The Job and What's Involved

Prosthetists and orthotists design, make and fit artificial limbs, braces and splints. These appliances are designed to aid people's mobility, correct a deformity and substitute for lost limbs. They play an active role in patient rehabilitation, helping them to lead as normal a life as possible.

Prosthetists design and fit artificial limbs (prostheses) for patients who have lost limbs through amputation or were born without a limb. Some prostheses are highly advanced and incorporate electronic or microprocessor-controlled parts or pneumatic or hydraulic mechanisms.

Orthotists design and fit surgical appliances (orthoses), such as braces for arms or legs, callipers, neck collars and splints to support the patient's limbs or spine, and special footwear and insoles. These aim to relieve patient discomfort, correct physical deformities, aid movement and prevent physical conditions deteriorating.

Prosthetists/orthotists use science, anatomy and engineering skills daily to assess patients and prescribe the most suitable device. Typical duties include:

• Assessing patients' physical capabilities and fitness before deciding on the best artificial limb or appliance to fit.
• Taking measurements and using digital imagery to create an individual cast, which is used to create the prosthesis or orthosis, ensuring a secure, comfortable device.
• Designing or selecting different components, using their knowledge of anatomy and physiology, biomechanics, technology and materials.
• Instructing orthosis manufacturers and prosthetic technicians to assemble and create each item.
• Fitting the finished prosthesis or orthosis, making sure it is safe and comfortable.
• Educating patients on fitting and using their device, referring them to physiotherapy for ongoing support.
• Conducting follow-up checks, making sure the device is working effectively, assessing the physical improvements and making necessary adjustments and repairs.

They work with a wide range of health professionals to provide integrated treatment, including physiotherapists, who oversee patients' exercise programme's, and occupational therapists, who support and train patients on undertaking daily activities with their new device. Technicians and assistants support the clinical work of prosthetists/orthotists.

Typical working hours are between 37 and 40 hours a week, Monday to Friday. Part-time work and flexible working may be available.

Prosthetists are usually based in specialised centres of hospitals that are dedicated to the rehabilitation of patients.

Orthotists are often based in hospital outpatient clinics. They may work in several different hospitals during their working week, as well as visiting schools and centres for people with special needs. A driving licence is essential for many orthotist positions.

Starting salaries in the NHS (National Health Service) for newly qualified prosthetists/orthotists are between £20,710 and £26,839 a year. With experience, specialists can earn between £24,831 and £33,436 a year. With NHS management responsibilities they can earn up to £39,273 a year.

Some prosthetists/orthotists earn over £60,000 working for manufacturers or in the most senior NHS positions.

Getting Started with this Career Choice

There are currently 877 prosthetists/orthotists registered with the Health Professions Council (HPC) in the UK. There is an overall shortage of graduate entrants in the UK and internationally.

Prosthetists and orthotists usually work within the NHS. They may be employed directly by the NHS or by a company contracted to provide prosthetic or orthotic clinical services. Opportunities may also exist with manufacturing and servicing companies, overseas healthcare providers and voluntary organisations such as the Red Cross. Some work in private practice.

Vacancies may be advertised in national newspapers and on medical recruitment agency websites. Jobs may also appear on the NHS Jobs website.

Education and Training

Before they can practice and use the title of prosthetist or orthotist, entrants must have an honours degree in prosthetics and orthotics approved by the British Association of Prosthetists and Orthotists (BAPO) and the HPC. The approved four-year course is currently available at two UK universities:

University of Salford, School of Health, Sport and Rehabilitation Sciences.

National Centre for Prosthetics and Orthotics, University of Strathclyde.

The approved degree courses offer a combination of academic study and supervised practical placements at prosthetic and orthotic clinics.

Study covers the human body, the effects of forces on the body (biomechanics), and materials and methods used in manufacturing prostheses and orthoses. Through practical placements, students learn how to assess, diagnose and treat people requiring prosthetic and orthotic care.

Entry requirements are usually at least five GCSE's (A*-C) including English, maths and a science-based subject and three A levels including maths or physics and either biology or chemistry.

Alternative qualifications may be accepted, such as AS levels, the Diploma in society, health and development (with an additional science subject), BTEC Nationals and Higher Nationals, the International Baccalaureate or Access courses. Candidates without the necessary science qualifications can take a science foundation programme.

The NHS funds all the places offered to UK and EU students at the two universities. Applicants may be eligible to apply for a means-tested bursary.

To work with children or vulnerable adults, applicants need to undergo checks through the Criminal Records Bureau. They are also medically screened prior to acceptance on a course.

A Few More Exams You Might Need

After completing their degree, BAPO recommends graduates should be mentored by an experienced prosthetist or orthotist during their first year of practice. It is possible to specialise in one area or practice both prosthetics and orthotics.

The University of Strathclyde offers a number of open-learning postgraduate qualifications in rehabilitation studies for qualified prosthetists and orthotists, which can lead to a:

- Postgraduate certificate (PgCert)
- Postgraduate diploma (PgDip)
- MSc

Qualified individuals may also pursue postgraduate research at Strathclyde, leading to MPhil or PhD awards.

To maintain HPC registration, prosthetists/orthotists must meet standards of proficiency and commit to undertake continuing professional development (CPD) activities. HPC registration renewals occur every two years. BAPO has devised a members' CPD programme, organising relevant workshops and seminars to help keep skills updated.

Skills and Personal Qualities Needed

Prosthetists/orthotists need to be:

• Good at science, particularly human biology and physics.
• Technically minded and practical, with good manual dexterity.
• Patient and sensitive and caring towards patients and their families.
• Creative, with good problem-solving ability.
• Resourceful and able to use initiative.
• Accurate, with an eye for detail.
• Good communicators and listeners.
• Good working in a larger team alongside other medical practitioners.
• Confident using IT.

Your Long Term Prospects

Skilled, experienced prosthetists/orthotists may progress to positions of more responsibility. Career development opportunities include moving into management roles or specialising in a particular area of clinical work. Teaching or research and development are also options.

There are opportunities to work overseas, particularly in the USA. Opportunities also exist with voluntary organisations, such as the Red Cross, particularly in communities affected by the consequences of war.

Get Further Information

British Association of Prosthetists and
Orthotists (BAPO), Sir James Clark Building,
Paisley PA1 1TJ
Tel: 0845 166 8490
Website: www.bapo.com

Health Professions Council (HPC),
Park House, 184 Kennington Park Road,
London SE11 4BU
Tel: 020 7582 0866
Website: www.hpc-uk.org

International Society for Prosthetics
and Orthotics (ISPO)
Website: www.ispoint.org

Limbless Association,
Queen Mary's Hospital,
Roehampton Lane, London SW15 5PN
Tel: 020 8788 1777
Website: www.limbless-association.org

National Centre for Prosthetics and Orthotics,
University of Strathclyde (Engineering Faculty),
Curran Building, 131 St James' Road,
Glasgow G4 0LS
Tel: 0141 548 3433
Website: www.strath.ac.uk

New Generations
Website: www.newgenerations.org.uk

NHS Careers
Tel: 0845 60 60 655
Websites: www.nhscareers.nhs.uk and www.jobs.nhs.uk,

Skills for Health, Goldsmiths House,
Broad Plain, Bristol BS2 0JP
Tel: 0117 922 1155
Website: www.skillsforhealth.org.uk

University of Salford,
School of Health, Sport and Rehabilitation Sciences,
Allerton Building, Frederick Road Campus,
Salford, Greater Manchester M6 6PU
Tel: 0845 234 0184
Website: www.healthcare.salford.ac.uk/prosthetics

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