The Certified Biomedical Equipment Technician (CBET) credential isn’t mandatory, but it can give biomeds an edge, advocates say.

By Steven Martinez 

Twice a year in either May or November, hundreds of biomedical equipment technicians sit down at testing sites across the country to take the exam to become a Certified Biomedical Equipment Technician or CBET.

Consisting of 165 multiple choice questions covering every aspect of the biomed field, the CBET is arguably difficult, with fail rates as high as 40%. After the test, those who pass must maintain their CBET certification through continuing education or retake the exam every three years. The certification is not required to have a career in the industry or even to get promoted. All of which begs the question, is the CBET worth it?

The ABCs of the CBET

Martin J. McLaughlin is the senior director of training at the Association for the Advancement of Medical Instrumentation (AAMI), which created the CBET along with other certifications for medical equipment technicians such as the Certified Associate in Biomedical Technology (CABT), and the Certified Healthcare Technology Manager (CHTM).

McLaughlin says that the CBET is about proving to the biomed and anyone who might employ them that they possess the minimum level of competency in their field. While it might not sound like the most glamorous achievement to attain the minimum level of competency, McLaughlin says it is not meant to be taken negatively but as a signifier that the person who passes the exam understands every critical aspect of their profession. 

It doesn’t mean they’re automatically an expert, but that they possess a breadth of knowledge about their chosen field. McLaughlin compares the CBET to something like a driver’s test.

“When you pass it, it doesn’t necessarily mean you’re the best driver in the world,” says McLaughlin. “It just means that you know enough to be street legal. We’ve pulled together enough professionals and enough subject matter experts to say, ‘These are the credentials for somebody who can go out in the field and perform well and not be a liability for their employer.’”

Inside the CBET Exam

The CBET exam covers the key subjects that a biomed should know. The test is divided into six areas of expertise: Anatomy and Physiology, Public Safety in the Healthcare Facility, Fundamentals of Electricity and Electronics, Healthcare Technology and Function, Healthcare Technology Problem Solving, and Healthcare Information Technology. Sections are weighted by importance to the job, so Healthcare Technology Problem Solving comprises around 25% of the exam while Anatomy and Physiology makes up only about 10%. 

To create the test, AAMI brought in several certified, experienced biomeds and asked them to break the job down into its essentials to portray the ideal CBET. They then created an outline for the exam based on these expert opinions that would only include information they deemed vital to the job. That’s why the certification is made available to biomeds with at least four years of experience, because it was designed for someone who already understands their field but are not exactly experts at it. Biomeds can take the exam with just two years of experience, but they’ll only be recognized as a CBET candidate when they reach the four-year mark.

“Somebody who’s been in the field for four years should be fairly proficient, but they’re not pros at that point. They’re still in the entry years of their career,” says McLaughlin.

The exam is regularly updated to align with advances in medical technology and better represent the tasks biomeds actually do. It’s why CBETs have to maintain their certification, McLaughlin explains. Some biomeds have a certification that dates back several decades, and the industry they started in might not resemble the one they’re in currently. The last update was in 2017, and AAMI will be working on another update next year, McLaughlin reveals.

“The last time we did it, we shifted a lot of the content away from the fundamentals of electricity and electronics and away from anatomy and physiology toward healthcare IT,” he says. “Obviously that trend is building. Fewer HTMs are actually soldering devices in the basement than they used to; instead, now they’re working on networks and they’re part swapping.”

So, while a CBET might be like a driver’s test in that it is about proving a baseline level of understanding, unlike a driver’s license, CBETs are not required and still comprise a minority of the biomed field.

Who Has a CBET?

McLaughlin says that only a few thousand biomeds have passed the CBET exam and maintain their certification. He estimates that, at best, it makes up 25%-30% of the industry. As a nonprofit, AAMI doesn’t lobby lawmakers to make the CBET mandatory for the industry so as it stands today, working toward a CBET still remains a self-motivated endeavor. However, there are barriers to entry that currently contribute to its low adoption rate among biomeds, some say.

For one, and maybe most importantly, it costs money to take the exam. For non-AAMI members, a CBET exam costs $400 while members get a $50 discount. Since there’s no guarantee that you will pass, fees could continue to grow from there. It costs $325 to retake the test and $275 for members. Fortunately, some workplaces will front the costs of the exam and help with paying for testing prep, a good resource to take advantage of to avoid recurring costs. 

Secondly, the exam is difficult, McLaughlin acknowledges. While CBET was designed for biomeds with four years of experience, in most cases, work experience alone is not sufficient to get a passing grade of 70%, or 116 out of 165. While the subject matter that hews closest to their daily work is likely second nature to an experienced biomed, remedial information about anatomy or the basics of electronics might not be at the ready if one decides to take the test cold. It’s important to note that the CBET exam can only be taken once per testing window and only three times before being forced to wait a full calendar year to take it again. McLaughlin says this was done to prevent test takers from becoming familiar with the questions and passing through brute force rather than an actual understanding of the material.

“It should be easy to say that if you’ve been in the field for seven years, you should absolutely be able to pass the exam. Well, that’s in theory true. But you also need to study,” says McLaughlin. “There’s some stuff that you still would want to go through and make sure that you study up on because it’s not an easy exam.”

Luckily for people who need a refresher or simply aren’t good at tests, there are resources available to improve their knowledge and knowledge recall. AAMI offers a free outline with references of everything that the CBET exam will cover. It also offers an instructor-led CBET study course the month before an exam window that includes 12 hours of training, covering all parts of the outline and practice exams.

A Biomed’s Perspective on CBET

A test can’t make you a better biomed, but it can certainly signify the kind of biomed you are or want to be in your career. Just ask Joshua Weatherford, CBET, the biomedical manager at ReNew Biomedical Services in Jackson, Tenn. He took the CBET exam and passed it on his first try with only two years of experience, technically making him a CBET candidate until he reaches the four-year mark of his career.

Coming from a family of nurses, Weatherford pursued a career in nursing before realizing that he’d rather work on equipment than people. He then became an ASE-certified auto mechanic before eventually finding his way into the biomedical field through connections he made along the way. Weatherford says he found that being a biomed combined the things he liked about nursing, the science and health, with the things he liked about being a mechanic, working with his hands.

Thanks to his healthcare background, he was already familiar with some of the aspects of HTM but lacked knowledge about the specific equipment he was going to be working on and industry jargon. After learning the ropes for a few years through on-the-job training and instructional resources provided through ReNew as part of the onboarding process, he began to eye the CBET.

ReNew is one of those workplaces that fully supports CBET certification, paying the cost of the exam and providing employees with training resources, according to Weatherford. “They didn’t push it, but they’re very encouraging to have those things,” he says. “It’s not a mandate, but they want to see team growth and they want to encourage that in any way they can.”

But the biggest reason he pursued certification was because of an internal drive to better himself and his career. After all, Weatherford had already received a CABT certification and was part of a biomed apprenticeship program through the state of Tennessee in partnership with ReNew and AAMI. The last step? Passing the CBET exam.

Preparing for the Test

Before taking the exam, Weatherford says he heard conflicting opinions of the test. Some peers said that it was the hardest test they’d ever taken, and others said it was a breeze. Luckily, Weatherford took the side of caution and “over prepared” as he put it. 

Over prepared might be an understatement. Before his exam date, Weatherford studied for a month and a half. During that time, he says that he studied 2.5 hours every night after work and an additional four to five hours a day on the weekends.

“I definitely put my time into studying,” says Weatherford. “Even after all that I was incredibly nervous and not confident that I was going to pass the morning of the test. Luckily, it all worked out and it was things that I knew.”

Weatherford passed the exam by a comfortable margin, scoring a 146 out of 165. “I’ve been told it’s one of the highest scores that people know of. That’s a good feeling,” says Weatherford. “It makes the study feel well worth it for sure.”

He says if he had to prepare for the exam again, he wouldn’t change the process but would start studying earlier to avoid cramming.

“The one tip I would give as far as studying is just to diversify your information,” he adds. “Don’t rely on one study resource because I’ve seen that caused some issues. I knew one person who studied only one provider’s material and I felt that if they would have diversified a little bit, they would have aced that test and instead they barely missed the mark on it.”

Weatherford used AAMI’s study materials and practice exams, saying he found the end-of-module quizzes especially helpful for understanding the content. To break up the monotony of reading and taking quizzes, he also watched YouTube videos on @Biomedical Engineers TV, which has material on X-ray imaging, dialysis, ventilators, anesthesia, and related topics.

Regarding the actual test, Weatherford says that understanding the concepts, not just memorizing answers, was critical for success. Several answers seemed plausible in some questions, he says, and the only way to identify the right one was to fully understand the topic.

“Memorizing information is only going to work for certain aspects,” he says. “Being able to understand what’s being asked and then reading through the answers is really a strong skill and a strong learning point from the study resources.”

Is a CBET Worth it?

Ultimately, the CBET is still an optional certification for HTM professionals, but as Weatherford sees it, it helps him stand out from the crowd. If he should ever need to find a new position, he thinks that having this credential could give him an edge.

“I’m a proponent of certification and the things that it can do as far as developing a career,” says Weatherford. “Not that I do, but if anyone has a desire for mobility in the field, I feel that certification is a really great step and a great card to have in your pocket if you ever want to look at changing [jobs].”

Weatherford says that because CBETs are still relatively rare, some shops don’t even stipulate having one in their job listings. However, he believes that someone with a CBET faces a favorable job market when they look for a new position.

“Usually someone that gets a CBET lands a dream job, and their intent is to stay there until they retire,” says Weatherford. “And, usually, those places that do recruit CBETs are intent on keeping them and keeping them happy. You see very few walking around looking for jobs.”

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Steven Martinez is managing editor of 24×7 Magazine. Questions and comments can be directed to [email protected].