For biomedical equipment technicians (BMETs) currently working in the field, the opportunities for advancement and growth have never been greater. The economic downturn, coupled with ever more sophisticated medical equipment, have placed a greater demand on BMET skills, offering career possibilities in a wide variety of fields and environments.

“There’s going to be a continuing downturn for at least 2 years, and most organizations are going to stop buying capital equipment, unless the machine completely fails and has to be replaced,” says James R. Knight, CBET, BSE, supervising engineer of the Sonora Regional Medical Center of Adventist Health CES Sonora in Sonora, Calif. “So this is an opportune time to be in the field of repairing medical equipment, especially complex systems, such as imaging in labs.”

Hospital, OEM, or ISO?

For biomeds casting an eye on broadening their horizons, there are three major career paths and dozens of other avenues to pursue. The major trajectories include working in a hospital; working for an original equipment manufacturer (OEM); or working for a third-party, independent service organization (ISO).

Hospitals

Developing a successful career within a hospital environment will mean deciding how far you want to advance and how fast. “We have some folks who graduate, don’t want to travel, and are not interested in advancement, so a smaller hospital may be the place to start,” says Roger Bowles, EdD, CBET, department chair and professor of the biomedical equipment technology program at Texas State Technical College in Waco, Tex. “If they want advancement, they’ll have to look at the larger hospitals.”

But hospitals, whether large or small, are mandating cost savings and efficiency, which only spells opportunity for BMETs and their sought-after skills. “The primary function of the hospital-based biomed is to improve safety, maintain the functionality of the equipment, and to save money,” says Larry Fennigkoh, PhD, PE, professor, biomedical engineering, Milwaukee School of Engineering. “It is typically cheaper for a hospital to support and maintain its own technology than to have to go outside.” Which means hospitals are embracing the biomed cost-cutting, revenue-saving skill set as never before.

Original Equipment Manufacturers

OEMs are also taking a look at BMETs with renewed interest. “In the 20th century, biomeds were looked upon as a necessary evil; even OEMs didn’t pay much attention,” Knight says. “That’s really changed in the last 5 years. General Electric is offering courses to biomeds that don’t have anything to do with their specific products because they realize that having an educated BMET will benefit them in troubleshooting the products that they do sell.”

Typically, OEMs do pay more than, say, what a biomed might make in a hospital or ISO, but that is in response to the higher demands placed on biomeds, particularly because of extensive travel and longer work hours. “The pay will depend on the size of the manufacturer, the market coverage for a particular area, market penetration, and size of the territory,” Bowles says.

Independent Service Organizations

According to Knight, the biggest opportunities for BMETs right now is with ISOs because hospitals need equipment maintained and repaired but are shying away from higher OEM costs. “With cutbacks in capital equipment funding, hospitals still need people to repair equipment, but they don’t want to pay OEMs,” he says. “So there’s a big demand right now for third-party.”

Biomeds might also find a more comfortable professional environment with ISOs because of their affinity to the field. “ISO management tends to understand the technically based, biomed mentality, which is somewhat foreign to the people-based health care system,” Fennigkoh says. “Historically, hospital-based BMETs and clinical engineers have always struggled with this fundamental difference in mind-set. Many technically based organizations such as ISOs are managed by technicians or engineers, so they are more likely to understand the needs of the biomed and how to keep them happy and feeling worthwhile.”

The Rewards of Specializing

In today’s ultratechnological landscape, BMETs who have worked in the field for a while can find a wealth of opportunity—and in many cases, money—by pursuing specialization, which can range from radiology and ultrasound to anesthesia and dialysis equipment to lab equipment specialist.

“It may take a year or two working at a hospital or for an ISO to get a feel for all the different types of equipment and areas that they might like to work in,” Bowles says. “There are so many options, it can be overwhelming, so a biomed needs to have a general sense of what they want to do.”

Those working within a specialization can also enjoy higher remuneration for their efforts. “The specialists have commanded higher salaries than the generalist biomed because they’re working on higher-end equipment that typically has much higher service costs associated with it,” Fennigkoh says.

Specialization does require some initial research to make sure the path you choose is viable within your organization. “The radiology or imaging path is a good one, but biomeds will have to be in a system that provides the training and tools that are needed to do the job,” says Tobey Clark, director, Instrumentation & Technical Services and adjunct faculty for biomedical engineering, University of Vermont. “If you’re a BMET in a hospital that doesn’t involve BMETs in the purchase process, it’s going to be very difficult in the future because you won’t have access to the proprietary tools and service needed to fix things. It’s best if the training is included at the time of purchase so you can set yourself up for the specialty.”

If specialization is not in your plans, plenty of rewarding career opportunities still await. “There are other things a BMET can do, even as a nonspecialist,” Fennigkoh says. “They can get into more sophisticated technologies that can be just as rewarding. They can move up the technology and complexity chain and do more complicated support functions. Getting involved, for example, with your hospital’s organ transplant program supporting the use of ventricular assist devices or artificial hearts, or becoming your department’s resident network expert or wireless guru. There may also be hidden op-portunities to join a nursing or purchasing-based new products committee if you have an ability and interest in new product testing. Such committees can often benefit tremendously from a member who has a technical background and can interpret specifications and identify potential compatibility, reliability, and maintenance issues.”

The Management Track

After a few years in the field, many biomeds begin to broaden their outlook with an eye to management. While a very viable path, biomeds need to understand that management takes more than just enhanced technical skills. In most cases, more education and a deft hand at interpersonal relations will also be required.

“First, they need to talk to somebody about what it’s like to be a manager to get a feel of whether or not it’s something they want to do,” Clark says. “They can take courses to understand management principles, and I think an MBA would be helpful.”

Some BMETs underestimate the demands that managing people can have, especially if it takes them away from working on the technical aspects of a job they once loved. “Many of the techs are good technically, but not all of them have those people skills,” Fennigkoh says. Biomeds seriously considering this path will have to have the ability to handle organizational politics, personnel issues, and budget issues.

The decision to pursue an MBA should depend on the requirements of the organization and your goals. “If the hospital promotes entrepreneurship within the organization, then it would be highly beneficial to have an MBA,” Clark says. “If you have an MBA, you have the ability to understand business, and it can create more opportunities. But I don’t think it’s necessary to get an MBA to be the manager of a small department in a community hospital.”

At the very least, according to Bowles, those BMETs aspiring to management will need a bachelor’s degree. “They can go into a supervisory position with an associate’s degree, but to move into a director’s position, where they are controlling several accounts, most employers are going to want to see a bachelor’s degree,” he says.

Alternative Paths

The lure of independence and big money can call some BMETs into entering the field of medical device sales. Here, interpersonal skills, the gift of gab, rounded out with a solid medical and technical background, can put most biomeds well ahead of the competition in this field.

“Personality and the willingness to travel are key things here,” Fennigkoh says. “If they have a good command of the technology, they are in a better position to talk about it intelligently and legitimately.”

Starting an ISO is also a viable option, particularly for those who have a few years of work experience under their belt and have a bent to the entrepreneurial.

“Receiving specialty training from a manufacturer, their hospital, or an ISO would give them the technical background to start their own company, which would probably be a good way to enter the ISO field,” Clark says.

Fennigkoh warns, however, that starting an ISO comes with its own perils. “It’s demanding and risky,” he says. “There are a lot of start-up costs associated with doing this, and you’ve got to have the funding and the resources, which can be tricky.”

Certification

Even if it is not required, many BMETs are opting to get certified out of a sense of professional pride. “It’s going to demonstrate to your current employer, or to your next employer, that you are serious about this field,” Knight says.

With the proliferation of technology, and the constant demand to stay technologically current, many biomeds are also opting for IT certification to boost their education and marketability.

“Biomeds have to learn the basics of networking and to communicate with the IT folks in the hospital,” Bowles says. “Some of our students are pursuing A+ and Network+ while they are in school because they know it makes them more employable.”

Fennigkoh agrees. “There is clearly a merging and blurring of the lines in the blending of the knowledge base, so [certification] can’t hurt,” he says. “And some organizations might be more prone to require it.”

The Importance of Mentoring

With an ever-changing professional landscape, smart biomeds are seeking out mentors that can help them enhance their skills and navigate the waters successfully. “A hospital environment, for both the ISO people as well as the in-house people, can be a rather brutal environment because of the expectations and demands that health care providers have on the technology,” Fennigkoh says. “A mentor can be really helpful to a BMET, if they can find some seasoned people to help them along.”

Clark agrees. “I think having a mentor is extremely important, especially when first entering the field. Later in your career, a mentor is valuable because you can only go so far on your own in courses and training,” he says. “You need to work with a mentor to understand the technical aspects that aren’t covered in manuals and to understand how to work with customers. And you’ll always have someone to talk to when you have a question.”

Bowles believes that a strong mentor can also enhance professional development by pointing out pitfalls to be avoided. “I think it’s very beneficial if you have somebody that has already gone down the path and will give you pointers on what to do and what not to do,” he says. “A mentor can even help with contacts and networking in a particular specialization.”

Knight goes a step further and encourages biomeds to be mentors themselves. “Being a mentor helps you verbalize what you’re doing,” he says.

Get Involved

No one underestimates the value networking can have in locating the people and opportunities that can push a career along. But scattered networking can waste valuable time and money. Biomeds who want to make the most of their networking opportunities should first look to joining the local and regional chapters of biomedical/clinical engineering associations.

“By being part of those local groups, you will find out about opportunities you just wouldn’t otherwise,” Fennigkoh says. “Not only is it rewarding educationally, as many of the groups put on education programs, but biomeds can be with their own kind, share their own stories, and find out they’re not alone in this.”

Bowles agrees. “The local or regional associations have probably the biggest benefit because they are closer [in location] to the person,” he says. “There is a North Texas Biomedical Association in Dallas, and we send our people to the meetings every other month and encourage them to join. We also encourage them to join the Association for the Advancement of Medical Instrumentation.”

Think Strategically

Since much of the medical equipment within health care is moving toward more system integration, where devices will more routinely interface with one another, biomeds who want to advance on their career paths will need to think strategically about this integration and how it will affect their careers. “So much of the equipment is now being networked, and many are realizing the importance of a smart, educated, and trained troubleshooter in the hospital,” Knight says.

Read more on careers in the January 2009 issue of 24×7.

He also recommends biomeds look within their organization, as well as outside, to determine the best career track at any given time. “Identify your employer’s needs,” Knight says. “If you want to look outside of, say, your hospital, you have to look at where you would be willing to move, whether there are enough hospitals, and whether the senior leadership is progressive enough.”

Fennigkoh has, perhaps, the most valuable recommendation: Follow your passion. “If you really like being in the operating room and supporting the technology during surgical procedures, that would be the path to follow,” he says. “If you really like strategic planning, budgets, optimizing service, and delivery issues, if you like dealing with people and you’re sensitive and adept at dealing with the realities of organizational politics, then you may wish to pursue a career path toward becoming a department supervisor, manager, or director. Be aware, however, that despite the apparent glory and often greater salaries that come with such positions, that they also have a way of sucking the passion out of something that you may have once loved. Follow what brings you passion and joy, for what the heart knows today, the head will understand tomorrow.”

Cynthia Kincaid is a contributing writer for 24×7. For more information, contact .