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[October 2006] Medical Engineering covers a broad field which not only makes it a very interesting area of work but can also lead to it not being clear exactly what being a Medical Engineer involves. This article focuses on the facet that is clinical work through interviews with Bioengineers about their backgrounds, their current job and what it is like to be a Bioengineer. The answers from the engineers below serve to illustrate this aspect of Medical Engineering and what a rewarding job it is.

Ben Cox is a Clinical Bioengineer in Edinburgh and Jemma Newman, is a
Clinical Bioengineer working for the Electronic Assistive Technology Service in Dundee.

What was your route to your current career?

Ben - Following the completion of my A-levels in Physics, Mathematics and
Creative Design, I spent a year travelling the world before commencing my
Undergraduate at Cardiff University (BEng Integrated Engineering). It was here during my final year that I discovered the application of engineering to healthcare and have never looked back. I decided to pursue further study, which led me to the University of Leeds to do a Masters (MSc Medical Engineering and Biomechanics) and to subsequently take up a research position in order to complete a PhD with a special interest in orthopaedics.

Jemma - Undergraduate Degree in Medical Engineering followed by NHS
Clinical Scientist Part I training (including an MSc in Medical Physics and Clinical Engineering, and a DipIPEM). Currently undertaking NHS Clinical Scientist Part II training.

What is your current job?

Ben - I currently work as a Clinical Bioengineer in the fields of gait analysis,
biomechanics and postural management. I am based in Edinburgh at the NHS SMART Centre (Southeast Mobility and Rehabilitation Technology), which is responsible for the management and delivery of Mobility, Prosthetics and Bioengineering Services for over 20% of Scotland's population. My clinical role is to provide input to the gait analysis laboratory and the adult special seating service for wheelchair users, however I am also actively involved in the centre's research and teaching commitments.

Jemma - Clinical Engineer for the Electronic Assistive Technology Service in Dundee.

Can you describe a typical day?

Ben - It is very difficult to describe a typical day in this job, although for me that is one of the key attractions to it. Of the patients that are referred to SMART, I will see those with conditions that affect their walking patterns and also those with conditions that affect their ability to sit correctly, comfortably and safely. Such conditions include cerebral palsy, muscular dystrophy, poliomyelitis, multiple sclerosis, motor neurone disease, CVAs, spinal cord lesions and traumatic brain injury. During a gait analysis clinic I normally work with one or two physiotherapists to make a detailed examination of limb movements and muscle actions as a patient
is walking. In order to do this we use a three-dimensional movement analysis system to follow the position of markers attached to the patient as they walk. At the same time the forces transmitted from the foot to the floor are measured by a force plate. We combine these data using specialist software to construct a model of the patient's musculo-skeletal system. Following analysis of this model a meeting with a consultant neurologist or orthopaedic surgeon is held to discuss appropriate therapy, surgery or other methods of treatment. If a patient is referred for special seating, the first and most crucial stage of the process is to make a comprehensive assessment of the patient's seating needs and abilities. During a clinic I will attempt to ascertain these through discussion with the patient, their carers, therapists, nurses and medical staff. If a patient is at risk of
developing pressure sores, I will use a pressure map to objectively evaluate the effect of different supports and positions. Following the assessment, I will produce a report and specification which may then be used to produce engineering drawings for the components of the seating system which need to be manufactured. Where standard components are not sufficient for an individual patient's needs I will specify modifications or produce a new design. A follow-up clinic is usually arranged for the patient to try out the seating and make any necessary changes.

Jemma - I don't really have a typical day, my day can involve assessments,
installations, repairs, modifications etc. These are generally for Environmental Control Systems but I also do special power chair controls, computer access, mountings for communication aids and am beginning to receive training on smart technology. There is also the mountain of work involved in co-ordinating between social services, housing associations, charities, wheelchair service, occupational therapy etc involved in installing and maintaining systems. I also do a fair amount of training on the systems, this can range from the patient and their carers, to therapists and people with limited knowledge of the technology through to technicians.

Why do you enjoy or why did you want to do medical engineering / rehabilitation engineering?

Ben - I was drawn to the field of Medical Engineering by the prospect of directly improving people’s quality of life. Having been involved in orthopaedic research, I became aware of the need for further research and development in Rehabilitation Engineering and was therefore inspired to pursue a role in this field. I enjoy the variety of work, the opportunity to forge productive relationships with other healthcare professionals and the experience of meeting patients, their families and carers. Recent changing attitude towards mobility and rehabilitation inspired me to be involved in Rehabilitation Engineering and I believe it provides a unique environment in which to work as an engineer.

Jemma - I enjoy the fact I meet a patient at that start and am actively involved in designing, installing and testing the solution. It is a basic engineering technique but this is applied to people which is very rewarding. It is also nice to see the difference the technology can make when issued correctly. I also like the fact the solution needs to be dynamic, the needs of an individual change over time and as such the equipment needs to be versatile to cope with this.

Many thanks to Ben and Jemma.

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