Key duties of surgical technologists include:

1. Prepare the operating theater before surgical procedures by mixing solutions, sterilizing all instruments and arranging them on the table for surgeons and nurses, and ensuring that all needed equipment is operating properly.
2. Prepare patients for surgical procedures by washing, sterilizing and shaving appropriate areas of the body.
3. Transport patients to the operating theater and placing them on the table in the correct position, and covering them with sterilized sheets.
4. Monitor patient vital signs such as heart rate and blood pressure during the procedure and assist the operating team to put on sterilized gowns, caps and gloves.
5. During surgery, they hand needed instruments and other items to the surgeon(s) and nurse(s), cut and sutures, and keep track of such supplies as sponges and needles.
6. Prepare and deliver laboratory specimens for analysis by laboratory clinicians.
7. Depending on level of experience, surgical technologists may prepare surgical dressings and operate suction and diagnostic equipment.
8. After an operation, surgical technologists clean and sterilize the operating room, transport patients to recovery area, and replaced surgical supplies.

Certified surgical techs may also work as surgical first assistant. Under the supervision of a surgeon, the surgical first assistant, as defined by the American College of Surgeons (ACS), helps ensure hemostasis by controlling blood flow and stopping hemorrhage, aids in prevention of infection, and performs other technical assistance to help promote a safe and hygienic operating environment.

A surgical first assistant may also talk with patients prior to surgery to advise them of the procedure, prepare patients for surgery, assist in administering anesthesia, and create a written record of the operation.

Career Outlook

According to the U.S. Bureau of Labor Statistics, the rate of growth in this career field is expected to be 25 percent through 2018. This represents a much faster rate of growth than for most other occupations as the number of surgeries being performed across all specialties increases.

The rise in the number of surgical procedures primarily arises from the continuing growth of the Baby Boomer and senior segment of the population. Both demographic groups have traditionally required a greater number of surgical procedures due to a variety of chronic and acute medical conditions.  In addition, advances in medical technology, such as the use of lasers and fiber optics, mean that many more surgical procedures are being performed on an outpatient basis making them accessible to larger numbers of people. Even so, hospitals continue to employ the largest number of surgical technologists.

Education and Training

Training to become a surgical technologist is available from two-year community and junior colleges, private vocational schools, as well as hospital-based programs. Two agencies accredit programs in surgical technology: The Commission on Accreditation of Allied Health Education Programs (CAAHEP) and the Accrediting Bureau of Health Education Schools (ABHES).

Programs may last from 9 months within private vocational schools and up to 24 months in community and junior colleges. The time difference is accounted for by the fact that private vocational schools focus exclusively on technical coursework while students in community and junior colleges will also need to complete a liberal arts component during the first year of attendance.

Coursework in both private schools and community/junior colleges will include anatomy and physiology, microbiology, chemistry and organic chemistry, clinical pharmacology, medical terminology, medical ethics (e.g. patient confidentiality) and psychology. Other topics include patient safety, sterilization techniques, infection control, surgical procedures and how to properly handle all surgical instruments and equipment.

View a list of schools in Texas offering surgical tech programs >

Licensing and Certification

Certification by the National Board of Surgical Technology and Surgical Assisting

As per the National Board of Surgical Technology and Surgical Assisting, (NBSTSA) certification is not currently required to work as a surgical technologist in the state of Texas.  However, most employers prefer to hire surgical technologists who are certified as it raises the standards of the profession.

Technologists may pursue voluntary certification as either a Surgical Technologist or Surgical Technologist First Assistant through the NBSTSA after having graduated from a training program that has been approved by the CAAHEP or ABHES and passing the national certification examination. Once these requirements have been met, technologists may use the Certified Surgical Technologist (CST) or Certified First Surgical Assistant (CFSA) designation.

For more information on eligibility requirements, fees, and applying to sit for the CST exam and exam details visit http://nbstsa.org/examinations-cst.html.

Full details regarding eligibility criteria to become a Surgical First Assistant (CFSA) may be found at http://nbstsa.org/examinations-csfa.html#fees

To maintain certification, surgical technologists will need to satisfactorily complete 60 hours of continuing education over a 4-year period or retake and pass the national certifying exam at the end of 4 years.

Certification by the National Center for Competency Testing

An alternative pathway is to obtain certification by passing an examination administered by the National Center for Competency Testing (NCCT). You may qualify to test via four separate routes, each requiring a high school diploma.

1. Graduation for an NCCT-approved surgical technologist training program within the past 10 years plus satisfactory completion of required practicum hours;
2. Completion of a hospital-based surgical technologist training program in addition to 1 year of “qualifying experience within the past 2 years” or 4 years of part time experience.
3. Seven (7) years of qualifying experience as a surgical technologist within the past 10 years;
4. Current licensure as a physician (MD), physician assistant (PA), registered nurse ((RN), licensed practical nurse (LPN) with significant “scrub experience.”

For complete information on eligibility, fees, application procedure refer to the Surgical Technologist Certification brochure, which can be downloaded from this webpage: http://www.ncctinc.com/Certifications/.

Salaries of Surgical Techs

Median Earnings of surgical technologist in select regional areas. Figures as per Salary.com June 2011.

View a list of schools in Texas offering surgical tech programs >

Specific job responsibilities vary among the four specialty areas: public accounting, management accounting, government accounting, and internal auditing. The most popular career is that of public accountant who performs a range of accounting, auditing, tax, and consulting work on behalf of clients. Some public accountants specialize in tax issues and advise corporations and individuals regarding tax advantages and disadvantages of various financial decisions. Other public accountants concentrate on auditing financial records of both companies and individuals to ensure they have been properly completed. Many public accounts are Certified Public Accountants (CPAs) and generally have their own practice or work for public accounting firm.

An interesting specialty within the field of public accounting is that of forensic accounting which involves the investigation and analysis of white-collar crimes such as securities fraud, embezzlement, bankruptcies. Forensic public accountants combine their knowledge of finance principles with law and investigation methods to determine whether illegal activity has occurred. Many forensic accountants work closely with law enforcement personnel and prosecutors during investigations and frequently provide testimony at trial.

Management accountants analyze the financial information of the companies for which they work. They perform budgeting, cost analysis, and asset management.

Government accountants work within the public sector and examine the financial records of government agencies and auditing companies and individuals who are subject to government regulation and taxation. Those employed by the Federal Government may work for the Internal Revenue Service (IRS).

Internal auditors verify internal controls of financial information and monitor financial mismanagement. They also evaluate their company’s management procedures, internal quality assurance controls to ensure that all financial records are accurate.

Technology has changed the nature of an accountant’s work. With the introduction of special financial software, accountants are able to summarize financial information in standardized formats.

Career Outlook

In an industry report, the Texas Workforce Solutions agency published data showing an average yearly increase of 2.6 percent in the employment of accountants in the state. This comes as no surprise since the companies primarily responsible for this healthy employment picture are technical and scientific corporations doing business with the many oil and gas exploration outfits in the state. Forensic accountants may find employment with the Federal Reserve Bank located in Dallas. Accountants familiar with the regulations of the International Financial Reporting Standards are needed to monitor global operations of such major companies as Marathon Oil and engineering giant URS Corporation.

As per Texas Workforce Solutions other employers include:

Fortune 150/Global 500 petroleum refining company, Tesoro Corporation, which is headquartered in San Antonio, and industrial hygiene services company, ALS Environmental, with offices in Houston, both employ environmental accountants and auditors. The proliferation of oil and natural gas exploration in Texas necessitates the services of these specially trained professionals to help ensure compliance with environmental regulations so as to avoid EPA fees that could otherwise work to erode the bottom line.

Education of Accountants

Most accountants, regardless of specialty, will need to possess at least a bachelor’s degree in accounting or finance. Many employers prefer candidates with a masters degree in business administration with a concentration in accounting or finance.

Coursework for a bachelor’s degree in accounting will include basic accounting, management accounting, business law, economics, financial statement analysis, marketing, management, and statistics. Some of these courses may be transferred from an associate’s degree program. Many students interested in becoming an accountant first purse an associate’s degree in accounting which will enable them to work as bookkeepers,  accounts payable clerk accounts receivable clerks and auditing clerks thereby gaining valuable experience in the field.

View schools in Texas offering programs in Accounting >

Certification and Licensure

Many public accountants choose to pursue the CPA credential to enhance their marketability and earnings potential. The CPA credential is also necessary for any accountant who files reports with the Securities and Exchange Commission (SEC).

The Texas State Board of Accountancy grants licenses to those interested in becoming Certified Public Accountants (CPAs). In accordance with the Uniform Accountancy Act, CPA candidates must possess at least a bachelor’s degree with a total of 150 semester hours of college credit, a minimum of one year of experience as a public accountant, and passing scores on the Uniform CPA Exam.

The required 150 hours includes the following coursework (applicable to all states):

• 36 semester hours or 54 quarter hours in such accounting specific courses as Taxation, Information Systems, Auditing, Financial, Cost and Managerial Accounting.
• 39 semester hours or 58 quarter hours in general business courses including 6 semester hours or 8 quarter hours in business law. One of these courses may be completed during your freshman or sophomore year but the second must be an upper division course.
• 12 semester hours or 18 quarter hours of upper division accounting coursework and 15 semester or 22 quarter hours of upper division general business courses.
  • A maximum of 9 semester hours or 13 quarter hours of computer courses and 6 upper division semester hours or 8 quarter hours of statistics courses can apply toward the general business course requirement.
  • A maximum of 3 semester or 4 quarter internship hours can be applied to the 36 semester hour requirement for accounting courses. Other internship hours may be applied to the general business hour requirement.

Other Certifications

The Institute of Management Accountants confers the designation Certified Management Accountant (CMA) to those candidates who possess a bachelor’s degree and attain a passing score on the Graduate Record Admission Test (GMAT). Applicants must have worked at least two years in management accounting, pass a four part exam, and meet continuing education requirement.  Te exam covers such topics as financial statement analysis, working-capital policy, capital structure, valuation issues, and risk management.

The Institute of Internal Auditors confers the Certified Internal Auditor (CIA) designation to those who have graduated from accredited colleges and have a minimum of two years experience and have passed a four-art exam.

Salary Information

Texas Workforce Solutions shows that the median annual salary for accountants in the state is $58,186 as of May 2009 (the latest date for which data is available). An entry level accountant working in the field of taxation can start at about $39,042 while an experienced accountant or CPA may earn approximately $79,156. Texas Workforce Solutions shows that accountants who are employed as financial managers and purchasing managers earn the highest median salaries in the state at $102,847 and $100,442 respectively.

Career Overview

Dental assistants play a support role and perform general office duties within a private dental office or the dental department of healthcare facilities. The responsibilities of dental assistants are diverse as they become involved with direct patient care, laboratory testing, as well as routine clerical tasks.

General Responsibilities of Dental Assistants:

• Prepare patients for dental examination and arrange instruments.
• Provide chair-side assistance to the dentist during examinations (e.g. handing instruments to the dentist and using suction and other devices to keep the patient’s mouths dry)
• Wash and sterilize or dispose of dental instruments and equipment after use.
• Record patient dental history and create/update/maintain patient charts.
• Educate patients with regard to proper oral hygiene and preventative dental care.
• Prepare materials to fill cavities and make dental impressions.
• Place dental dams to separate teeth for examination and/or x-rays.
• May take and develop dental X-rays under the supervision of the dentist. As per the Texas State Board of Dental Examiners (SBDE), “You are permitted to make x-rays in Texas for one year from the first day of being hired as a dental assistant under the direct supervision of a dentist.  During this first year of employment you will want to consider taking one of the Dental Board-approved courses listed below to continue making x-rays in your 2nd, 3rd and future years of service as a dental assistant.”
• Administer topical anesthetics to gums in preparation for root canal and other procedures and remove post-surgery sutures. .
• Administers cavity-preventative materials to teeth, and removes excess dental cement used to fill cavities.
• Administrative responsibilities may include scheduling patients appointments, creating and sending patient bills to insurance carriers, receive and record payments, and order needed office and dental supplies. .
• Dental assistants who are given laboratory duties make casts from dental impressions and create temporary crowns.
• Many states are now registering dental assistants who are then provided with additional responsibilities, such as polishing teeth and restorative procedures cavity fillings or root canal. For full details regarding the job duties that registered dental assistants  (RDAs) may perform in Texas, refer to “Regulation of Dental Assistants” guidelines.
• For an overview of Dental Assistant Rule and Regulations visit the  Texas State Board of Dental Examiners/Dental Assisting Laws and Regulations.

Career Outlook

As per the U.S. Bureau of Labor Statistics, the rate of growth is expected to be 36 percent through 2018, a rate that is much faster than that for most other occupations.  There are two primary factors for this rate of growth: 1) increase in population size with an accompanying increase in the demand for dental services so that dentists need to hire assistants to perform routine tasks; 2) greater emphasis on overall preventative health  care, including dental care, by all age groups.

Education of Dental Assistants

According to the Commission on Dental Accreditation, there are no formal education requirements to become an entry-level dental assistant in any state and many dental assistants continue to be trained on-the-job.  In these situations, the supervising dentist, dental hygienist, or senior dental assistant teach needed skills such as dental terminology, dental procedures, chairside assistance, recording patient histories, setting up patient charts, scheduling patient appointments and other office tasks. It may take a new dental assistant three to four months to become fully versed about job duties and able to work without constant supervision.

If you are a high school student with an interest in becoming a dental assistant, it is recommended that you take courses in biology, chemistry, mathematics, computers, and psychology.

For those wishing to pursue training in the field, The Commission on Dental Accreditation (CODA) of the American Dental Association accredits nearly 300 programs throughout the country. Most programs combine classroom study, laboratory work, and instruction in dental assisting practice and theory.

View a list of dental assisting programs in Texas >>

Coursework will include fundamentals of dentistry, dental pharmacology, dental office procedures, dental anatomy and physiology, clinical dental procedures, and dental equipment.

Programs within private vocational schools take about one year to complete and graduates will be awarded a certificate or diploma. Two year programs are offered in community and junior colleges and lead to an associate in science (A.S.) degree. Entry to either a certificate or associate’s program requires either a high school diploma or general equivalency diploma (GED).

Even those who have graduated from accredited training programs will participate in some type of formal on-the-job training or have previous experience.  This training is necessary because dentists have varying work styles, office procedures, and methods of patient relations. Because of continuing advances in technology, dental assistants will also need to be kept current with regard to new equipment, instruments, and procedures.

Licensure and Certification

According to the Texas Board of Dental Examiners there are three levels of dental assistants:

“Qualified Dental Assistant” is a dental assistant who has received on-the-job training or instruction through a dental assisting school.  There is no credential for this level of training or instruction.

“Registered Dental Assistant” is a dental assistant who has successfully completed the state-level registration process with the SBDE (State board of Dental Examiners).  Dental Assistants who successful register and have been issued a Dental Assistant Registration Certificate by the SBDE may use the credential “Registered Dental Assistant” or “RDA”. Registration is required for those dental assistants who wish to take and develop X-rays.

“Certified Dental Assistant”  is a dental assistant who meets the education and/or experience prerequisites established by the Dental Assistant National Board (DANB). Experiential requirements are typically 2 to 4 years experience as a dental assistant on either a full or part time basis. Candidates must also passes the DANB Certified Dental Assistant (CDA) Examination (including Radiation Health and Safety (RHS), Infection Control (ICE) and national-level General Chairside (GC) component(s), is currently CPR-certified and continues to maintain the CDA credential by meeting DANB requirements.  Dental Assistants who complete this process may use the credential “Certified Dental Assistant” or “CDA.” The designation Certified Dental assistant is required for those who wish to perform radiologic procedures

Aside from higher salaries, certification will enable dental assistants to earn higher salaries and be eligible for such career advancement opportunities as a dental office manager, instructor in training programs, dental products sales representative, or claims processor/adjuster with health insurance carriers. Dental assistants may also return to school to become dental hygienists and be eligible for a much broader range of clinical patient care.

Steps in applying for the Certification Exam through DANB:

1. Complete the application and mail or fax to DANB with all required documentation along with the fee of $375.00. Your training program’s DANB certification number is to be recorded on the application.
   • For those students who are still attending their training program but scheduled to graduate within 90 days of test date, you may submit a letter attesting to upcoming program completion on official school stationary signed and dated by the program director.
   • Graduates of accredited programs are required to submit a copy of their final transcript or diploma.
2. Current CPR certificate
3. DANB will review once all documentation has been received. You will receive notice in about three to four weeks from the date you submit your application and supporting paperwork. If you are approved to sit for the exam DANB will send you a “Test Admission Notice” which will be necessary in order to register and enter the testing site.
4. Schedule the location, date, and time of the exam through the Pearsons Vue the DANB testing vendor. Specific instructions to register for the test will be sent with the “Test Admission Notice.”
5. Once you have completed the test you will be provided with unofficial score report subject to review by DANB.
6. DANB will mail the official score report about 3 to 4 weeks after the exam date.

Texas Dental Assisting Salaries

Earning of/Dental Assistant in select Texas cities. All figures as per Salary.com August 2011.

View a list of dental assisting programs in Texas >>

Career Overview

The specific duties of a medical assistant may vary from office to office depending on the size of the practice and physician specialty. In smaller offices, medical assistants may be responsible for both administrative and clinical tasks and typically report to the physician, office manager, or head nurse. Those employed by larger practices usually specialize in a specific area, under the supervision of department mangers.  It is important not to confuse medical assistants with physician assistants who are eligible to perform patient examinations, diagnose illness, and treat patients under the supervision of a licensed physician.

Administrative Medical Assistants primarily perform office support functions to include updating patient records, completing insurance forms, coordinating hospital admissions, scheduling patient visits, as well billing and bookkeeping.

Clinical Medical Assistants have varied responsibilities. Common tasks include recording patient histories, taking vital signs, explaining treatment procedures, preparing patients for physical examinations, and assisting the clinician during the exam. Other duties include:

• Collect and prepare laboratory specimens.
• Laboratory testing under the supervision of a physician or physician assistant.
• Dispose of contaminated equipment.
• Instruct patients in the proper use of medications and special dietary plans.
• Prepare and administer medication and telephone drug orders and refillsto the pharmacy.
• Draw blood and prepare patients for X-rays.
• Record electrocardiograms.
• Remove sutures and change dressings.
• Arrange medical instruments for patient examination.

Ophthalmic medical assistants, optometric assistants, and podiatric medical assistants perform additional duties to those noted above.

Ophthalmic assistants help ophthalmologists provide eye care by:

• Performing diagnostic eye tests, measuring and recording visual acuity, and testing eye muscle strength.
• Applying eye dressing and administering eye drops and salve.
• Maintaining optical equipment and instruments, and assisting the ophthalmologist during surgery.

Optometric assistants:

• Provide chair-side assistance to optometrists during eye exams.
• Instruct patients in the use of contact lenses and care.
• Perform preliminary eye chart exams.

Podiatric medical assistants create castings of feet, expose and develop X-rays, and may assist podiatrists in surgery.

Career Outlook

According to the U.S. Bureau of Labor Statistics, the employment of medical assistants is expected to grow at a rate of 34 percent from 2008 through 2018, much faster than the rate for all other occupations. There is an increased need for healthcare workers at all levels due to the advances in technology combined with the aging of the population and rising need for medical care. The increased prevalence of obesity and diabetes will also result in an increased demand for healthcare services within private physician offices.

Education and Training Requirements

According to Don Balasa, Executive Director and Legal Counsel for the American Association of Medical Assistants (AAMA), there are no mandatory educational requirements to become a medical assistant in Texas with many entry level candidates being trained on the job in private medical offices. However, Mr. Balasa, states that “increasing numbers of employers prefer to hire medical assistants who have graduated from a CAAHEP or ABHES accredited medical assisting program and who have the CMA (AAMA) credential.”  Graduating from an accredited training program can result in a greater number of employment opportunities with higher starting salaries and advancement opportunities.

Medical assisting programs are offered at private vocational schools, as well as junior and community colleges. Programs typically last one year and include coursework in anatomy and physiology, medical terminology, computer skills, office management, accounting, and insurance claims processing.  Students will also learn clinical and diagnostic procedures, laboratory techniques, basics of pharmacology, and first aid.  Most programs offer an internship experience that provides real-world experience in private medical offices or other healthcare facilities.

There are two agencies that provide accreditation to medical assisting training programs: the Commission on Accreditation of Allied Health Education (CAAHEP) or the Accrediting Bureau of Health Education Schools (ABHES). Graduates of accredited programs are eligible to sit for the Certification exam administered by the American Association of Medical Assistants (AAMA).

View a list of medical assisting programs in Texas.

Certification as a Medical Assistant

As per the Mr. Balasa of the AAMA “medical assistants are not licensed in Texas or in almost any other state.”However, as noted  although certification is not required to enter the field of medical assisting, a large majority of job opportunities in Texas will require that you possess this credential. You may obtain certification through the American Association of Medical Assistants (AAMA).

Certification process with AAMA:

As per the AAMA the Certified Medical Assistant (CMA) designation is the “gold standard” of the profession which confers increased prestige among your colleagues, along with enhanced job opportunities and job security.

1. Must be a graduate of a medical assistant program accredited by either the CAAHS or ABHES.
2. Apply to sit for the certification exam administered by the National Board of Medical Examiners by completing an application and submitting all required documentation.
   1. If you are a recent graduate the only documentation required is a verification letter from school director attesting to your graduation from the program.
   2. Non-recent graduates (over 12 months) will need to supply an official transcripts showing program completion.

The exam consists of 200 multiple choice questions of which 180 will be scored, the remainder being in the pre-test phase. These pre-test questions are spread throughout the exam so you will not be able to identify them. You can read the exam handbook which provides complete details about test construction and testing sites by visiting:

http://www.aama-ntl.org/resources/library/ExamApp.pdf

1. Pay the certification exam fee. This fee is $125. for members of AAMA, CAAHEP or ABHES. All others pay $250. Personal checks are not accepted.
2. The certification department of AAMA will notify you of your application status within a 30 day period.
3. Schedule an appointment to take the exam after your application has been approved. You will receive a testing schedule permit that will allow you to make an appointment at a Prometric test center in your area. The exam is given on a rolling basis and may be taken at any point during the year.
4. Review the Content Outline for the exam and take the practice test.  You can also take a review CMA review course offered by a local chapter of the AAMA. The Texas chapter may be found at http://www.tsma-tx.org/.
5. Once you pass the exam you will receive an official certificate and wallet-size card to attesting to possession of the CMA credential.  Potential employers will also be able to verify your certification via the AAMA Web site.
6. You are required to recertify every 60 months. You can do so by passing another exam or by participating in continuing education. For further details regarding recertification, visit http://www.aama-ntl.org/recertified/faqs_recertification.aspx

Career Advancement

Medical assistants may advance their careers through additional training or experience. Some medical assistants go on to teach medical assisting in vocation schools or community colleges. Others choose to return to school to work in some other healthcare capacity such as nurses, physical therapists, even physician assistants. Administrative medical assistants can advance into position of office manager and have responsibility for office operations, as well as supervision of other support staff.

Salary of Medical Assistants

The following provides median entry level salaries for medical assistants in select Texas cities:

Source: Salary.com, June 2011

View a list of medical assisting programs in Texas.

Career Overview

Paralegals have assumed many of the duties that were once the sole responsibility of attorneys. However, they are still explicitly prohibited from providing legal advice, setting fees, or representing clients in court.

The specific job duties of a paralegal will vary depending on the type of legal setting in which you work. Below is a brief description of the two most common practice areas.

Corporate Paralegals

Corporate law offers a wide variety of sub-specialties, such as patents and trademarks, copyright, entertainment law, banking, and securities, among others.

Partial list of responsibilities:

• Assist in the preparation of contracts;
• Draft corporate resolutions, shareholder reports, and annual financial reports;
• Prepare documentation for mergers and acquisitions;
• Review and monitor government regulations to ensure compliance;
• Assist with dissolution of businesses;
• Maintain calendar of quarterly and annual shareholder meetings;
• Prepare notices of incorporation.
• Draft buy/sell contracts, leasing agreements, and promissory notes for business loans

Litigation Paralegal

There are also several subspecialties within the area of litigation law: family law, criminal law, medical malpractice, employment law, bankruptcy and torts (product liability).

Specific responsibilities include:

• Analyze legal documents and maintain case files;
• Collect and analyze evidence for use at agency hearings or trial;
• Help prepare witnesses for testimony;
• Conduct research of case law in preparation for trial using such legal databases as Lexus and Nexus, as well as review of legal articles in practice area journals.
• When authorized by state law, may represent clients at administrative hearings (e.g. housing court).
• During trial, paralegals may assist with developing legal arguments, draft pre-trial motions, obtain witness affidavits, and organizing evidence files so they are easily accessible to attorneys.

Other areas include real estate law where paralegals may prepare mortgage and closing documents for both residential and commercial properties, and represent clients at property closings. Paralegals working in the field of probate law help clients prepare wills, become involved with property transfers, and perform asset verification.

A career as a paralegal is an excellent choice for those interested in pursuing a legal career but don’t wish to pursue a law school degree. Paralegals have become essential members of the legal team, enjoying competitive wages and a career offering diversity and challenge.  Those with several years experience may be promoted to Senior Paralegal, performing traditional paralegal duties, along with office management and supervision of junior paralegals.

If law school is in your plans, working as a paralegal is also an excellent stepping stone as it provides you with exposure to many practice areas so you may decide which interests you the most. Depending on your employer, you may also be eligible to have at least part of your law school tuition paid for by the firm in which you work!

Work Environment

The majority of paralegals are employed in law firms, corporate legal departments, and government agencies.  Most work is performed in office environments or law libraries.  Paralegals typically work a 40 hour week but may be required to put in significant overtime in preparation for trials.

Job Outlook

Employment of paralegals is expected to grow by 28 percent through 2018, which represents a much faster than average rate of growth.  This growth arises from the needs of employers to reduce legal costs, as well as the expanding specialties of environment law, health care law/medical malpractice, and elder law. The emergence of pre-paid legal plans should also contribute to the rising demand.

Paralegal Education and Training Requirements

While there is no mandatory education requirement to become a Paralegal in Texas, the majority of candidates now entering the field possess at least an associates or certificate in Paralegal Studies. Programs are also offered at the bachelor’s level.

It is to your benefit to attend a program accredited by the American Bar Association (ABA) as these programs have met strict quality-based guidelines with regard to curriculum, materials, and internship experiences.

View a list of paralegal schools in Texas.

Associate degree programs in paralegal studies

Associate degree programs are offered by two-year community and junior colleges. The curriculum includes general liberal arts study, electives, along with paralegal-specific coursework.  In most cases, an associate’s program will prepare you to work as a generalist in the field. You will receive instruction in such areas as introduction to the paralegal profession and law, methods of research, torts, business law, estate planning, criminal law, family law, and real estate.

Upon graduation you will receive an Associate in Science or Associate in Applied Science degree.

Baccalaureate programs in paralegal studies

Several colleges and universities in Texas have developed four-year programs in Paralegal Studies. Courses taken during the final two years of study in a bachelor’s program are more in-depth and advanced than is the case with associate’s programs and allow students to develop a specialization in one or more legal areas. Some programs also include coursework in the management of a law office.

Graduates of Bachelor’s Paralegal programs typically earn a B.S. or B.A. degree. Paralegal programs may be found under the umbrella of different departments, such as Political Science, Business, or Criminal Justice.

Certificate programs in paralegal studies

Certificate programs are offered by community colleges, 4-year institutions, and private schools. Certificate programs are geared toward those who hold either an associate’s or bachelor’s degree in a different field of study. Coursework is similar to that of an associate’s degree with specializations offered in business law, litigation, real estate, and estate planning.

Certificate programs may be completed on an accelerated schedule, usually within four months of full time study but up to two years for those attending part time. Part time schedules are flexible with courses often available during evenings and weekends, as well as during the summer session.

Internships

Many paralegal programs offer an internship experience as part of the curriculum. The internship permits students to gain “real-world” experience in a variety of settings, including private law firms, corporate law departments, government agencies, and legal aid organizations.

For a list of ABA approved paralegal programs in Texas visit: http://apps.americanbar.org/legalservices/paralegals/directory/tx.html

Paralegal Certification

As per the Texas Board of Legal Specialization (TBLS), Texas has no mandatory certification requirements for paralegals. This is primarily due to the fact that regulatory laws are designed to protect consumers and paralegals do not work autonomously with consumers but are under the supervision of attorneys. However, most paralegals do pursue voluntary certification to enhance their employability and be recognized by employers as having a certain level of expertise in the field.

The National Association of Legal Assistants (NALA) has established standards for the certification of paralegals. These standards include a combination of experience and education.  Those who meet these requirements are able to sit for a two-day examination, now administered exclusively online. Upon passing you will receive the designation Certified Legal Assistant (CLS) or Certified Paralegal (CP).

To be eligible to sit for the examination, candidates must:

1. Graduate from a paralegal program that is:

• Approved by the ABA; or

• An associate’s degree in Paralegal Studies; or
• A bachelor’s degree in Paralegal Studies; or
• A post-baccalaureate certificate program in Paralegal Studies; or
• A certificate program consisting of 60 semester hours of which 15 hours must involve legal-related coursework; or

2.  A bachelor’s degree in any field with 1+ year’s experience as a paralegal. Successful completion of 15 hours in legal coursework will constitute the equivalent of one year experience; or

3.  A high school diploma with 7 years experience as a paralegal under the supervision of an attorney and 20 hours of continuing legal education completed within two years of examination date.

4.  The application must be completed in full and submitted with all supporting documents, such as attorney references and official school transcripts. Application for the exam may be found at: http://nala.org/FORMS/CLAAPP/CLAapp.htm.

5.   The fee to sit for the Certified Paralegal examination is $250. for NALA members and $275. for non-members.

For additional information regarding the NALA certification examination, visit:  http://www.nala.org/examinee.aspx

Certification is valid for five years during which time paralegals need to complete 50 hours of continuing education coursework to renew their credential.

Texas-based Certification

The Texas Board of Legal Specialization (TBLS) offers advanced certification for paralegal with 5+ years experience under supervision of an attorney admitted to the Texas state bar. As per Carmen Galvez, Coordinator of Paralegal Certification, paralegals may certify in two of six areas: civil law, estate planning, criminal law, personal injury, real estate law, and family law.

For a complete list of certification requirements with TBLS, visit: http://www.tbls.org/FAQs/FAQ.aspx?id=1

Paralegal Salary

The following are median salaries for entry level Paralegals across all specialties in select Texas cities. Salaries will vary depending on your practice area, location, and level of education.

View a list of paralegal schools in Texas to get started today.

Career Overview

Information collected by medical coders includes patient health history, medical diagnosis, treatment protocol, and prescribed medications. Every diagnosis and medical procedure is assigned an alpha-numeric code using specialized classification software. Medical billing and coding professionals must be familiar with several different coding systems depending on whether the patient is privately insured or billed through Medicare and type of setting where services performed (outpatient or hospital-based).

Step-by-step process guide:

1. It is the medical biller and coder’s responsibility to input patient information into the patient database using the appropriate codes to create an insurance claim.
2. This claim is then submitted to the appropriate insurance carrier where it will be either accepted or denied.
   1. If the claim is accepted, the health care provider will reimbursed according to the rates set for the specific code.
   2. If the claim in denied, the medical biller and coder must follow-up with the insurance carrier to determine the reason. They must then notify the health care provider, update the status of the claim in the database, and send a bill to the patient.
3. Medical billers and coders are also responsible for handling collections and working with insurance companies to investigate possible instances of insurance fraud.

Career Outlook

According to the U.S. Bureau of Labor Statistics, employment of medical billers and coders is expected grow by about 20 percent through 2018 which is faster than the average for all occupations.  Job growth will be due to aging of the population, along with the rise in the number of medical tests and procedures being performed.

Educational and Training Requirements

According to Josh Berndt, Public Relations Officer with the American Academy of Professional Coders (AAPC) there are no mandated educational requirements to begin a career as a medical biller or coder in Texas, ”although it helps to have some courses in anatomy and physiology.” However, there are certain skill sets and knowledge specific to the field that can best be learned through an accredited educational program.

You may earn a 2-year associate degree or 4-year bachelor degree in the field of Medical Billing and Coding. Having an associate’s degree will provide you with a competitive edge over those with only high school diploma in obtaining competitive-wage employment. Earning a bachelor’s degree in the field will almost guarantee that you will obtain a more lucrative position and be eligible for promotional opportunities, such Health Information Services Manger overseeing the work of medical billers and coders. Those already in possession of an associate or bachelor’s degree may earn a certificate in medical billing and coding. Certificate programs are generally three to nine months in length depending on whether you attend on a part or full time basis.  Most degree and certificate programs include an externship during which you will gain real-world experience as a medical biller and coder.

Coursework will include the anatomy and physiology, medical terminology, basis office procedures, insurance claims, the use of medical billing software, coding systems and coding terminology.

The two organizations that provide accreditation for medical billing and coding programs are the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC).

View a list of medical billing and coding programs in Texas >>

Certification requirements

As per Mr. Berndt of AAPC, most states, Texas included, have no mandated certification requirements to work as a Medical Biller and Coder. However, a 2005 survey by AHIMA showed that over 73% of employers nationwide believe that credentialing is very important for Medical Coding professionals¹.

Additional Benefits of Certification:

• Enhance your earning potential
• Eligibility for promotional opportunities and career development
• Receive recognition from your peers as a professional in the field.

You may obtain medical coding certification from either of the following organizations:

• American Health Information Management Association (AHIMA)
• American Academy of Professional Coders (AAPC)

Each organization will award medical coding certification upon successfully passing an extensive five-and-a-half hour examination.  To sit for either exam, candidates must possess a high school diploma or GED.

For details on the AHIMA exam, visit: http://www.ahima.org/downloads/pdfs/certification/CCS_Content_Outline.pdf

For details on the AAPC exam, visit http://www.aapc.com/certification/cpc.aspx

The American Health Information Management Association (AHIMA) will confer a Certified Coding Specialist (CCS) credential.

The American Academy of Professional Coders (AAPC) confers the Certified Professional Coder (CPC) credential. Those will less than two years experience will be given the designation CPC-A (Apprentice). Once the apprentice has accumulated two years experience, they must provide two letters of recommendation or one letter and show evidence of 80 hours of continuing education to obtain the full CPC designation: CPC.

Steps to take AHIMA CCS exam:

• Read the Candidate Guide
• Apply for exam
• Register online
• Complete the application
• Submit transcripts and resume
• Pay exam fee ($299 AHIMA member; $399 non-members
• Read authorization test (ATT)
• Schedule exam online

Steps to take the AAPC CPS exam:

• Complete Application
• Submit transcripts and resume
• Pay $300 exam fee – 4 weeks before schedule exam date
• Be a current AAPC member ($70 for students; $125 for regular membership)
• Exam sites are located in Dallas, Fort Worth Houston, and Temple

Medical Billing and Coding Salary Ranges in Texas

Texas provides wonderful opportunities in the medical billing and coding field as it is home to of the most renowned medical centers in the country, such as Baylor Medical Center and Methodist Hospital System based in Houston.

The table below provides the median salaries for Medical Billers and Coders in select cities:*

* Salary.com (April 2011)

References:

^{1 http://ahima.org/downloads/pdfs/certification/EmployeeValuesurvey.pdf}

View a list of medical billing and coding programs in Texas >>

According to the Texas State Board of Pharmacy, a pharmacy technician is an individual who is registered with the Board as a pharmacy technician and whose responsibility in a pharmacy is to provide technical services that do not require professional judgment regarding preparing and distributing drugs and who works under the direct supervision of and is responsible to a pharmacist.

The main duties of pharmacy technicians include:

• Preparing and filling prescription medications
• Assisting customers when placing or picking up their orders
• Routine clerical tasks such as taking prescription requests from doctors, inputting customer information into the computer, and labeling bottles.
• Pharmacy technicians are able to perform most of the work of pharmacists up to an including filling prescriptions but may not offer advice or perform the final count of dispensed medication.  In all cases, they work under the direct supervision of pharmacists.

Although the majority of pharmacy technicians work in retail stores such as WalMart, Walgreens, or CVS, there are also job opportunities available in such other settings as hospitals, nursing homes, assisted-living facilities, pharmaceutical warehouses, mail order pharmacies, research labs, as well as federal agencies (e.g. Food and Drug Administration).

To succeed in this role, pharmacy technicians must be highly detail oriented, be good with numbers, exercise sound judgment, able to multitask, and possess excellent customer service skills.

Education and Training Requirements

As per Gay Dodson, R.Ph. Executive Director of the Texas State Board of Pharmacy (TSBP) there are currently no formal educational requirements to become a pharmacy technician in the state, aside from possession of a high school diploma or GED. This is because most pharmacy technicians are trained on-the-job by senior pharmacy technicians or pharmacists.

For those who do choose to pursue training through a local community college or vocational school, the TSBP recommends enrolling in a program that is accredited by the American Society of Health System Pharmacists (ASHP). The TSBP designates any program as “board approved” that has such accreditation.

View a list of schools in Texas offering pharmacy technician programs.

Many training programs will include a clinical component during which students will have the opportunity to work in a pharmacy setting under supervision of Pharmacist. Students must be registered with TSBP as a pharmacy technician trainee before they may participate in such a clinical placement.

While a degree or certificate is not necessary to become a pharmacy technician in Texas, it can help you to obtain a supervisory position, along with increased pay.

How to become a Pharmacy Technician Trainee

A pharmacy technician trainee is an individual who is registered with the board as a pharmacy technician trainee and is authorized to participate in an externship program offered by a 2-year college or vocational school.  The requirements to become a trainee are as follows:

• Possess high school diploma or GED
• Active enrollment in a certificate or two-year Pharmacy Technician program
• Obtain Pharmacy Technician Trainee status through the Texas State Board of Pharmacy. Trainee status is valid for two years during which time the student must take and pass the certification exam administered by the PTCB.
  • Complete an application with date of high school graduate/award of GED and social security number and program of study.
  • Have fingerprints taken
  • The name, address, and pharmacy license number of your clinical site
  • No felony convictions
  • No suspension, denial, revocation, or limitations on your registration or licensure by any State Board of Pharmacy;
  • No substance-abuse convictions, including pharmacy-related drugs. Any violations, including misdemeanors, must be reported to PTCB.

How to become a Pharmacy Technician

• Possess high school diploma or GED
• Complete an application with date of high school graduate/award of GED and social security number
• Have fingerprints taken
• Pass certification exam administered by the Pharmacy Technician Certification Board (PTCB). Once you pass this exam you will designed a Certified Pharmacy technician (CPhT)
• Become registered with the Texas State Board of Pharmacy after passing the PTCB exam
• The name, address, and pharmacy license number of the pharmacy in which you plan to work, if known
• No felony convictions
• No suspension, denial, revocation, or limitations on your registration or licensure by any State Board of Pharmacy;
• No substance-abuse convictions, including pharmacy-related drugs. Any violations, including misdemeanors, must be reported to PTCB.

Career Outlook

As the aging of the population continues to grow with new families of drugs being introduced on a fairly regular basis, greater numbers of people are using prescription medication to treat illness and disease. In tandem with this trend, cost-minded health insurance providers are calling upon pharmacists to expand their role into direct patient care and education. Pharmacists, in turn, are relying upon pharmacy technicians to meet the increased demand for medications while maintaining high levels of safety and accuracy. Arising from this, there will continue to be a strong demand for pharmacy technicians.  The U.S. Bureau of Labor Statistics predicts that the field of pharmacy technician is expected to increase by 31% from 2008 to 2016, reflecting a much faster rate of growth than the average for all occupations.

Salary

Below are the median annual salaries for Pharmacy Technicians-Level 1 (Entry-level) in major metropolitan cities:

Career Growth

There is also opportunity for pharmacy technicians to specialize in one area such as chemotherapy or nuclear medicine.  Those with strong performance records in larger-size companies may be promoted into such supervisory roles as Senior Pharmacy Technician, although they will still be under the direct supervision of pharmacists. Another avenue of career growth is for pharmacy technicians to continue their education to become a pharmacist (typically through a five year undergraduate program).

Work Environment. As noted, pharmacy technicians work in a variety of settings. They often have scattered schedules with evenings, weekend and holiday work often required, especially within health care settings, such as hospitals, that are open 24 hours. Physical stamina is important as the work requires standing for long periods, along with the need to lift sometimes heavy boxes of medication and using stepladders to retrieve supplied from higher shelves.

Resources

¹ Texas State Board of Pharmacy http://www.tsbp.state.tx.us/Pharmacytechs.htm

Having formal education or training is not a requirement to start working as a cook at most neighborhood restaurants, particularly at franchise restaurants with fixed menus. However, if you are interested in creating your own recipes and menus, or perhaps owning your own restaurant some day, then attending a quality culinary school is a must.

Culinary Careers

Within the culinary world, there are several positions you might look for depending on your skills and interests.

Chef De Partie is the general term for chefs who are in charge of a specific section of the kitchen. They are also called station chefs. In large kitchens, they work as managers of their section of the kitchen, managing other cooks or assistants.  Examples of Chef De Partie include Pastry Chefs, Saute Chefs, Fry Chefs, and Vegetable Chefs.

Pastry Chefs, also called Pâtissier, focus on creating desserts, breads and breakfast pastries. As a pastry chef, you will be responsible for baking, creating fillings and frostings, decorating, and possibly also managing and supervising the work of others.  You might work in a bakery, a cafe, the bakery portion of a grocery store, or in a restaurant.  If you are the head pastry chef at an independent restaurant, you will also help in developing the dessert menu and in the purchasing of dessert ingredients.

Executive Chefs, also called Chef de Cuisine,  are the top supervisors in a kitchen. This is a position more common in formal work environments such as in hotels or fine dining restaurants.

Sous Chefs work just under the executive chef. Sous Chefs take over many of the responsibilities of the executive chef when the executive chef is not working.  In addition, sous chefs may take over a larger share of the unusual shifts such as night shifts or holidays.

In addition to dealing with food, some chef positions like the executive chef position also require business management skills. Chefs have to anticipate menu popularity so they can make lists to assign work for the prep cooks, and so they can place appropriate food and ingredient orders. Chefs may also have to hire, train and supervise all other staff in their kitchen to make sure the food is being prepared in a sanitary environment, on-time for customers, and of course, following the recipe.

What you learn in a Culinary Arts Program

Culinary programs at schools in Texas include certificate programs, Associate degrees and Bachelor degrees. A Bachelor of Arts in Culinary Arts will provide you with the most well-rounded curriculum including classes in: prep cutting, food presentation and design, basic cooking techniques and recipes, and management. Some schools such as Remington College and The Art Institute, also offer classes such as food service nutrition, menu management, and wine pairing.

Make sure to look at the program curriculum when choosing your culinary arts program. While a Bachelors degree may have more business elements to it than an Associates degree, the same may not be true of an Associates degree compared to a certificate program. Some certificate programs are so complete that the only difference they have to an Associates degree is that they don’t include general education classes.  Some culinary programs also differentiate themselves by including an externship requirement where students get to practice the skills from the classroom in the real world. Having this little bit of real life experience in a kitchen is extremely valuable when you are looking for a job.

Cost and Length of Culinary Arts Programs

At Le Cordon Bleu, you can earn a certificate in 30 weeks, or an Associates degree in about 2 years to 2 and ½ years. The Associates degree costs about $42,330, and the certificate costs about $15,325. The school also offers a 42-week certificate in patisserie and baking, for $30,749.

Similarly, the cost for a 30-week certificate from the Culinary Institute of America, costs $27,320.

Like other schools, the minimum requirements for admission include having your high school diploma or a General Equivalency Diploma, (GED). Also, if necessary, they may test you for your ability to handle college level course work, or for your proficiency in the English language.

Are you ready to find a program?  There are many culinary arts programs available in Texas.

Additional Culinary Certifications and Memberships

There are memberships that you can pay for to help advance your resume, as well as a sanitation certification offered by the National Restaurant Association Educational Foundation. Some employers prefer to hire chefs who have this Servsafe certification. The certification is obtained by taking an online assessment when you’re ready. The site also provides a course you can use before taking the test. The course takes between 60 and 90 minutes to complete, but has no set time limit. There are 40 questions regarding sanitation, food temperatures, allergens and personal hygiene. The course and the test are also offered in Spanish.

The Texas Chefs Association/ American Culinary Federation also offer a membership that you can use to network with other professionals. Having this membership also entitles you to discounts on the association’s training seminars and conferences. Depending on your position in the food industry, and if you are a student, prices range from $71 to $300 for a year-long membership.