEA accredited 90 programs for
medical record technicians.
Experienced medical record technicians generally advance in one
of two ways—by specializing or managing. Many senior medical re
cord technicians specialize in coding, particularly Medicare coding
or in tumor registry.
In large medical record departments, experienced technicians
may become section supervisors, overseeing the work of the coding,
correspondence, or discharge sections, for example. Senior techni
cians with ART credentials may become director or assistant direc
tor of a medical record department in a small facility. However, in
larger institutions the director is a medical records administrator,
with a bachelor’s degree in medical record administration. (See the
statement on health services managers elsewhere in the Handbook.)
Job Outlook
Medical record technicians may also be referred to as health
information technicians.
12
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Hospitals will continue to employ the most technicians. Most job
openings will occur because of replacement needs. The job prospects
for formally trained technicians should be very good. Employment
of medical record technicians is expected to grow much faster than
the average for all occupations through the year 2005 due to rapid
growth in the number of medical tests, treatments, and procedures
and because medical records will be increasingly scrutinized by
third-party payers, courts, and consumers.
The need for detailed medical records in offices and clinics of doc
tors of medicine should translate into rapid growth in employment
opportunities for medical record technicians in large group prac
tices and offices of specialists. Rapid growth is also expected in
health maintenance organizations, nursing homes, and home health
agencies.
Earnings
According to a 1992 survey of AHIMA members, accredited record
technicans who worked as coders averaged $11.30 an hour; unac
credited coders averaged $9.77 an hour; and accredited record tech
nicians in supervisory positions averaged $29,599 a year. The aver
age annual salary for medical record technicians in the Federal
Government in nonsupervisory, supervisory, and managerial posi
tions was $22,008 in 1993.
-Jl
Related Occupations
Medical record technicians need a strong clinical background to an
alyze the contents of medical records. Other occupations that re
quire a knowledge of medical terminology, anatomy, and physiol
ogy without directly touching the patient are medical secretaries,
medical transcribers, medical writers, and medical illustrators.
Sources of Additional Information
Information on careers in medical record technology, including the
Independent Study Program, is available from:
W American Health Information Management Association, 919 N. Michi
gan Ave., Suite 1400, Chicago, IL 60611.
A list of CAHEA-accredited programs for medical record techni
cians is available from:
Nuclear medicine technologists must adhere to radiation safety
guidelines.
(D.O.T. 078.361-018)
shift work are also available. In addition, technologists in hospitals
may be on-call duty on a rotational basis.
Because technologists are on their feet much of the day, and may
lift or turn disabled patients, physical stamina is important.
Although there is potential for radiation exposure in this field, it
is kept to a minimum by the use of shielded syringes, gloves, and
other protective devices. Technologists also wear badges that mea
sure radiation levels. Because of safety programs, however, badge
measurements rarely exceed established safety levels.
Nature of the Work
Employment
isr American Medical Association, Division of Allied Health Education and
Accreditation, 515 N. State St., Chicago, IL 60610.
Nuclear Medicine Technologists
In nuclear medicine, radionuclides—unstable atoms that emit radi
ation spontaneously—are used to diagnose and treat disease. Ra
dionuclides are purified and compounded like other drugs to form
radiopharmaceuticals. Nuclear medicine technologists administer
these radiopharmaceuticals to patients, then moniter the character
istics and functions of tissues or organs in which they localize. Ab
normal areas show higher or lower concentrations of radioactivity
than normal.
Nuclear medicine technologists operate cameras that detect and
map the radioactive drug in the patient’s body to create an image on
photographic film. Radiologic technologists also operate diagnostic
imaging equipment, but their equipment creates an image by pro
jecting an x ray through the patient. (See the statement on radiologic
technologists elsewhere in the Handbook.)
Nuclear medicine technologists explain test procedures to pa
tients. They prepare a dosage of the radiopharmaceutical and ad
minister it by mouth, injection, or other means. When preparing
radiopharmaceuticals, technologists adhere to safety standards that
keep the radiation dose to workers and patients as low as possible.
Technologists position patients and start a gamma scintillation
camera, or scanner, which creates images of the distribution of a
radiopharmaceutical as it passes through or localizes in the patient’s
body. Technologists produce the images on a computer screen or on
film for a physician to interpret. Some nuclear medicine studies,
such as cardiac function studies, are processed with the aid of a
computer.
Nuclear medicine technologists also perform radioimmunoassay
studies which assess the behavior of a radioactive substance inside
the body. For example, technologists may add radioactive sub
stances to blood or serum to determine levels of hormones or thera
peutic drug content.
Technologists keep patient records and record the amount and
type of radionuclides received, used, and disposed of.
Working Conditions
Nuclear medicine technologists generally work a 40-hour week.
This may include evening or weekend hours in departments which
operate on an extended schedule. Opportunities for part-time and
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Nuclear medicine technologists held about 12,000 jobs in 1992.
About 9 out of 10 jobs were in hospitals. The rest were in physicians’
offices and clinics, including imaging centers.
Training, Other Qualifications, and Advancement
Nuclear medicine technology programs range in length from 1 to 4
years and lead to a certificate, associate degree, or bachelor’s degree.
Generally, certificate programs are offered in hospitals; associate
programs in community colleges; and baccalaureate programs in 4
year-colleges and in universities. Courses cover physical sciences,
the biological effects of radiation exposure, radiation protection and
procedures, the use of radiopharmaceuticals, imaging techniques,
and computer applications. Associate and bachelor’s programs also
cover liberal arts.
One-year certificate programs are for health professionals, espe
cially radiologic technologists and ultrasound technologists wishing
to specialize in nuclear medicine. They also attract medical technol
ogists, registered nurses, and others who wish to change fields or
specialize. Others interested in the nuclear medicine technology
field have three options: a 2-year certificate program, a 2-year asso
ciate program, or a 4-year baccalaureate program.
The Committee on Allied Health Education and Accreditation
(CAHEA) accredits most formal training programs in nuclear
medicine technology. In 1992, there were 112 CAHEA-accredited
programs.
All nuclear medicine technologists must meet the minimum Fed
eral standards on the administration of radioactive drugs and the
operation of radiation detection equipment. In addition, about half
of all States require technologists to be licensed. Technologists also
may obtain voluntary professional certification or registration. Re
gistration or certification is available from the American Registry of
Radiologic Technologists (ARRT) and from the Nuclear Medicine
Technology Certification Board (NMTCB). Most employers prefer
to hire certified or registered technologists.
Technologists may advance to supervisor, then to chief technolo
gist, and to department administrator or director. (See statement on
health services managers elsewhere in the Handbook.) Some tech
nologists specialize in a clinical area such as nuclear cardiology or
13
computer analysis or leave patient care to take positions in research
laboratories. Some become instructors or directors in nuclear
medicine technology programs, a step that usually requires a bache
lor’s degree or master’s in nuclear medicine technology. Others
leave the occupation to work as sales or training representatives for
health equipment and radiopharmaceutical manufacturing firms, or
as radiation safety officers in regulatory agencies or hospitals.
Job Outlook
Employment of nuclear medicine technologists is expected to grow
much faster than the average for all occupations through the year
2005. Substantial growth in the number of middle-aged and older
persons will spur demand for diagnostic procedures, including nu
clear medicine tests. Furthermore, technological innovations seem
likely to increase the diagnostic uses of nuclear medicine. One exam
ple is the use of radiopharmaceuticals in combination with
monoclonal antibodies to detect cancer at far earlier stages than is
customary today, and without resorting to surgery. Another is the
use of radionuclides to examine the heart’s ability to pump blood.
Wider use of positron emission tomography imaging to observe met
abolic and biochemical changes for neurology, cardiology, and on
cology procedures, will also spur demand for nuclear medicine tech
nologists.
Cost considerations will affect the speed with which new applica
tions of nuclear medicine grow. Some promising nuclear medicine
procedures, such as positron emission tomography, are extremely
costly, and hospitals contemplating them will have to consider
equipment costs, reimbursement policies, and the number of poten
tial users.
Earnings
According to a University of Texas Medical Branch national survey
of hospitals and medical centers, the median annual salary of nu
clear medicine technologists, based on a 40 hour week and exclud
ing shift or area differentials, was $32,843 in October 1992. The av
erage minimum salary was $26,402 and the average maximum was
$38,840.
Related Occupations
Nuclear medical technologists operate sophisticated equipment to
help physicians and other health practitioners diagnose and treat
patients. So do radiologic technologists, diagnostic medical sonographers, cardiology technologists, electroencephalographic
technologists, clinical laboratory technologists, perfusionists, and
respiratory therapists.
Ophthalmic Laboratory Technicians
(D.O.T. 711.381-010; 713.381-010, .681-010; 716.280-010, -014, and -018,
.381-014, .382-010, -014, -018, and -022, .462-010, .681-010 and -018, and
.682-018)
Nature of the Work
Ophthalmic laboratory technicians—also known as manufacturing
opticians, optical mechanics, or optical goods workers—make pre
scription eyeglass lenses. Some manufacture lenses for other optical
instruments, such as telescopes and binoculars. Prescription lenses
are curved in such a way that light is correctly focused onto the ret
ina of the patient’s eye, improving vision. Ophthalmic laboratory
technicians cut, grind, edge, and finish lenses according to specifica
tions provided by dispensing opticians, optometrists, or ophthal
mologists, and then assemble the lenses with frames to produce fin
ished glasses.
Ophthalmic laboratory technicians should not be confused with
workers in other vision care occupations. Ophthalmologists and op
tometrists are “eye doctors” who examine eyes, diagnose and treat
vision problems, and prescribe corrective lenses. Ophthalmologists
also perform eye surgery. Dispensing opticians, who may also do
work described here, help patients select frames and lenses, and ad
just finished eyeglasses. (See the statement on physicians, which in
cludes ophthalmologists, and the statements on optometrists and
dispensing opticians elsewhere in the Handbook.)
Ophthalmic laboratory technicians read prescription specifica
tions, then select standard glass or plastic lens blanks and mark
them to indicate where the curves specified on the prescription
should be ground. They place the lens into the lens grinder, set the
dials for the prescribed curvature, and start the machine. After a
minute or so, the lens is ready to be “finished” by a process in which
a machine rotates the lens against a fine abrasive to grind the lens
and smooth out rough edges. The lens is then placed in a polishing
machine, with an even finer abrasive, to polish the lens to a smooth,
bright finish.
Next, the technician examines the lens through a lensometer, an
instrument similar in shape to a microscope, and makes sure the de
gree and placement of the curve is correct. The technician then cuts
the lenses and bevels the edges to fit the frame, dips each lens into
dye if the prescription calls for tinted or coated lenses, polishes the
edges, and assembles the lenses and frame parts into a finished pair
of glasses.
In small laboratories, technicians generally handle every phase of
the operation. In large ones, technicians may specialize in one or
more steps, assembly-line style.
Sources of Additional Information
Additional information on a career as a nuclear medicine technolo
gist is available from:
r^The Society of Nuclear Medicine-Technologist Section, 136 Madison
Ave., New York, NY 10016.
W American Society of Radiologic Technologists, 15000 Central Ave., Al
buquerque, NM 87123.
For a list of accredited programs in nuclear medicine technology,
write to:
fW Joint Review Committee on Educational Programs in Nuclear Medicine
Technology, 1144 West 3300 South, Salt Lake City, UT 84119.
Information on certification is available from:
W Nuclear Medicine Technology Certification Board, 2970 Clairmont Rd.,
Suite 610, Atlanta, GA 30329.
I^The American Registry of Radiologic Technologists, 1255 Northland
Dr., Mendota Heights, MN 55120.
14
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Nearly all ophthalmic laboratory technicians learn their skills on the
job.
Working Conditions
Related Occupations
Ophthalmic laboratory technicians work in relatively clean and
well-lighted laboratories and have limited contact with the public.
Surroundings are relatively quiet despite the humming of machines.
At times, technicians may need to wear goggles to protect their eyes,
and may spend a great deal of time standing.
Most ophthalmic laboratory technicians work a 5-day, 40-hour
week, which may include weekends, evenings, or occasionally, some
overtime. Some work part time.
Ophthalmic laboratory technicians need to take precautions
against the hazards associated with cutting glass, handling chemi
cals, and working near machinery.
Workers in other precision production occupations include bi
omedical equipment technicians, dental laboratory technicians, or
thodontic technicians, orthotics technicians, prosthetics techni
cians, and instrument repairers.
Sources of Additional Information
For general information about a career as an ophthalmic laboratory
technician and for a list of accredited programs in ophthalmic labo
ratory technology, contact:
iw Commission on Opticianry Accreditation, 10111 Martin Luther King,
Jr. Hwy., Suite 100, Bowie, MD 20720-4299.
Employment
Ophthalmic laboratory technicians held about 19,000 jobs in 1992.
About half of these jobs were in retail stores that manufacture and
sell prescription glasses—mostly chains of optical goods stores or
independent retailers. Most of the rest were in optical laboratories.
These laboratories manufacture eyewear for dispensing by retail
stores that sell but do not fabricate prescription glasses, and by oph
thalmologists and optometrists. A few work for optometrists or
ophthalmologists who dispense glasses directly to patients.
Training, Other Qualifications, and Advancement
Nearly all ophthalmic laboratory technicians learn their skills on
the job. Employers filling trainee jobs prefer applicants who are high
school graduates. Courses in science and mathematics are valuable;
manual dexterity and the ability to do precision work is essential.
Technician trainees start on simple tasks such as marking or
blocking lenses for grinding, then progress to lens grinding, lens cut
ting, edging, beveling, and eyeglass assembly. Depending on the in
dividual’s aptitude, it may take 6 to 18 months to become proficient
in all phases of the work.
Some ophthalmic technicians learn their trade in the Armed
Forces. Others attend the few programs in optical technology of
fered by vocational-technical institutes or trade schools. These pro
grams have classes in optical theory, surfacing and lens finishing,
and the reading and applying of prescriptions. Programs vary in
length from 6 months to 1 year, and award certificates or diplomas.
Ophthalmic laboratory technicians can become supervisors and
managers. Some technicians become dispensing opticians, although
further education or training may be required.
Job Outlook
Employment of ophthalmic laboratory technicians is expected to in
crease about as fast as the average for all occupations through the
year 2005 due to rising demand for corrective lenses. Nonetheless,
most job openings will come from the need to replace technicians
who transfer to other occupations or leave the labor force.
Demographic trends make it likely that many more Americans
will wear glasses in the years ahead. Not only will the population
grow, but the number of middle-aged and older adults will grow
particularly rapidly. Middle age is a time when many people use
corrective lenses for the first time, and older persons require appre
ciably more vision care than the rest of the population.
The public’s heightened awareness of vision care should also in
crease demand for corrective lenses. The emergence of eyewear as a
fashion item—eyewear now comes in an assortment of attractive
shapes and colors—has been enticing many people to purchase two
or three pair of glasses rather than just one. Most new jobs for
ophthalmic laboratory technicians will be in retail optical chains
that manufacture prescription glasses on the premises and provide
fast service.
Earnings
According to the Opticians Association of America, the beginning
average salary for ophthalmic laboratory technicians in retail opti
cal stores was $15,040 in 1992. Those with 3 to 5 years of experience
averaged $16,700; 6 to 9 years, $21,700; and 10 years or more,
$24,370. Trainees may start at the minimum wage.
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Radiologic Technologists
(D.O.T. 078.361-034, .362-026, -046, -054, -058, .364-010)
Nature of the Work
Perhaps the most familiar use of the x ray is the diagnosis of broken
bones. However, medical uses of radiation go far beyond that. Radi
ation is used not only to produce images of the interior of the body,
but to treat cancer as well. At the same time, the use of imaging
techniques that do not involve x rays, such as ultrasound and mag
netic resonance scans, is growing rapidly. The term “diagnostic
imaging” embraces these procedures as well as the familiar x ray.
Radiographers produce x-ray films (radiographs) of parts of the
human body for use in diagnosing medical problems. They prepare
patients for radiologic examinations by explaining the procedure,
removing articles such as jewelry, through which x rays cannot pass,
and positioning patients so that the correct parts of the body can be
radiographed. To prevent unnecessary radiation exposure, technol
ogists surround the exposed area with radiation protection devices,
such as lead shields, or limit the size of the x-ray beam. Radi
ographers position radiographic equipment at the correct angle and
height over the appropriate area of a patient’s body. Using instru
ments similar to a measuring tape, technologists may measure the
thickness of the section to be radiographed and set controls on the
machine to produce radiographs of the appropriate density, detail,
and contrast. They place the x-ray film under the part of the pa
tient’s body to be examined and make the exposure. They then re
move the film and develop it.
Experienced radiographers may perform more complex imaging
tests. For fluoroscopies, radiographers prepare a solution of con
trast medium for the patient to drink, allowing the radiologist, a
physician who interprets x rays, to see soft tissues in the body. Some
radiographers operate computed tomography scanners to produce
cross-sectional views of patients and may be called CT technolo
gists. Others operate machines using giant magnets and radiowaves
rather than radiation to create an image and may be called magnetic
resonance imaging (MRI) technologists.
Radiation therapy technologists, also known as radiation ther
apists, prepare cancer patients for treatment and administer pre
scribed doses of ionizing radiation to specific body parts. They oper
ate many kinds of equipment, including high-energy linear
accelerators with electron capabilities. They position patients under
the equipment with absolute accuracy in order to expose affected
body parts to treatment while protecting the rest of the body from
radiation.
They also check the patients reactions for radiation side effects
such as nausea, hair loss, and skin irritation. They give instructions
and explanations to patients who are likely to be very ill and may be
dying. Radiation therapists, in contrast to other radiologic technol
ogists, are likely to see the same patient a number of times during
the course of treatment.
Sonographers, also known as ultrasound technologists, use non
ionizing, high frequency sound waves into areas of the patient’s
body; the equipment then collects reflected echoes to form an image.
The image is viewed on a screen and may be recorded on a printout
15
strip or photographed for interpretation and diagnosis by physi
cians. Sonographers explain the procedure, record additional medi
cal history, and then position the patient for testing. Viewing the
screen as the scan takes place, sonographers look for subtle differ
ences between healthy and pathological areas, and judge if the
images are satisfactory for diagnostic purposes. Sonographers may
specialize in neurosonography (the brain), vascular (blood flows),
echocardiography (the heart), abdominal (the liver, kidneys, spleen,
and pancreas), obstetrics/gynecology (the female reproductive sys
tem), and ophthalmology (the eye).
Radiologic technologists follow precisely physicians’ instructions
and regulations concerning use of radiation to insure that they, pa
tients, and co-workers are protected from over exposure.
In addition to preparing patients and operating equipment, radio
logic technologists keep patient records and adjust and maintain
equipment. They may also prepare work schedules, evaluate equip
ment purchases, or manage a radiology department.
Working Conditions
Most full-time radiologic technologists work about 40 hours a week;
they may have evening and weekend or on- call hours.
Technologists are on their feet for long periods and may lift or
turn disabled patients. They work at radiologic machines but may
also do some procedures at patients bedsides. Some radiologic tech
nologists travel to patients in large vans equipped with sophisticated
diagnostic equipment.
Radiation therapists are prone to emotional “bum out” since they
regularly treat extremely ill and dying patients on a daily basis. Al
though potential radiation hazards exist in this occupation, they
have been minimized by the use of lead aprons, gloves, and other
shielding devices, as well as by instruments that measure radiation
exposure. Technologists wear badges that measure radiation levels
in the radiation area, and detailed records are kept on their cumula
tive lifetime dose.
Employment
Radiologic technologists held about 162,000 jobs in 1992. Most
technologists were radiographers. Some were sonographers and ra
diation therapists. About 1 radiologic technologist in 5 worked part
time.
About 3 out of 5 jobs are in hospitals. The rest are in physicians’
offices and clinics, including diagnostic imaging centers.
Training, Other Qualifications, and Advancement
Preparation for this profession is offered in hospitals, colleges and
universities, vocational-technical institutes, and the Armed Forces.
Hospitals, which employ most radiologic technologists, prefer to
hire those with formal training.
Formal training is offered in radiography, radiation therapy, and
diagnostic medical sonography (ultrasound). Programs range in
length from 1 to 4 years and lead to a certificate, associate degree, or
bachelor’s degree. Two-year programs are most prevalent.
Some 1-year certificate programs are for individuals from other
health occupations such as medical technologists and registered
nurses who want to change fields or experienced radiographers who
want to specialize in radiation therapy technology or sonography. A
bachelor’s or master’s degree in one of the radiologic technologies is
desirable for supervisory, administrative, or teaching positions.
The Committee on Allied Health Education and Accreditation
(CAHEA) accredits most formal training programs for this field.
CAHEA accredited 687 radiography programs, 120 radiation ther
apy programs, and 52 diagnostic medical sonography programs in
1992.
Radiography programs require, at a minimum, a high school di
ploma or the equivalent. High school courses in mathematics, phys
ics, chemistry, and biology are helpful. The programs provide both
classroom and clinical instruction in anatomy and physiology, pa
tient care procedures, radiation physics, radiation protection, prin
ciples of imaging, medical terminology, positioning of patients,
medical ethics, radiobiology, and pathology.
For training programs in radiation therapy and diagnostic medi
cal sonography, applicants with a background in science, or experi
ence in one of the health professions, generally are preferred. Some
programs consider applicants with liberal arts backgrounds, how
ever, as well as high school graduates with courses in math and sci
ence.
Radiographers and radiation therapists are covered by provisions
of the Consumer-Patient Radiation Health and Safety Act of 1981,
which aims to protect the public from the hazards of unnecessary
exposure to medical and dental radiation by ensuring operators of
radiologic equipment are properly trained. The act requires the Fed
eral Government to set standards that the States, in turn, may use
for accrediting training programs and certifying individuals who en
gage in medical or dental radiography.
By 1992, 26 States required radiographers to be licensed, and 23
required radiation therapists to be licensed. (Puerto Rico requires a
license for the practice of either specialty.) One State, Utah, licenses
diagnostic medical sonographers.
Voluntary registration is offered by the American Registry of Ra
diologic Technologists (ARRT) in both radiography and radiation
therapy. The American Registry of Diagnostic Medical So
nographers (ARDMS) certifies the competence of sonographers. To
become registered, technologists must be graduates of a CAHEAaccredited program or meet other prerequisites and have passed an
examination. Many employers prefer to hire registered technolo
gists.
With experience and additional training, staff technologists may
become specialists, performing CT scanning, ultrasound, angiogra
phy, and magnetic resonance imaging. Experienced technologists
may also be promoted to supervisor, chief radiologic technologist,
and—ultimately—department administrator or director. Depend
ing on the institution, courses or a master’s degree in business or
health administration may be necessary for the director’s position.
Some technologists progress by becoming instructors or directors in
radiologic technology programs; others take jobs as sales represent
atives or instructors with equipment manufacturers.
With additional education, available at major cancer centers, ra
diation therapy technologists can specialize as medical radiation
dosimetrists. Dosimetrists work with health physicists and oncolo
gists (physicians who specialize in the study and treatment of tu
mors) to develop treatment plans.
Job Outlook
Radiologic technologists may be on their feet for extended periods of
time.
16
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Employment radiologic technologists is expected to grow much
faster than the average for all occupations through 2005, as the
health care industries grow, and because of the vast clinical poten
tial of diagnostic imaging and therapeutic technology. Current as
well as new uses of imaging equipment are virtually certain to
sharply increase demand for radiologic technologists.
Technology will continue to evolve. New generations of diagnos
tic imaging equipment are expected to give even better information
to physicians and be used more widely. Since ultrasound is non-invasive, it is also less risky and uncomfortable for the patient than ex
ploratory surgery.
Radiation therapy will continue to be used—alone or in combina
tion with surgery or chemotherapy—to treat cancer. More treat
ment of cancer is anticipated due to the aging of the population, edu
cational efforts aimed at early detection, and improved ability to
detect malignancies through radiologic procedures such as mam
mography.
Although physicians are enthusiastic about the clinical benefits of
new technologies, the extent to which they are adopted depends
largely on cost and reimbursement considerations. Some promising
new technologies may not come into widespread use because they
are too expensive and third-party payers may not be willing to pay
for their use. But on the whole, it appears that radiologic procedures
will be used more widely.
Hospitals will remain the principal employer of radiologic tech
nologists. However, employment is expected to grow most rapidly
in offices and clinics of physicians, including diagnostic imaging
centers. Health facilities such as these are expected to grow very
rapidly through 2005 due to the strong shift toward outpatient care,
encouraged by third-party payers and made possible by technologi
cal advances that permit more procedures to be performed outside
the hospital. Some jobs will also come from the need to replace tech
nologists who leave the occupation.
Earnings
In 1992, the median annual earnings for radiologic technologists
who worked year round full time were $28,236. The middle 50 per
cent earned between $22,932 and $33,748 a week; 10 percent earned
less than $19,708 a week; and 10 percent earned more than $40,456.
According to a University of Texas Medical Branch national sur
vey of hospitals and medical centers, the median annual salary for
radiation technologists, based on a 40 hour week and excluding shift
or area differentials, was $25,615 in October 1992. The average min
imum salary was $22,250 and the average maximum was $32,553.
For radiation therapy technologists the median was $34,278 and for
ultrasound technologists, $32,219.
Surgical Technologists
(D.O.T. 079.374-022)
Nature of the Work
Surgical technologists, also called operating room technicians, assist
in operations under the supervision of surgeons or registered nurses.
Before an operation, surgical technologists 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). They
assemble, adjust, and check nonsterile equipment to ensure that it is
in working order. Technologists also “prep” (prepare) patients for
surgery by washing, shaving, and disinfecting incision sites. They
transport patients to the operating room, help position them on the
operating table, and cover them with sterile surgical “drapes.”
Technologists also observe patients’ vital signs, check charts, and
help the surgical team scrub and put on gloves, gowns, and masks.
During surgery, technologists pass instruments and other sterile
supplies to surgeons and surgeon assistants. They may hold retrac
tors, cut sutures, and help count sponges, needles, supplies, and in
struments. Surgical technologists help prepare, care for, and dispose
of specimens taken for laboratory analysis and may help apply
dressings. They may operate sterilizers, lights, or suction machines,
and help operate diagnostic equipment. Technologists may also
maintain specified supplies of fluids such as plasma and blood.
After an operation, surgical technologists may help transfer pa
tients to the recovery room and clean and restock the operating
room.
Working Conditions
Surgical technologists work in clean, well-lighted, cool environ
ments. They must stand for long periods of time and and remain
alert during operations.
Most surgical technologists work a regular 40-hour week, al
though they may be “on call” (available to work on short notice for
emergencies) during weekends and evenings on a rotating basis.
Related Occupations
Employment
Radiologic technologists operate sophisticated equipment to help
physicians, dentists, and other health practitioners diagnose and
treat patients. Workers in related occupations include nuclear
medicine technologists, cardiovascular technologists and techni
cians, perfusionists, respiratory therapists, clinical laboratory tech
nologists, and electroencephalographic technologists.
Surgical technologists held about 44,000 jobs in 1992. Most surgical
technologists are employed by hospitals. Others are employed in
clinics and surgicenters, and in the offices of physicians and dentists
who perform outpatient surgery. A few, known as private scrubs,
are employed directly by surgeons who have special surgical teams
like those for liver transplants.
Sources of Additional Information
-M
For career information, enclose a stamped, self-addressed businesssize envelope with your request to:
fS“ American Society of Radiologic Technologists, 15000 Central Ave. SE.,
Albuquerque, NM 87123-3917.
fW Society of Diagnostic Medical Sonographers, 12770 Coit Rd., Suite 508,
Dallas, TX 75251.
S’American Healthcare Radiology Administrators, 111 Boston Post Rd.,
Suite 215, P.O. Box 334, Sudbury, MA 01776.
For the current list of accredited education programs in radiogra
phy, radiation therapy technology, or diagnostic medical so
nography, write to:
XS” Division of Allied Health Education and Accreditation, American Medi
cal Association, 515 N. State St., Chicago, IL 60610.
For information on certification in radiologic technology, con
tact:
O’American Registry of Radiologic Technologists, 1255 Northland Dr.,
Mendota Heights, MN 55120.
For information on certification in sonography, contact:
O’ American Registry of Diagnostic Medical Sonographers, 2368 Victory
Pky., Suite 510, Cincinnati, OH 45206.
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Surgical technologists set up the operating room with surgical
instruments and equipment.
17
Training, Other Qualifications, and Advancement
Job Outlook
Surgical technologists receive their training in formal programs of
fered by community and junior colleges, vocational schools, univer
sities, hospitals, and the military. In 1993, the Committee on Allied
Health Education and Accreditation (CAHEA) of the American
Medical Association recognized 130 accredited programs. High
school graduation normally is required for admission. Programs last
9 to 24 months and lead to a certificate, diploma, or associate de
gree.
Programs provide classroom education and supervised clinical
experience. Required study includes anatomy, physiology, microbi
ology, pharmacology, and medical terminology. Other studies cover
care and safety of patients during surgery, aseptic techniques, and
surgical procedures. Students also learn to sterilize instruments;
prevent and control infection; and handle special drugs, solutions,
supplies, and equipment.
Technologists may obtain voluntary professional certification
from the Liaison Council on Certification for the Surgical Technol
ogist by graduating from a formal program and passing a national
certification examination. Continuing education or reexamination is
required to maintain certification, which must be renewed every 6
years. Some employers prefer to hire certified technologists.
Surgical technologists need manual dexterity to handle instru
ments quickly. They also must be conscientious, orderly, and emo
tionally stable to handle the demands of surgeons. Technologists
must respond quickly and know procedures well so that they may
have instruments ready for surgeons without having to be told. They
are expected to keep abreast of new developments in the field. Rec
ommended high school courses include 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
“unsterile” member of the surgical team who prepares patients;
helps with anesthesia; gets, opens, and holds packages for the “ster
ile” persons during the procedure; interviews the patient before sur
gery; keeps a written account of the surgical procedure; and answers
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. Surgical technologists may man
age central supply departments in hospitals, or take positions with
insurance companies, sterile supply services, and operating equip
ment firms.
Employment of surgical technologists is expected to grow much
faster than the average for all occupations through the year 2005, as
the volume of surgery increases and operating room staffing pat
terns change.
The number of surgical procedures is expected to rise as the popu
lation grows and ages. Older people require more surgical proce
dures. Technological advances, such as fiber optics and laser tech
nology, will also permit new surgical procedures.
Some employers may seek to substitute surgical technologists for
operating room nurses to reduce costs. However, because some fa
cilities and States limit the work that surgical technologists can do,
widespread displacement of operating room nurses is not likely to
occur.
Hospitals will continue to be the primary employer of surgical
technologists. Nonetheless, the shift to outpatient or ambulatory
surgery will create faster growth for technologists in offices and
clinics of physicians, including “surgicenters.”
18
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Earnings
According to a University of Texas Medical Branch survey of hospi
tals and medical centers, the median annual salary of surgical tech
nologists, based on a 40 hour week and excluding shift or area differ
entials, was $21,741 in October 1992. The average minimum salary
was $18,087 and the average maximum was $26,480.
Related Occupations
Other health occupations requiring approximately 1 year of training
after high school are licensed practical nurses, respiratory therapy
technicians, medical laboratory assistants, medical assistants, dental
assistants, optometric assistants, and physical therapy aides.
Sources of Additional Information
For additional information on a career as a surgical technologist
and a list of CAHEA-accredited programs, contact:
fW Association of Surgical Technologists, 7108-C S. Alton Way, Engle
wood, CO 80112.
For information on certification, contact:
xw Liaison Council on Certification for the Surgical Technologist, 7108-C S.
Alton Way, Englewood, CO 80112.
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Bulletin 2451
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