Barbara Christe, PhD
DeVry University and Brown Mackie College (both with campuses across the US) have announced substantial closures of their HTM-related academic programs. As institutions discontinue technician/technologist training programs, several people have asked me to speculate regarding closure causes.
Initially, I emphasized the challenges associated with our relatively unknown discipline and our inability to attract students to the major. Other educators have postulated ideas centered around traditionally aged college students and their changing career expectations. However, I wonder if another underlying issue is a core challenge.
Before I identify what I perceive as a unique HTM-related hurdle, let me describe some common relationships between corporate America and academia. For many institutions and students, corporate partnerships extend beyond the employment of graduates, featuring scholarships and program sponsorships. Some affiliations are strictly focused on innovation and research, sharing faculty talent and student manpower in corporate research projects. Other associations are more service-focused—such as Johnson & Johnson, which support nursing programs and students, thus promoting an overall improvement in the human condition.
Regardless of the purpose, corporate connections draw positive press, increase student enrollments, and offer institutions—especially public ones—much-needed funds. In addition, the ability for a program to thrive may depend on these financial arrangements.
As an example of the power of corporate relationships, the motorsports engineering program in my school enjoys a million-dollar partnership with Dallara, raising the visibility of the program and offering superior academic experiences using state-of-the-art equipment. Other collaborations for Indiana University–Purdue University Indianapolis (IUPUI) motorsports engineering include well-known companies like Penske and Lucas Oil, which offer program donations and internships for students.
With this corporate-academic framework in mind, let’s explore the current state of HTM-related academic programs and corporate partnerships. In 2005, I sought to create a bachelor’s degree at my school. The Indiana Commission for Higher Education set clear expectations: If I wanted to create this degree, I must locate external funding. Fortunately, Aramark made a significant donation of $100,000 to allow the baccalaureate program to move forward. However, that was more than 10 years ago. Some government funds have created a few HTM-related associate degree programs, but I am not aware of any other major corporate partnerships in our discipline.
The only connections I have with some major corporations are hallway conversations at the annual conference of the Association for the Advancement of Medical Instrumentation (AAMI), where I ask for business cards and talk about potential collaborations. Follow-up has been completely fruitless, even to place my graduates as employees.
As I lament regularly, I offer one of only a few baccalaureate programs in the country, awarding a Purdue University degree with a first-rate national reputation; yet I struggle to make corporate connections of any kind. While I maintain strong, synergistic relationships with clinical sites around Indianapolis and the state, the lack of corporate partnerships is painfully obvious to my administration and myself.
With this in mind, I have been left with this question: Do corporations associated with the HTM profession have an incentive to promote and support academic programs, as modeled in other disciplines? After careful reflection, I believe the converse is true: Perhaps some corporations benefit from a shortage of trained technicians in our field. Perhaps the HTM repair/service/support model promotes dependency on a few skilled workers and disincentivizes academic collaborations that may increase graduate production.
Like I mentioned earlier, some third-party service providers have reached out to me, and we work together in small ways to increase the number of trained technicians/technologists. Understandably, many of these collaborative activities are focused narrowly on their employees. However, I believe these organizations may lack the financial depth and associated philanthropic infrastructure essential to broad and substantial support.
Our professional society has tried to fill academic fiscal gaps, offering funds for course development and recruiting tools. The literature created for the IamHTM campaign has been extremely helpful to academic programs. In addition, the scholarships AAMI offers to students from all institutions are supportive steps. But AAMI’s pockets are not deep—and their actions limited by the scope of their mission.
To return to my example of our motorsports program partnership with Dallara, enrollment in that major is up 20% from last year, with the majority of students coming from outside of Indiana, generating an additional $10k in tuition per student per semester, which is a highly valued achievement. While I recognize industrial partnerships may not be directly related to increased enrollments, positive publicity certainly contributes to the success of the IUPUI motorsports engineering program.
As an industry, could hospitals, outside service providers, and professional societies insist on academic support from corporate entities similar to the relationships fostered in other fields? If collaborations with corporations are not possible in our field, then we must identify and implement other mechanisms to support academic programs—or they will close as we have seen this year. We know a large portion of our HTM workforce is retiring in the next five years.
What is the transition plan to train technicians to enter the employment pipeline? A pipeline, after all, that just became narrower with program closures.
Barbara Christe, PhD, is associate professor and program director of healthcare engineering technology management at Indiana University–Purdue University Indianapolis and a member of 24×7′s editorial board.
Many Manufacturers see Biomeds as “competitors”. I used to work for one of the biggest companies. They had no interest in supporting local Biomed Associations, nor education, UNLESS they felt it would somehow enhance their ability to sell products.
For students seeking a BSET degree, Healthcare Technology Management (HTM) field sounds too much like a spin-off of Business Management or IT Management fields. Students seeking degrees in STEM, probably want the position to reflect their area of study. Although much thought and deliberation was placed into the Healthcare Technology Management title, it isn’t sexy enough to attract students to the Clinical Engineering area of study.
I read with great interest the “Soapbox” by Barbara Christe in the October 24X7. It was right on and thought provoking. I would like to share some thoughts I have concerning the issues and challenges. As an “old” BMET I am concerned.
First of all, it is not just the four year biomedical engineering programs closing. Recently the Intellitec College of Colorado Springs, CO, closed and it was a two year A.S. degree program. There are now no two year (worker bee) programs in Colorado. I believe that is more of the norm throughout the country rather than the exception.
One thing for sure, we need trained personnel working on medical devices. This training is ever expanding as we enter the IT world with connectivity of devices within their own parameters and to the EMR.
Barbara is speaking to the formal education programs but I would also like to address continuing education needs. With that thought I think we need to examine ourselves as BMET’s. What is the national percentage of CCE, CBET, CLES, CRES, and now the latest certification in HTM? This is a voluntary certification but is a temperature of the profession. It is also a barometer of the education available to aspiring, new, and old technicians. It is interesting that when I take my automobiles to the “garage” there is a wall full of certificates for ASE certified auto technicians. I look for this when I have my vehicles serviced, it has value. Training for auto mechanics is often at similar colleges/schools to Intellitec, previously mentioned. They promote the training and certification for excellence in service. It seems to be a higher average than our own profession. BMET certification is increasingly difficult without formal education…but where to find?
Yes, we can OJT (on the job) train engineers and electronic technicians but that takes time and lots of personal perseverance and self-study. I do this with BMET’s in Africa through Project CURE but circumstances are quite different there. They (engineers) do not have lots of high paying options and gravitate to hospitals to utilize their skills. Here in the U.S., a non-BMET trained tech starts at a low salary and takes quite some time to meet pay scales elsewhere in the job market. Also, I have taken on many electronics techs and successfully trained them into BMET’s…but there are few electronics A.S. degrees available as well as BMET programs. One area often missed by cross trainees is the required anatomy and physiology to understand the equipment and its interaction with the human body. This is the first part of training provided to the African cross trainees I have worked with recently. Yes, we have the military training (excellent training if I say so myself as a USAF trained biomed!) but will that be enough for demand?
What about medical equipment manufacturers? Why don’t they support higher BMET/CCE education in colleges and universities? Because it does not behoove them. They would prefer to be the sole source for service. They prefer to train their technicians on a narrow group of equipment items solely manufactured by them, not as a “back up” service group but as sole service. Once again, service can be a profit margin. We have seen that for 45 years so why do we expect that to change. So why would OEM’s want to create price competition? Yet they will not be there to face the nurses and doctors when a service problem emerges on a critical patient, only after the fact. This is only done by in-house or in-house ISO vendors. In-house BMET’s service, PM, and train staff as regular duty on all devices.
We (BMET’s) also have the problem of a lesser job population (then say auto mechanics). The need is probably 1000-1 and therefore schools find 2 or 4 year programs not to be cost effective. As stated by Barbara in her soapbox, AAMI cannot make up this financial difference, they can help in continuing education though. The low student volume makes a high cost program such as clinical engineering cost prohibitive. But then, OEM service only makes healthcare cost prohibitive which is why BMET/CE’s came into being. While the need is there, the finances are not. It is a circular conundrum and one today’s healthcare financial environment can little afford.
And then there are organizations such as CABMET in Colorado who offer free training which is not utilized to the extent it should be by BMET’s. I’m a regular to the bi-monthly meeting and annual symposium. But I’m retired! Where are the working BMET’s? Of course this is only continuing education and not formal course work but it is necessary in our field. Nursing has similar problems in training so it is not only a biomedical engineering problem. As do other medical fields of endeavor, respiratory, imaging, etc. So this is really indicative of a major healthcare personnel crisis in the foreseeable future. As BMET’s retire (self-included) we are going to have more openings which cannot be filled with qualified technicians. And the qualifications are getting higher to maintain, test, and provide training to users on new devices. With nursing, the teaching staff pay is not comparable to hospital or manufacturing jobs requiring equal education. This is most likely the same in all medical fields. This only adds to the higher education problems.
Obviously this paper and awareness of a problem will not solve it but is a wake up to the future of medical instrumentation service and the associated costs. No hospital can operate without regular maintenance as CMS mandates it and without Medicare/Medicaid and other government financial support from customers, they will close their doors. I only hope a solution can be achieved.