Perfusionist

The Job and What's Involved

Clinical perfusionists are the highly skilled professionals who manage heart-lung equipment during open heart operations.

Heart-lung equipment pumps blood around the body in place of the patient's own heart, and oxygenates the blood and removes excess carbon dioxide in place of the patient's lungs. This allows the surgeon to perform the operation on the patient's heart in a controlled way.

Perfusionists are responsible for setting up the highly sophisticated mechanical and electronic machinery.

During surgery, they control the machines that pump blood around the patient's body and replace carbon dioxide with oxygen in the patient's bloodstream.

They are responsible for monitoring the patient's condition throughout the operation, which involves interpreting and managing blood gases and blood chemistry.

There are at least 33,000 open heart operations performed in Great Britain and Ireland each year, and each of these procedures requires the expertise of the perfusionist. These operations can vary from heart valve repair or replacement, and coronary artery bypass graft surgery, to heart and heart-lung transplants. The age of the patient can vary from adults to the newborn who may have been born with malformations of the heart and require corrective cardiac surgery.

Perfusionists also work in intensive care units, where they are responsible for the machinery that supports the blood circulation of critically ill patients. They are also involved in a technique called isolated limb perfusion, a method of treating malignant skin cancers, and liver transplant operations.

The perfusionist is an integral part of the cardiac surgical team, made up of the surgeon, anaesthetist, theatre nurses, operating department practitioners and cardiology technicians.

Some perfusionists are engaged in research into improving techniques and applying them to new treatments.

Perfusionists generally work 37.5 hours a week, which includes shifts, evenings and weekends. They may sometimes have to work overtime and be on call for emergencies. Some qualified perfusionists work part time.

Perfusionists spend most of their time in operating theatres, recovery rooms and intensive care units. These areas are light and need to be kept scrupulously clean and free from germs. Perfusionists may stand for long periods. They wear protective clothes during operations.

Trainee perfusionists normally start on around £20,000 a year. Staff working in and around London are paid extra. Salaries in the private sector may be higher.

Getting Started with this Career Choice

The number of perfusionists is gradually increasing. There are currently about 350 qualified perfusionists in the UK. They work in hospitals with perfusion units. There are 40 of these units within the NHS and others in private hospitals.

Competition for trainee vacancies is intense, but less so for positions for qualified perfusionists. Vacancies are advertised in The Perfusionist journal, New Scientist, on www.jobs.nhs.uk and on the website of the Society of Clinical Perfusion Scientists of Great Britain and Ireland.

People interested in this type of work may be able to arrange a visit to their nearest perfusion unit. A list of hospitals with perfusion units can be obtained from the Society of Clinical Perfusion Scientists.

Education and Training

Entry to this work is normally with a degree or postgraduate degree in a relevant life science (usually biological, biomedical or clinical sciences). Degrees in other subjects such as chemistry or physical science may be appropriate if accompanied by relevant clinical experience.

Entry to a first degree in life sciences is with at least two A levels in science subjects (biology and chemistry being the most useful), plus five GCSE's (A*-C), including English and maths. Alternative qualifications may be accepted, such as a BTEC National Diploma/Certificate in science.

Entry requirements vary widely so it is important to check with individual institutions. Courses usually last three years full time, or four years where one year is spent gaining practical experience.

A Few More Exams You Might Need

The first step in training is to obtain a post as a trainee in a hospital perfusion unit. Trainees work under supervision, while studying part time for a one-year postgraduate certificate in clinical sciences (perfusion), followed by a one-year diploma, both at North East Surrey College of Technology (NESCOT). Study is by block release and combines college-based and work-based modules.

To become a qualified perfusionist it is necessary to have:

• Successfully completed the postgraduate diploma in clinical sciences (perfusion).
• Been employed as a trainee clinical perfusion scientist for at least two years.
• Carried out a minimum of 150 clinical cardio-pulmonary bypass procedures as a primary clinical perfusion scientist under direct supervision.

On successfully completing the postgraduate diploma, perfusionists are accredited by the Society of Clinical Perfusion Scientists. They must then register with the College of Clinical Perfusion Scientists before they can work unsupervised.

Advanced qualifications, such as an MSc in perfusion science, are helpful for career progression.