How to become A Prosthetist

It is estimated that 300 to 500 individuals lose a limb every day to accidents, injuries, congenital disabilities or illnesses. Prosthetists engineer mini-miracles every time they help create and fit prostheses for people who require artificial limb replacements, so they have improved mobility and less pain.

• Certified Prosthetist/Orthotist (CPO) 

• Licensed Prosthetist/Orthotist (LPO) 

• Orthotic/Prosthetic Practitioner 

• O&P Professional

What do Prosthetists do?

A Prosthetist would typically need to:

• Design and fabricate customised medical supportive devices to help patients who have lost a leg or arm at birth or in an accident/illness regain their mobility

• Assess and interview the patient to determine their specific challenges and needs

• Perform gait analysis - appraise the patient’s movements to identify any biomechanical abnormalities

• Evaluate the joint range of movement and muscle strength; assist the physician in creating a treatment plan which may include a prosthesis 

• Take measurements of impressions of the part of the patient’s body that needs to be fitted with an artificial limb

• Create a prototype of the required orthopaedic/prosthetic device based on the identification of the patient’s needs and the physician’s prescription

• Shape capture using plaster or digital imaging and 3D scanning, CAD (computer-aided design), and CAM (computer-aided modelling) to create a model

• Use their knowledge of anatomy, physiology, biomechanics, and technology to select or engineer various components 

• Select appropriate materials for the construction of the prosthetic device; liaise with and supervise the technicians who manufacture the prosthesis

• Fit the constructed device on the patient with the help of the attending physician and physical therapist

• Make necessary modifications to the device to ensure a comfortable and secure fit and proper application 

• Monitor the impact of the new prosthesis on the patient’s movements and functioning ability; help the patient adjust to using the new device

• Instruct the patient on how to use and care for their device; repair or replace the prosthetic device, as required

• Document all pertinent activities in the patient’s record

Prosthetists work in a shop/laboratory healthcare setting as part of a multidisciplinary team that includes physicians, nurses, podiatrists, technicians, physiotherapists and occupational therapists to help manage the patient’s rehabilitation. Travel may be necessary if you work in more than one location.

Most Prosthetists have a regular work schedule from Monday to Friday. Although typical work hours average 37 to 40 hours a week, some shift work, including nights and weekends, is likely. You can opt for part-time and flexible working hours.

Finding a new job might seem challenging. Prosthetists can boost their job search by asking their network for referrals, contacting employers directly, using job search platforms, going to job fairs, leveraging social media, and inquiring at staffing agencies.

Prosthetists may choose to practice solo or in a group practice. They may opt to be employed by healthcare facilities or work with them on an independent contractor basis. They may also choose temporary locum tenens positions offered by practices, hospitals, or healthcare organisations with an unfilled clinical need.

Prosthetists are generally employed by:

• Public & Private Hospitals, Clinics, & Health Centres

• Rehabilitation Centres

• Commercial & Private Prosthetics Companies

• Prostheses Manufacturing & Servicing Firms

• Overseas Healthcare Providers

• Voluntary Organisations

• Government Agencies

• Health & Personal Care Stores

• Ambulatory Healthcare Services

Professional associations and organisations, such as The International Society for Prosthetics and Orthotics (ISPOINT), are crucial for Prosthetists interested in pursuing professional development or connecting with like-minded professionals in their industry or occupation. Membership in one or more adds value to your resume while bolstering your credentials and qualifications.

• The disparity in quality of service offered in a public setting as opposed to the more prompt private or military setting

• Lack of continuity in care in a location that employs contracted clinicians

• Changes in the shape and volume of the residual limb following changes in the weather or physical activity

• Skin breakdown and infection in the residual limb due to temperature and moisture build-up from the use of non-breathable socks or liners that aid comfort and fit

• Significant pain and skin breakdown due to adherent scars and skin grafts

• Demotivation among patients who do not experience the kind of progress they anticipated with the prosthesis

•  Pain, discomfort, skin breakdown, pressure sore development, and musculoskeletal overuse injuries due to ill-fitting sockets

• Lack of adequate time to build a healthy and constructive relationship with the patient

• Lack of standard practices in treating ill-fitting sockets, wearing prosthetics, and scheduled check-ups

Any academic program that a potential Prosthetist takes up generally requires a period of supervised practical placements at prosthetic clinics. Students learn how to assess, diagnose and treat individuals who need prosthetic care.

You will gain optimal benefit from your tasks outside of the classroom when they line up perfectly with your lessons inside it. You may get to hear countless stories from more experienced professionals and obtain valuable hands-on experience when they manage to turn seemingly routine incidents into unique learning moments.

In addition to the mandatory clinical component in your master’s programme, you may need to complete an accredited one-year residency in prosthetics. Furthermore, registration with the local health and care professions council will require successful completion of a degree apprenticeship in prosthetics.

Since it can be challenging to get work experience in this field, read about the profession and interview or job shadow experts working in prosthetics to prove your commitment to course providers and prospective employers.

Contact your local disability service centres to see if they have any viable opportunities. Paid or voluntary work experience in other health and care disciplines would also prove handy, especially if you interact with the patients.

A bachelor’s degree in orthotics or prosthetics covering the human body, the effect of biomechanics on the body, and the materials/methods used in manufacturing prostheses may fetch you an entry-level job. 

However, many potential Prosthetists choose to pursue a two-year master’s degree programme that includes courses in upper and lower extremity orthotics,/prosthetics, spinal orthotics, and plastics and other materials used for fabrication. 

Prerequisites may vary by programme but usually include a bachelor’s degree in any discipline, provided the applicant completes stipulated courses in science and math. Candidates who complete AS or AP levels, a diploma in society, health and development (with an additional science subject), vocational courses, the IB or access courses, or a science foundation programme, may also be eligible for entry to the programme. 

Focus on English, maths, physics, biology and chemistry in high school.

Many Prosthetists become certified and licensed regardless of local government requirements because certification in prosthetics demonstrates competence and increases your chances of advancement. In addition, successful certification programs protect public welfare by incorporating a Code of Ethics.

A combination of education, experience, and testing is generally required to gain board certification, though requirements differ from region to region. Applicants may need to complete an accredited master’s programme, an accredited residency programme, and pass three exams.

Aspiring Prosthetists with an associate degree in unrelated fields can apply for authorised credentials after completing accredited certification programmes, working for four years in the area, and passing relevant exams.

Typically, a Prosthetist’s licensure requires an application, processing fees, an examination, and relevant education and experience. 

Duly certified and licenced Prosthetists can register with their local health and care professions council.

You may need to undergo an employment background check that can include but is not limited to a person’s work history, education, credit history, motor vehicle reports (MVRs), criminal record, medical history, use of social media, and drug screening.

Performance, experience, and the acquisition of professional qualifications drive the career progression of Prosthetists who may become Senior Clinicians or move into supervisory and management posts within the field. 

It is also possible to take up research and development (R&D) or teaching. Other options include setting up your own practice or applying for a senior sales position.

Some professionals prefer to become experts in a specific clinical area, such as sports injuries, neurology or diabetes, or within particular client groups, such as children or the elderly. You may also have opportunities to work overseas, especially with voluntary organisations, such as the Red Cross in communities affected by war.

Candidates with a master’s degree in prosthetics, board certification and licensure, besides communicating compassionately with their patients, have the best job prospects.

Continuing professional development (CPD) will help an active Prosthetist build personal skills and proficiency through work-based learning, a professional activity, 

formal education, or self-directed learning. CPD also enables the regular renewal of desirable certifications, licensure, and registration.

Seek an experienced mentor who can help consolidate your skills and knowledge. Attend conferences, workshops, and seminars to ensure you stay abreast of the latest developments in the field and network with other Prosthetists.

Invest in an MPhil or PhD degree if you wish to move into research and teaching. Take advantage of open-learning postgraduate qualifications in rehabilitations studies which can fetch you a postgraduate certificate (PgCert) or postgraduate diploma (PgDip).

Prosthetists can expect support and additional training from the academic institution or from Vitae, a non-profit global leader with over 50 years of experience in enhancing the skills of researchers.

In partnership with governments, funders of research, professional bodies, trusts & foundations, universities, and research institutes, Vitae offers training, resources, events, consultancy, and membership.

Skills - Intrinsic and Learned

Prosthetists must communicate well with their patients and other members of their healthcare team to ensure the patients’ needs are well met. Attention to detail and manual dexterity helps with precise measurements, fabrication of intricate mechanical parts, and a secure and comfortable fit of the prosthetic device. 

Physical stamina, patience, and problem-solving skills will go a long way in ascertaining the patients receive due attention.

Essential Trivia

Prosthetic comes from Greek and means “addition.” A 3000-year-old prosthetic toe made of wood and leather was found in Cairo.

Wood, steel, aluminium, leather, cloth, rubber, and plastic can be used to fabricate prosthetic devices. However, most prosthetic wear is now crafted from titanium, aluminium and carbon fibre; thermoplastic prostheses are the most lightweight.

Age, gender, weight, health, and lifestyle are some of the factors that need consideration while fabricating a prosthetic device for one size will not fit everyone. 

The residual limb fits into a customised carbon fibre sock that prevents swelling in the residual limb when the prosthesis is not attached. A silicone gel cover helps protect the residual limb during movement.

Sucking, elevated vacuum, and locking help hold a prosthetic device to the residual limb. The socket’s elevated vacuum helps heal the limb, lighten the weight of the prosthesis, and maintain its size. Prosthetic limbs with jointed ankles can be adjusted to different heights using a button.

Most amputees get a prosthetic limb after complete recovery from surgery. The average prosthesis lasts no more than five years and needs to be changed, regardless of the extent of its use.

The Current Scenario

As the global population ages and is increasingly affected by obesity and diabetes, there is a compelling need for rehabilitative care. At the same time, technological advancements allow more people to have new devices, and insurance companies provide greater access to prosthetic devices. So, career prospects for Prosthetists are pretty good, provided you are willing to relocate to where the jobs are.

Potential Pros & Cons of Freelancing vs Full-Time Employment

Freelancing Prosthetists have more flexible work schedules and locations. They have full ownership of the business and can select their projects and clients. However, they experience inconsistent work and cash flow, which means more responsibility, effort and risk.

On the other hand, a full-time Prosthetist has company-sponsored health benefits, insurance, and retirement plans. They have job security with a fixed, reliable source of income and guidance from their bosses. Yet, they may experience boredom due to a lack of flexibility, ownership, and variety.

When deciding between freelancing or being a full-time employee, consider the pros and cons to see what works best for you.

3D printing technology can make available a 100,000-dollar-worth prosthesis at a fraction of the cost - USD4,000!

It is not a pleasant walk in the park by any means; the job description calls for dedicated and unswerving service to the successful rehabilitation of all patients with missing limbs that seek your help. However, the satisfaction you experience at helping a truly needy individual is worth all the stress and time you devote to your career as an accomplished Prosthetist.

Since desirable educational options are limited in the field of prosthetics, gear yourself to attend school in a location away from home.