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Appearance & Dress at an interview signifies how you feel about yourself.
Quick Tip: That greeting hand shake is absolutely a must!
Choosing a college is a big decision. The key is to remember that there's no such thing as a "perfect" school—you'll find many colleges and universities that match your preferences. Explore your interests and take the time to find the college that's right for you.
When choosing a vocation, consider choosing one that is tied to the infrastructure that's required to support new residents –this kind of work has to be delivered locally. These are jobs that won't go offshore.
The information below, was obtained from the top recruiter firms in the U.S. and these were their recommendations: An interview gives you the opportunity to showcase your qualifications to an employer, so it pays to be well prepared. The following information provides some helpful hints.
Test (if employer gives one):
Information to bring to an interview:
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Maintaining a strong national defense encompasses such diverse activities as running a hospital, commanding a tank, programming computers, operating a nuclear reactor, or repairing and maintaining a helicopter. The military provides training and work experience in these and many other fields for more than 2.6 million people. More than 1.4 million people serve in the active Army, Navy, Marine Corps, and Air Force, and more than 1.2 million serve in their Reserve components, and the Air and Army National Guard. The Coast Guard, which is now part of the U.S. Department of Homeland Security.
The military distinguishes between enlisted and officer careers. Enlisted personnel, who make up about 85 percent of the Armed Forces, carry out the fundamental operations of the military in areas such as combat, administration, construction, engineering, health care, and human services. Officers, who make up the remaining 15 percent of the Armed Forces, are the leaders of the military, supervising and managing activities in every occupational specialty of the Armed Forces.
The sections that follow discuss the major occupational groups for enlisted personnel and officers.
Enlisted occupational groups
Administrative careers include a wide variety of positions. The military must keep accurate information for planning and managing its operations. Both paper and electronic records are kept on personnel and on equipment, funds, supplies, and all other aspects of the military. Administrative personnel record information, type reports, maintain files, and review information to assist military officers. Personnel may work in a specialized area such as finance, accounting, legal affairs, maintenance, supply, or transportation.
Combat specialty occupations refer to enlisted specialties, such as infantry, artillery, and special forces, whose members operate weapons or execute special missions during combat. Persons in these occupations normally specialize by the type of weapon system or combat operation. These personnel maneuver against enemy forces and position and fire artillery, guns, and missiles to destroy enemy positions. They also may operate tanks and amphibious assault vehicles in combat or scouting missions. When the military has difficult and dangerous missions to perform, they call upon special forces teams. These elite combat forces maintain a constant state of readiness to strike anywhere in the world on a moment’s notice. Team members from the special forces conduct offensive raids, demolitions, intelligence, search-and-rescue missions, and other operations from aboard aircraft, helicopters, ships, or submarines.
Construction occupations in the military include personnel who build or repair buildings, airfields, bridges, foundations, dams, bunkers, and the electrical and plumbing components of these structures. Personnel in construction occupations operate bulldozers, cranes, graders, and other heavy equipment. Construction specialists also may work with engineers and other building specialists as part of military construction teams. Some personnel specialize in areas such as plumbing or electrical wiring. Plumbers and pipefitters install and repair the plumbing and pipe systems needed in buildings and on aircraft and ships. Building electricians install and repair electrical-wiring systems in offices, airplane hangars, and other buildings on military bases.
Electronic and electrical equipment repair personnel repair and maintain electronic and electrical equipment used in the military. Repairers normally specialize by type of equipment, such as avionics, computer, optical, communications, or weapons systems. For example, electronic instrument repairers install, test, maintain, and repair a wide variety of electronic systems, including navigational controls and biomedical instruments. Weapons maintenance technicians maintain and repair weapons used by combat forces; most of these weapons have electronic components and systems that assist in locating targets and in aiming and firing the weapon.
Engineering, science, and technical personnel in the military require specific knowledge to operate technical equipment, solve complex problems, or provide and interpret information. Personnel normally specialize in one area, such as space operations, information technology, environmental health and safety, or intelligence. Space operations specialists use and repair ground-control command equipment having to do with spacecraft, including electronic systems that track the location and operation of a craft. Information technology specialists develop software programs and operate computer systems. Environmental health and safety specialists inspect military facilities and food supplies for the presence of disease, germs, or other conditions hazardous to health and the environment. Intelligence specialists gather and study information by means of aerial photographs and various types of radar and surveillance systems.
Health care personnel assist medical professionals in treating and providing services for men and women in the military. They may work as part of a patient-service team in close contact with doctors, dentists, nurses, and physical therapists to provide the necessary support functions within a hospital or clinic. Health care specialists normally specialize in a particular area—emergency medical treatment, the operation of diagnostic tools such as x-ray and ultrasound equipment, laboratory testing of tissue and blood samples, or maintaining pharmacy supplies or patients’ records, among others. Dental and optical laboratory technicians construct and repair dental equipment and eyeglasses for military personnel.
Human resources development specialists recruit and place qualified personnel and provide the training programs necessary to help people perform their jobs effectively. Personnel in this career area normally specialize by activity. For example, recruiting specialists provide information about military careers to young people, parents, schools, and local communities and explain the Armed Service’s employment and training opportunities, pay and benefits, and service life. Personnel specialists collect and store information about the people in the military, including information on their previous and current training, job assignments, promotions, and health. Training specialists and instructors teach classes and give demonstrations to provide military personnel with the knowledge they need to perform their jobs.
Machine operator and production personnel operate industrial equipment, machinery, and tools to fabricate and repair parts for a variety of items and structures. They may operate engines, turbines, nuclear reactors, and water pumps. Often, they specialize by type of work performed. Welders and metalworkers, for instance, work with various types of metals to repair or form the structural parts of ships, submarines, buildings, or other equipment. Survival equipment specialists inspect, maintain, and repair survival equipment such as parachutes and aircraft life support equipment.
Media and public affairs personnel deal with the public presentation and interpretation of military information and events. They take and develop photographs; film, record, and edit audio and video programs; present news and music programs; and produce graphic artwork, drawings, and other visual displays. Other public affairs specialists act as interpreters and translators to convert written or spoken foreign languages into English or other languages.
Protective service personnel include those who enforce military laws and regulations and provide emergency response to natural and human-made disasters. These personnel normally specialize by function. For example, military police control traffic, prevent crime, and respond to emergencies. Other law enforcement and security specialists investigate crimes committed on military property and guard inmates in military correctional facilities. Firefighters put out, control, and help prevent fires in buildings, on aircraft, and aboard ships.
Support service personnel provide subsistence services and support the morale and well-being of military personnel and their families. Food service specialists prepare all types of food in dining halls, hospitals, and ships. Counselors help military personnel and their families deal with personal issues. They work as part of a team that may include social workers, psychologists, medical officers, chaplains, personnel specialists, and commanders. Religious program specialists assist chaplains with religious services, religious education programs, and related administrative duties.
Transportation and material handling specialists ensure the safe transport of people and cargo. Most personnel within this occupational group are classified according to mode of transportation, such as aircraft, motor vehicle, or ship. Aircrew members operate equipment on board aircraft during operations. Vehicle drivers operate all types of heavy military vehicles, including fuel or water tank trucks, semi-trailers, heavy troop transports, and passenger buses. Quartermasters and boat operators navigate and pilot many types of small watercraft, including tugboats, gunboats, and barges. Cargo specialists load and unload military supplies, using equipment such as forklifts and cranes.
Vehicle and machinery mechanics conduct preventive and corrective maintenance on aircraft, automotive and heavy equipment, heating and cooling systems, marine engines, and powerhouse station equipment. These workers typically specialize by the type of equipment that they maintain. For example, aircraft mechanics inspect, service, and repair helicopters and airplanes. Automotive and heavy equipment mechanics maintain and repair vehicles such as humvees, trucks, tanks, self-propelled missile launchers, and other combat vehicles. They also repair bulldozers, power shovels, and other construction equipment. Heating and cooling mechanics install and repair air-conditioning, refrigeration, and heating equipment. Marine engine mechanics repair and maintain gasoline and diesel engines on ships, boats, and other watercraft. They also repair shipboard mechanical and electrical equipment. Powerhouse mechanics install, maintain, and repair electrical and mechanical equipment in power-generating stations.
Officer occupational groups
Combat specialty officers plan and direct military operations, oversee combat activities, and serve as combat leaders. This category includes officers in charge of tanks and other armored assault vehicles, artillery systems, special forces, and infantry. Combat specialty officers normally specialize by the type of unit that they lead. Within the unit, they may specialize by the type of weapon system. Artillery and missile system officers, for example, direct personnel as they target, launch, test, and maintain various types of missiles and artillery. Special-operations officers lead their units in offensive raids, demolitions, intelligence gathering, and search-and-rescue missions.
Engineering, science, and technical officers have a wide range of responsibilities based on their area of expertise. They lead or perform activities in areas such as space operations, environmental health and safety, and engineering. These officers may direct the operations of communications centers or the development of complex computer systems. Environmental health and safety officers’ study the air, ground, and water to identify and analyze sources of pollution and its effects. They also direct programs to control safety and health hazards in the workplace. Other personnel work as aerospace engineers to design and direct the development of military aircraft, missiles, and spacecraft.
Executive, administrative, and managerial officers oversee and direct military activities in key functional areas such as finance, accounting, health administration, international relations, and supply. Health services administrators, for instance, are responsible for the overall quality of care provided at the hospitals and clinics they operate. They must ensure that each department works together to provide the highest quality of care. As another example, purchasing and contracting managers negotiate and monitor contracts for the purchase of the billions of dollars’ worth of equipment, supplies, and services that the military buys from private industry each year.
Health care officers provide health services at military facilities, on the basis of their area of specialization. Officers who examine, diagnose, and treat patients with illness, injury, or disease include physicians, registered nurses, and dentists. Other health care officers provide therapy, rehabilitative treatment, and additional services for patients. Physical and occupational therapists plan and administer therapy to help patients adjust to disabilities, regain independence, and return to work. Speech therapists evaluate and treat patients with hearing and speech problems. Dietitians manage food service facilities and plan meals for hospital patients and for outpatients who need special diets. Pharmacists manage the purchase, storage, and dispensation of drugs and medicines. Physicians and surgeons in this occupational group provide the majority of medical services to the military and their families. Dentists treat diseases and disorders of the mouth. Optometrists treat vision problems by prescribing eyeglasses or contact lenses. psychologists provide mental health care and also conduct research on behavior and emotions.
Human resource development officers manage recruitment, placement, and training strategies and programs in the military. They normally specialize by activity. Recruiting managers direct recruiting efforts and provide information about military careers to young people, parents, schools, and local communities. Personnel managers direct military personnel functions such as job assignment, staff promotion, and career counseling. Training and education directors identify training needs and develop and manage educational programs designed to keep military personnel current in the skills they need to perform their jobs.
Media and public affairs officers oversee the development, production, and presentation of information or events for the public. These officers may produce and direct motion pictures, videotapes, and television and radio broadcasts that are used for training, news, and entertainment. Some plan, develop, and direct the activities of military bands. Public information officers respond to inquiries about military activities and prepare news releases and reports to keep the public informed.
Protective service officers are responsible for the safety and protection of individuals and property on military bases and vessels. Emergency management officers plan and prepare for all types of natural and human-made disasters. They develop warning, control, and evacuation plans to be used in the event of a disaster. Law enforcement and security officers enforce all applicable laws on military bases and investigate crimes when the law has been broken.
Support services officers manage food service activities and perform services in support of the morale and well-being of military personnel and their families. Food services managers oversee the preparation and delivery of food services within dining facilities located on military installations and vessels. Social workers focus on improving conditions that cause social problems such as drug and alcohol abuse, racism, and sexism. Chaplains conduct worship services for military personnel and perform other spiritual duties covering the beliefs and practices of all religious faiths.
Transportation officers manage and perform activities related to the safe transport of military personnel and material by air and water. These officers normally specialize by mode of transportation or area of expertise because, in many cases, they must meet licensing and certification requirements. Pilots in the military fly various types of specialized airplanes and helicopters to carry troops and equipment and to execute combat missions. Navigators use radar, radio, and other navigation equipment to determine their position and plan their route of travel. Officers on ships and submarines work as a team to manage the various departments aboard their vessels. Ship engineers direct engineering departments aboard ships and submarines, including engine operations, maintenance, repair, heating, and power generation.
Training and other Qualifications
Enlisted personnel. In order to join the services, enlisted personnel must sign a legal agreement called an enlistment contract, which usually involves a commitment to 8 years of service. Depending on the terms of the contract, 2 to 6 years are spent on active duty, and the balance is spent in the National Guard or Reserves. The enlistment contract obligates the service to provide the agreed-upon job, rating, pay, cash bonuses for enlistment in certain occupations, medical and other benefits, occupational training, and continuing education. In return, enlisted personnel must serve satisfactorily for the period specified.
Requirements for each service vary, but certain qualifications for enlistment are common to all branches. In order to enlist, one must be between 17 and 35 years old for active service, be a U.S. citizen or an alien holding permanent resident status, not have a felony record, and possess a birth certificate. Applicants who are aged 17 must have the consent of a parent or legal guardian before entering the service. Coast Guard enlisted personnel must enter active duty before their 28th birthday, whereas Marine Corps enlisted personnel must not be over the age of 29. Applicants must both pass a written examination—the Armed Services Vocational Aptitude Battery—and meet certain minimum physical standards, such as height, weight, vision, and overall health. All branches of the Armed Forces require high school graduation or its equivalent.
People thinking about enlisting in the military should learn as much as they can about military life before making a decision. Doing so is especially important if you are thinking about making the military a career. Speaking to friends and relatives with military experience is a good idea. Find out what the military can offer you and what it will expect in return. Then, talk to a recruiter, who can determine whether you qualify for enlistment, explain the various enlistment options, and tell you which military occupational specialties currently have openings. Bear in mind that the recruiter’s job is to recruit promising applicants into his or her branch of military service, so the information that the recruiter gives you is likely to stress the positive aspects of military life in the branch in which he or she serves.
Ask the recruiter for the branch you have chosen to assess your chances of being accepted for training in the occupation of your choice, or, better still, take the aptitude exam to see how well you score. The military uses this exam as a placement exam, and test scores largely determine an individual’s chances of being accepted into a particular training program. Selection for a particular type of training depends on the needs of the service, your general and technical aptitudes, and your personal preference. Because all prospective recruits are required to take the exam, those who do so before committing themselves to enlist have the advantage of knowing in advance whether they stand a good chance of being accepted for training in a particular specialty. The recruiter can schedule you for the Armed Services Vocational Aptitude Battery without any obligation. Many high schools offer the exam as an easy way for students to explore the possibility of a military career, and the test also affords an insight into career areas in which the student has demonstrated aptitudes and interests.
If you decide to join the military, the next step is to pass the physical examination and sign an enlistment contract. Negotiating the contract involves choosing, qualifying for, and agreeing on a number of enlistment options, such as the length of active-duty time, which may vary according to the option. Most active-duty programs have first-term enlistments of 4 years, although there are some 2-, 3-, and 6-year programs. The contract also will state the date of enlistment and other options—for example, bonuses and the types of training to be received. If the service is unable to fulfill any of its obligations under the contract, such as providing a certain kind of training, the contract may become null and void.
All branches of the Armed Services offer a delayed entry program (DEP) by which an individual can delay entry into active duty for up to 1 year after enlisting. High school students can enlist during their senior year and enter a service after graduation. Others choose this program because the job training they desire is not currently available, but will be within the coming year, or because they need time to arrange their personal affairs.
Women are eligible to enter most military specialties; for example, they may become mechanics, missile maintenance technicians, heavy-equipment operators, and fighter pilots, or they may enter into medical care, administrative support, and intelligence specialties. Generally, only occupations involving direct exposure to combat are excluded.
People planning to apply the skills gained through military training to a civilian career should first determine how good the prospects are for civilian employment in jobs related to the military specialty that interests them. Second, they should know the prerequisites for the related civilian job. Because many civilian occupations require a license, certification, or minimum level of education, it is important to determine whether military training is sufficient for a person to enter the civilian equivalent or, if not, what additional training will be required. Other Handbook statements discuss the job outlook, training requirements, and other aspects of civilian occupations for which military training and experience are helpful. Additional information often can be obtained from school counselors.
Following enlistment, new members of the Armed Forces undergo initial-entry training, better known as “basic training” or “boot camp.” Through courses in military skills and protocol recruit training provides a 6-week to 13-week introduction to military life. Days and nights are carefully structured and include rigorous physical exercise designed to improve strength and endurance and build each unit’s cohesion.
Following basic training, most recruits take additional training at technical schools that prepare them for a particular military occupational specialty. The formal training period generally lasts from 10 to 20 weeks, although training for certain occupations—nuclear power plant operator, for example—may take as long as a year. Recruits not assigned to classroom instruction receive on-the-job training at their first duty assignment.
Many service people get college credit for the technical training they receive on duty, which, combined with off-duty courses, can lead to an associate degree through programs in community colleges such as the Community College of the Air Force. In addition to on-duty training, military personnel may choose from a variety of educational programs. Most military installations have tuition assistance programs for people wishing to take courses during off-duty hours. The courses may be correspondence courses or courses in degree programs offered by local colleges or universities. Tuition assistance pays up to 100 percent of college costs up to a credit-hour and annual limit. Each branch of the service provides opportunities for full-time study to a limited number of exceptional applicants. Military personnel accepted into these highly competitive programs in law or medicine, for example receive full pay, allowances, tuition, and related fees. In return, they must agree to serve an additional amount of time in the service. Other highly selective programs enable enlisted personnel to qualify as commissioned officers through additional military training.
Warrant officers. Warrant officers are technical and tactical leaders who specialize in a specific technical area; for example, Army aviators make up one group of warrant officers. The Army Warrant Officer Corps constitutes less than 5 percent of the total Army. Although the Corps is small in size, its level of responsibility is high. Its members receive extended career opportunities, worldwide leadership assignments, and increased pay and retirement benefits. Selection to attend the Warrant Officer Candidate School is highly competitive and restricted to those who meet rank and length-of-service requirements. The only exception is the Army aviator warrant officer, which has no prior military service requirements (table 3).
Officers. Officer training in the Armed Forces is provided through the Federal service academies (Military, Naval, Air Force, and Coast Guard); the Reserve Officers Training Corps (ROTC) program offered at many colleges and universities; Officer Candidate School (OCS) or Officer Training School (OTS); the National Guard (State Officer Candidate School programs); the Uniformed Services University of Health Sciences; and other programs. All are highly selective and are good options for those wishing to make the military a career. Persons interested in obtaining training through the Federal service academies must be single to enter and graduate, while those seeking training through OCS, OTS, or ROTC need not be single. Single parents with one or more minor dependents are not eligible to become commissioned officers.
Federal service academies provide a 4-year college program leading to a bachelor-of-science degree. Midshipmen or cadets are provided free room and board, tuition, medical and dental care, and a monthly allowance. Graduates receive regular or reserve commissions and have a 5-year active-duty obligation, or more if they are entering flight training.
To become a candidate for appointment as a cadet or midshipman in one of the service academies, applicants are required to obtain a nomination from an authorized source, usually a member of Congress. Candidates do not need to know a member of Congress personally to request a nomination. Nominees must have an academic record of the requisite quality, college aptitude test scores above an established minimum, and recommendations from teachers or school officials; they also must pass a medical examination. Appointments are made from the list of eligible nominees. Appointments to the Coast Guard Academy, however, are based strictly on merit and do not require a nomination.
ROTC programs train students in about 575 Army, 130 Navy and Marine Corps, and 300 Air Force units at participating colleges and universities. Trainees take 3 to 5 hours of military instruction a week, in addition to regular college courses. After graduation, they may serve as officers on active duty for a stipulated period. Some may serve their obligation in the Reserves or National Guard. In the last 2 years of a ROTC program, students typically receive a monthly allowance while attending school, as well as additional pay for summer training. ROTC scholarships for 2, 3, and 4 years are available on a competitive basis. All scholarships pay for tuition and have allowances for textbooks, supplies, and other costs.
College graduates can earn a commission in the Armed Forces through OCS or OTS programs in the Army, Navy, Air Force, Marine Corps, Coast Guard, and National Guard. These officers generally must serve their obligation on active duty. Those with training in certain health professions may qualify for direct appointment as officers. In the case of persons studying for the health professions, financial assistance and internship opportunities are available from the military in return for specified periods of military service. Prospective medical students can apply to the Uniformed Services University of Health Sciences, which offers a salary and free tuition in a program leading to a doctor-of-medicine (M.D.) degree. In return, graduates must serve for 7 years in either the military or the U.S. Public Health Service. Direct appointments also are available for those qualified to serve in other specialty areas, such as the judge advocate general (legal) or chaplain corps. Flight training is available to commissioned officers in each branch of the Armed Forces. In addition, the Army has a direct enlistment option to become a warrant officer aviator.
Each service has different criteria for promoting personnel. Generally, the first few promotions for both enlisted and officer personnel come easily; subsequent promotions are much more competitive. Criteria for promotion may include time in service and in grade, job performance, a fitness report (supervisor’s recommendation), and passing scores on written examinations
Click here for the current number of military personnel. https://en.wikipedia.org/wiki/United_States_Armed_Forces
Click here for the current military earnings: https://militarybenefits.info/2020-military-pay-charts
The US Armed forces reported that in 2019 there were a total of 1,055.600 reserve and deployed personnel in the military.
Chiropractors, also known as doctors of chiropractic or chiropractic physicians, diagnose and treat patients whose health problems are associated with the body's muscular, nervous, and skeletal systems, especially the spine. Chiropractors believe that interference with these systems impairs the body's normal functions and lowers its resistance to disease. They also hold that spinal or vertebral dysfunction alters many important body functions by affecting the nervous system and that skeletal imbalance through joint or articular dysfunction, especially in the spine, can cause pain.
The chiropractic approach to health care is holistic, stressing the patient's overall health and wellness. It recognizes that many factors affect health, including exercise, diet, rest, environment, and heredity. Chiropractors provide natural, drugless, nonsurgical health treatments and rely on the body's inherent recuperative abilities. They also recommend changes in lifestyle in eating, exercise, and sleeping habits, for example to their patients. When appropriate, chiropractors consult with and refer patients to other health practitioners.
Like other health practitioners, chiropractors follow a standard routine to secure the information they need for diagnosis and treatment. They take the patient's medical history; conduct physical, neurological, and orthopedic examinations; and may order laboratory tests. X rays and other diagnostic images are important tools because of the chiropractor's emphasis on the spine and its proper function. Chiropractors also employ a postural and spinal analysis common to chiropractic diagnosis.
In cases in which difficulties can be traced to the involvement of musculoskeletal structures, chiropractors manually adjust the spinal column. Some chiropractors use water, light, massage, ultrasound, electric, acupuncture, and heat therapy. They also may apply supports such as straps, tapes, and braces. Chiropractors counsel patients about wellness concepts such as nutrition, exercise, changes in lifestyle, and stress management, but do not prescribe drugs or perform surgery.
Some chiropractors specialize in sports injuries, neurology, orthopedics, pediatrics, nutrition, internal disorders, or diagnostic imaging.
Many chiropractors are solo or group practitioners who also have the administrative responsibilities of running a practice. In larger offices, chiropractors delegate these tasks to office managers and chiropractic assistants. Chiropractors in private practice are responsible for developing a patient base, hiring employees, and keeping records.
Chiropractors work in clean, comfortable offices. Their average workweek is about 40 hours, although longer hours are not uncommon. Solo practitioners set their own hours, but may work evenings or weekends to accommodate patients.
Like other health practitioners, chiropractors are sometimes on their feet for long periods. Chiropractors who take x rays must employ appropriate precautions against the dangers of repeated exposure to radiation.
Training, and other qualifications
All States and the District of Columbia regulate the practice of chiropractic and grant licenses to chiropractors who meet the educational and examination requirements established by the State. Chiropractors can practice only in States where they are licensed. Some States have agreements permitting chiropractors licensed in one State to obtain a license in another without further examination, provided that their educational, examination, and practice credentials meet State specifications.
Most State boards require at least 2 years of undergraduate education; an increasing number are requiring a 4-year bachelor's degree. All boards require the completion of a 4-year program at an accredited chiropractic college leading to the Doctor of Chiropractic degree.
For licensure, most State boards recognize either all or part of the four-part test administered by the National Board of Chiropractic Examiners. State examinations may supplement the National Board tests, depending on State requirements. All States except New Jersey require the completion of a specified number of hours of continuing education each year in order to maintain licensure. Chiropractic associations and accredited chiropractic programs and institutions offer continuing education programs.
In 2018, 15 chiropractic programs and 2 chiropractic institutions in the United States were accredited by the Council on Chiropractic Education. Applicants are required to have at least 90 semester hours of undergraduate study leading toward a bachelor's degree, including courses in English, the social sciences or humanities, organic and inorganic chemistry, biology, physics, and psychology. Many applicants have a bachelor’s degree, which may eventually become the minimum entry requirement. Several chiropractic colleges offer pre-chiropractic study, as well as a bachelor's degree program. Recognition of pre-chiropractic education offered by chiropractic colleges varies among the State boards.
Chiropractic programs require a minimum of 4,200 hours of combined classroom, laboratory, and clinical experience. During the first 2 years, most chiropractic programs emphasize classroom and laboratory work in basic science subjects such as anatomy, physiology, public health, microbiology, pathology, and biochemistry. The last 2 years stress courses in manipulation and spinal adjustment and provide clinical experience in physical and laboratory diagnosis, neurology, orthopedics, geriatrics, physiotherapy, and nutrition. Chiropractic programs and institutions grant the degree of Doctor of Chiropractic.
Chiropractic colleges also offer Postdoctoral training in orthopedics, neurology, sports injuries, nutrition, rehabilitation, radiology, industrial consulting, family practice, pediatrics, and applied chiropractic sciences. Once such training is complete, chiropractors may take specialty exams leading to diplomatic status in a given specialty. Exams are administered by specialty chiropractic associations.
Chiropractic requires keen observation to detect physical abnormalities. It also takes considerable manual dexterity, but not unusual strength or endurance, to perform adjustments. Chiropractors should be able to work independently and handle responsibility. As in other health-related occupations, empathy, understanding, and the desire to help others are good qualities for dealing effectively with patients.
Newly licensed chiropractors can set up a new practice, purchase an established one, or enter into partnership with an established practitioner. They also may take a salaried position with an established chiropractor, a group practice, or a health care facility.
Chiropractors held about 50,300 jobs in 2018. Approximately 58 percent of chiropractors are self-employed. Most chiropractors are in solo practice, although some are in group practice or work for other chiropractors. A small number teach, conduct research at chiropractic institutions, or work in hospitals and clinics.
Many chiropractors are located in small communities. However, there still often are geographic imbalances in the distribution of chiropractors, in part because many establish practices close to one of the few chiropractic institutions.
Job prospects are expected to be good for persons who enter the practice of chiropractic. Employment of chiropractors is expected to grow faster than average for all occupations through the year 2024 as consumer demand for alternative health care grows. Because chiropractors emphasize the importance of healthy lifestyles and do not prescribe drugs or perform surgery, chiropractic care is appealing to many health-conscious Americans. Chiropractic treatment of the back, neck, extremities, and joints has become more accepted as a result of research and changing attitudes about alternative, noninvasive health care practices. The rapidly expanding older population, with its increased likelihood of mechanical and structural problems, also will increase demand for chiropractors.
Demand for chiropractic treatment, however, is related as well to the ability of patients to pay, either directly or through health insurance. Although more insurance plans now cover chiropractic services, the extent of such coverage varies among plans. Increasingly, chiropractors must educate communities about the benefits of chiropractic care in order to establish a successful practice.
In this occupation, replacement needs arise almost entirely from retirements. Chiropractors usually remain in the occupation until they retire; few transfer to other occupations. Establishing a new practice will be easiest in areas with a low concentration of chiropractors.
The mean salary for chiropractors was $71,410 in 2018. The best-paid 25 percent made $99,290 that year, while the lowest-paid 25 percent made $51,890.
In chiropractic, as in other types of independent practice, earnings are relatively low in the beginning and increase as the practice grows. Geographic location and the characteristics and qualifications of the practitioner also may influence earnings. Self-employed chiropractors must provide their own health insurance and retirement.
(Jobs that will not go-offshore).
Education is one of Life's precious and extraordinary experiences leading to a world of opportunities and understanding.
Dental assistants perform a variety of patient care, office, and laboratory duties. They work chair side as dentists examine and treat patients. They make patients as comfortable as possible in the dental chair, prepare them for treatment, and obtain their dental records. Assistants hand instruments and materials to dentists and keep patients’ mouths dry and clear by using suction or other devices. Assistants also sterilize and disinfect instruments and equipment, prepare trays of instruments for dental procedures, and instruct patients on postoperative and general oral health care.
Some dental assistants prepare materials for impressions and restorations, take dental x rays, and process x-ray film as directed by a dentist. They also may remove sutures, apply topical anesthetics to gums or cavity-preventive agents to teeth, remove excess cement used in the filling process, and place rubber dams on the teeth to isolate them for individual treatment.
Those with laboratory duties make casts of the teeth and mouth from impressions, clean and polish removable appliances, and make temporary crowns. Dental assistants with office duties schedule and confirm appointments, receive patients, keep treatment records, send bills, receive payments, and order dental supplies and materials.
Dental assistants should not be confused with dental hygienists, who are licensed to perform different clinical tasks.
Dental assistants work in a well-lighted, clean environment. Their work area usually is near the dental chair so that they can arrange instruments, materials, and medication and hand them to the dentist when needed. Dental assistants must wear gloves, masks, eyewear, and protective clothing to protect themselves and their patients from infectious diseases. Assistants also follow safety procedures to minimize the risks associated with the use of x-ray machines.
About half of dental assistants have a 35- to 40-hour workweek, which may include work on Saturdays or evenings, although, most practices now operate Monday through Thursday.
Training and other Qualifications
Most assistants learn their skills on the job, although an increasing number are trained in dental-assisting programs offered by community and junior colleges, trade schools, technical institutes, or the Armed Forces. Assistants must be a second pair of hands for a dentist; therefore, dentists look for people who are reliable, work well with others, and have good manual dexterity. High school students interested in a career as a dental assistant should take courses in biology, chemistry, health, and office practices.
Programs include classroom, laboratory, and preclinical instruction in dental-assisting skills and related theory. In addition, students gain practical experience in dental schools, clinics, or dental offices. Most programs take 1 year or less to complete and lead to a certificate or diploma. Two-year programs offered in community and junior colleges lead to an associate degree. All programs require a high school diploma or its equivalent, and some require science or computer-related courses for admission. A number of private vocational schools offer 4-month to 6-month courses in dental assisting, but the Commission on Dental Accreditation does not accredit these programs.
Most States regulate the duties that dental assistants are allowed to perform through licensure or registration. Licensure or registration may require passing a written or practical examination. States offering licensure or registration have a variety of schools offering courses approximately 10 to 12 months in length—that meet their State’s requirements. Other States require dental assistants to complete State-approved education courses of 4 to 12 hours in length. Some States offer registration of other dental assisting credentials with little or no education required. Some States require continuing education to maintain licensure or registration. A few States allow dental assistants to perform any function delegated to them by the dentist.
Individual States have adopted different standards for dental assistants who perform certain advanced duties, such as radiological procedures. Completion of the Radiation Health and Safety examination offered by the Dental Assisting National Board (DANB) meets those standards in more than 30 States. Some States require completion of a State-approved course in radiology as well.
Certification is available through DANB and is recognized or required in more than 30 States. Other organizations offer registration, most often at the State level. Certification is an acknowledgment of an assistant’s qualifications and professional competence and may be an asset when one is seeking employment. Candidates may qualify to take the DANB certification examination by graduating from an ADA-accredited dental assisting education program or by having 2 years of full-time, or 4 years of part-time, experience as a dental assistant. In addition, applicants must have current certification in cardiopulmonary resuscitation. For annual recertification, individuals must earn continuing education credits.
Without further education, advancement opportunities are limited. Some dental assistants become office managers, dental-assisting instructors, or dental product sales representatives. Others go back to school to become dental hygienists. For many, this entry-level occupation provides basic training and experience and serves as a steppingstone to more highly skilled and higher paying jobs.
Dental assistants held about 295,300 jobs in 2019. Almost all jobs for dental assistants were in offices of dentists. A small number of jobs were in the Federal, State, and local governments or in offices of physicians. About 2 out of 5 dental assistants worked part time, sometimes in more than one dental office.
Job prospects for dental assistants should be excellent. Employment is expected to grow much faster than average for all.
In addition to job openings due to employment growth, numerous job openings will arise out of the need to replace assistants who transfer to other occupations, retire, or leave for other reasons. Many opportunities are for entry-level positions offering on-the-job training.
Population growth and greater retention of natural teeth by middle-aged and older people will fuel demand for dental services. Older dentists, who have been less likely to employ assistants, are leaving the occupation and will be replaced by recent graduates, who are more likely to use one or even two assistants. In addition, as dentists’ workloads increase, they are expected to hire more assistants to perform routine tasks, so that they may devote their own time to more complex procedures.
median salary of $37,630 in 2017.The best-paid 25 percent made $46,000 that year, while the lowest-paid 25 percent made $31,160. Benefits vary substantially by practice setting and may be contingent upon full-time employment. According to the American Dental Association (ADA), almost all full-time dental assistants employed by private practitioners received paid vacation time. The ADA also found that 9 out of 10 full-time and part-time dental assistants received dental coverage.
Making informed career decisions requires reliable information about opportunities in the future. Opportunities result from the relationships between the population, labor force, and the demand for goods and services.
Population ultimately limits the size of the labor force individuals working or looking for work which constrains how much can be produced. Demand for various goods and services determines employment in the industries providing them. Occupational employment opportunities, in turn, result from demand for skills needed within specific industries. Opportunities for medical assistants and other healthcare occupations, for example, have surged in response to rapid growth in demand for health services. Population trends affect employment opportunities in a number of ways. Changes in population influence the demand for goods and services. For example, a growing and aging population has increased the demand for health services. Equally important, population changes produce corresponding changes in the size and demographic composition of the labor force. Population trends affect employment opportunities in a number of ways. Changes in population influence the demand for goods and services. For example, a growing and aging population has increased the demand for health services. Equally important, population changes produce corresponding changes in the size and demographic composition of the labor force.
Engineers apply the principles of science and mathematics to develop economical solutions to technical problems. Their work is the link between perceived social needs and commercial applications.
Engineers consider many factors when developing a new product. For example, in developing an industrial robot, engineers precisely specify the functional requirements; design and test the robot's components; integrate the components to produce the final design; and evaluate the design's overall effectiveness, cost, reliability, and safety. This process applies to the development of many different products, such as chemicals, computers, gas turbines, helicopters, and toys.
In addition to design and development, many engineers work in testing, production, or maintenance. These engineers supervise production in factories, determine the causes of component failure, and test manufactured products to maintain quality. They also estimate the time and cost to complete projects. Some move into engineering management or into sales. In sales, an engineering background enables them to discuss technical aspects and assist in product planning, installation, and use. Supervisory engineers are responsible for major components or entire projects.
Engineers use computers extensively to produce and analyze designs; to simulate and test how a machine, structure, or system operates; and to generate specifications for parts. Many engineers also use computers to monitor product quality and control process efficiency. The field of nanotechnology, which involves the creation of high-performance materials and components by integrating atoms and molecules, also is introducing entirely new principles to the design process.
Most engineers specialize. This section provides details on the 17 engineering specialties covered in the Federal Government's Standard Occupational Classification system and on engineering in general. Numerous specialties are recognized by professional societies, and the major branches of engineering have numerous subdivisions. Some examples include structural and transportation engineering, which are subdivisions of civil engineering; and ceramic, metallurgical, and polymer engineering, which are subdivisions of materials engineering. Engineers also may specialize in one industry, such as motor vehicles, or in one type of technology, such as turbines or semiconductor materials.
· Aerospace engineers design, develop, and test aircraft, spacecraft, and missiles and supervise the manufacture of these products. Those who work with aircraft are called aeronautical engineers, and those working specifically with spacecraft are astronautical engineers. Aerospace engineers develop new technologies for use in aviation, defense systems, and space exploration, often specializing in areas such as structural design, guidance, navigation and control, instrumentation and communication, or production methods. They also may specialize in a particular type of aerospace product, such as commercial aircraft, military fighter jets, helicopters, spacecraft, or missiles and rockets, and may become experts in aerodynamics, thermodynamics, celestial mechanics, propulsion, acoustics, or guidance and control systems.
· Agricultural engineers apply knowledge of engineering technology and science to agriculture and the efficient use of biological resources. They design agricultural machinery and equipment and agricultural structures. Some specialize in areas such as power systems and machinery design; structures and environment engineering; and food and bioprocess engineering. They develop ways to conserve soil and water and to improve the processing of agricultural products. Agricultural engineers often work in research and development, production, sales, or management.
· Biomedical engineers develop devices and procedures that solve medical and health-related problems by combining their knowledge of biology and medicine with engineering principles and practices. Many do research, along with life scientists, chemists, and medical scientists, to develop and evaluate systems and products such as artificial organs, prostheses (artificial devices that replace missing body parts), instrumentation, medical information systems, and health management and care delivery systems. Biomedical engineers may also design devices used in various medical procedures, imaging systems such as magnetic resonance imaging (MRI), and devices for automating insulin injections or controlling body functions. Most engineers in this specialty need a sound background in another engineering specialty, such as mechanical or electronics engineering, in addition to specialized biomedical training. Some specialties within biomedical engineering include biomaterials, biomechanics, medical imaging, rehabilitation engineering, and orthopedic engineering.
· Chemical engineers apply the principles of chemistry to solve problems involving the production or use of chemicals and biochemicals. They design equipment and processes for large-scale chemical manufacturing, plan and test methods of manufacturing products and treating byproducts, and supervise production. Chemical engineers also work in a variety of manufacturing industries other than chemical manufacturing, such as those producing energy, electronics, food, clothing, and paper. They also work in healthcare, biotechnology, and business services. Chemical engineers apply principles of chemistry, physics, mathematics, and mechanical and electrical engineering. Some may specialize in a particular chemical process, such as oxidation or polymerization. Others specialize in a particular field, such as materials science, or in the development of specific products. They must be aware of all aspects of chemicals manufacturing and how the manufacturing process affects the environment and the safety of workers and consumers.
· Civil engineers design and supervise the construction of roads, buildings, airports, tunnels, dams, bridges, and water supply and sewage systems. They must consider many factors in the design process, from the construction costs and expected lifetime of a project to government regulations and potential environmental hazards such as earthquakes. Civil engineering, considered one of the oldest engineering disciplines, encompasses many specialties. The major specialties are structural, water resources, construction, environmental, transportation, and geotechnical engineering. Many civil engineers hold supervisory or administrative positions, from supervisor of a construction site to city engineer. Others may work in design, construction, research, and teaching.
· Computer hardware engineers research, design, develop, test, and oversee the installation of computer hardware and supervise its manufacture and installation. Hardware refers to computer chips, circuit boards, computer systems, and related equipment such as keyboards, modems, and printers. The work of computer hardware engineers is very similar to that of electronics engineers, but, unlike electronics engineers, computer hardware engineers work exclusively with computers and computer-related equipment. The rapid advances in computer technology are largely a result of the research, development, and design efforts of computer hardware engineers.
· Electrical engineers design, develop, test, and supervise the manufacture of electrical equipment. Some of this equipment includes electric motors; machinery controls, lighting, and wiring in buildings; automobiles; aircraft; radar and navigation systems; and power-generating, and transmission devices used by electric utilities. Although the terms electrical and electronics engineering often are used interchangeably in academia and industry, electrical engineers have traditionally focused on the generation and supply of power, whereas electronics engineers have worked on applications of electricity to control systems or signal processing. Electrical engineers specialize in areas such as power systems engineering or electrical equipment manufacturing.
· Electronics engineers, except computer, are responsible for a wide range of technologies, from portable music players to the global positioning system (GPS), which can continuously provide the location of a vehicle. Electronics engineers design, develop, test, and supervise the manufacture of electronic equipment such as broadcast and communications systems. Many electronics engineers also work in areas closely related to computers. However, engineers whose work is related exclusively to computer hardware are considered computer hardware engineers. Electronics engineers specialize in areas such as communications, signal processing, and control systems or have a specialty within one of these areas—industrial robot control systems or aviation electronics, for example.
· Environmental engineers develop solutions to environmental problems using the principles of biology and chemistry. They are involved in water and air pollution control, recycling, waste disposal, and public health issues. Environmental engineers conduct hazardous-waste management studies in which they evaluate the significance of the hazard, advise on treatment and containment, and develop regulations to prevent mishaps. They design municipal water supply and industrial wastewater treatment systems. They conduct research on the environmental impact of proposed construction projects, analyze scientific data, and perform quality-control checks. Environmental engineers are concerned with local and worldwide environmental issues. They study and attempt to minimize the effects of acid rain, global warming, automobile emissions, and ozone depletion. They may also be involved in the protection of wildlife. Many environmental engineers work as consultants, helping their clients to comply with regulations and to clean up hazardous sites.
· Health and safety engineers, except mining safety engineers and inspectors, promote worksite or product safety by applying knowledge of industrial processes and mechanical, chemical, and human performance principles. Using this specialized knowledge, they identify and measure potential hazards to people or property, such as the risk of fires or the dangers involved in the handling of toxic chemicals. Health and safety engineers develop procedures and designs to reduce the risk of injury or damage. Some work in manufacturing industries to ensure the designs of new products do not create unnecessary hazards. They must be able to anticipate, recognize, and evaluate hazardous conditions, as well as develop hazard control methods.
· Industrial engineers determine the most effective ways to use the basic factors of production people, machines, materials, information, and energy—to make a product or to provide a service. They are mostly concerned with increasing productivity through the management of people, methods of business organization, and technology. To solve organizational, production, and related problems efficiently, industrial engineers carefully study the product requirements, use mathematical methods to meet those requirements, and design manufacturing and information systems. They develop management control systems to aid in financial planning and cost analysis, and design production planning and control systems to coordinate activities and ensure product quality. They also design or improve systems for the physical distribution of goods and services, as well as determine the most efficient plant locations. Industrial engineers develop wage and salary administration systems and job evaluation programs. Many industrial engineers move into management positions because the work is closely related to the work of managers.
· Marine engineers and naval architects are involved in the design, construction, and maintenance of ships, boats, and related equipment. They design and supervise the construction of everything from aircraft carriers to submarines, and from sailboats to tankers. Naval architects work on the basic design of ships, including hull form and stability. Marine engineers work on the propulsion, steering, and other systems of ships. Marine engineers and naval architects apply knowledge from a range of fields to the entire design and production process of all water vehicles. Workers who operate or supervise the operation of marine machinery on ships and other vessels also may be called marine engineers or, more frequently, ship engineers.
· Materials engineers are involved in the development, processing, and testing of the materials used to create a range of products, from computer chips and television screens to golf clubs and snow skis. They work with metals, ceramics, plastics, semiconductors, and composites to create new materials that meet certain mechanical, electrical, and chemical requirements. They also are involved in selecting materials for new applications. Materials engineers have developed the ability to create and then study materials at an atomic level, using advanced processes to replicate the characteristics of materials and their components with computers. Most materials engineers specialize in a particular material. For example, metallurgical engineers specialize in metals such as steel, and ceramic engineers develop ceramic materials and the processes for making ceramic materials into useful products such as glassware or fiber optic communication lines.
· Mechanical engineers research, develop, design, manufacture, and test tools, engines, machines, and other mechanical devices. They work on power-producing machines such as electric generators, internal combustion engines, and steam and gas turbines, as well as power-using machines such as refrigeration and air-conditioning equipment, machine tools, material handling systems, elevators and escalators, industrial production equipment, and robots used in manufacturing. Mechanical engineers also design tools that other engineers need for their work. Mechanical engineering is one of the broadest engineering disciplines. Mechanical engineers may work in production operations in manufacturing or agriculture, maintenance, or technical sales; many are administrators or managers.
· Mining and geological engineers, including mining safety engineers, find, extract, and prepare coal, metals, and minerals for use by manufacturing industries and utilities. They design open-pit and underground mines, supervise the construction of mine shafts and tunnels in underground operations, and devise methods for transporting minerals to processing plants. Mining engineers are responsible for the safe, economical, and environmentally sound operation of mines. Some mining engineers work with geologists and metallurgical engineers to locate and appraise new ore deposits. Others develop new mining equipment or direct mineral- processing operations that separate minerals from the dirt, rock, and other materials with which they are mixed. Mining engineers frequently specialize in the mining of one mineral or metal, such as coal or gold. With increased emphasis on protecting the environment, many mining engineers work to solve problems related to land reclamation and water and air pollution. Mining safety engineers use their knowledge of mine design and practices to ensure the safety of workers and to comply with State and Federal safety regulations. They inspect walls and roof surfaces, monitor air quality, and examine mining equipment for compliance with safety practices.
· Nuclear engineers research and develop the processes, instruments, and systems used to derive benefits from nuclear energy and radiation. They design, develop, monitor, and operate nuclear plants to generate power. They may work on the nuclear fuel cycle the production, handling, and use of nuclear fuel and the safe disposal of waste produced by the generation of nuclear energy or on the development of fusion energy. Some specialize in the development of nuclear power sources for spacecraft; others find industrial and medical uses for radioactive materials, as in equipment used to diagnose and treat medical problems.
· Petroleum engineers search the world for reservoirs containing oil or natural gas. Once these resources are discovered, petroleum engineers work with geologists and other specialists to understand the geologic formation and properties of the rock containing the reservoir, determine the drilling methods to be used, and monitor drilling and production operations. They design equipment and processes to achieve the maximum profitable recovery of oil and gas. Because only a small proportion of oil and gas in a reservoir flows out under natural forces, petroleum engineers develop and use various enhanced recovery methods. These include injecting water, chemicals, gases, or steam into an oil reservoir to force out more of the oil and doing computer-controlled drilling or fracturing to connect a larger area of a reservoir to a single well. Because even the best techniques in use today recover only a portion of the oil and gas in a reservoir, petroleum engineers research and develop technology and methods to increase recovery and lower the cost of drilling and production operations.
Most engineers work in office buildings, laboratories, or industrial plants. Others may spend time outdoors at construction sites and oil and gas exploration and production sites, where they monitor or direct operations or solve onsite problems. Some engineers travel extensively to plants or worksites.
Many engineers work a standard 40-hour
week. At times, deadlines or design standards may bring extra pressure to a
job, requiring engineers to work longer hours
A bachelor’s degree in engineering is required for almost all entry-level engineering jobs. College graduates with a degree in a physical science or mathematics occasionally may qualify for some engineering jobs, especially in specialties in high demand. Most engineering degrees are granted in electrical, electronics, mechanical, or civil engineering. However, engineers trained in one branch may work in related branches. For example, many aerospace engineers have training in mechanical engineering. This flexibility allows employers to meet staffing needs in new technologies and specialties in which engineers may be in short supply. It also allows engineers to shift to fields with better employment prospects or to those that more closely match their interests.
Most engineering programs involve a concentration of study in an engineering specialty, along with courses in both mathematics and the physical and life sciences. General courses not directly related to engineering, such as those in the social sciences or humanities, are often a required component of programs. Many programs also include courses in general engineering. A design course, sometimes accompanied by a computer or laboratory class or both, is part of the curriculum of most programs.
In addition to the standard engineering degree, many colleges offer 2- or 4-year degree programs in engineering technology. These programs, which usually include various hands-on laboratory classes that focus on current issues in the application of engineering principles, prepare students for practical design and production work, rather than for jobs that require more theoretical and scientific knowledge. Graduates of 4-year technology programs may get jobs similar to those obtained by graduates with a bachelor’s degree in engineering. Engineering technology graduates, however, are not qualified to register as professional engineers under the same terms as graduates with degrees in engineering. Some employers regard technology program graduates as having skills between those of a technician and an engineer.
Graduate training is essential for engineering faculty positions and many research and development programs, but is not required for the majority of entry-level engineering jobs. Many engineers obtain graduate degrees in engineering or business administration to learn new technology and broaden their education. Many high-level executives in government and industry began their careers as engineers.
About 360 colleges and universities offer bachelor’s degree programs in engineering that are accredited by the Accreditation Board for Engineering and Technology (ABET), Inc., and about 230 colleges offer accredited programs in engineering technology. ABET accreditation is based on an examination of an engineering programs student achievement, program improvement, faculty, curriculum, facilities, and institutional commitment to certain principles of quality and ethics. Although most institutions offer programs in the major branches of engineering, only a few offer programs in the smaller specialties. Also, programs of the same title may vary in content. For example, some programs emphasize industrial practices, preparing students for a job in industry, whereas others are more theoretical and are designed to prepare students for graduate work. Therefore, students should investigate curriculums and check accreditation's carefully before selecting a college.
Admissions requirements for undergraduate engineering schools include a solid background in mathematics (algebra, geometry, trigonometry, and calculus) and science (biology, chemistry, and physics), with courses in English, social studies, and humanities. Bachelor's degree programs in engineering typically are designed to last 4 years, but many students find that it takes between 4 and 5 years to complete their studies. In a typical 4-year college curriculum, the first 2 years are spent studying mathematics, basic sciences, introductory engineering, humanities, and social sciences. In the last 2 years, most courses are in engineering, usually with a concentration in one specialty. Some programs offer a general engineering curriculum; students then specialize on the job or in graduate school.
Some engineering schools and 2-year colleges have agreements whereby the 2-year college provides the initial engineering education, and the engineering school automatically admits students for their last 2 years. In addition, a few engineering schools have arrangements that allow students who spend 3 years in a liberal arts college studying pre-engineering subjects and 2 years in an engineering school studying core subjects to receive a bachelor’s degree from each school. Some colleges and universities offer 5-year master’s degree programs. Some 5-year or even 6-year cooperative plans combine classroom study and practical work, permitting students to gain valuable experience and to finance part of their education.
All 50 States and the District of Columbia require licensure for engineers who offer their services directly to the public. Engineers who are licensed are called professional engineers (PE). This licensure generally requires a degree from an ABET-accredited engineering program, 4 years of relevant work experience, and successful completion of a State examination. Recent graduates can start the licensing process by taking the examination in two stages. The initial Fundamentals of Engineering (FE) examination can be taken upon graduation. Engineers who pass this examination commonly are called engineers in training (EIT) or engineer interns (EI). After acquiring suitable work experience, EITs can take the second examination, the Principles and Practice of Engineering exam. Several States have imposed mandatory continuing education requirements for re-licensure. Most States recognize licensure from other States, provided that the manner in which the initial license was obtained meets or exceeds their own licensure requirements. Many civil, electrical, mechanical, and chemical engineers are licensed PEs. Independent of licensure, various certification programs are offered by professional organizations to demonstrate competency in specific fields of engineering.
Engineers should be creative, inquisitive, analytical, and detail oriented. They should be able to work as part of a team and to communicate well, both orally and in writing. Communication abilities are important because engineers often interact with specialists in a wide range of fields outside engineering.
Beginning engineering graduates usually work under the supervision of experienced engineers and, in large companies, also may receive formal classroom or seminar-type training. As new engineers gain knowledge and experience, they are assigned more difficult projects with greater independence to develop designs, solve problems, and make decisions. Engineers may advance to become technical specialists or to supervise a staff or team of engineers and technicians. Some may eventually become engineering managers or enter other managerial or sales jobs.
In 2019 engineers held 1.68 million jobs. The distribution of employment by engineering specialty is as follows:
About 555,000 engineering jobs were found in manufacturing industries, and another 378,000 wage and salary jobs were in the professional, scientific, and technical services sector, primarily in architectural, engineering, and related services and in scientific research and development services. Many engineers also worked in the construction and transportation, telecommunications, and utilities industries.
Federal, State, and local governments employed about 194,000 engineers in 2018. About 91,000 of these were in the Federal Government, mainly in the U.S. Departments of Defense, Transportation, Agriculture, Interior, and Energy and in the National Aeronautics and Space Administration. Most engineers in State and local government agencies worked in highway and public works departments. In 2018, about 44,000 engineers were self-employed, many as consultants.
Engineers are employed in every State, in small and large cities and in rural areas. Some branches of engineering are concentrated in particular industries and geographic areas for example, petroleum engineering jobs tend to be located in areas with sizable petroleum deposits, such as Texas, Louisiana, Oklahoma, Alaska, and California. Others, such as civil engineering, are widely dispersed, and engineers in these fields often move from place to place to work on different projects.
Engineers are employed in every major industry. The industries employing the most engineers in each specialty are given in the table below, along with the percent of occupational employment in the industry.
Overall engineering employment is expected to grow about as fast as the average for all occupations over the next decade. Engineers have traditionally been concentrated in slow-growing manufacturing industries, in which they will continue to be needed to design, build, test, and improve manufactured products. However, increasing employment of engineers in faster growing service industries should generate most of the employment growth. Overall job opportunities in engineering are expected to be favorable because the number of engineering graduates should be in rough balance with the number of job openings over this period. However, job outlook varies by specialty, as discussed later in this section.
Competitive pressures and advancing technology will force companies to improve and update product designs and to optimize their manufacturing processes. Employers will rely on engineers to further increase productivity as investment in plant and equipment increases to expand output of goods and services. New technologies continue to improve the design process, enabling engineers to produce and analyze various product designs much more rapidly than in the past. Unlike in other fields, however, technological advances are not expected to limit employment opportunities substantially, because they will permit the development of new products and processes.
There are many well-trained, often English-speaking engineers available around the world willing to work at much lower salaries than are U.S. engineers. The rise of the Internet has made it relatively easy for much of the engineering work previously done by engineers in this country to be done by engineers in other countries, a factor that will tend to hold down employment growth. Even so, the need for onsite engineers to interact with other employees and with clients will remain.
Compared with most other workers, a smaller proportion of engineers leave their jobs each year. Nevertheless, many job openings will arise from replacement needs, reflecting the large size of this profession. Numerous job openings will be created by engineers who transfer to management, sales, or other professional occupations; additional openings will arise as engineers retire or leave the labor force for other reasons.
Many engineers work on long-term research and development projects or in other activities that continue even during economic slowdowns. In industries such as electronics and aerospace, however, large cutbacks in defense expenditures and in government funding for research and development have resulted in significant layoffs of engineers in the past. The trend toward contracting for engineering work with engineering services firms, both domestic and foreign, has had the same result.
It is important for engineers, as it is for those working in other technical and scientific occupations, to continue their education throughout their careers because much of their value to their employer depends on their knowledge of the latest technology. Engineers in high-technology areas, such as advanced electronics or information technology, may find that technical knowledge can become outdated rapidly. By keeping current in their field, engineers are able to deliver the best solutions and greatest value to their employers. Engineers who have not kept current in their field may find themselves passed over for promotions or vulnerable to layoffs.
The following section discusses job outlook by engineering specialty.
· Aerospace engineers are expected to have slower-than-average growth in employment over the projection period. Although increases in the number and scope of military aerospace projects likely will generate new jobs, increased efficiency will limit the number of new jobs in the design and production of commercial aircraft. Even with slow growth, the employment outlook for aerospace engineers through 2024 appears favorable: the number of degrees granted in aerospace engineering declined for many years because of a perceived lack of opportunities in this field, and, although this trend is reversing, new graduates continue to be needed to replace aerospace engineers who retire or leave the occupation for other reasons.
· Agricultural engineers are expected to have employment growth about as fast as the average for all occupations through 2024. The growing interest in worldwide standardization of agricultural equipment should result in increased employment of agricultural engineers. Job opportunities also should result from the need to feed a growing population, develop more efficient agricultural production, and conserve resources.
· Biomedical engineers are expected to have employment growth that is much faster than the average for all occupations through 2024. The aging of the population and the focus on health issues will drive demand for better medical devices and equipment designed by biomedical engineers. Along with the demand for more sophisticated medical equipment and procedures, an increased concern for cost- effectiveness will boost demand for biomedical engineers, particularly in pharmaceutical manufacturing and related industries. However, because of the growing interest in this field, the number of degrees granted in biomedical engineering has increased greatly. Biomedical engineers, particularly those with only a bachelor’s degree, may face competition for jobs. Unlike the case for many other engineering specialties, a graduate degree is recommended or required for many entry-level jobs.
· Chemical engineers are expected to have employment growth about as fast as the average for all occupations though 2024. Although overall employment in the chemical manufacturing industry is expected to decline, chemical companies will continue to research and develop new chemicals and more efficient processes to increase output of existing chemicals. Among manufacturing industries, pharmaceuticals may provide the best opportunities for jobseekers. However, most employment growth for chemical engineers will be in service industries such as scientific research and development services, particularly in energy and the developing fields of biotechnology and nanotechnology.
· Civil engineers Spurred by general population growth and an increased emphasis on infrastructure security, more civil engineers will be needed to design and construct safe and higher capacity transportation, water supply, and pollution control systems, as well as large buildings and building complexes. They also will be needed to repair or replace existing roads, bridges, and other public structures. Because construction and related industries including those providing design services—employ many civil engineers, employment opportunities will vary by geographic area and may decrease during economic slowdowns, when construction often is curtailed.
· Computer hardware engineers are expected to have average continuing employment growth through 2024. Although the use of information technology continues to expand rapidly, the manufacture of computer hardware is expected to be adversely affected by intense foreign competition. As computer and semiconductor manufacturing contract out more of their engineering needs, much of the growth in employment should occur in the computer systems design and related services industry. However, use of foreign computer hardware engineering services also will serve to limit job growth. Computer engineers should still have favorable employment opportunities, as the number of new entrants is expected to be in balance with demand.
Electrical engineers should have favorable employment opportunities. The number of job openings resulting from employment growth and from the need to replace electrical engineers who transfer to other occupations or leave the labor force is expected to be in rough balance with the supply of graduates. Employment of electrical engineers is expected to increase about as fast as the average for all occupations through 2024. Although international competition and the use of engineering services performed in other countries may limit employment growth, strong demand for electrical devices such as giant electric power generators or wireless phone transmitters should boost growth. Prospects should be particularly good for electrical engineers working in engineering services firms providing technical expertise to other companies on specific projects.
· Electronics engineers, except computer, should have good job opportunities, and employment is expected to increase about as fast as the average for all occupations through 2024. Although rising demand for electronic goods including advanced communications equipment, defense-related electronic equipment, medical electronics, and consumer products should continue to increase employment, foreign competition in electronic products development and the use of engineering services performed in other countries will act to limit employment growth. Job growth is expected to be fastest in service-providing industries particularly consulting firms that provide expertise in electronics engineering.
· Environmental engineers should have favorable job opportunities. Employment of environmental engineers is expected to increase much faster than the average for all occupations. More environmental engineers will be needed to comply with environmental regulations and to develop methods of cleaning up existing hazards. A shift in emphasis toward preventing problems rather than controlling those that already exist, as well as increasing public health concerns, also will spur demand for environmental engineers. Even though employment of environmental engineers should be less affected by economic conditions than that of most other types of engineers, a significant economic downturn could reduce the emphasis on environmental protection, reducing environmental engineers job opportunities.
· Health and safety engineers, except mining safety engineers and inspectors, are projected to experience average continued employment growth through 2024. Because the main function of health and safety engineers is to make products and production processes as safe as possible, their services should be in demand as concern for health and safety within work environments increases. As new technologies for production or processing are developed, health and safety engineers will be needed to ensure their safety.
· Industrial engineers are expected to have employment growth about as fast as the average for all occupations. As firms seek to reduce costs and increase productivity, they increasingly will turn to industrial engineers to develop more efficient processes to reduce costs, delays, and waste. Because their work is similar to that done in management occupations, many industrial engineers leave the occupation to become managers. Many openings will be created by the need to replace industrial engineers who transfer to other occupations or leave the labor force.
· Marine engineers and naval architects likely will experience employment growth that is slower than the average for all occupations. Strong demand for naval vessels and for yachts and other small craft should more than offset the long-term decline in the domestic design and construction of large oceangoing vessels. There should be good prospects for marine engineers and naval architects because of growth in employment, the need to replace workers who retire or take other jobs, and the limited number of students pursuing careers in this occupation.
· Materials engineers are expected to have employment growth about as fast as the average for all occupations. Although many of the manufacturing industries in which materials engineers are concentrated are expected to experience declining employment, materials engineers still will be needed to develop new materials for electronics, biotechnology, and plastics products. Growth should be particularly strong for materials engineers working on nano materials and biomaterials. As manufacturing firms contract for their materials engineering needs, employment growth is expected in professional, scientific, and technical services industries.
· Mechanical engineers are projected to have an average rate of employment growth through 2024. Although total employment in manufacturing industries in which employment of mechanical engineers is concentrated is expected to decline, employment of mechanical engineers in manufacturing should increase as the demand for improved machinery and machine tools grows and as industrial machinery and processes become increasingly complex. Also, emerging technologies in biotechnology, materials science, and nanotechnology will create new job opportunities for mechanical engineers. Additional opportunities for mechanical engineers will arise because the skills acquired through earning a degree in mechanical engineering often can be applied in other engineering specialties.
· Mining and geological engineers, including mining safety engineers, are expected to have good employment opportunities, despite a projected decline in employment. Many mining engineers currently employed are approaching retirement age, a factor that should create some job openings over the next few years. In addition, relatively few schools offer mining engineering programs, and the small number of yearly graduates is not expected to increase substantially. Favorable job opportunities also may be available worldwide as mining operations around the world recruit graduates of U.S. mining engineering programs. As a result, some graduates may travel frequently or even live abroad. Employment of mining and geological engineers, including mining safety engineers, is projected to, primarily because most of the industries in which mining engineers are concentrated such as coal, metal, and copper mining are expected to experience declines in employment.
· Nuclear engineers are expected to have good opportunities because the small number of nuclear engineering graduates is likely to be in rough balance with the number of job openings. Most openings will result from the need to replace nuclear engineers who transfer to other occupations or leave the labor force. Although no commercial nuclear power plants have been built in the United States for many years, nuclear engineers will be needed to operate existing plants. In addition, nuclear engineers may be needed to research and develop future nuclear power sources. They also will be needed to work in defense-related areas, to develop nuclear medical technology, and to improve and enforce waste management and safety standards.
· Petroleum engineers Petroleum engineers must have a bachelor’s degree in engineering, preferably petroleum engineering. However, a bachelor’s degree in mechanical, civil, chemical engineering may meet employer requirements. Employers also value work experience, so cooperative-education programs, in which students earn academic credit and job experience, are valuable as well.
· The median annual wage for petroleum engineers was $137,170 in 2018.
· Employment of petroleum engineers is projected to grow 3 percent from 2018 to 2024, slower than the average for all occupations. Oil prices will be a major determinant of employment growth. Higher prices can cause oil and gas companies to increase capital investment in new facilities and expand existing production operations, along with exploration.
. All job openings should result from the need to replace petroleum engineers who transfer to other occupations or leave the labor force. Petroleum engineers work around the world and, in fact, the best employment opportunities may be in other countries. Many foreign employers seek U.S.-trained petroleum engineers, and many U.S. employers maintain overseas branches.
To become an FBI Special Agent, you must be a U.S. citizen or a citizen of the Northern Mariana Islands. You must be at least 23 years of age, but younger than 37 upon your appointment as a Special Agent. You must possess a four-year degree from a college or university accredited by one of the regional or national institutional associations recognized by the United States Secretary of Education. You must have at least three years of professional work experience. You must also possess a valid driver's license and be completely available for assignment anywhere in the FBI's jurisdiction.
All applicants for the Special Agent position must first qualify under one of five Special Agent Entry Programs. These programs include:
After qualifying for one of the five Entry Programs, applicants will be prioritized in the hiring process based upon certain Critical Skills for which the FBI is recruiting. The FBI is currently recruiting for Special Agent candidates with one or more of the following Critical Skills:
Candidates with these Critical Skills are essential to address our increasingly complex responsibilities. As such, candidates with one or more of these skills will be prioritized in the hiring process.
All candidates that meet the Entry Program and Critical Skill requirements must also:
Dentists diagnose, prevent, and treat problems with teeth or mouth tissue. They remove decay, fill cavities, examine x rays, place protective plastic sealants on children’s teeth, straighten teeth, and repair fractured teeth. They also perform corrective surgery on gums and supporting bones to treat gum diseases. Dentists extract teeth and make models and measurements for dentures to replace missing teeth. They provide instruction on diet, brushing, flossing, the use of fluorides, and other aspects of dental care. They also administer anesthetics and write prescriptions for antibiotics and other medications.
Dentists use a variety of equipment, including x-ray machines; drills; and instruments such as mouth mirrors, probes, forceps, brushes, and scalpels. They wear masks, gloves, and safety glasses to protect themselves and their patients from infectious diseases.
Dentists in private practice oversee a variety of administrative tasks, including bookkeeping and buying equipment and supplies. They may employ and supervise dental hygienists, dental assistants, dental laboratory technicians, and receptionists.
Most dentists are general practitioners, handling a variety of dental needs. Other dentists’ practice in any of nine specialty areas. Orthodontists, the largest group of specialists, straighten teeth by applying pressure to the teeth with braces or retainers. The next largest group, oral and maxillofacial surgeons, operates on the mouth and jaws. The remainder may specialize as pediatric dentists (focusing on dentistry for children); periodontists (treating gums and bone supporting the teeth); prosthodontists (replacing missing teeth with permanent fixtures, such as crowns and bridges, or with removable fixtures such as dentures); endodontists (performing root canal therapy); public health dentists (promoting good dental health and preventing dental diseases within the community); oral pathologists (studying oral diseases); or oral and maxillofacial radiologists (diagnosing diseases in the head and neck through the use of imaging technologies).
Most dentists work 4 or 5 days a week. Some work evenings and weekends to meet their patient’s needs. Most full-time dentists work between 35 and 40 hours a week, but others work more. Initially, dentists may work more hours as they establish their practice. Experienced dentists often work fewer hours. Many continue in part-time practice well beyond the usual retirement age.
Most dentists are solo practitioners,
meaning that they own their own businesses and work alone or with a small
staff. Some dentists have partners, and a few work for other dentists as
All 50 States and the District of Columbia require dentists to be licensed. To qualify for a license in most States, candidates must graduate from 1 of the 56 dental schools accredited by the American Dental Association's (ADA's) Commission on Dental Accreditation in 2019, and then must pass written and practical examinations. Candidates may fulfill the written part of the State licensing requirements by passing the National Board Dental Examinations. Individual States or regional testing agencies administer the written or practical examinations.
Dental schools require a minimum of 2 years of college-level pre-dental education, regardless of the major chosen. However, most dental students have at least a bachelor's degree. Predental education emphasizes coursework in science, and many applicants to dental school major in a science such as biology or chemistry, while other applicants major in another subject and take many science courses as well. A few applicants are accepted to dental school after 2 or 3 years of college and complete their bachelor's degree while attending dental school.
All dental schools require applicants to take the Dental Admissions Test (DAT). When selecting students, schools consider scores earned on the DAT, applicants grade point averages, and information gathered through recommendations and interviews. Competition for admission to dental school is keen.
Dental school usually lasts 4 academic years. Studies begin with classroom instruction and laboratory work in basic sciences, including anatomy, microbiology, biochemistry, and physiology. Beginning courses in clinical sciences, including laboratory techniques, also are provided at this time. During the last 2 years, students treat patients, usually in dental clinics, under the supervision of licensed dentists. Most dental schools award the degree of Doctor of Dental Surgery (DDS). The rest award an equivalent degree, Doctor of Dental Medicine (DMD).
Some dental school graduates work for established dentists as associates for 1 to 2 years to gain experience and save money to equip an office of their own. Most dental school graduates, however, purchase an established practice or open a new one immediately after graduation.
In 2018, 17 States licensed or certified dentists who intended to practice in a specialty area. Requirements include 2 to 4 years of postgraduate education and, in some cases, the completion of a special State examination. Most State licenses permit dentists to engage in both general and specialized practice. Dentists who want to teach or conduct research usually spend an additional 2 to 5 years in advanced dental training, in programs operated by dental schools or hospitals. According to the ADA, each year about 12 percent of new graduates enroll in postgraduate training programs to prepare for a dental specialty.
Dentistry requires diagnostic ability
and manual skills. Dentists should have good visual memory, excellent
judgment regarding space and shape, a high degree of manual dexterity, and
scientific ability. Good business sense, self-discipline, and good
communication skills are helpful for success in private practice. High school
and college students who want to become dentists should take courses in
biology, chemistry, physics, health, and mathematics.
About one third of dentists were self-employed and not incorporated. Almost all dentists work in private practice. According to ADA, 78 percent of dentists in private practice are sole proprietors, and 14 percent belong to a partnership. A few salaried dentists work in hospitals and offices of physicians.
Employment of dentists is projected to grow about as fast as average for all occupations, although employment growth will provide some job opportunities, most jobs will result from the need to replace the large number of dentists expected to retire. Job prospects should be good as new dentists take over established practices or start their own.
Demand for dental care should grow substantially through 2024. As members of the baby-boom generation advance into middle age, a large number will need complicated dental work, such as bridges. In addition, elderly people are more likely to retain their teeth than were their predecessors, so they will require much more care than in the past. The younger generation will continue to need preventive checkups despite treatments such as fluoridation of the water supply, which decreases the incidence of tooth decay. However, employment of dentists is not expected to grow as rapidly as the demand for dental services. As their practices expand, dentists are likely to hire more dental hygienists and dental assistants to handle routine services.
Dentists will increasingly provide
care and instruction aimed at preventing the loss of teeth, rather than
simply providing treatments such as fillings. Improvements in dental
technology also will allow dentists to offer more effective and less painful
treatment to their patients.
Median annual earnings of salaried dentists were $174,110 in 2017. Comparable jobs earned the following average salary in 2017: Oral and Maxillofacial Surgeons made $242,740, Physicians made $198,370, Prosthodontists made $196,960, and Dental Hygienists made $74,680.
Self-employed dentists in private practice tend to earn more than do salaried dentists, and a relatively large proportion of dentists is self-employed. Like other business owners, these dentists must provide their own health insurance, life insurance, and retirement benefits.
Once you receive a job offer, you are faced with a difficult decision and must evaluate the offer carefully. Fortunately, most organizations will not expect you to accept or reject an offer immediately.
There are many issues to consider when assessing a job offer. Will the organization be a good place to work? Will the job be interesting? Are there opportunities for advancement? Is the salary fair? Does the employer offer good benefits? If you have not already figured out exactly what you want, the following discussion may help you to develop a set of criteria for judging job offers, whether you are starting a career, reentering the labor force after a long absence, or planning a career change.
The organization. Background information on an organization can help you to decide whether it is a good place for you to work. Factors to consider include the organizations business or activity, financial condition, age, size, and location.
You generally can get background information on an organization, particularly a large organization, on its Internet site or by telephoning its public relations office. A public company’s annual report to the stockholders tells about its corporate philosophy, history, products or services, goals, and financial status. Most government agencies can furnish reports that describe their programs and missions. Press releases, company newsletters or magazines, and recruitment brochures also can be useful. Ask the organization for any other items that might interest a prospective employee. If possible, speak to current or former employees of the organization.
Background information on the organization may be available at your public or school library. If you cannot get an annual report, check the library for reference directories that may provide basic facts about the company, such as earnings, products and services, and number of employees. Some directories widely available in libraries either in print or as online databases include:
Stories about an organization in magazines and newspapers can tell a great deal about its successes, failures, and plans for the future. You can identify articles on a company by looking under its name in periodical or computerized indexes in libraries. However, it probably will not be useful to look back more than 2 or 3 years
Does the organization’s business or activity match your own
interests and beliefs?
How will the size of
the organization affect you?
Jobs in small firms may offer broader authority and responsibility, a closer working relationship with top management, and a chance to clearly see your contribution to the success of the organization.
Should you work for a
relatively new organization or one that is well established?
Does it make a
difference if the company is private or public?
Is the organization
in an industry with favorable long-term prospects?
Nature of the job. Even if everything else about the job is attractive, you will be unhappy if you dislike the day-to-day work. Determining in advance whether you will like the work may be difficult. However, the more you find out about the job before accepting or rejecting the offer, the more likely you are to make the right choice. Actually, working in the industry and, if possible, for the company would provide considerable insight. You can gain work experience through part-time, temporary, or summer jobs, or through internship or work-study programs while in school, all of which can lead to permanent job offers.
Where is the job
Does the work match
your interests and make good use of your skills?
How important is the
job in this company?
Are you comfortable
with the hours?
How long do most
people who enter this job stay with the company?
Opportunities offered by employers. A good job offers you opportunities to learn new skills, increase your earnings, and rise to positions of greater authority, responsibility, and prestige. A lack of opportunities can dampen interest in the work and result in frustration and boredom.
The company should have a training plan for you. What valuable new skills does the company plan to teach you?
The employer should give you some idea of promotion possibilities within the organization. What is the next step on the career ladder? If you have to wait for a job to become vacant before you can be promoted, how long does this usually take? When opportunities for advancement do arise, will you compete with applicants from outside the company? Can you apply for jobs for which you qualify elsewhere within the organization, or is mobility within the firm limited?
Salaries and benefits. It is for the employer to introduce these subjects. Some companies will not talk about pay until they have decided to hire you. In order to know if their offer is reasonable, you need a rough estimate of what the job should pay. You may have to go to several sources for this information. Try to find family, friends, or acquaintances that recently were hired in similar jobs. Ask your teachers and the staff in placement offices about starting pay for graduates with your qualifications. Help-wanted ads in newspapers sometimes give salary ranges for similar positions. Check the library or your schools career center for salary surveys such as those conducted by the National Association of Colleges and Employers or various professional associations.
If you are considering the salary and benefits for a job in another geographic area, make allowances for differences in the cost of living, which may be significantly higher in a large metropolitan area than in a smaller city, town, or rural area.
You also should learn the organizations policy regarding overtime. Depending on the job, you may or may not be exempt from laws requiring the employer to compensate you for overtime. Find out how many hours you will be expected to work each week and whether you receive overtime pay or compensatory time off for working more than the specified number of hours in a week.
Also take into account that the starting salary is just that the start. Your salary should be reviewed on a regular basis; many organizations do it every year. How much can you expect to earn after 1, 2, or 3 or more years? An employer cannot be specific about the amount of pay if it includes commissions and bonuses.
Benefits also can add a lot to your base pay, but they vary widely. Find out exactly what the benefit package includes and how much of the cost you must bear.
The largest demographic group in the United States is heading for retirement. Of course, this will mean something very different for many Baby Boomers than for older generations. Boomers have maintained their health and stayed in the job market longer than any other generation of citizens in our country's history.
As they grow older, Baby Boomers will require more frequent, specialized medical care. They will also want to maintain connections with careers and family for as long as possible. Therefore, expect to see continued growth in fields that cater to their wishes. The assisted living industry will continue to outpace other areas of healthcare, while growing teams of social workers will help care for less fortunate Baby Boomers.
Despite fears that many American companies look overseas for development of new technology, the rapid advance of ideas and the need for constant upgrades assure U.S. technology professionals of consistent job security over the next ten years. Businesses of all kinds have found themselves locked into the equivalent of an arms race with their competitors. Companies must provide their teams with the best equipment and resources, or face defeat.
Likewise, continual innovation assures technology workers that new machines, cables, and other equipment will have to be installed every few years. Even Internet infrastructure, which was designed to provide nearly limitless connections, is being overhauled to accommodate a previously unimaginable number of new devices. Therefore, IT professionals who specialize in networking, installation, and support will remain in demand as more businesses rely on new technology to help them compete.
Nature of the Work
Physician assistants (PAs) practice medicine under the supervision of physicians and surgeons. They should not be confused with medical assistants, who perform routine clinical and clerical tasks. (medical assistants are discussed elsewhere in the Handbook.) PAs are formally trained to provide diagnostic, therapeutic, and preventive health care services, as delegated by a physician. Working as members of the health care team, they take medical histories, examine and treat patients, order and interpret laboratory tests and x rays, and make diagnoses. They also treat minor injuries, by suturing, splinting, and casting. PAs record progress notes, instruct and counsel patients, and order or carry out therapy. In 48 States and the District of Columbia, physician assistants may prescribe medications. PAs also may have managerial duties. Some order medical supplies or equipment and supervise technicians and assistants.
Physician assistants work under the supervision of a physician. However, PAs may be the principal care providers in rural or inner-city clinics, where a physician is present for only 1 or 2 days each week. In such cases, the PA confers with the supervising physician and other medical professionals as needed and as required by law. PAs also may make house calls or go to hospitals and nursing care facilities to check on patients, after which they report back to the physician.
The duties of physician assistants are determined by the supervising physician and by State law. Aspiring PAs should investigate the laws and regulations in the States in which they wish to practice.
Many PAs work in primary care specialties, such as general internal medicine, pediatrics, and family medicine. Other specialty areas include general and thoracic surgery, emergency medicine, orthopedics, and geriatrics. PAs specializing in surgery provide preoperative and postoperative care and may work as first or second assistants during major surgery.
Although PAs usually work in a
comfortable, well-lighted environment, those in surgery often stand for long
periods, and others do considerable walking. Schedules vary according to the
practice setting, and often depend on the hours of the supervising physician.
The workweek of hospital-based PAs may include weekends, nights, or early
morning hospital rounds to visit patients. These workers also may be on call.
PAs in clinics usually work a 40-hour week.
All States require that PAs complete an accredited, formal education program and pass a National exam to obtain a license. PA programs usually last at least 2 years and are full time. Most programs are in schools of allied health, academic health centers, medical schools, or 4-year colleges; a few are in community colleges, the military, or hospitals. Many accredited PA programs have clinical teaching affiliations with medical schools.
In 2005, more than 135 education programs for physician assistants were accredited or provisionally accredited by the American Academy of Physician Assistants. More than 90 of these programs offered the option of a master’s degree, and the rest offered either a bachelor’s degree or an associate degree. Most applicants to PA educational programs already have a bachelor’s degree.
Admission requirements vary, but many programs require 2 years of college and some work experience in the health care field. Students should take courses in biology, English, chemistry, mathematics, psychology, and the social sciences. Many PAs have prior experience as registered nurses, while others come from varied backgrounds, including military corpsman/medics and allied health occupations such as respiratory therapists, physical therapists, and emergency medical technicians and paramedics.
PA education includes classroom instruction in biochemistry, pathology, human anatomy, physiology, microbiology, clinical pharmacology, clinical medicine, geriatric and home health care, disease prevention, and medical ethics. Students obtain supervised clinical training in several areas, including family medicine, internal medicine, surgery, prenatal care and gynecology, geriatrics, emergency medicine, psychiatry, and pediatrics. Sometimes, PA students serve one or more of these “rotations” under the supervision of a physician who is seeking to hire a PA. The rotations often lead to permanent employment.
All States and the District of Columbia have legislation governing the qualifications or practice of physician assistants. All jurisdictions require physician assistants to pass the Physician Assistant National Certifying Examination, administered by the National Commission on Certification of Physician Assistants (NCCPA) and open only to graduates of accredited PA education programs. Only those successfully completing the examination may use the credential “Physician Assistant-Certified.” In order to remain certified, PAs must complete 100 hours of continuing medical education every 2 years. Every 6 years, they must pass a recertification examination or complete an alternative program combining learning experiences and a take-home examination.
Some PAs pursue additional education in a specialty such as surgery, neonatology, or emergency medicine. PA postgraduate educational programs are available in areas such as internal medicine, rural primary care, emergency medicine, surgery, pediatrics, neonatology, and occupational medicine. Candidates must be graduates of an accredited program and be certified by the NCCPA.
Physician assistants need leadership skills, self-confidence, and emotional stability. They must be willing to continue studying throughout their career to keep up with medical advances.
As they attain greater clinical knowledge and experience, PAs can advance to added responsibilities and higher earnings. However, by the very nature of the profession, clinically practicing PAs always are supervised by physicians.
Physician assistants held about 118.800 jobs in 2019. The number of jobs is greater than the number of practicing PAs because some hold two or more jobs. For example, some PAs work with a supervising physician, but also work in another practice, clinic, or hospital. According to the American Academy of Physician Assistants, about 15 percent of actively practicing PAs worked in more than one clinical job concurrently.The projected is grow 31 percent from 2018 to 2028
More than half of jobs for PAs were in the offices of physicians. About a quarter were in hospitals, public or private. The rest were mostly in outpatient care centers, including health maintenance organizations; the Federal Government; and public or private colleges, universities, and professional schools. A few were self-employed.
Employment of PAs is expected to grow much faster than average for all occupations through the year 2022, ranking among the fastest growing occupations, due to anticipated expansion of the health care industry and an emphasis on cost containment, resulting in increasing utilization of PAs by physicians and health care institutions.
Physicians and institutions are expected to employ more PAs to provide primary care and to assist with medical and surgical procedures because PAs are cost-effective and productive members of the health care team. Physician assistants can relieve physicians of routine duties and procedures. Telemedicine using technology to facilitate interactive consultations between physicians and physician assistants also will expand the use of physician assistants. Job opportunities for PAs should be good, particularly in rural and inner-city clinics, because those settings have difficulty attracting physicians.
Besides the traditional office-based setting, PAs should find a growing number of jobs in institutional settings such as hospitals, academic medical centers, public clinics, and prisons. Additional PAs may be needed to augment medical staffing in inpatient teaching hospital settings as the number of hours physician residents are permitted to work is reduced, encouraging hospitals to use PAs to supply some physician resident services. Opportunities will be best in States that allow PAs a wider scope of practice.
Physician Assistants made a median salary of $108,610 in 2018. The best-paid 25 percent made $127,220 that year, while the lowest-paid 25 percent made $90,150.
According to the 2018 AAPA Salary and Compensation Report, the median annual wages for physician assistants in the top industries in which these PAs worked were as follows:
Nature of Work
Medical assistants perform administrative and clinical tasks to keep the offices of physicians, podiatrists, chiropractors, and other health practitioners running smoothly. They should not be confused with physician assistants, who examine, diagnose, and treat patients under the direct supervision of a physician.
The duties of medical assistants vary from office to office, depending on the location and size of the practice and the practitioner’s specialty. In small practices, medical assistants usually are generalists, handling both administrative and clinical duties and reporting directly to an office manager, physician, or other health practitioner. Those in large practices tend to specialize in a particular area, under the supervision of department administrators.
Medical assistants perform many administrative duties, including answering telephones, greeting patients, updating and filing patients’ medical records, filling out insurance forms, handling correspondence, scheduling appointments, arranging for hospital admission and laboratory services, and handling billing and bookkeeping.
Clinical duties vary according to State law and include taking medical histories and recording vital signs, explaining treatment procedures to patients, preparing patients for examination, and assisting the physician during the examination. Medical assistants collect and prepare laboratory specimens or perform basic laboratory tests on the premises, dispose of contaminated supplies, and sterilize medical instruments. They instruct patients about medications and special diets, prepare and administer medications as directed by a physician, authorize drug refills as directed, telephone prescriptions to a pharmacy, draw blood, prepare patients for x rays, take electrocardiograms, remove sutures, and change dressings.
Medical assistants also may arrange examining room instruments and equipment, purchase and maintain supplies and equipment, and keep waiting and examining rooms neat and clean.
Ophthalmic medical assistants and podiatric medical assistants are examples of specialized assistants who have additional duties. Ophthalmic medical assistants help ophthalmologists provide eye care. They conduct diagnostic tests, measure and record vision, and test eye muscle function. They also show patients how to insert, remove, and care for contact lenses, and they apply eye dressings. Under the direction of the physician, ophthalmic medical assistants may administer eye medications. They also maintain optical and surgical instruments and may assist the ophthalmologist in surgery. Podiatric medical assistants make castings of feet, expose and develop x rays, and assist podiatrists in surgery.
Most full-time medical assistants work a regular 40-hour week. Many work part time, evenings, or weekends.
Training and Other Qualifications
Most employers prefer graduates of formal programs in medical assisting. Such programs are offered in vocational-technical high schools, postsecondary vocational schools, and community and junior colleges. Postsecondary programs usually last either 1 year, resulting in a certificate or diploma, or 2 years, resulting in an associate degree. Courses cover anatomy, physiology, and medical terminology, as well as typing, transcription, recordkeeping, accounting, and insurance processing. Students learn laboratory techniques, clinical and diagnostic procedures, pharmaceutical principles, the administration of medications, and first aid. They study office practices, patient relations, medical law, and ethics. Accredited programs include an internship that provides practical experience in physicians’ offices, hospitals, or other health care facilities.
Both the Commission on Accreditation of Allied Health Education Programs (CAAHEP) and the Accrediting Bureau of Health Education Schools (ABHES) accredit programs in medical assisting. In 2018, there were over 500 medical assisting programs accredited by CAAHEP and about 170 accredited by ABHES. The Committee on Accreditation for Ophthalmic Medical Personnel approved 17 programs in ophthalmic medical assisting and 2 programs in ophthalmic clinical assisting.
Formal training in medical assisting, while generally preferred, is not always required. Some medical assistants are trained on the job, although this practice is less common than in the past. Applicants usually need a high school diploma or the equivalent. Recommended high school courses include mathematics, health, biology, typing, bookkeeping, computers, and office skills. Volunteer experience in the health care field also is helpful.
Although medical assistants are not licensed, some States require them to take a test or a course before they can perform certain tasks, such as taking x rays or giving injections.
Employers prefer to hire experienced workers or certified applicants who have passed a national examination, indicating that the medical assistant meets certain standards of competence. The American Association of Medical Assistants awards the Certified Medical Assistant credential; American Medical Technologists awards the Registered Medical Assistant credential; the American Society of Podiatric Medical Assistants awards the Podiatric Medical Assistant, Certified credential; and the Joint Commission on Allied Health Personnel in Ophthalmology awards credentials at three levels: Certified Ophthalmic Assistant; Certified Ophthalmic Technician; and Certified Ophthalmic Medical Technologist.
Medical assistants deal with the public; therefore, they must be neat and well-groomed and have a courteous, pleasant manner. Medical assistants must be able to put patients at ease and explain physicians’ instructions. They must respect the confidential nature of medical information. Clinical duties require a reasonable level of manual dexterity and visual acuity.
Medical assistants may be able to advance to office manager. They may qualify for a variety of administrative support occupations or may teach medical assisting. With additional education, some enter other health occupations, such as nursing and medical technology.
Medical assistants held about 686,6000 jobs in 2018. About 6 out of 10 worked in offices of physicians; about 14 percent worked in public and private hospitals, including inpatient and outpatient facilities; and 11 percent worked in offices of other health practitioners, such as chiropractors, optometrists, and podiatrists. The rest worked mostly in outpatient care centers, public and private educational services, other ambulatory health care services, State and local government agencies, employment services, medical and diagnostic laboratories, and nursing care facilities.
Employment of medical assistants is expected to grow much faster than average for all occupations through the year 2024 as the health care industry expands because of technological advances in medicine and the growth and aging of the population. Increasing utilization of medical assistants in the rapidly growing health care industry will further stimulate job growth. In fact, medical assistants are projected to be one of the fastest growing occupations.
Employment growth will be driven by the increase in the number of group practices, clinics, and other health care facilities that need a high proportion of support personnel, particularly the flexible medical assistant who can handle both administrative and clinical duties. Medical assistants work primarily in outpatient settings, a rapidly growing sector of the health care industry.
In view of the preference of many health care employers for trained personnel, job prospects should be best for medical assistants with formal training or experience, particularly for those with certification.The median annual wage for software developers, systems software was $33,610 in 2018.
Nature of Work
Every time a patient receives health care, a record is maintained of the observations, medical or surgical interventions, and treatment outcomes. This record includes information that the patient provides concerning his or her symptoms and medical history, the results of examinations, reports of x rays and laboratory tests, diagnoses, and treatment plans. Medical records and health information technicians organize and evaluate these records for completeness and accuracy.
Technicians assemble patient’s health information. They make sure that patients’ initial medical charts are complete, that all forms are completed and properly identified and signed, and that all necessary information is in the computer. They regularly communicate with physicians and other health care professionals to clarify diagnoses or to obtain additional information.
Some medical records and health information technicians specialize in coding patients’ medical information for insurance purposes. Technicians who specialize in coding are called health information coders, medical record coders, coder/abstractors, or coding specialists. These technicians assign a code to each diagnosis and procedure. They consult classification manuals and also rely on their knowledge of disease processes. Technicians then use computer software to assign the patient to one of several hundred “diagnosis-related groups,” or DRGs. The DRG determines the amount for which the hospital will be reimbursed if the patient is covered by Medicare or other insurance programs using the DRG system. In addition to the DRG system, coders use other coding systems, such as those geared toward ambulatory settings or long-term care.
Some technicians also use computer programs to tabulate and analyze data to improve patient care, control costs, provide documentation for use in legal actions, respond to surveys, or use in research studies. For example, cancer (or tumor) registrars maintain facility, regional, and national databases of cancer patients. Registrars review patient records and pathology reports, assign codes for the diagnosis and treatment of different cancers and selected benign tumors. Registrars conduct annual follow-ups on all patients in the registry to track their treatment, survival, and recovery. Physicians and public health organizations then use this information to calculate survivor rates and success rates of various types of treatment, locate geographic areas with high incidences of certain cancers, and identify potential participants for clinical drug trials. Cancer registry data also is used by public health officials to target areas for the allocation of resources to provide intervention and screening.
Medical records and health information technicians’ duties vary with the size of the facility where they work. In large to medium-sized facilities, technicians might specialize in one aspect of health information or might supervise health information clerks and transcriptionists while a medical records and health information administrator manages the department. In small facilities, a credentialed medical records and health information technician sometimes manages the department.
Medical records and health information technicians usually work a 40-hour week. Some overtime may be required. In hospitals where health information departments often are open 24 hours a day, 7 days a week technician may work day, evening, and night shifts.
Medical records and health information technicians work in pleasant and comfortable offices. This is one of the few health occupations in which there is little or no direct contact with patients. Because accuracy is essential in their jobs, technicians must pay close attention to detail. Technicians who work at computer monitors for prolonged periods must guard against eyestrain and muscle pain.
Training and other Qualifications
Medical records and health information technicians entering the field usually have an associate degree from a community or junior college. In addition to general education, coursework includes medical terminology, anatomy and physiology, legal aspects of health information, coding and abstraction of data, statistics, database management, quality improvement methods, and computer science. Applicants can improve their chances of admission into a program by taking biology, chemistry, health, and computer science courses in high school.
Hospitals sometimes advance promising health information clerks to jobs as medical records and health information technicians, although this practice may be less common in the future. Advancement usually requires 2 to 4 years of job experience and completion of a hospital’s in-house training program.
Most employers prefer to hire Registered Health Information Technicians (RHIT), who must pass a written examination offered by the American Health Information Management Association (AHIMA). To take the examination, a person must graduate from a 2-year associate degree program accredited by the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM). Technicians trained in non-CAHIIM-accredited programs or trained on the job are not eligible to take the examination. In 2005, CAHIIM accredited 184 programs for health information technicians.
Experienced medical records and health information technicians usually advance in one of two ways by specializing or managing. Many senior technicians specialize in coding, particularly Medicare coding, or in cancer registry. Most coding and registry skills are learned on the job. Some schools offer certificates in coding as part of the associate degree program for health information technicians, although there are no formal degree programs in coding. For cancer registry, there were 11 formal 2-year certificate programs in 2005 approved by the National Cancer Registrars Association (NCRA). Some schools and employers offer intensive 1- to 2-week training programs in either coding or cancer registry. Once coders and registrars gain some on-the-job experience, many choose to become certified. Certifications in coding are available either from AHIMA or from the American Academy of Professional Coders. Certification in cancer registry is available from the NCRA.
In large medical records and health
information departments, experienced technicians may advance to section supervisor,
overseeing the work of the coding, correspondence, or discharge sections, for
example. Senior technicians with RHIT credentials may become director or
assistant director of a medical records and health information department in
a small facility. However, in larger institutions, the director usually is an
administrator with a bachelor’s degree in medical records and health
Medical records and health information technicians held about 215,500 jobs in 2018. About 2 out of 5 jobs were in hospitals. The rest were mostly in offices of physicians, nursing care facilities, outpatient care centers, and home health care services. Insurance firms that deal in health matters employ a small number of health information technicians to tabulate and analyze health information. Public health departments also hire technicians to supervise data collection from health care institutions and to assist in research.
Employment of medical records and health information technicians is projected to grow 11 percent from 2018 to 2028, much faster than the average for all occupations. The demand for health services is expected to increase as the population ages. Due to the rapid growth in the number of medical tests, treatments, and procedures that will be increasingly scrutinized by health insurance companies, regulators, courts, and consumers. Also, technicians will be needed to enter patient information into computer databases to comply with Federal legislation mandating the use of electronic patient records.
Although employment growth in hospitals will not keep pace with growth in other health care industries, many new jobs will, nevertheless, be created. The majority of new jobs is expected in offices of physicians as a result of increasing demand for detailed records, especially in large group practices. Rapid growth also is expected in home health care services, outpatient care centers, and nursing and residential care facilities. Additional job openings will result from the need to replace technicians who retire or leave the occupation permanently.
Technicians with a strong background in medical coding will be in particularly high demand. Changing government regulations and the growth of managed care have increased the amount of paperwork involved in filing insurance claims. Additionally, health care facilities are having difficulty attracting qualified workers, primarily because of the lack of both formal training programs and sufficient resources to provide on-the-job training for coders. Job opportunities may be especially good for coders employed through temporary help agencies or by professional services firms.
Some cancer registrars may have difficulty finding open positions in their geographic area because of a limited number of registrars employed by health care facilities and low job turnover. However, when a position does become vacant, qualified cancer registrars have excellent prospects because of the limited number of trained registrars available for employment.
he median annual wage for medical records and health information technicians was $40,350 in 2018.
Medical records and health information technicians need a strong clinical background to analyze the contents of medical records. Other workers who need knowledge of medical terminology, anatomy, and physiology but have little or no direct contact with patients include medical secretaries and medical transcriptionists.
Software engineers working in applications or systems development analyze users’ needs and design, construct, test, and maintain computer applications software or systems. Software engineers can be involved in the design and development of many types of software, including software for operating systems and network distribution, and compilers, which convert programs for execution on a computer. In programming, or coding, software engineers instruct a computer, line by line, how to perform a function. They also solve technical problems that arise. Software engineers must possess strong programming skills, but are more concerned with developing algorithms and analyzing and solving programming problems than with actually writing code.
Computer applications software engineers analyze users’ needs and design, construct, and maintain general computer applications software or specialized utility programs. These workers use different programming languages, depending on the purpose of the program. The programming languages most often used are C, C++, and Java, with Fortran and COBOL used less commonly. Some software engineers develop both packaged systems and systems software or create customized applications.
Computer systems software engineers coordinate the construction and maintenance of a company’s computer systems and plan their future growth. Working with the company, they coordinate each departments computer needs ordering, inventory, billing, and payroll recordkeeping, for example and make suggestions about its technical direction. They also might set up the companies intranets networks that link computers within the organization and ease communication among the various departments.
Systems software engineers work for companies that configure, implement, and install complete computer systems. These workers may be members of the marketing or sales staff, serving as the primary technical resource for sales workers and customers. They also may be involved in product sales and in providing their customers with continuing technical support. Since the selling of complex computer systems often requires substantial customization for the purchaser’s organization, software engineers help to explain the requirements necessary for installing and operating the new system in the purchasers computing environment. In addition, systems software engineers are responsible for ensuring security across the systems they are configuring.
Computer software engineers often work as part of a team that designs new hardware, software, and systems. A core team may comprise engineering, marketing, manufacturing, and design people, who work together until the product is released.
Computer software engineers normally work in well-lighted and comfortable offices or laboratories in which computer equipment is located. Most software engineers work at least 40 hours a week; however, due to the project-oriented nature of the work, they also may have to work evenings or weekends to meet deadlines or solve unexpected technical problems. Like other workers who sit for hours at a computer, typing on a keyboard, software engineers are susceptible to eyestrain, back discomfort, and hand and wrist problems such as carpal tunnel syndrome.
As they strive to improve software for users, many computer software engineers interact with customers and coworkers. Computer software engineers who are employed by software vendors and consulting firms, for example, spend much of their time away from their offices, frequently traveling overnight to meet with customers. They call on customers in businesses ranging from manufacturing plants to financial institutions.
As networks expand, software engineers
may be able to use modems, laptops, e-mail, and the Internet to provide more
technical support and other services from their main office, connecting to a
customer’s computer remotely to identify and correct developing problems.
Most employers prefer to hire persons who have at least a bachelor’s degree and broad knowledge of, and experience with, a variety of computer systems and technologies. The usual degree concentration for applications software engineers is computer science or software engineering; for systems software engineers, it is computer science or computer information systems. Graduate degrees are preferred for some of the more complex jobs.
Academic programs in software engineering emphasize software and may be offered as a degree option or in conjunction with computer science degrees. Increasing emphasis on computer security suggests that software engineers with advanced degrees that include mathematics and systems design will be sought after by software developers, government agencies, and consulting firms specializing in information assurance and security. Students seeking software engineering jobs enhance their employment opportunities by participating in internship or co-op programs offered through their schools. These experiences provide the students with broad knowledge and experience, making them more attractive candidates to employers. Inexperienced college graduates may be hired by large computer and consulting firms that train new employees in intensive, company-based programs. In many firms, new hires are mentored, and their mentors have an input into the performance evaluations of these new employees.
For systems software engineering jobs that require workers who have a college degree, a bachelor’s degree in computer science or computer information systems is typical. For systems engineering jobs that place less emphasis on workers having a computer-related degree, computer training programs leading to certification are offered by systems software vendors. Nonetheless, most training authorities feel that program certification alone is not sufficient for the majority of software engineering jobs.
Persons interested in jobs as computer software engineers must have strong problem-solving and analytical skills. They also must be able to communicate effectively with team members, other staff, and the customers they meet. Because they often deal with a number of tasks simultaneously, they must be able to concentrate and pay close attention to detail.
As is the case with most occupations, advancement opportunities for computer software engineers increase with experience. Entry-level computer software engineers are likely to test and verify ongoing designs. As they become more experienced, they may become involved in designing and developing software. Eventually, they may advance to become a project manager, manager of information systems, or chief information officer. Some computer software engineers with several years of experience or expertise find lucrative opportunities working as systems designers or independent consultants or starting their own computer consulting firms.
As technological advances in the computer field continue, employers demand new skills. Computer software engineers must continually strive to acquire such skills if they wish to remain in this extremely dynamic field. For example, computer software engineers interested in working for a bank should have some expertise in finance as they integrate new technologies into the computer system of the bank. To help them keep up with the changing technology, continuing education and professional development seminars are offered by employers, software vendors, colleges and universities, private training institutions, and professional computing societies.
The U.S. Bureau of Labor Statistics predicts that in 2020 there will be 1.4 million more software development jobs than applicants who can fill them. Although they are employed in most industries, the largest concentration of computer software engineers almost 30 percent are in computer systems design and related services. Many computer software engineers also work for establishments in other industries, such as software publishers, government agencies, manufacturers of computers and related electronic equipment, and management of companies and enterprises.
Employers of computer software engineers range from startup companies to established industry leaders. The proliferation of Internet, e-mail, and other communications systems is expanding electronics to engineering firms that are traditionally associated with unrelated disciplines. Engineering firms specializing in building bridges and power plants, for example, hire computer software engineers to design and develop new geographic data systems and automated drafting systems. Communications firms need computer software engineers to tap into growth in the personal communications market. Major communications companies have many job openings for both computer software applications engineers and computer systems engineers.
An increasing number of computer software engineers are employed on a temporary or contract basis, with many being self-employed, working independently as consultants. Some consultants work for firms that specialize in developing and maintaining client companies’ Web sites and intranets.
Computer software engineers are projected to be one of the fastest-growing occupations from 2018 to 2028. Rapid employment growth in the computer systems design and related services industry, which employs the greatest number of computer software engineers, should result in very good opportunities for those college graduates with at least a bachelor’s degree in computer engineering or computer science and practical experience working with computers. Employers will continue to seek computer professionals with strong programming, systems analysis, interpersonal, and business skills. With the software industry beginning to mature, however, and with routine software engineering work being increasingly outsourced overseas, job growth will not be as rapid as during the previous decade.
Employment of computer software engineers is expected to increase much faster than the average for all occupations, as businesses and other organizations adopt and integrate new technologies and seek to maximize the efficiency of their computer systems. Competition among businesses will continue to create an incentive for increasingly sophisticated technological innovations, and organizations will need more computer software engineers to implement these changes. In addition to jobs created through employment growth, many job openings will result annually from the need to replace workers who move into managerial positions, transfer to other occupations, or leave the labor force.
Demand for computer software engineers will increase as computer networking continues to grow. For example, the expanding integration of Internet technologies and the explosive growth in electronic commerce doing business on the Internet have resulted in rising demand for computer software engineers who can develop Internet, intranet, and World Wide Web applications. Likewise, expanding electronic data-processing systems in business, telecommunications, government, and other settings continue to become more sophisticated and complex. Growing numbers of systems software engineers will be needed to implement, safeguard, and update systems and resolve problems. Consulting opportunities for computer software engineers also should continue to grow as businesses seek help to manage, upgrade, and customize their increasingly complicated computer systems.
New growth areas will continue to arise from rapidly evolving technologies. The increasing uses of the Internet, the proliferation of Web sites, and mobile technology such as the wireless Internet have created a demand for a wide variety of new products. As individuals and businesses rely more on hand-held computers and wireless networks, it will be necessary to integrate current computer systems with this new, more mobile technology. Also, information security concerns have given rise to new software needs. Concerns over cyber security should result in businesses and government continuing to invest heavily in software that protects their networks and vital electronic infrastructure from attack. The expansion of this technology in the next 10 years will lead to an increased need for computer engineers to design and develop the software and systems to run these new applications and integrate them into older systems.
As with other information technology
jobs, employment growth of computer software engineers may be tempered
somewhat as more software development is contracted out abroad. Firms may
look to cut costs by shifting operations to lower wage foreign countries with
highly educated workers who have strong technical skills. At the same time,
jobs in software engineering are less prone to being sent abroad compared
with jobs in other computer specialties, because the occupation requires
innovation and intense research and development
The median annual wage for software developers, applications was $105,590 per year in May 2018.
The median annual wage for software developers, systems software was $110,000 in May 2018.
Employment of software developers is projected to grow 21 percent from 2018 to 2028, much faster than the average for all occupations. Software developers will be needed to respond to an increased demand for computer software.
Other workers who use mathematics and logic extensively include computer systems analysts, computer scientists and database administrators, computer programmers, computer hardware engineers, computer support specialists and systems administrators, engineers, statisticians, mathematicians, and actuaries.
Attracting the most qualified employees and matching them to the jobs for which they are best suited is significant for the success of any organization. However, many enterprises are too large to permit close contact between top management and employees. Human resources, training, and labor relations managers and specialists provide this connection. In the past, these workers have been associated with performing the administrative function of an organization, such as handling employee benefits questions or recruiting, interviewing, and hiring new staff in accordance with policies and requirements that have been established in conjunction with top management. Today’s human resources workers manage these tasks and, increasingly, consult top executives regarding strategic planning. They have moved from behind-the-scenes staff work to leading the company in suggesting and changing policies. Senior management is recognizing the significance of the human resources department to their financial success.
In an effort to enhance morale and productivity, limit job turnover, and help organizations increase performance and improve business results, they also help their firms effectively use employee skills, provide training and development opportunities to improve those skills, and increase employee’s satisfaction with their jobs and working conditions. Although some jobs in the human resources field require only limited contact with people outside the office, dealing with people is an important part of the job.
In a small organization, a human resources generalist may handle all aspects of human resources work, and thus require an extensive range of knowledge. The responsibilities of human resources generalists can vary widely, depending on their employer’s needs. In a large corporation, the top human resources executive usually develops and manages human resources programs and policies. These policies usually are implemented by a director or manager of human resources and, in some cases, a director of industrial relations.
The director of human resources may supervise several departments, each headed by an experienced manager who most likely specializes in one human resources activity, such as employment, compensation, benefits, training and development, or employee relations.
Employment and placement managers supervise the hiring and separation of employees and supervise various workers, including equal employment opportunity specialists and recruitment specialists. Employment, recruitment, and placement specialists recruit and place workers.
Recruiters maintain contacts within the community and may travel considerably, often to college campuses, to search for promising job applicants. Recruiters screen, interview, and occasionally test applicants. They also may check references and extend job offers. These workers must be thoroughly familiar with the organization and its human resources policies in order to discuss wages, working conditions, and promotional opportunities with prospective employees. They also must keep informed about equal employment opportunity (EEO) and affirmative action guidelines and laws, such as the Americans with Disabilities Act.
EEO officers, representatives, or affirmative action coordinators handle EEO matters in large organizations. They investigate and resolve EEO grievances, examine corporate practices for possible violations, and compile and submit EEO statistical reports.
Employer relations representatives, who usually work in government agencies, maintain working relationships with local employers and promote the use of public employment programs and services. Similarly, employment interviewers whose many job titles include human resources consultants, human resources development specialists, and human resources coordinators help to match employers with qualified jobseekers.
Compensation, benefits, and job analysis specialists conduct programs for employers and may specialize in specific areas such as position classifications or pensions. Job analysts, occasionally called position classifiers, collect and examine detailed information about job duties in order to prepare job descriptions. These descriptions explain the duties, training, and skills that each job requires. Whenever a large organization introduces a new job or reviews existing jobs, it calls upon the expert knowledge of the job analyst.
Occupational analysts conduct research, usually in large firms. They are concerned with occupational classification systems and study the effects of industry and occupational trends upon worker relationships. They may serve as technical liaison between the firm and other firms, government, and labor unions.
Establishing and maintaining a firm's pay system is the principal job of the compensation manager. Assisted by staff specialists, compensation managers devise ways to ensure fair and equitable pay rates. They may conduct surveys to see how their firm’s rates compare with others and to see that the firm's pay scale complies with changing laws and regulations. In addition, compensation managers often manage their firm’s performance evaluation system, and they may design reward systems such as pay-for-performance plans.
Employee benefits managers and specialists manage the company's employee benefits program, notably its health insurance and pension plans. Expertise in designing and administering benefits programs continues to take on importance as employer-provided benefits account for a growing proportion of overall compensation costs, and as benefit plans increase in number and complexity. For example, pension benefits might include savings and thrift, profit-sharing, and stock ownership plans; health benefits might include long-term catastrophic illness insurance and dental insurance. Familiarity with health benefits is a top priority for employee benefits managers and specialists, as more firms struggle to cope with the rising cost of health care for employees and retirees. In addition to health insurance and pension coverage, some firms offer employees life and accidental death and dismemberment insurance, disability insurance, and relatively new benefits designed to meet the needs of a changing workforce, such as parental leave, child and elder care, long-term nursing home care insurance, employee assistance and wellness programs, and flexible benefits plans. Benefits managers must keep abreast of changing Federal and State regulations and legislation that may affect employee benefits.
Employee assistance plan managers, also called employee welfare managers, are responsible for a wide array of programs covering occupational safety and health standards and practices; health promotion and physical fitness, medical examinations, and minor health treatment, such as first aid; plant security; publications; food service and recreation activities; carpooling and transportation programs, such as transit subsidies; employee suggestion systems; child care and elder care; and counseling services. Child care and elder care are increasingly significant because of growth in the number of dual-income households and the elderly population. Counseling may help employees deal with emotional disorders, alcoholism, or marital, family, consumer, legal, and financial problems. Some employers offer career counseling as well. In large firms, certain programs, such as those dealing with security and safety, may be in separate departments headed by other managers.
Training and development managers and specialists conduct and supervise training and development programs for employees. Increasingly, management recognizes that training offers a way of developing skills, enhancing productivity and quality of work, and building worker loyalty to the firm, and most importantly, increasing individual and organizational performance to achieve business results. While training is widely accepted as an employee benefit and a method of improving employee morale, enhancing employee skills has become a business imperative. Increasingly, managers and leaders realize that the key to business growth and success is through developing the skills and knowledge of its workforce.
Other factors involved in determining whether training is needed include the complexity of the work environment, the rapid pace of organizational and technological change, and the growing number of jobs in fields that constantly generate new knowledge, and thus, require new skills. In addition, advances in learning theory have provided insights into how adults learn, and how training can be organized most effectively for them.
Training managers provide worker training either in the classroom or onsite. This includes setting up teaching materials prior to the class, involving the class, and issuing completion certificates at the end of the class. They have the responsibility for the entire learning process, and its environment, to ensure that the course meets its objectives and is measured and evaluated to understand how learning impacts business results.
Training specialists plan, organize, and direct a wide range of training activities. Trainers respond to corporate and worker service requests. They consult with onsite supervisors regarding available performance improvement services and conduct orientation sessions and arrange on-the-job training for new employees. They help all employees maintain and improve their job skills, and possibly prepare for jobs requiring greater skill. They help supervisors improve their interpersonal skills in order to deal effectively with employees. They may set up individualized training plans to strengthen an employee's existing skills or teach new ones. Training specialists in some companies set up leadership or executive development programs among employees in lower level positions. These programs are designed to develop leaders to replace those leaving the organization and as part of a succession plan. Trainers also lead programs to assist employees with job transitions as a result of mergers and acquisitions, as well as technological changes. In government-supported training programs, training specialists function as case managers. They first assess the training needs of clients and then guide them through the most appropriate training method. After training, clients may either be referred to employer relations representatives or receive job placement assistance.
Planning and program development is an essential part of the training specialist's job. In order to identify and assess training needs within the firm, trainers may confer with managers and supervisors or conduct surveys. They also evaluate training effectiveness to ensure that the training employees receive, helps the organization meet its strategic business goals and achieve results.
Depending on the size, goals, and nature of the organization, trainers may differ considerably in their responsibilities and in the methods they use. Training methods include on-the-job training; operating schools that duplicate shop conditions for trainees prior to putting them on the shop floor; apprenticeship training; classroom training; and electronic learning, which may involve interactive Internet-based training, multimedia programs, distance learning, satellite training, other computer-aided instructional technologies, videos, simulators, conferences, and workshops.
An organization’s director of industrial relations forms labor policy, oversees industrial labor relations, negotiates collective bargaining agreements, and coordinates grievance procedures to handle complaints resulting from management disputes with unionized employees. The director of industrial relations also advises and collaborates with the director of human resources, other managers, and members of their staff, because all aspects of human resources policy such as wages, benefits, pensions, and work practices may be involved in drawing up a new or revised union contract.
Labor relations managers and their staffs implement industrial labor relations programs. Labor relations specialists prepare information for management to use during collective bargaining agreement negotiations, a process that requires the specialist to be familiar with economic and wage data and to have extensive knowledge of labor law and collective bargaining trends. The labor relations staff interprets and administers the contract with respect to grievances, wages and salaries, employee welfare, health care, pensions, union and management practices, and other contractual stipulations. As union membership continues to decline in most industries, industrial relations personnel are working more often with employees who are not members of a labor union.
Dispute resolution attaining tacit or contractual agreements has become increasingly significant as parties to a dispute attempt to avoid costly litigation, strikes, or other disruptions. Dispute resolution also has become more complex, involving employees, management, unions, other firms, and government agencies. Specialists involved in dispute resolution must be highly knowledgeable and experienced, and often report to the director of industrial relations. Conciliators, or mediators, advise and counsel labor and management to prevent and, when necessary, resolve disputes over labor agreements or other labor relations issues. Arbitrators, occasionally called umpires or referees, decide disputes that bind both labor and management to specific terms and conditions of labor contracts. Labor relations specialists who work for unions perform many of the same functions on behalf of the union and its members.
Other emerging specialties include international human resources managers, who handle human resources issues related to a company's foreign operations; and human resources information system specialists, who develop and apply computer programs to process human resources information, match job seekers with job openings, and handle other human resources matters.
Human resources work usually takes place in clean, pleasant, and comfortable office settings. Arbitrators and mediators may work out of their homes. Many human resources, training, and labor relations managers and specialists work a standard 35- to 40-hour week. However, longer hours might be necessary for some workers for example, labor relations managers and specialists, arbitrators, and mediators when contract agreements are being prepared and negotiated.
Although most human resources, training, and labor relations managers and specialists work in the office, some travel extensively. For example, recruiters regularly attend professional meetings and visit college campuses to interview prospective employees; arbitrators and mediators often must travel to the site chosen for negotiations
The educational backgrounds of human resources, training, and labor relations managers and specialists vary considerably because of the diversity of duties and levels of responsibility. In filling entry-level jobs, many employers seek college graduates who have majored in human resources, human resources administration, or industrial and labor relations. Other employers look for college graduates with a technical or business background or a well-rounded liberal arts education.
Many colleges and universities have programs leading to a degree in personnel, human resources, or labor relations. Some offer degree programs in human resources administration or human resources management, training and development, or compensation and benefits. Depending on the school, courses leading to a career in human resources management may be found in departments of business administration, education, instructional technology, organizational development, human services, communication, or public administration, or within a separate human resources institution or department.
Because an interdisciplinary background is appropriate in this field, a combination of courses in the social sciences, business, and behavioral sciences is useful. Some jobs may require a more technical or specialized background in engineering, science, finance, or law, for example. Most prospective human resources specialists should take courses in compensation, recruitment, training and development, and performance appraisal, as well as courses in principles of management, organizational structure, and industrial psychology. Other relevant courses include business administration, public administration, psychology, sociology, political science, economics, and statistics. Courses in labor law, collective bargaining, labor economics, labor history, and industrial psychology also provide a valuable background for the prospective labor relations specialist. As in many other fields, knowledge of computers and information systems also is useful.
An advanced degree is increasingly important for some jobs. Many labor relations jobs require graduate study in industrial or labor relations. A strong background in industrial relations and law is highly desirable for contract negotiators, mediators, and arbitrators; in fact, many people in these specialties are lawyers. A background in law also is desirable for employee benefits managers and others who must interpret the growing number of laws and regulations. A master's degree in human resources, labor relations, or in business administration with a concentration in human resources management is highly recommended for those seeking general and top management positions.
For many specialized jobs in the human resources field, previous experience is an asset; for more advanced positions, including those of managers as well as arbitrators and mediators, it is essential. Many employers prefer entry-level workers who have gained some experience through an internship or work-study program while in school. Human resources administration and human resources development require the ability to work with individuals as well as a commitment to organizational goals. This field also demands other skills that people may develop elsewhere using computers, selling, teaching, supervising, and volunteering, among others. The field offers clerical workers opportunities for advancement to professional positions. Responsible positions occasionally are filled by experienced individuals from other fields, including business, government, education, social services administration, and the military.
The human resources field demands a range of personal qualities and skills. Human resources, training, and labor relations managers and specialists must speak and write effectively. The growing diversity of the workforce requires that they work with or supervise people with various cultural backgrounds, levels of education, and experience. They must be able to cope with conflicting points of view, function under pressure, and demonstrate discretion, integrity, fair-mindedness, and a persuasive, congenial personality.
The duties given to entry-level workers will vary, depending on whether the new workers have a degree in human resource management, have completed an internship, or have some other type of human resources-related experience. Entry-level employees commonly learn the profession by performing administrative duties helping to enter data into computer systems, compiling employee Handbooks, researching information for a supervisor, or answering the phone and handling routine questions. Entry-level workers often enter formal or on-the-job training programs in which they learn how to classify jobs, interview applicants, or administer employee benefits. They then are assigned to specific areas in the human resources department to gain experience. Later, they may advance to a managerial position, supervising a major element of the human resources program compensation or training, for example.
Exceptional human resources workers may be promoted to director of human resources or industrial relations, which can eventually lead to a top managerial or executive position. Others may join a consulting firm or open their own business. A Ph.D. is an asset for teaching, writing, or consulting work.
Most organizations specializing in
human resources offer classes intended to enhance the marketable skills of
their members. Some organizations offer certification programs, which are
signs of competence and can enhance one's advancement opportunities. For
example, the International Foundation of Employee Benefit Plans confers a
designation to persons who complete a series of college-level courses and
pass exams covering employee benefit plans. The American Society for Training
& Development Certification Institute offers certification; it requires
passing a knowledge-based exam and successful work product. The Society for
Human Resource Management has two levels of certification; both require
experience and a passing score on a comprehensive exam.
Human resources, training, and labor relations managers and specialists were employed in virtually every industry. The private sector accounted for more than 8 out of 10 salaried jobs, including 11 percent in administrative and support services; 9 percent in professional, scientific, and technical services; 9 percent in manufacturing; 9 percent in health care and social assistance; and 9 percent in finance and insurance firms.
Government employed 17 percent of human resources managers and specialists. They handled the recruitment, interviewing, job classification, training, salary administration, benefits, employee relations, and other matters related to the Nation’s public employees.
The abundant supply of qualified college graduates and experienced workers should create keen competition for jobs. Overall employment of human resources, training, and labor relations managers and specialists is expected to grow faster than the average for all occupations through 2024. In addition to openings due to growth, many job openings will arise from the need to replace workers who transfer to other occupations or leave the labor force.
Legislation and court rulings setting standards in various areas occupational (OSHA) safety and health, equal (EEOC) employment opportunity, wages, health care, pensions, and family leave, among others will increase demand for human resources, training, and labor relations experts. Rising health care costs should continue to spur demand for specialists to develop creative compensation and benefits packages that firms can offer prospective employees. Employment of labor relations staff, including arbitrators and mediators, should grow as firms become more involved in labor relations, and attempt to resolve potentially costly labor-management disputes out of court. Additional job growth may stem from increasing demand for specialists in international human resources management and human resources information systems.
Demand may be particularly strong for certain specialists. For example, employers are expected to devote greater resources to job-specific training programs in response to the increasing complexity of many jobs, the aging of the workforce, and technological advances that can leave employees with obsolete skills. This should result in strong demand for training and development specialists. In addition, increasing efforts throughout industry to recruit and retain quality employees should create many jobs for employment, recruitment, and placement specialists.
Among industries, firms involved in management, consulting, and employment services should offer many job opportunities, as businesses increasingly contract out human resources functions or hire human resources specialists on a temporary basis in order to deal with the increasing cost and complexity of training and development programs. Demand also should increase in firms that develop and administer complex employee benefits and compensation packages for other organizations.
Demand for human resources, training, and labor relations managers and specialists also are governed by the staffing needs of the firms for which they work. A rapidly expanding business is likely to hire additional human resources workers either as permanent employees or consultants while a business that has experienced a merger or a reduction in its workforce will require fewer human resources workers. Also, as human resources management becomes increasingly important to the success of an organization, some small and medium-size businesses that do not have a human resources department may assign employees various human resources duties together with other unrelated responsibilities. In any particular firm, the size and the job duties of the human resources staff are determined by the firm's organizational philosophy and goals, skills of its workforce, pace of technological change, government regulations, collective bargaining agreements, standards of professional practice, and labor market conditions.
Job growth could be limited by the widespread use of computerized human resources information systems that make workers more productive. Like that of other workers, employment of human resources, training, and labor relations managers and specialists, particularly in larger firms, may be adversely affected by corporate downsizing, restructuring, and mergers.
Nature of Work
Dental hygienists remove soft and hard deposits from teeth, teach patients how to practice good oral hygiene, and provide other preventive dental care. Hygienists examine patients’ teeth and gums, recording the presence of diseases or abnormalities. They remove calculus, stains, and plaque from teeth; perform root planning as a periodontal therapy; take and develop dental x rays; and apply cavity-preventive agents such as fluorides and pit and fissure sealants. In some States, hygienists administer anesthetics; place and carve filling materials, temporary fillings, and periodontal dressings; remove sutures; and smooth and polish metal restorations. Although hygienists may not diagnose diseases, they can prepare clinical and laboratory diagnostic tests for the dentist to interpret. Hygienists sometimes work chairside with the dentist during treatment.
Dental hygienists also help patients develop and maintain good oral health. For example, they may explain the relationship between diet and oral health or inform patients how to select toothbrushes and show them how to brush and floss their teeth.
Dental hygienists use hand and rotary instruments and ultrasonic’s to clean and polish teeth, x-ray machines to take dental pictures, syringes with needles to administer local anesthetics, and models of teeth to explain oral hygiene.
Flexible scheduling is a distinctive feature of this job. Full-time, part-time, evening, and weekend schedules are widely available. Dentists frequently hire hygienists to work only 2 or 3 days a week, so hygienists 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, and the use of appropriate protective devices
when administering anesthetic gas. Dental hygienists also wear safety
glasses, surgical masks, and gloves to protect themselves and patients from
Dental hygienists must be licensed by the State in which they practice. To qualify for licensure in nearly all States, a candidate must graduate from an accredited dental hygiene school and pass both a written and clinical examination. The American Dental Associations Joint Commission on National Dental Examinations administers the written examination, which is accepted by all States and the District of Columbia. State or regional testing agencies administer the clinical examination. In addition, most States require an examination on the legal aspects of dental hygiene practice. Alabama allows candidates to take its examinations if they have been trained through a State-regulated on-the-job program in a dentist’s office.
In 2019, the Commission on Dental Accreditation accredited 335 programs in dental hygiene. Most dental hygiene programs grant an associate degree, although some also offer a certificate, a bachelor’s degree, or a master’s degree. A minimum of an associate degree or certificate in dental hygiene is generally required for practice in a private dental office. A bachelors or master’s degree usually is required for research, teaching, or clinical practice in public or school health programs.
A high school diploma and college entrance test scores are usually required for admission to a dental hygiene program. Also, some dental hygiene programs prefer applicants who have completed at least 1 year of college. Requirements vary from one school to another. Schools offer laboratory, clinical, and classroom instruction in subjects such as anatomy, physiology, chemistry, microbiology, pharmacology, nutrition, 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 and must have good manual dexterity, because they use dental
instruments within a patient’s mouth, with little room for error. High school
students interested in becoming a dental hygienist should take courses in
biology, chemistry, and mathematics.
There are in excess of 150,000 registered dental hygienists in the US. The majority of all jobs for dental hygienists were in offices of dentists, and a small number worked for employment services or in offices of physicians.
Employment of dental hygienists is expected to grow much faster than average for all occupations through 2024, ranking among the fastest growing occupations, in response to increasing demand for dental care and the greater utilization of hygienists to perform services previously performed by dentists. Job prospects are expected to remain excellent.
Population growth and greater retention of natural teeth will stimulate demand for dental hygienists. Older dentists, who have been less likely to employ dental hygienists, are leaving the occupation and will be replaced by recent graduates, who are more likely to employ one or even two hygienists. In addition, as dentists’ workloads increase, they are expected to hire more hygienists to perform preventive dental care, such as cleaning, so that they may devote their own time to more profitable procedures.
Dental Hygienists made a median salary of $74,820 in 2018. Earnings vary by geographic location, employment setting, and years of experience. Dental hygienists may be paid on an hourly, daily, salary, or commission basis.
Benefits vary substantially by practice setting and may be contingent upon full-time employment. According to the American Dental Association (ADA), almost all full-time dental hygienists employed by private practitioners received paid vacation. The ADA also found that 9 out of 10 full-time and part-time dental hygienists received dental coverage. Dental hygienists who work for school systems, public health agencies, the Federal Government, or State agencies usually have substantial benefits.
Other workers supporting health practitioners in an office setting include dental assistants, medical assistants, occupational therapist assistants and aides, physical therapist assistants and aides, physician assistants, and registered nurses.
Physical therapists provide services that help restore function, improve mobility, relieve pain, and prevent or limit permanent physical disabilities of patients suffering from injuries or disease. They restore, maintain, and promote overall fitness and health. Their patients include accident victims and individuals with disabling conditions such as low-back pain, arthritis, heart disease, fractures, head injuries, and cerebral palsy.
Therapists examine patients’ medical histories and then test and measure the patients’ strength, range of motion, balance and coordination, posture, muscle performance, respiration, and motor function. They also determine patients’ ability to be independent and reintegrate into the community or workplace after injury or illness. Next, physical therapists develop plans describing a treatment strategy, its purpose, and its anticipated outcome. Physical therapist assistants, under the direction and supervision of a physical therapist, may be involved in implementing treatment plans with patients. Physical therapist aides perform routine support tasks, as directed by the therapist.
Treatment often includes exercise for patients who have been immobilized and lack flexibility, strength, or endurance. Physical therapists encourage patients to use their own muscles to increase their flexibility and range of motion before finally advancing to other exercises that improve strength, balance, coordination, and endurance. The goal is to improve how an individual functions at work and at home.
Physical therapists also use electrical stimulation, hot packs or cold compresses, and ultrasound to relieve pain and reduce swelling. They may use traction or deep-tissue massage to relieve pain. Therapists also teach patients to use assistive and adaptive devices, such as crutches, prostheses, and wheelchairs. They also may show patients exercises to do at home to expedite their recovery.
As treatment continues, physical therapists document the patient’s progress, conduct periodic examinations, and modify treatments when necessary. Besides tracking the patient’s progress, such documentation identifies areas requiring more or less attention.
Physical therapists often consult and practice with a variety of other professionals, such as physicians, dentists, nurses, educators, social workers, occupational therapists, speech-language pathologists, and audiologists.
Some physical therapists treat a wide range of ailments; others specialize in areas such as pediatrics, geriatrics, orthopedics, sports medicine, neurology, and cardiopulmonary physical therapy.
Physical therapists’ practice in hospitals, clinics, and private offices that have specially equipped facilities, or they treat patients in hospital rooms, homes, or schools.
Most full-time physical therapists worked a 40-hour week; some worked evenings and weekends to fit their patients’ schedules. About 1 in 4 physical therapists worked part time. The job can be physically demanding because therapists often have to stoop, kneel, crouch, lift, and stand for long periods. In addition, physical therapists move heavy equipment and lift patients or help them turn, stand, or walk
All States require physical therapists to pass a licensure exam before they can practice, after graduating from an accredited physical therapist educational program.
According to the American Physical Therapy Association, there were 400 accredited physical therapist programs in 2019. Of the accredited programs, 94 offered master’s degrees, and 111 offered doctoral degrees. All physical therapist programs seeking accreditation are required to offer degrees at the master’s degree level and above, in accordance with the Commission on Accreditation in Physical Therapy Education.
Physical therapist programs start with basic science courses such as biology, chemistry, and physics and then introduce specialized courses, including biomechanics, neuroanatomy, human growth and development, manifestations of disease, examination techniques, and therapeutic procedures. Besides getting classroom and laboratory instruction, students receive supervised clinical experience. Among the courses that are useful when one applies to a physical therapist educational program are anatomy, biology, chemistry, social science, mathematics, and physics. Before granting admission, many professional education programs require experience as a volunteer in a physical therapy department of a hospital or clinic. For high school students, volunteering with the school athletic trainer is a good way to gain experience.
Physical therapists should have strong interpersonal skills in order to be able to educate patients about their physical therapy treatments. Physical therapists also should be compassionate and possess a desire to help patients. Similar traits are needed to interact with the patients family.
Physical therapists are expected to continue their professional development by participating in continuing education courses and workshops. In fact, a number of States require continuing education as a condition of maintaining licensure.
The number of people employed as Physical therapists has been growing at a rate of 0.75%, from 247,225 people in 2017 to 249,079 people in 2018. Nearly 6 out of 10 physical therapists worked in hospitals or in offices of physical therapists. Other jobs were in home health care services, nursing care facilities, outpatient care centers, and offices of physicians.
Some physical therapists were self-employed in private practices, seeing individual patients and contracting to provide services in hospitals, rehabilitation centers, nursing care facilities, home health care agencies, adult day care programs, and schools. Physical therapists also teach in academic institutions and conduct research.
Future medical developments also should permit a higher percentage of trauma victims to survive, creating additional demand for rehabilitative care. In addition, growth may result from advances in medical technology that could permit the treatment of more disabling conditions.
Widespread interest in health promotion also should increase demand for physical therapy services. A growing number of employers are using physical therapists to evaluate worksites, develop exercise programs, and teach safe work habits to employees in the hope of reducing injuries in the workplace.
Fortunately, physical therapy is a well-compensated profession in the United States (the mean annual wage for physical therapists in 2018 was $88,880, according to the Bureau of Labor Statistics) there are still opportunities for higher-paying jobs in the field of healthcare.
Owners of pets and other animals today expect state-of-the-art veterinary care. To provide this service, veterinarians use the skills of veterinary technologists and technicians, who perform many of the same duties for a veterinarian that a nurse would for a physician, including routine laboratory and clinical procedures. Although specific job duties vary by employer, there often is little difference between the tasks carried out by technicians and by technologists, despite some differences in formal education and training. As a result, most workers in this occupation are called technicians.
Veterinary technologists and technicians typically conduct clinical work in a private practice under the supervision of a veterinarian often performing various medical tests along with treating and diagnosing medical conditions and diseases in animals. For example, they may perform laboratory tests such as urinalysis and blood counts, assist with dental prophylaxis, prepare tissue samples, take blood samples, or assist veterinarians in a variety of tests and analyses in which they often utilize various items of medical equipment, such as test tubes and diagnostic equipment. While most of these duties are performed in a laboratory setting, many are not. For example, some veterinary technicians obtain and record patients’ case histories, expose and develop x rays, and provide specialized nursing care. In addition, experienced veterinary technicians may discuss a pet’s condition with its owners and train new clinic personnel. Veterinary technologists and technicians assisting small-animal practitioners usually care for companion animals, such as cats and dogs, but can perform a variety of duties with mice, rats, sheep, pigs, cattle, monkeys, birds, fish, and frogs. Very few veterinary technologists work in mixed animal practices where they care for both small companion animals and larger, nondomestic animals.
Besides working in private clinics and animal hospitals, veterinary technologists and technicians may work in research facilities, where they may administer medications orally or topically, prepare samples for laboratory examinations, and record information on an animal’s genealogy, diet, weight, medications, food intake, and clinical signs of pain and distress. Some may be required to sterilize laboratory and surgical equipment and provide routine postoperative care. At research facilities, veterinary technologists typically work under the guidance of veterinarians, physicians, and other laboratory technicians. Some veterinary technologists vaccinate newly admitted animals and occasionally are required to euthanize seriously ill, severely injured, or unwanted animals.
While the goal of most veterinary technologists and technicians is to promote animal health, some contribute to human health as well. Veterinary technologists occasionally assist veterinarians as they work with other scientists in medical-related fields such as gene therapy and cloning. Some find opportunities in biomedical research, wildlife medicine, the military, livestock management, or pharmaceutical sales.
People who love animals get satisfaction from working with and helping them. However, some of the work may be unpleasant, physically and emotionally demanding, and sometimes dangerous. At times, veterinary technicians must clean cages and lift, hold, or restrain animals, risking exposure to bites or scratches. These workers must take precautions when treating animals with germicides or insecticides. The work setting can be noisy.
Veterinary technologists and
technicians who witness abused animals or who euthanize unwanted, aged, or
hopelessly injured animals may experience emotional stress. Those working for
humane societies and animal shelters often deal with the public, some of whom
might react with hostility to any implication that the owners are neglecting
or abusing their pets. Such workers must maintain a calm and professional
demeanor while they enforce the laws regarding animal care. In some animal
hospitals, research facilities, and animal shelters, a veterinary technician
is on duty 24 hours a day, which means that some may work night shifts. Most
full-time veterinary technologists and technicians work about 40 hours a
week, although some work 50 or more hours a week.
There are primarily two levels of education and training for entry to this occupation: a 2-year program for veterinary technicians and a 4-year program for veterinary technologists. Most entry-level veterinary technicians have a 2-year degree, usually an associate’s degree, from an accredited community college program in veterinary technology in which courses are taught in clinical and laboratory settings using live animals. About 15 colleges offer veterinary technology programs that are longer and that culminate in a 4-year bachelor’s degree in veterinary technology. These 4-year colleges, in addition to some vocational schools, also offer 2-year programs in laboratory animal science. Approximately 5 schools offer distance learning.
There are 30 schools or colleges of veterinary medicine (CVMs) in the U.S. (2019) that are accredited or have accreditation pending and all of them are AAVMC members 116 veterinary technology programs in 43 States were accredited by the American Veterinary Medical Association (AVMA). Graduation from an AVMA-accredited veterinary technology program allows students to take the credentialing exam in any State in the country. Each State regulates veterinary technicians and technologists differently; however, all States require them to pass a credentialing exam following coursework. Passing the State exam assures the public that the technician or technologist has sufficient knowledge to work in a veterinary clinic or hospital. Candidates are tested for competency through an examination that includes oral, written, and practical portions and that is regulated by the State Board of Veterinary Examiners or the appropriate State agency. Depending on the State, candidates may become registered, licensed, or certified. Most States, however, use the National Veterinary Technician (NVT) exam. Prospects usually can have their passing scores transferred from one State to another, so long as both States utilize the same exam.
Employers recommend American Association for Laboratory Animal Science (AALAS) certification for those seeking employment in a research facility. AALAS offers certification for three levels of technician competence, with a focus on three principal areas—animal husbandry, facility management, and animal health and welfare. Those who wish to become certified must satisfy a combination of education and experience requirements prior to taking an exam. Work experience must be directly related to the maintenance, health, and well-being of laboratory animals and must be gained in a laboratory animal facility as defined by AALAS. Candidates who meet the necessary criteria can begin pursuing the desired certification on the basis of their qualifications. The lowest level of certification is Assistant Laboratory Animal Technician (ALAT), the second level is Laboratory Animal Technician (LAT), and the highest level of certification is Laboratory Animal Technologist (LATG). The examination consists of multiple-choice questions and is longer and more difficult for higher levels of certification, ranging from 2 hours for the ALAT to 3 hours for the LATG.
Persons interested in careers as veterinary technologists and technicians should take as much high school science, biology, and math courses as possible. Science courses taken beyond high school, in an associate’s or bachelor’s degree program, should emphasize practical skills in a clinical or laboratory setting. Because veterinary technologists and technicians often deal with pet owners, communication skills are very important. In addition, technologists and technicians should be able to work well with others, because teamwork with veterinarians is common. Organizational ability and the ability to pay attention to detail also are important.
Technologists and technicians usually
begin work as trainees in routine positions under the direct supervision of a
veterinarian. Entry-level workers whose training or educational background
encompasses extensive hands-on experience with a variety of laboratory
equipment, including diagnostic and medical equipment, usually require a
shorter period of on-the-job training. As they gain experience, technologists
and technicians take on more responsibility and carry out more assignments
under only general veterinary supervision. Some eventually may become
There are approximately 79,600 people employed as a Veterinary Technologists and Technicians. Most worked in veterinary services. The remainder worked in boarding kennels, animal shelters, stables, grooming salons, zoos, and local, State, and Federal agencies.
Employment of veterinary technologists and technicians is expected to grow much faster than average for all occupations Job openings also will stem from the need to replace veterinary technologists and technicians who leave the occupation. Keen competition is expected for veterinary technologist and technician jobs in zoos, due to expected slow growth in zoo capacity, low turnover among workers, the limited number of positions, and the fact that the occupation attracts many candidates.
Pet owners are becoming more affluent and more willing to pay for advanced care because many of them consider their pet to be part of the family. This growing affluence and view of pets will spur employment growth for veterinary technologists and technicians. The number of dogs used as companion pets, which also drives employment growth, is expected to increase more slowly during the projection period than in the previous decade. However, the rapidly growing number of cats utilized as companion pets is expected to boost the demand for feline medicine and services, offsetting any reduced demand for veterinary care for dogs. The availability of advanced veterinary services, such as preventive dental care and surgical procedures, may provide opportunities for workers specializing in those areas. Biomedical facilities, diagnostic laboratories, wildlife facilities, humane societies, animal control facilities, drug or food manufacturing companies, and food safety inspection facilities will provide additional jobs for veterinary technologists and technicians. Furthermore, demand for these workers will stem from the desire to replace veterinary assistants with more highly skilled technicians and technologists in animal clinics and hospitals, shelters, kennels, and humane societies.
Employment of veterinary technicians and technologists is relatively stable during periods of economic recession. Layoffs are less likely to occur among veterinary technologists and technicians than in some other occupations because animals will continue to require medical care.
The median annual wage for veterinary technologists and technicians was $34,420 in May 2018. The median wage is the wage at which half the workers in an occupation earned more than that amount and half earned less. The lowest 10 percent earned less than $23,490, and the highest 10 percent earned more than $50,010.
Others who work extensively with animals include animal care and service workers, veterinary assistants, and laboratory animal caretakers. Like veterinary technologists and technicians, they must have patience and feel comfortable with animals. However, the level of training required for these occupations is less than that needed by veterinary technologists and technicians. Veterinarians, who need much more formal education, also work extensively with animals, preventing, diagnosing, and treating their diseases, disorders, and injuries.
Athletic trainers help prevent and treat injuries for people of all ages. Their clients include everyone from professional athletes to industrial workers. Recognized by the American Medical Association as allied health professionals, athletic trainers specialize in the prevention, assessment, treatment, and rehabilitation of musculoskeletal injuries. Athletic trainers are often one of the first heath care providers on the scene when injuries occur, and therefore must be able to recognize, evaluate, and assess injuries and provide immediate care when needed. They also are heavily involved in the rehabilitation and reconditioning of injuries.
Athletic trainers often help prevent injuries by advising on the proper use of equipment and applying protective or injury-preventive devices such as tape, bandages, and braces. Injury prevention also often includes educating people on what they should do to avoid putting themselves at risk for injuries. Athletic trainers should not be confused with fitness trainers or personal trainers, who are not health care workers, but rather train people to become physically fit. (Fitness workers are discussed elsewhere in the Handbook.)
Athletic trainers work under the supervision of a licensed physician, and in cooperation with other health care providers. The level of medical supervision varies, depending upon the setting. Some athletic trainers meet with the team physician or consulting physician once or twice a week; others interact with a physician every day. The extent of the supervision ranges from discussing specific injuries and treatment options with a physician to performing evaluations and treatments as directed by a physician.
Athletic trainers also may have administrative responsibilities. These may include regular meetings with an athletic director or other administrative officer to deal with budgets, purchasing, policy implementation, and other business-related issues.
The work of athletic trainers requires frequent interaction with others. This includes consulting with physicians as well as frequent contact with athletes and patients to discuss and administer treatments, rehabilitation programs, injury-preventive practices, and other health-related issues. Many athletic trainers work indoors most of the time; others, especially those in some sports-related jobs, spend much of their time working outdoors. The job also might require standing for long periods, working with medical equipment or machinery, and being able to walk, run, kneel, crouch, stoop, or crawl. Some travel may be required.
Schedules vary by work setting. Athletic trainers in non-sports settings generally have an established schedule with nights and weekends off; the number of hours differs by employer, but usually are about 40 to 50 hours per week. Athletic trainers working in hospitals and clinics spend part of their time working at other locations on an outreach basis. Most commonly, those outreach programs include secondary schools, colleges, and commercial business locations. Athletic trainers in sports settings, however, deal with schedules that are longer and more variable. These workers must be present for team practices and games, which often are on evenings and weekends, and their schedules, can change on short notice when games and practices have to be rescheduled. As a result, athletic trainers in sports settings regularly may have to work 6 or 7 days per week, including late hours.
In high schools, athletic trainers who also teach may work at least 60 to 70 hours a week. In NCAA Division I colleges and universities, athletic trainers generally work with one team; when that team’s sport is in season, working at least 50 to 60 hours a week is common. Athletic trainers in smaller colleges and universities often work with several teams and have teaching responsibilities. During the off-season, a 40-hour to 50-hour work week may be normal in most settings. Athletic trainers for professional sports teams generally work the most hours per week. During training camps, practices, and competitions, they may be required to work up to 12 hours a day.
There is some stress involved with
being an athletic trainer, as there is with most health-related occupations.
Athletic trainers are responsible for their clients’ health, and sometimes
have to make quick decisions that could affect the health or career of their
clients. Athletics trainers also can be affected by the pressure to win that
is typical of competitive sports team
A bachelor’s degree from an accredited college or university is required for almost all jobs as an athletic trainer. There are more than 300 accredited programs nationwide. Students in these programs are educated both in the classroom and in clinical settings. Formal education includes many science and health-related courses, such as human anatomy, physiology, nutrition, and biomechanics.
A bachelor’s degree with a major in athletic training from an accredited program is part of the requirement for becoming certified by the Board of Certification (BOC). In addition, a successful candidate for board certification must pass an examination that includes written questions and practical applications. To retain certification, credential holders must continue taking medical-related courses and adhere to standards of practice. In the 43 States with athletic trainer licensure or registration or both in 2020, BOC certification was required.
According to the National Athletic Trainers' Association, 70 percent of athletic trainers have a master’s or doctoral degree. Athletic trainers may need a master’s or higher degree to be eligible for some positions, especially those in colleges and universities, and to increase their advancement opportunities. Because some positions in high schools involve teaching along with athletic trainer responsibilities, a teaching certificate or license could be required.
There are a number of ways in which athletic trainers can advance or move into related positions. Assistant athletic trainers may become head athletic trainers and, eventually, athletic directors. Athletic trainers might also enter a physician group practice and assume a management role. Some athletic trainers move into sales and marketing positions, using their athletic trainer expertise to sell medical and athletic equipment.
Because all athletic trainers deal directly with a variety of people, they need good social and communication skills. They should be able to manage difficult situations and the stress associated with them for example, when disagreements arise with coaches, clients, or parents regarding suggested treatment. Athletic trainers also should be organized, be able to manage time wisely, be inquisitive, and have a strong desire to help people.
The National Athletic Trainers' Association represents more than 44,000 members in the U.S. and internationally, and there are about 50,000 ATs practicing nationally. NATA represents students in 325 accredited collegiate academic programs. Most athletic trainer jobs are related to sports, although many also work in non-sports settings. About one-third of athletic trainers worked in health care, including jobs in hospitals, offices of physicians, and offices of other health practitioners. Another one-third were found in public and private educational services, primarily in colleges, universities, and high schools. About 20 percent worked in fitness and recreational sports centers.
Employment of athletic trainers is expected to grow much faster than the average for all occupations through 2024. Job growth will be concentrated in health care industry settings, such as ambulatory heath care services and hospitals. Growth in sports-related positions will be somewhat slower, as most professional sports clubs and colleges, universities, and professional schools already have complete athletic training staffs. Job prospects should be good for people looking for a position in the health care industry. Athletic trainers looking for a position with a sports team, however, may face competition.
The demand for health care should grow dramatically as the result of advances in technology, increasing emphasis on preventive care, and an increasing number of older people who are more likely to need medical care. Athletic trainers will benefit from this expansion, because they provide a cost-effective way to increase the number of health professionals in an office or other setting. Also, employers increasingly emphasize sports medicine, in which an immediate responder, such as an athletic trainer, is on site to help prevent injuries and provide immediate treatment for any injuries that do occur. Athletic trainers’ increased licensure requirements and regulation has led to a greater acceptance of their role as qualified health care providers. As a result, third-party reimbursement is expected to continue to grow for athletic training services. As athletic trainers continue to expand their services, more employers are expected to use these workers to realize the cost savings that can be achieved by providing health care in-house. Settings outside the sports world, especially those that focus on health care, are expected to experience fast employment growth among athletic trainers over the next decade. Continuing efforts to have an athletic trainer in every high school reflect concern for student-athletes’ health as well as efforts to provide more funding for schools, and may lead to growth in the number of athletic trainers employed in high schools.
Turnover among athletic trainers is limited. When dealing with sports teams, there is a tendency to want to continue to work with the same coaches, administrators, and players when a good working relationship already exists. Because of relatively low worker turnover, the settings with the best job prospects will be the ones that are expected to grow most quickly, primarily positions in health care settings. There will also be opportunities in elementary and secondary schools as more positions are created. Some of these positions also will require teaching responsibilities. There will be more competition for positions within colleges, universities, and professional schools as well as professional sports clubs. The occupation is expected to continue to change over the next decade including more administrative responsibilities, adapting to new technology, and working with larger populations, and job seekers must be able to adapt to these changes.
Athletic trainers earned a median income of $46,630 a year as of May 2017, according to the Bureau of Labor Statistics. Wages were less for half of athletic trainers and higher for half of them. The lowest paid athletic trainers received less than $30,740 a year, and the highest paid made more than $69,530.
The American Medical Association recognizes athletic trainers as allied health professionals. They work under the direction of physicians and provide immediate care for injuries. Also, they provide education and advice on the prevention of injuries and work closely with injured patients to rehabilitate and recondition injuries, often through therapy. Other occupations that may require similar responsibilities include emergency medical technicians and paramedics, physical therapists, physician assistants, registered nurses, licensed practical and licensed vocational nurses, recreational therapists, occupational therapists, and respiratory therapists.
Registered nurses (RNs), regardless of specialty or work setting, perform basic duties that include treating patients, educating patients and the public about various medical conditions, and providing advice and emotional support to patients family members. RNs record patients medical histories and symptoms, help to perform diagnostic tests and analyze results, operate medical machinery, administer treatment and medications, and help with patient follow-up and rehabilitation.
RNs teach patients and their families how to manage their illness or injury, including post-treatment home care needs, diet and exercise programs, and self-administration of medication and physical therapy. Some RNs also are trained to provide grief counseling to family members of critically ill patients. RNs work to promote general health by educating the public on various warning signs and symptoms of disease and where to go for help. RNs also might run general health screening or immunization clinics, blood drives, and public seminars on various conditions.
RNs can specialize in one or more patient care specialties. The most common specialties can be divided into roughly four categories by work setting or type of treatment; disease, ailment, or condition; organ or body system type; or population. RNs may combine specialties from more than one area for example, pediatric oncology or cardiac emergency depending on personal interest and employer needs.
RNs may specialize by work setting or by type of care provided. For example, ambulatory care nurses treat patients with a variety of illnesses and injuries on an outpatient basis, either in physicians’ offices or in clinics. Some ambulatory care nurses are involved in telehealth, providing care and advice through electronic communications media such as videoconferencing or the Internet. Critical care nurses work in critical or intensive care hospital units and provide care to patients with cardiovascular, respiratory, or pulmonary failure. Emergency, or trauma, nurses work in hospital emergency departments and treat patients with life-threatening conditions caused by accidents, heart attacks, and strokes. Some emergency nurses are flight nurses, who provide medical care to patients who must be flown by helicopter to the nearest medical facility. Holistic nurses provide care such as acupuncture, massage and aroma therapy, and biofeedback, which are meant to treat patients mental and spiritual health in addition to their physical health. Home health care nurses provide at-home care for patients who are recovering from surgery, accidents, and childbirth. Hospice and palliative care nurses provide care for, and help ease the pain of, terminally ill patients outside of hospitals. Infusion nurses administer medications, fluids, and blood to patients through injections into patient’s veins. Long- term care nurses provide medical services on a recurring basis to patients with chronic physical or mental disorders. Medical-surgical nurses provide basic medical care to a variety of patients in all health settings. Occupational health nurses provide treatment for job-related injuries and illnesses and help employers to detect workplace hazards and implement health and safety standards. Perianesthesia nurses provide preoperative and postoperative care to patients undergoing anesthesia during surgery. Perioperative nurses assist surgeons by selecting and handling instruments, controlling bleeding, and suturing incisions. Some of these nurses also can specialize in plastic and reconstructive surgery. Psychiatric nurses treat patients with personality and mood disorders. Radiologic nurses provide care to patients undergoing diagnostic radiation procedures such as ultrasounds and magnetic resonance imaging. Rehabilitation nurses care for patients with temporary and permanent disabilities. Transplant nurses care for both transplant recipients and living donors and monitor signs of organ rejection.
RNs specializing in a particular disease, ailment, or condition are employed in virtually all work settings, including physicians’ offices, outpatient treatment facilities, home health care agencies, and hospitals. For instance, addictions nurses treat patients seeking help with alcohol, drug, and tobacco addictions. Developmental disabilities nurses provide care for patients with physical, mental, or behavioral disabilities; care may include help with feeding, controlling bodily functions, and sitting or standing independently. Diabetes management nurses help diabetics to manage their disease by teaching them proper nutrition and showing them how to test blood sugar levels and administer insulin injections. Genetics nurses provide early detection screenings and treatment of patients with genetic disorders, including cystic fibrosis and Huntington’s disease. HIV/AIDS nurses care for patients diagnosed with HIV and AIDS. Oncology nurses care for patients with various types of cancer and may administer radiation and chemotherapies. Finally, wound, ostomy, and continence nurses treat patients with wounds caused by traumatic injury, ulcers, or arterial disease; provide postoperative care for patients with openings that allow for alternative methods of bodily waste elimination; and treat patients with urinary and fecal incontinence.
RNs specializing in treatment of a particular organ or body system usually are employed in specialty physicians’ offices or outpatient care facilities, although some are employed in hospital specialty or critical care units. For example, cardiac and vascular nurses treat patients with coronary heart disease and those who have had heart surgery, providing services such as postoperative rehabilitation. Dermatology nurses treat patients with disorders of the skin, such as skin cancer and psoriasis. Gastroenterology nurses treat patients with digestive and intestinal disorders, including ulcers, acid reflux disease, and abdominal bleeding. Some nurses in this field also specialize in endoscopic procedures, which look inside the gastrointestinal tract using a tube equipped with a light and a camera that can capture images of diseased tissue. Gynecology nurses provide care to women with disorders of the reproductive system, including endometriosis, cancer, and sexually transmitted diseases. Nephrology nurses care for patients with kidney disease caused by diabetes, hypertension, or substance abuse. Neuroscience nurses care for patients with dysfunctions of the nervous system, including brain and spinal cord injuries and seizures. Ophthalmic nurses provide care to patients with disorders of the eyes, including blindness and glaucoma, and to patients undergoing eye surgery. Orthopedic nurses care for patients with muscular and skeletal problems, including arthritis, bone fractures, and muscular dystrophy. Otorhinolaryngology nurses care for patients with ear, nose, and throat disorders, such as cleft palates, allergies, and sinus disorders. Respiratory nurses provide care to patients with respiratory disorders such as asthma, tuberculosis, and cystic fibrosis. Urology nurses care for patients with disorders of the kidneys, urinary tract, and male reproductive organs, including infections, kidney and bladder stones, and cancers.
Finally, RNs may specialize by providing preventive and acute care in all health care settings to various segments of the population, including newborns (neonatology), children and adolescents (pediatrics), adults, and the elderly (gerontology or geriatrics). RNs also may provide basic health care to patients outside of health care settings in such venues as including correctional facilities, schools, summer camps, and the military. Some RNs travel around the United States and abroad providing care to patients in areas with shortages of medical professionals.
Most RNs work as staff nurses, providing critical health care services along with physicians, surgeons, and other health care practitioners. However, some RNs choose to become advanced practice nurses, who often are considered primary health care practitioners and work independently or in collaboration with physicians. For example, clinical nurse specialists provide direct patient care and expert consultations in one of many of the nursing specialties listed above. Nurse anesthetists administer anesthesia, monitor patient's vital signs during surgery, and provide post-anesthesia care. Nurse midwives provide primary care to women, including gynecological exams, family planning advice, prenatal care, assistance in labor and delivery, and neonatal care. Nurse practitioners provide basic preventive health care to patients, and increasingly serve as primary and specialty care providers in mainly medically underserved areas. The most common areas of specialty for nurse practitioners are family practice, adult practice, women's health, pediatrics, acute care, and gerontology; however, there are many other specialties. In most States, advanced practice nurses can prescribe medications.
Some nurses have jobs that require little or no direct patient contact. Most of these positions still require an active RN license. Case managers ensure that all of the medical needs of patients with severe injuries and illnesses are met, including the type, location, and duration of treatment. Forensics nurses combine nursing with law enforcement by treating and investigating victims of sexual assault, child abuse, or accidental death. Infection control nurses identify, track, and control infectious outbreaks in health care facilities; develop methods of outbreak prevention and biological terrorism responses; and staff immunization clinics. Legal nurse consultants assist lawyers in medical cases by interviewing patients and witnesses, organizing medical records, determining damages and costs, locating evidence, and educating lawyers about medical issues. Nurse administrators supervise nursing staff, establish work schedules and budgets, and maintain medical supply inventories. Nurse educators teach student nurses and also provide continuing education for RNs. Nurse informaticists collect, store, and analyze nursing data in order to improve efficiency, reduce risk, and improve patient care. RNs also may work as health care consultants, public policy advisors, pharmaceutical and medical supply researchers and salespersons, and medical writers and editors.
Most RNs work in well-lighted, comfortable health care facilities. Home health and public health nurses travel to patients homes, schools, community centers, and other sites. RNs may spend considerable time walking and standing. Patients in hospitals and nursing care facilities require 24-hour care; consequently, nurses in these institutions may work nights, weekends, and holidays. RNs also may be on call available to work on short notice. Nurses who work in office settings are more likely to work regular business hours. About 23 percent of RNs worked part time in 2018, and some held more than one job.
Nursing has its hazards, especially in hospitals, nursing care facilities, and clinics, where nurses may care for individuals with infectious diseases. RNs must observe rigid, standardized guidelines to guard against disease and other dangers, such as those posed by radiation, accidental needle sticks, chemicals used to sterilize instruments, and anesthetics. In addition, they are vulnerable to back injury when moving patients, shocks from electrical equipment, and hazards posed by compressed gases. RNs who work with critically ill patients also may suffer emotional strain from observing patient suffering and from close personal contact with patients families.
Training and other Qualifications
In all States and the District of Columbia, students must graduate from an approved nursing program and pass a national licensing examination, known as the NCLEX-RN, in order to obtain a nursing license. Nurses may be licensed in more than one State, either by examination or by the endorsement of a license issued by another State. Currently 18 States participate in the Nurse Licensure Compact Agreement, which allows nurses to practice in member States without recertifying. All States require periodic renewal of licenses, which may involve continuing education.
There are three major educational paths to registered nursing: A bachelor’s of science degree in nursing (BSN), an associate degree in nursing (ADN), and a diploma. BSN programs, offered by colleges and universities, take about 4 years to complete. Nursing programs offered degrees at the bachelor's level. ADN programs, offered by community and junior colleges, take about 2 to 3 years to complete. Diploma programs, administered in hospitals, last about 3 years. Generally, licensed graduates of any of the three types of educational programs qualify for entry-level positions as staff nurses.
Many RNs with an ADN or diploma later enter bachelor's programs to prepare for a broader scope of nursing practice. Often, they can find a staff nurse position and then take advantage of tuition reimbursement benefits to work toward a BSN by completing an RN-to-BSN program.
Accelerated BSN programs also are available for individuals who have a bachelor's or higher degree in another field and who are interested in moving into nursing. In 2019, more than 165 of these programs were available. Accelerated BSN programs last 12 to 18 months and provide the fastest route to a BSN for individuals who already hold a degree.
Individuals considering nursing should carefully weigh the advantages and disadvantages of enrolling in a BSN program, because, if they do, their advancement opportunities usually are broader. In fact, some career paths are open only to nurses with a bachelor's or master's degree. A bachelor's degree often is necessary for administrative positions and is a prerequisite for admission to graduate nursing programs in research, consulting, and teaching, and all four advanced practice nursing specialties clinical nurse specialists, nurse anesthetists, nurse midwives, and nurse practitioners. Individuals who complete a bachelor's receive more training in areas such as communication, leadership, and critical thinking, all of which are becoming more important as nursing care becomes more complex. Additionally, bachelor's degree programs offer more clinical experience in nonhospital settings.
All four advanced practice nursing specialties require at least a master's degree. Most programs last about 2 years and require a BSN degree and some programs require at least 1 to 2 years of clinical experience as an RN for admission. Upon completion of a program, most advanced practice nurses become nationally certified in their area of specialty. In some States, certification in a specialty is required in order to practice that specialty.
All nursing education programs include classroom instruction and supervised clinical experience in hospitals and other health care facilities. Students take courses in anatomy, physiology, microbiology, chemistry, nutrition, psychology and other behavioral sciences, and nursing. Coursework also includes the liberal arts for ADN and BSN students.
Supervised clinical experience is provided in hospital departments such as pediatrics, psychiatry, maternity, and surgery. A growing number of programs include clinical experience in nursing care facilities, public health departments, home health agencies, and ambulatory clinics.
Nurses should be caring, sympathetic, responsible, and detail oriented. They must be able to direct or supervise others, correctly assess patients conditions, and determine when consultation is required. They need emotional stability to cope with human suffering, emergencies, and other stresses.
Some RNs start their careers as licensed practical nurses or nursing aides, and then go back to school to receive their RN degree. Most RNs begin as staff nurses, and with experience and good performance often are promoted to more responsible positions. In management, nurses can advance to assistant head nurse or head nurse and, from there, to assistant director, director, and vice president. Increasingly, management-level nursing positions require a graduate or an advanced degree in nursing or health services administration. They also require leadership, negotiation skills, and good judgment.
Some nurses move into the business side of health care. Their nursing expertise and experience on a health care team equip them to manage ambulatory, acute, home-based, and chronic care. Employers including hospitals, insurance companies, pharmaceutical manufacturers, and managed care organizations, among others need RNs for health planning and development, marketing, consulting, policy development, and quality assurance. Other nurses work as college and university faculty or conduct research.
Foreign-educated nurses wishing to
work in the United States must obtain a work visa. Applicants are required to
undergo a review of their education and licensing credentials and pass a
nursing certification and English proficiency exam, both conducted by the
Commission on Graduates of Foreign Nursing Schools. (The commission is an
immigration-neutral, nonprofit organization that is recognized
internationally as an authority on credentials evaluation in the health care
field.) Applicants from Australia, Canada (except Quebec), Ireland, New
Zealand, and the United Kingdom are exempt from the language proficiency
exam. In addition to these national requirements, most States have their own
There are currently around 2.86 million registered nurses in the United States. About 3 out of 5 jobs were in hospitals, in inpatient and outpatient departments. Others worked in offices of physicians, nursing care facilities, home health care services, employment services, government agencies, and outpatient care centers. The remainder worked mostly in social assistance agencies and educational services, public and private. About 1 in 4 RNs worked part time.
Job opportunities for RNs in all specialties are expected to be excellent. Employment of registered nurses is expected to grow much faster than average for all occupations through 2024, and, because the occupation is very large, many new jobs will result. In fact, registered nurses are projected to create the second largest number of new jobs among all occupations. Thousands of job openings also will result from the need to replace experienced nurses who leave the occupation, especially as the median age of the registered nurse population continues to rise.
Much faster-than-average growth will be driven by technological advances in patient care, which permit a greater number of medical problems to be treated, and by an increasing emphasis on preventive care. In addition, the number of older people, who are much more likely than younger people to need nursing care, is projected to grow rapidly.
Employers in some parts of the country and in certain employment settings are reporting difficulty in attracting and retaining an adequate number of RNs, primarily because of an aging RN workforce and a lack of younger workers to fill positions. Enrollments in nursing programs at all levels have increased more rapidly in the past couple of years as students seek jobs with stable employment. However, many qualified applicants are being turned away because of a shortage of nursing faculty to teach classes. The need for nursing faculty will only increase as a large number of instructors nears retirement. Many employers also are relying on foreign-educated nurses to fill open positions.
Even though employment opportunities for all nursing specialties are expected to be excellent, they can vary by employment setting. For example, employment is expected to grow more slowly in hospitals which comprise health care's largest industry than in most other health care industries. While the intensity of nursing care is likely to increase, requiring more nurses per patient, the number of inpatients (those who remain in the hospital for more than 24 hours) is not likely to grow by much. Patients are being discharged earlier, and more procedures are being done on an outpatient basis, both inside and outside hospitals. Rapid growth is expected in hospital outpatient facilities, such as those providing same-day surgery, rehabilitation, and chemotherapy.
Despite the slower employment growth in hospitals, job opportunities should still be excellent because of the relatively high turnover of hospital nurses. RNs working in hospitals frequently work overtime and night and weekend shifts and also treat seriously ill and injured patients, all of which can contribute to stress and burnout. Hospital departments in which these working conditions occur most frequently critical care units, emergency departments, and operating rooms generally will have more job openings than other departments.
To attract and retain qualified nurses, hospitals may offer signing bonuses, family-friendly work schedules, or subsidized training. A growing number of hospitals also are experimenting with online bidding to fill open shifts, in which nurses can volunteer to fill open shifts at premium wages. This can decrease the amount of mandatory overtime that nurses are required to work.
More and more sophisticated procedures, once performed only in hospitals, are being performed in physicians’ offices and in outpatient care centers, such as freestanding ambulatory surgical and emergency centers. Accordingly, employment is expected to grow much faster than average in these places as health care in general expands. However, RNs may face greater competition for these positions because they generally offer regular working hours and more comfortable working environments.
Employment in nursing care facilities is expected to grow faster than average because of increases in the number of elderlies, many of whom require long-term care. In addition, the financial pressure on hospitals to discharge patients as soon as possible should produce more admissions to nursing care facilities. Job growth also is expected in units that provide specialized long-term rehabilitation for stroke and head injury patients, as well as units that treat Alzheimer's victims.
Employment in home health care is expected to increase rapidly in response to the growing number of older persons with functional disabilities, consumer preference for care in the home, and technological advances that make it possible to bring increasingly complex treatments into the home. The type of care demanded will require nurses who are able to perform complex procedures.
Generally, RNs with at least a bachelor's degree will have better job prospects than those without a bachelors. In addition, all four advanced practice specialties clinical nurse specialists, nurse practitioners, midwives, and anesthetists will be in high demand, particularly in medically underserved areas such as inner cities and rural areas. Relative to physicians, these RNs increasingly serve as lower-cost primary care providers.
The U.S. Average Registered Nurse RN Salary is $73,550
In the United States the average annual salary for a Registered Nurse is currently $73,550 which breaks down as an average of $35.36 per hour, $1,414 per week and a monthly salary of $6,129.
Many employers offer flexible work schedules, child care, educational benefits, and bonuses.
The Direct Loan Program offers loan repayment plans designed to meet the needs of almost every borrower. Direct Loans are funded by the U.S. Department of Education through your school and are managed by the Direct Loan Servicing Center, under the supervision of the Department. The Direct Loan Program allows you to choose your repayment plan and to switch your plan if your needs change.
To find out more about repayment options before receiving a Direct Loan, borrowers may contact their school's financial aid office or the Federal Student Aid Information Center at 1-800-4-FED-AID (1-800-433-3243). If you currently have a Direct Loan and would like the exact payment amount on your loan, you can find it out online at the website for the Direct Loan Servicing Center or you can call the center at 1-888-447-4460.
Direct PLUS Loan borrowers may only choose from the standard, extended, or graduated options.
With the standard plan, you'll pay a fixed amount each month until your loans are paid in full. Your monthly payments will be at least $50, and you'll have up to 10 years to repay your loans.
The standard plan is good for you if you can handle higher monthly payments because you'll repay your loans more quickly. Your monthly payment under the standard plan may be higher than it would be under the other plans because your loans will be repaid in the shortest time. For the same reason - the 10-year limit on repayment - you may pay the least interest.
Under the extended plan, you'll still have minimum monthly payments of at least $50, but you can take from 12 to 30 years to repay your loans. The maximum length of your repayment period (see the table below) will depend on the total amount you owe when your loans go into repayment.
This is a good plan if you will need to make smaller monthly payments. Because the repayment period generally will be at least 12 years, your monthly payments will be less than with the standard plan. However, you may pay more in interest because you're taking longer to repay the loans. Remember that the longer your loans are in repayment, the more interest you will pay.
With this plan your payments start out low then increase, generally every two years. The length of your repayment period will depend on the total amount you owe when your loans go into repayment. See the graduated repayment table below. If you expect your income to increase steadily over time, this plan may be right for you. Your initial monthly payments will be equal to either the interest that accumulates on your loans or half of the payment you would make each month using the standard plan, whichever is greater. However, your monthly payments will never increase to more than 1.5 times what you would pay with the standard plan.
A Federal Pell Grant, unlike a loan, does not have to be repaid. Pell Grants are awarded usually only to undergraduate students who have not earned a bachelor's or a professional degree. (In some cases, however, a student enrolled in a post-baccalaureate teacher certification program might receive a Pell Grant.) Pell Grants are considered a foundation of federal financial aid, to which aid from other federal and nonfederal sources might be added.
How much can I get?
The maximum Federal Pell Grant award is $6,195 for the 2019–20 award year. The maximum can change each award year and depends on program funding. The amount you get, though, will depend not only on your financial need, but also on your costs to attend school, your status as a full-time or part-time student, and your plans to attend school for a full academic year or less.
If I am eligible, how will I get the Pell Grant money?
Your school can apply Pell Grant funds to your school costs, pay you directly (usually by check), or combine these methods. The school must tell you in writing how much your award will be and how and when you'll be paid. Schools must disburse funds at least once per term (semester, trimester, or quarter). Schools that do not use semesters, trimesters, or quarters must disburse funds at least twice per academic year.
Parents can borrow a PLUS Loan to help pay your education expenses if you are a dependent undergraduate student enrolled at least half time in an eligible program at an eligible school. PLUS Loans are available through the Federal Family Education Loan (FFEL) Program and the William D. Ford Federal Direct Loan (Direct Loan) Program. Your parents can get either loan, but not both, for you during the same enrollment period. They also must have an acceptable credit history.
How do my parents get a loan?
For a Direct PLUS Loan, your parents must complete a Direct PLUS Loan application and promissory note, contained in a single form that you get from your schools financial aid office.
For a FFEL PLUS Loan, your parents must complete and submit a PLUS Loan application, available from your school, lender, or your state guaranty agency. After the school completes its portion of the application, it must be sent to a lender for evaluation.
Also, your parents generally will be required to pass a credit check. If your parents don't pass the credit check, they might still be able to receive a loan if someone, such as a relative or friend who is able to pass the credit check, agrees to endorse the loan. An endorser promises to repay the loan if your parents fail to do so. Your parents might also qualify for a loan without passing the credit check if they can demonstrate that extenuating circumstances exist. You and your parents must also meet other general eligibility requirements for federal student financial aid.
How much can my parents borrow?
The yearly limit on a PLUS Loan is equal to your cost of attendance minus any other financial aid you receive. If your cost of attendance is $6,000, for example, and you receive $4,000 in other financial aid, your parents can borrow up to $2,000.
Who gets my parents' loan money?
Either the U.S. Department of Education (for a Direct PLUS Loan) or your parents’ lender (for a FFEL PLUS Loan) will send the loan funds to your school. Your school might require your parents to endorse a disbursement check and send it back to the school. In most cases, the loan will be disbursed in at least two installments, and no installment will be greater than half the loan amount. The funds will first be applied to your tuition, fees, room and board, and other school charges. If any loan funds remain, your parents will receive the amount as a check or in cash, unless they authorize the amount to be released to you or to be put into your school account. Any remaining loan funds must be used for your education expenses.
What's the interest rate?
The Interest rates on PLUS Loans are
fixed. The current interest rates for new PLUS Loans in 2019-2020 are 7.08%
for parents of undergraduate students (Parent PLUS Loans) and for graduate
Your parents will pay a fee of up to 4 percent of the loan, deducted proportionately each time a loan disbursement is made. For a FFEL PLUS Loan, a portion of this fee goes to the federal government, and a portion goes to the guaranty agency (the organization that administers the PLUS Loan Program in your state) to help reduce the cost of the loans. For a Direct PLUS Loan, the entire fee goes to the government to help reduce the cost of the loans. Also, your parents may be charged collection costs and late fees if they don’t make their loan payments when scheduled.
When do my parents begin repaying the loan?
Generally, the first payment is due within 60 days after the loan is fully disbursed. There is no grace period for these loans. Interest begins to accumulate at the time the first disbursement is made. Your parents must begin repaying both principal and interest while you're in school.
How do my parents pay back these loans?
They'll repay a FFEL PLUS Loan to a private lender or loan servicer. They'll repay their Direct PLUS Loan to the U.S. Department of Education's Direct Loan Servicing Center. To read more about repayment options under both programs, read the PLUS Loans section in Funding Education Beyond High School: The Guide to Federal Student Aid.
Is it ever possible to postpone repayment of a PLUS Loan?
Yes, under certain circumstances, your parents can receive a deferment on their loans.
If they temporarily can’t meet the repayment schedule, they can also receive forbearance on their loan, as long as it isn’t in default. During forbearance, their payments are postponed or reduced.
Generally, the conditions for eligibility and procedures for requesting a deferment or forbearance apply to both Stafford Loans and PLUS Loans. However, since all PLUS Loans are unsubsidized, your parents will be charged interest during periods of deferment or forbearance. If they don’t pay the interest as it accrues, it will be capitalized (that is, added to the principal amount of the loan, and additional interest will be based on that higher amount).
Can a PLUS Loan be discharged (canceled)?
Yes, under certain conditions. A discharge (cancellation) releases your parents from all obligation to repay the loan.
Your parents’ PLUS Loan can’t be canceled for these reasons: You didn’t complete your program of study at your school (unless you couldn’t complete the program for a valid reason because the school closed, for example), you didn’t like the school or the program of study, or you didn’t obtain employment after completing the program of study.
For more information about loan discharge or repayment: If your parents have a Direct PLUS Loan, they should contact the Direct Loan Servicing Center at 1-800-848-0979., they should contact the lender or agency holding the loan.
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Respiratory therapists and respiratory therapy technicians also known as respiratory care practitioners evaluate, treat, and care for patients with breathing or other cardiopulmonary disorders. Practicing under the direction of a physician, respiratory therapists assume primary responsibility for all respiratory care therapeutic treatments and diagnostic procedures, including the supervision of respiratory therapy technicians. Respiratory therapy technicians follow specific, well-defined respiratory care procedures under the direction of respiratory therapists and physicians. In clinical practice, many of the daily duties of therapists and technicians overlap; furthermore, the two have the same education and training requirements. However, therapists generally have greater responsibility than technicians. For example, respiratory therapists will consult with physicians and other health care staff to help develop and modify individual patient care plans. Respiratory therapists also are more likely to provide complex therapy requiring considerable independent judgment, such as caring for patients on life support in intensive-care units of hospitals. In this Handbook statement, the term respiratory therapists include both respiratory therapists and respiratory therapy technicians.
Respiratory therapists evaluate and treat all types of patients, ranging from premature infants whose lungs are not fully developed to elderly people whose lungs are diseased. Respiratory therapists provide temporary relief to patients with chronic asthma or emphysema, as well as emergency care to patients who are victims of a heart attack, stroke, drowning, or shock.
To evaluate patients, respiratory therapists interview them, perform limited physical examinations, and conduct diagnostic tests. For example, respiratory therapists test patients’ breathing capacity and determine the concentration of oxygen and other gases in patients’ blood. They also measure patients’ pH, which indicates the acidity or alkalinity of the blood. To evaluate a patient’s lung capacity, respiratory therapists have the patient breathe into an instrument that measures the volume and flow of oxygen during inhalation and exhalation. By comparing the reading with the norm for the patient’s age, height, weight, and sex, respiratory therapists can provide information that helps determine whether the patient has any lung deficiencies. To analyze oxygen, carbon dioxide, and pH levels, therapists draw an arterial blood sample, place it in a blood gas analyzer, and relay the results to a physician, who then may make treatment decisions.
To treat patients, respiratory therapists use oxygen or oxygen mixtures, chest physiotherapy, and aerosol medications. When a patient has difficulty getting enough oxygen into his or her blood, therapists increase the patient’s concentration of oxygen by placing an oxygen mask or nasal cannula on the patient and set the oxygen flow at the level prescribed by a physician. Therapists also connect patients who cannot breathe on their own to ventilators that deliver pressurized oxygen into the lungs. The therapists insert a tube into the patient’s trachea, or windpipe; connect the tube to the ventilator; and set the rate, volume, and oxygen concentration of the oxygen mixture entering the patient’s lungs.
Therapists perform regular assessments of patients and equipment. If the patient appears to be having difficulty breathing or if the oxygen, carbon dioxide, or pH level of the blood is abnormal, therapists change the ventilator setting according to the doctor’s orders or check the equipment for mechanical problems. In home care, therapists teach patients and their families to use ventilators and other life-support systems. In addition, therapists visit patients several times a month to inspect and clean equipment and to ensure its proper use. Therapists also make emergency visits if equipment problems arise.
Respiratory therapists perform chest physiotherapy on patients to remove mucus from their lungs and make it easier for them to breathe. For example, during surgery, anesthesia depresses respiration, so chest physiotherapy may be prescribed to help get the patient’s lungs back to normal and to prevent congestion. Chest physiotherapy also helps patients suffering from lung diseases, such as cystic fibrosis, that cause mucus to collect in the lungs. Therapists place patients in positions that help drain mucus, and then vibrate the patients’ rib cages and instruct the patients to cough.
Respiratory therapists also administer aerosols liquid medications suspended in a gas that forms a mist which is inhaled and teach patients how to inhale the aerosol properly to ensure its effectiveness.
In some hospitals, therapists perform tasks that fall outside their traditional role. Therapists’ tasks are expanding into areas such as pulmonary rehabilitation, smoking cessation counseling, disease prevention, case management, and polysomnography the diagnosis of breathing disorders during sleep, such as apnea. Respiratory therapists also increasingly treat critical care patients, either as part of surface and air transport teams or as part of rapid-response teams in hospitals.
Respiratory therapists generally work between 35 and 40 hours a week. Because hospitals operate around the clock, therapists may work evenings, nights, or weekends. They spend long periods standing and walking between patients’ rooms. In an emergency, therapists work under a great deal of stress. Respiratory therapists employed in home health care must travel frequently to the homes of patients.
Respiratory therapists are trained to
work with hazardous gases stored under pressure. Adherence to safety
precautions and regular maintenance and testing of equipment minimize the
risk of injury. As in many other health occupations, a respiratory therapist
run the risk of catching an infectious disease, but carefully following
proper procedures minimizes this risk.
Formal training is necessary for entry into this field. Training is offered at the postsecondary level by colleges and universities, medical schools, vocational-technical institutes, and the Armed Forces. An associate’s degree is required for entry into the field. Most programs award associate’s or bachelor’s degrees and prepare graduates for jobs as advanced respiratory therapists. A limited number of associate’s degree programs lead to jobs as entry-level respiratory therapists. According to the Commission on Accreditation of Allied Health Education Programs (CAAHEP), 51 entry-level and 329 advanced respiratory therapy programs were accredited in the United States, including Puerto Rico.
Among the areas of study in respiratory therapy are human anatomy and physiology, pathophysiology, chemistry, physics, microbiology, pharmacology, and mathematics. Other courses deal with therapeutic and diagnostic procedures and tests, equipment, patient assessment, cardiopulmonary resuscitation, the application of clinical practice guidelines, patient care outside of hospitals, cardiac and pulmonary rehabilitation, respiratory health promotion and disease prevention, and medical recordkeeping and reimbursement.
The National Board for Respiratory Care (NBRC) offers certification and registration to graduates of programs accredited by CAAHEP or the Committee on Accreditation for Respiratory Care (CoARC). Two credentials are awarded to respiratory therapists who satisfy the requirements: Registered Respiratory Therapist (RRT) and Certified Respiratory Therapist (CRT). Graduates from accredited entry-level or advanced-level programs in respiratory therapy may take the CRT examination. CRTs who were graduated from advanced-level programs and who meet additional experience requirements can take two separate examinations leading to the award of the RRT credential.
All States (except Alaska and Hawaii), the District of Columbia, and Puerto Rico require respiratory therapists to obtain a license. Passing the CRT exam qualifies respiratory therapists for State licenses. Also, most employers require respiratory therapists to maintain a cardiopulmonary resuscitation (CPR) certification. Supervisory positions and intensive-care specialties usually require the RRT or at least RRT eligibility.
Therapists should be sensitive to patients’ physical and psychological needs. Respiratory care practitioners must pay attention to detail, follow instructions, and work as part of a team. In addition, operating advanced equipment requires proficiency with computers.
High school students interested in a career in respiratory care should take courses in health, biology, mathematics, chemistry, and physics. Respiratory care involves basic mathematical problem solving and an understanding of chemical and physical principles. For example, respiratory care workers must be able to compute dosages of medication and calculate gas concentrations.
Respiratory therapists advance in clinical practice by moving from general care to the care of critically ill patients who have significant problems in other organ systems, such as the heart or kidneys. Respiratory therapists, especially those with bachelor’s or master’s degrees, also may advance to supervisory or managerial positions in a respiratory therapy department. Respiratory therapists in home health care and equipment rental firms may become branch managers. Some respiratory therapists advance by moving into teaching positions.
There are approximately 27,900 people employed as a Respiratory Therapists. More than 4 out of 5 jobs were in hospital departments of respiratory care, anesthesiology, or pulmonary medicine. Most of the remaining jobs were in offices of physicians or other health practitioners, consumer-goods rental firms that supply respiratory equipment for home use, nursing care facilities, and home health care services. Holding a second job is relatively common for respiratory therapists. About 13 percent held another job, compared with 5 percent of workers in all occupations.
Job opportunities are expected to be very good, especially for respiratory therapists with cardiopulmonary care skills or experience working with infants. Employment of respiratory therapists is expected to increase faster than average for all occupations through the year 2024, because of substantial growth in the numbers of the middle-aged and elderly population a development that will heighten the incidence of cardiopulmonary disease and because of the expanding role of respiratory therapists in the early detection of pulmonary disorders, case management, disease prevention, and emergency care.
Older Americans suffer most from respiratory ailments and cardiopulmonary diseases such as pneumonia, chronic bronchitis, emphysema, and heart disease. As their numbers increase, the need for respiratory therapists will increase as well. In addition, advances in inhalable medications and in the treatment of lung transplant patients, heart attack and accident victims, and premature infants (many of whom are dependent on a ventilator during part of their treatment) will increase the demand for the services of respiratory care practitioners.
Although hospitals will continue to employ the vast majority of therapists, a growing number can expect to work outside of hospitals in home health care services, offices of physicians or other health practitioners, or consumer-goods rental firms.
Median annual earnings of respiratory therapists were $60,280 in 2019. The best-paid 25 percent made $72,760 that year, while the lowest-paid 25 percent made $51,430.
In addition to, the U.S. Department of Education administers the Federal Family Education Loan (FFEL) Program and the William D. Ford Federal Direct Loan (Direct Loan) Program. Both the FFEL and Direct Loan programs consist of what are generally known as Stafford Loans (for students) and PLUS Loans (for parents).
Schools generally participate in either the FFEL or Direct Loan program but sometimes participate in both. Under the Direct Loan Program, the funds for your loan come directly from the federal government. Funds for your FFEL will come from a bank, credit union, or other lender that participates in the program. Eligibility rules and loan amounts are identical under both programs, but repayment plans differ somewhat.
How can I get a FFEL or Direct Loan?
For either type of loan, you must fill out a FAFSA. After your FAFSA is processed, your school will review the results and will inform you about your loan eligibility. You also will have to sign a promissory note, a binding legal document that lists the conditions under which you're borrowing and the terms under which you agree to repay your loan.
How to Choose and Evaluate Lenders
You'll need to choose a lender if you obtain a FFEL Stafford Loan. (If you have a Direct Stafford Loan, the federal government through the U.S. Department of Education is your lender.) Schools that participate in the FFEL Program will usually have a list of preferred lenders. Student loan borrowers may choose a lender from that list, or choose a different lender they prefer (for example, a credit union). Here are a few things to think about when selecting a FFEL lender.
How much can I borrow?
It depends on your year in school and whether you have a subsidized or unsubsidized Direct or FFEL Stafford Loan. A subsidized loan is awarded on the basis of financial need. If you're eligible for a subsidized loan, the government will pay (subsidize) the interest on your loan while you're in school, for the first six months after you leave school, and if you qualify to have your payments deferred. Depending on your financial need, you may borrow subsidized money for an amount up to the annual loan borrowing limit for your level of study (see below).
You might be able to borrow loan funds beyond your subsidized loan amount even if you don't have demonstrated financial need. In that case, you'd receive an unsubsidized loan. Your school will subtract the total amount of your other financial aid from your cost of attendance to determine whether you're eligible for an unsubsidized loan. Unlike a subsidized loan, you are responsible for the interest from the time the unsubsidized loan is disbursed until it's paid in full. You can choose to pay the interest or allow it to accrue (accumulate) and be capitalized (that is, added to the principal amount of your loan). Capitalizing the interest will increase the amount you have to repay.
You can receive a subsidized loan and an unsubsidized loan for the same enrollment period as long as you don't exceed the annual loan limits.
How will I get the loan money?
For both the Direct Loan and FFEL programs, you'll be paid through your school in at least two installments. No installment may exceed one-half of your loan amount. Your loan money must first be applied to pay for tuition and fees, room and board, and other school charges. If loan money remains, you'll receive the funds by check or in cash, unless you give the school written authorization to hold the funds until later in the enrollment period.
Generally, if you're a first-year undergraduate student and a first-time borrower, your school cannot disburse your first payment until 30 days after the first day of your enrollment period. This practice ensures you won't have a loan to repay if you don't begin classes or if you withdraw during the first 30 days of classes.
A school with a cohort default rate of less than 10 percent for each of the three most recent fiscal years for which data are available are not required to delay the delivery or disbursement of the first disbursement of a loan for 30 days for first-time, first year undergraduate borrowers.
What's the interest rate?
The new fixed interest rates will be 4.529% on the Federal Stafford loan for undergraduate students, 6.079% for the Federal Stafford loan for graduate students and 7.079% for the Federal Grad PLUS and Federal Parent PLUS loans.
Other than interest, is there a charge for this loan?
For Direct Stafford Loans, both subsidized and unsubsidized, the origination fee is 1.069 percent of the total amount of the loan.
When do I pay back my Stafford Loans?
After you graduate, leave school, or drop below half-time enrollment, you will have a six-month "grace period" before you begin repayment. During this period, you'll receive repayment information, and you'll be notified of your first payment due date. You're responsible for beginning repayment on time, even if you don't receive this information. Payments are usually due monthly.
During the grace period on a subsidized loan, you don’t have to pay any principal, and you won’t be charged interest. During the grace period on an unsubsidized loan, you don’t have to pay any principal, but you will be charged interest. You can either pay the interest or it will be capitalized (added to your principal loan balance, thus increasing the amount you’ll repay).
How do I pay back my loans?
You’ll repay your FFEL Stafford Loan to a private lender or loan servicer. You’ll repay your Direct Loan to the U.S. Department of Education’s Direct Loan Servicing Center. Both the Direct Loan and FFEL programs offer four repayment plans you can choose from, but the terms differ slightly. You will receive more detailed information on your repayment options during entrance and exit counseling sessions your school will provide.
What if I have trouble repaying the loan?
Under certain circumstances, you can receive a deferment or forbearance on your loan, as long as it’s not in default. During a deferment, no payments are required. You won’t be charged interest for a subsidized FFEL or Direct Stafford loan. If you have an unsubsidized Stafford Loan, you are responsible for the interest during deferment.
If you’re temporarily unable to meet your repayment schedule (for example due to poor health or other unforeseen personal problems), but you’re not eligible for a deferment, your lender might grant you forbearance for a limited and specified period.
Can my Stafford Loan ever be discharged (canceled)?
Yes, but only under a few circumstances. Your loan can’t be canceled because you didn’t complete the program of study at the school (unless you couldn’t complete the program for a valid reason the school closed, for example), or because you didn’t like the school or the program of study, or you didn’t obtain employment after completing the program of study.
College graduates in the U.S. enjoy the lowest unemployment rates, presently at slightly over 2.2%
Airlines transport passengers and freight over regularly scheduled routes or on routes, called “charters,” specifically designed for a group of travelers or a particular cargo. Several classes of airlines function in the United States. Presently there are 18 major airlines— and 4 all cargo which the U.S. Department of Transportation defines as having operating revenues of more than $1 billion. The largest of these, often called the Big Six, generally have a “hub” and also fly internationally. A hub is a centrally located airport designated by an airline to receive a large number of its flights from many locations, and at which passengers can transfer to flights to any of the locations served by the airlines system. In this way, the greatest number of passengers, from as many locations as possible, can be served in the most efficient way with a given set of resources.
In competition with the Big Six are low-cost, low-fare carriers. These carriers have traditionally not used hub and spoke systems and have offered flights between limited numbers of cities. They primarily have focused on flying shorter routes (400 miles or less) and on serving leisure travelers. But some low-fare carriers are expanding their routes to include longer transcontinental and nonstop flights. These moves have helped low-fare carriers expand their customer base to include more business travelers.
Another type of passenger airline carrier is the commuter or regional carrier. As of 2017, there were approximately 26 of these carriers. Regional airlines operate short- and medium-haul scheduled airline service connecting smaller communities with larger cities and with hubs. Some of the largest regional carriers are subsidiaries of the major airlines, but most are independently owned, often contracting their services to the majors. The regional airlines’ fleet consists primarily of smaller 19- to 68-seat turboprop and 40- to 70-seat jet aircraft. The regional airlines are the fastest growing segment of commercial aviation with 1 out of every 7 domestic airline passengers flying on a regional airline during at least part of his or her trip.
Air cargo is another sector of the airline industry. Cargo can be carried in cargo holds of passenger airlines or on aircraft designed exclusively to carry freight. Cargo carriers in this industry do not provide door-to-door service. Instead, they provide only air transport from an airport near the cargo’s origin to an airport near the cargo’s destination. Companies that provide door-to-door delivery of parcels either across town or across the continent are classified in the couriers and messenger’s industry.
As the low-fare airlines continue to compete and gain market share over the higher-cost major airlines, and as passenger traffic remains lower, managing costs has become more critical to the survival of some airlines. Labor costs are the airlines’ largest cost component amounting to over 40 percent of some airlines’ operating costs and reducing these costs is a key part of the recovery plans of several major airlines. Reducing costs usually involves getting their constituent labor groups to restructure their wages, benefits, and work rules while continuing to improve labor productivity.
The airline industry faces many challenges in the future. Airlines must focus on cost control, cash preservation, and cautious growth. The goal of the industry is to be prepared to respond quickly to economic recovery. Passenger volume should slowly improve, but it will take longer for rapid employment growth to return to the air transportation industry.
Working conditions in air transportation vary widely, depending on the occupation. Most employees work in fairly comfortable surroundings, such as offices, terminals, or airplanes. However, mechanics and others who service aircraft are subject to excessive noise, dirt, and grease and sometimes work outside in bad weather.
Airlines operate flights at all hours of the day and night. As a result, many workers have irregular hours or variable work schedules. Flight and ground personnel, including mechanics and reservation and transportation ticket agents, may have to work at night or on weekends or holidays. Flight personnel may be away from their home bases frequently. When they are away from home, the airlines provide them with hotel accommodations, transportation between the hotel and airport, and an allowance for meals and expenses. Flight attendants typically fly from 65 to 85 hours a month. In addition to flight time, they have about 50 hours a month of duty time between flights.
Flight crews, especially those on international routes, often suffer jet lag disorientation and fatigue caused by flying into different time zones. Because employees must report for duty well rested, they must allow ample time to rest during their layovers.
Although pilots and flight attendants are the most visible occupations in this industry, two-thirds of all employees in air transportation work in ground occupations. Two of the largest ground occupations are aircraft mechanics and service technicians and reservation and transportation ticket agents and travel clerks.
Aircraft mechanics and service technician’s service, inspect, and repair planes. They may work on several different types of aircraft, such as jet transports, small propeller-driven airplanes, or helicopters. Many mechanics and technicians specialize, working on the airframe (the body of the aircraft) or the power plant (the engines) or avionics (the parts of an aircraft that depend on electronics, such as navigation and communication equipment). In small, independent repair shops, they usually inspect and repair many different types of aircraft.
Some mechanics and technicians specialize in scheduled maintenance required by the Federal Aviation Administration (FAA). Following a schedule based on the number of hours flown, calendar days, cycles of operation, or a combination of these factors, mechanics inspect the engines, landing gear, instruments, and other parts of aircraft and perform necessary maintenance and repairs.
A reservation and transportation ticket agent is most often the first employee that passengers meet after entering the airport. Ticket agents work at airport ticket counters and boarding gates and use computers to provide customer service to incoming passengers. They can make and confirm reservations, sell tickets, and issue boarding passes. They also may work in call centers, answering phone inquiries about flight schedules and fares, verifying reservations, issuing tickets, and handling payments. Customer service representatives assist passengers, check tickets when passengers board or disembark from an airplane, and check luggage at the reception area and ensure that it is placed on the proper carrier. They assist elderly or handicapped persons and unaccompanied children in claiming personal belongings and baggage, and in getting on and off the plane. They also may provide assistance to passengers who become ill or injured.
Other ground occupations include airplane cargo agents, baggage handlers, and aircraft cleaners. Airplane cargo agents take orders from shippers and arrange for transportation of their goods. Baggage handlers, classified under laborers and freight, stock, and material movers, hand, are responsible for loading and unloading passengers’ baggage. They stack baggage on specified carts or conveyors to see that it gets to the proper destination and also return baggage to passengers at airline terminals. Aircraft cleaner’s clean aircraft interiors after each flight.
Flight crewmembers make up 33 percent of air transportation employment, and include pilots and flight attendants. Airline pilots, copilots, and flight engineers are highly trained professionals who fly and navigate jet and turboprop airplanes. Generally, the most experienced pilot, or captain, is in command and supervises all other crewmembers. The pilot and copilot split flying and other duties, such as communicating with air traffic controllers and monitoring the instruments. Some aircraft have a third pilot in the cockpit the flight engineer or second officer who assists the other pilots by monitoring and operating many of the instruments and systems and watching for other aircraft. Most new aircraft are designed to be flown without a flight engineer. Small aircraft and helicopters that transport passengers and cargo and perform activities such as crop-dusting, monitoring traffic, firefighting, and rescue missions are flown and navigated by commercial pilots.
Airline flights must have one or more flight attendants on board, depending on the number of passengers. The attendants’ most important function is assisting passengers in the event of an emergency. This may range from reassuring passengers during occasional encounters with strong turbulence to opening emergency exits and inflating escape chutes. More routinely, flight attendants instruct passengers in the use of safety and emergency equipment. Once in the air, they serve meals and snacks, answer questions about the flight, distribute magazines and pillows, and help care for small children and elderly and disabled persons. They also may administer first aid to passengers who become ill.
The airline industry also relies on many management, professional, and administrative support workers to keep operations running smoothly.
Training and Advancement
The skills and experience needed by workers in the air transportation industry differ by occupation. Some jobs may be entered directly from high school, while others require specialized training. Most positions in the airline industry involve extensive customer service contact, requiring strong interpersonal and communication skills. Mechanics and pilots require specialized formal training and must be certified by the FAA. Skills for many other air transportation occupations can be learned on the job or through company-sponsored training.
Pilots must have a commercial pilot’s license with an instrument rating, must have a medical certificate, and must be certified to fly the types of aircraft that their employer operates. For example, helicopter pilots must hold a commercial pilot’s certificate with a helicopter rating. Pilots receive their flight training from the military or from civilian flying schools. Physical requirements are strict. A medical exam, from an FAA-designated physician, must be taken to get a medical certificate. With or without glasses, pilots must have 20/20 vision and good hearing and be in excellent health. In addition, airlines generally require 2 years of college and increasingly prefer or require a college degree. Pilots who work for smaller airlines may advance to flying for larger companies. They also can advance from flight engineer to copilot to captain and, by becoming certified, to flying larger planes.
Applicants for flight attendant jobs must be in excellent health. Employers increasingly prefer applicants who have a college degree and experience in dealing with the public. Speaking a foreign language also is an asset. Airlines operate flight attendant training programs on a continuing basis. Training usually lasts from 4 to 8 weeks, depending on the size and the type of carrier, and may include crew resource management, which emphasizes teamwork and safety. Courses also are provided in personal grooming and weight control. After completing initial training, flight attendants must go through additional training and pass an FAA safety exam each year in order to continue flying. Advancement opportunities are limited, although some attendants become customer service directors, instructors, or recruiting representatives.
When hiring aircraft mechanics, employers prefer graduates of aircraft mechanic trade schools, particularly those who gained experience in the military and are certified. Additionally, employers prefer mechanics who are in good physical condition and able to perform a variety of tasks. After being hired, aircraft mechanics must keep up to date on the latest technical changes and improvements in aircraft and associated systems. Most mechanics remain in the maintenance field, but they may advance to lead mechanic and, sometimes, to crew chief or shop supervisor.
A good speaking voice and a pleasant personality are essential for reservation and transportation ticket agents and Customer service representatives. Airlines prefer applicants with experience in sales or in dealing with the public, and most require a high school education, although some college is preferred. Formal company training is required to learn how to operate airline computer systems, issue tickets, and plan trips. Agents and service representatives usually are promoted through the ranks. For example, an experienced ticket agent may advance to lead worker on the shift. Agents who obtain additional skills, experience, and training improve their chances for advancement, although a college degree may be required for some administrative positions.
Some entry-level jobs in this industry, such as baggage handler and aircraft cleaner, require little or no previous training. The basic tasks associated with many of these jobs are learned in less than a week, and most newly hired workers are trained on the job under the guidance of an experienced employee or a manager. However, advancement opportunities for many ground occupations are limited because of the narrow scope of duties and specialized skills necessary for other occupations. Some may advance to supervisor or to another administrative position.
Senior pilots for major airlines are among the highest paid workers in the Nation. Most employees in the air transportation industry receive standard benefits, such as paid vacation and sick leave; life and health insurance; and often profit-sharing and retirement plans. Some airlines provide allowances to employees for purchasing and cleaning their company uniforms. A unique benefit free or reduced-fare transportation for airline employees and their immediate families attracts many job seekers.
Industry future outlook
The number of job openings may vary from year to year, because the demand for air travel particularly pleasure travel, a discretionary expense fluctuates with ups and downs in the economy. In the long run, passenger and cargo traffic is expected to continue expanding in response to increases in population, income, and business activity. Job prospects generally are better in regional and low-fare carriers than in major airlines, where competition for many jobs is keen.
Despite a recent slowdown in passenger air travel, demographic and income trends indicate favorable conditions for leisure travel in the United States and abroad over the next decade. The aging of the population, in combination with growth of disposable income among older people, should increase the demand for air transportation services. Also, business travel should improve as the U.S. economy and world trade expands, companies continue to go global, and the economies in many foreign countries become more robust. However, as businesses also try to reduce costs, they are resorting to cheaper alternatives to flying and finding new ways to communicate. Many business travelers are using other means of transportation for example,, driving or using the railway system and are conducting more business by phone, e-mail, and better quality and lower cost videoconferencing technologies.
International cargo traffic is expected to increase with the economy and growing world trade. It should also be stimulated by the development of global electronic commerce and manufacturing trends such as just-in-time delivery, which requires materials to be shipped rapidly. Growth of domestic air cargo traffic is not expected to increase as much as international cargo, primarily because of the rise of time-definite trucking. Increasingly, shipments will be sent via trucks, as opposed to aircraft, because trucks are reliable, trackable through GPS technology, and more cost effective.
Job opportunities in the air transportation industry are expected to vary depending on the occupation. Employment of pilots and flight attendants is projected to grow through 2022 as the economy and passenger traffic rebound from the severe industry downturn. In the near term, the best opportunities will be with the faster growing regional and low-fare carriers. College graduates and former military pilots can expect to have the best job prospects. In addition to growth, turnover among flight attendants will produce job openings as many in this occupation leave for more stable work schedules or better salaries.
The number of reservation and transportation ticket agents will grow more slowly than the overall industry as more airlines phase out paper tickets and allow passengers to purchase electronic tickets over the Internet. However, the safety and security responsibilities of these jobs will continue, thereby preventing job declines. Competition for ticket agent and customer service representative jobs will continue to be keen as many more people are likely to apply for these jobs than there are openings, in part because of the travel benefits.
Opportunities should be excellent for aircraft and avionics equipment mechanics and service technicians. The likelihood of fewer entrants from the military and a large number of retirements indicates excellent opportunities for students just beginning technician training. Most job openings are likely to be at smaller airlines since these airlines typically pay less than major airlines, leading to fewer applicants. Competition for jobs is expected to be stiff at major airlines; applicants with experience should have the best job prospects.
Opportunities also are expected to be good for those seeking unskilled, entry-level positions, such as baggage handler and aircraft cleaner, because many workers leave these jobs and need to be replaced.
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