August 25, 2008

Healthcare Careers: There’s More to Medicine Than an M.D. Degree

By Venturella, Krysta

As baby-boomers approach retirement age, there is a growing trend toward maintaining health and preventing illnesses, rather than treating diseases. Health consciousness has created a demand for a wide range of health professions, and New Jersey's institutions of higher education are preparing students to enter these emerging fields.

"People are living longer, and with chronic diseases that would have killed them in the past," says Carol Kleinman, chair of nursing at New Jersey City University (NJCU), Jersey City. "This creates a climate in which there are increased opportunities, new careers and new jobs that did not even exist before, beyond nursing."

Career Outlook

Gregory Sobol, assistant director/health professions specialist of career services at Rutgers University, New Brunswick, says the appeal of a healthcare profession is three-fold: good salaries, job security and meaningful work.

A fourth reason might be job availability. Currently, there is a shortage of nurses that is unlike any in the past, and it is unlikely to go away anytime soon, says Kleinman.

A problem, however, exists. "Fewer nurses who are qualified go into teaching. That, in many ways, limits how many students can enter nursing programs, or how many nursing programs there can be," says Sandra Bloomberg, dean in the college of professional studies at NJCU. "Nurses are able to move into advanced practice roles that didn't even exist 20 or 30 years ago, such as nurse practitioners, clinician specialists and nurse midwives." This has created a crisis for nursing educators at the higher education level, says Kristie Reilly, Ph.D., dean of the Nathan Weiss Graduate College at Kean University, Union.

The most sought-after medical professionals are multi-skilled workers who can draw blood, do an EKG and take blood pressure, says John Brandt, CEO of the National Healthcareer Association (NHA), Cedar Knolls, an allied health certification agency. With the shortage of physicians and nurses, "allied healthcare workers become an important part of the support system in a hospital, even to the point where they become the arms and legs for nurses."

NHA writes, develops and publishes the certification exams for nine allied health professions: medical assistant, phlebotomy, EKG, mental health technician, pharmacy technician, medical billing and coding, administrative medical assistants, medical transcription and medical coding.

Having NHA certification validates that students understand the requirements needed to enter into the healthcare field. "Our certification exams are the benchmark in allied health," says Brandt. Certification allows students without experience "to enter the marketplace, where a lot of doors are closed if they are not certified," he says.

Four-Year Universities

Four-year universities remain one of the most effective avenues for a career in allied health and nursing. Many of the programs are geared toward students interested in post-graduate study.

For instance, Rutgers University, which has a medical school acceptance rate of 54 percent, has a 16-month accelerated post- baccalaureate pre-health program for adults with a non-science bachelor's degree who want to go to medical school after years in the workforce. This is in addition to their pre-medical education program.

Rutgers University also offers a Mini-MBA: Business Essentials Program designed to educate students on the business of pharmaceutical and biotech industries, which "offers an overview of the key concepts, tools and techniques that are required to succeed in today's challenging business environment," according to the university website.

At Caldwell College, students can save one year of tuition and time with an accelerated seven year program. This allows for three years at Caldwell College and four years at one of five affiliated institutions: University of Medicine and Dentistry of New Jersey (UMDNJ)-Dental School; NYU-Dental School; Pennsylvania College of Optometry; New York Chiropractic College; and New York College of Podiatric Medicine.

"In order to get into professional school, you need to have four years of undergraduate school," says Sook Choi, Ph.D., Alvin Calman chair professor of biology and chief health professions advisor at Caldwell College. Usually, the first year of professional school and the fourth year of undergraduate program courses both teach basic sciences, but with this accelerated program, the courses aren't repeated. Before beginning this competitive program, students must be accepted by both institutions and meet educational requirements.

In collaboration with UMDNJ, Newark, Caldwell College offers an accelerated nursing program for students who already have a degree, but want to go into nursing. Psychology and biology major graduates can learn the professional portion of nursing courses in 15 months and become licensed, registered nurses.

Similar to Caldwell College, NJCU offers an accelerated program for non-nurses who already have a degree in another field. This 12- month program allows students to take the coursework required to become a nurse, and receive a second bachelor's degree in the end. "This is probably one of the fastest growing programs in the country," says Bloomberg. "Students take clinical courses that expose them to the actual healthcare environment. They are taking the theoretical learning in the classroom and applying it to real patient care situations."

Kean University offers a new B.S./M.D. program in collaboration with Drexel University College of Medicine, Philadelphia, and Saint Peter's University Hospital, New Brunswick.

"Students enter into the program as freshmen, and if they continue to meet the criteria, they are guaranteed a spot at Drexel Medical School upon graduation," says Reilly. "It's a pretty big safety net." This eight-year program will be offered this fall.

Eileen Carrigg Specchio, Ph.D., R.N., director of the undergraduate program in nursing at College of Saint Elizabeth (CSE), Morristown, says that many hospitals are trying to increase the percentage of nurses with bachelor's degrees. "There has been research showing that the higher the education level of the staff, the better the patient care outcomes."

CSE offers a Masters of Science in Nursing, in which nurse educators work with simulation mannequins, "to develop situations where students would have to anticipate what will happen next," says Specchio. "The student has so much time to respond, but if they respond wrong, the computer simulation program will display a poor outcome. You can immediately see how hesitation or wrong decisions would result in disaster. This helps students learn quickly that they don't have second chances."

Community Colleges

While four-year universities offer a number of excellent programs, community colleges also provide means into healthcare fields.

For instance, Bergen Community College offers an associate's degree program, called health sciences, for hospital-trained individuals who have not yet acquired an associate's degree, in which credits are awarded for hospital and class time.

At Bergen, students work hands-on with state-of-the-art equipment that is similar to what they would experience in a clinical facility. Surgical technology students prepare to work in hospitals in an operating room suite with a prepping room and a classroom. Dental hygiene students have 40 dental seats where cleanings and digital imaging are performed on local residents. Students work with 'Meti-man,' a simulation mannequin that helps "students experience exactly what a patient would be going through when, say, a heart attack occurs," says Professor Joe Mamatz, head of the college's radiography department.

What is taught in the classroom is integrated into the laboratories, "so by the time students go to clinical, they are prepared to perform their skills competently," Mamatz says. "The transition from student to professional is almost seamless."

Union County College (UCC), Cranford, offers state-of-the-art simulation mannequins to practice nursing, and for emergency medical and paramedic procedures. Students can monitor blood pressures, body sounds, lung sounds, heart sounds and heart rates. "There are computer programs that give you a simulation of things happening to patients and what you need to do for them," says Patricia Castaldi, R.N., director of the practical nursing program at UCC.

Practical nursing and registered nursing are fairly quick ways to get into the field and get involved, says Castaldi. The practical nursing program at UCC, which has some 200 students enrolled, takes about a year and a half to complete. Upon completion, students can take the license exam. The R.N. program, which is in cooperation with Trinitas Hospital, Elizabeth, takes two years.

Rewards and Challenges of Healthcare

People entering into healthcare fields must enjoy working with people. In nursing, Bloomberg says, she is always amazed by how many applicants have a positive experience with a nurse at some point in their lives. "They are impacted by the caring, compassion and professionalism, and it has motivated them to want to do the same thing and express those human values in their own lives."

Rutgers University's Gregory Sobol agrees. "The students of this generation applying to school have less of a 'me' orientation and more of a service orientation to other people," he says. Students pursuing medical fields must have extremely good study skills and a commitment to life-long learning. "The healthcare profession is not a field where you would stop reading books after you graduate," Sobol says. "For example, to be a physician's assistant, you have to be recertified every six years."

According to the spring 2008 quarterly salary survey by the National Association of Colleges and Employers, a professional association in Bethlehem, Pennsylvania, the average starting salary of registered nurses with a bachelor's degree was $53,911. Richard White, director of career services at Rutgers University, New Brunswick, says, "That would be the same as accounting, engineering and other business majors. They are in the business mix."

As far as nursing goes, Specchio says starting salaries do not differ much for people with a bachelor's degree or an associate's degree. "Hospitals, however, are now putting a differentiation in because they realize the value of the bachelor's degree," says Specchio. "The clinical ladder programs are in place where you can move to a higher salary with more responsibility."

"You never know where your path is going to take you in healthcare, because there are just so many opportunities for growth," says Reilly. "People can continue to be practitioners or go into research. They can also go into the more entrepreneurial, business side of healthcare."

When students enter the workforce, Dr. Felissa R. Lashley, former dean of the Rutgers University College of Nursing, wants them to feel confident, but not overly confident. "They must realize they have learned the basics, but if they haven't had enough practice, they should look for help."

Future of Healthcare Careers in New Jersey

Allied health careers in this country are expected to grow by 3.6 million by the year 2014. "I think New Jersey is in a very high- crunch area for growth because of our population," says NHA's Brandt.

Coping with diversity in healthcare is a huge issue in New Jersey. Specchio recently returned from a service leadership program trip to the Dominican Republic, where students learned cultural competence. "Many students did not speak Spanish, but were in a Spanish-speaking country," says Specchio. "They got to feel how it is on the other end of the spectrum, where your patients come in and try to communicate with you." Specchio says the trip showed students how grateful people were for their help. "That is what makes a difference for a nurse, to make a difference in one person's life," says Specchio.

Nurses and other non-M.D.s may begin to provide everyday patient care. "It is predicted that over the next 10 years, a large amount of the primary care is going to be handled by nurse practitioners as well as physician's assistants," says Sobol. "A big trend we are going to see in healthcare is that primary care providers might move away to higher paying areas."

Either way, healthcare professionals must be prepared for the future. "There are things we cannot even predict will happen," says Castaldi. Aside from the known diseases, "we don't know what kind of flus or public health issues are going to develop. We need to have a workforce that is prepared to deal with anything."

As Brandt says, "we need an army of healthcare workers in this country and in this state."

Eight years of school is no longer required to enter into a medical profession. "You can be part of the healthcare field without being a medical doctor," says Dr. Choi. "You cannot get into medical school with a 2.9 GPA, but you still can be a healthcare provider."

Copyright New Jersey Business & Industry Association Aug 2008

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