The challenge for those recruiting for such positions is to find the right people with the right skills. As the country’s demographic landscape continues to change, many leaders, including President Clinton and Surgeon General David Satcher, have recognized the need to develop a health career's workforce that more closely resembles the population. This will ensure that the research, healthcare and public health needs of a multi-ethnic nation will be satisfied. Career opportunities in biomedicine fit this paradigm of demographic change.

The term biomedical careers encompasses a broad scope of professions. They include health and science professionals like physicians, dentists, nurses and veterinarians and newer biotechnology-related research areas, which offer positions available to those with master's-level degrees and doctorates. Biomedical careers also include areas that interface with medicine and health, such as the engineering fields (i.e. biomedical engineering) that apply engineering techniques to solve biological and medical problems, medical/science/technical writers, and biophotographers.

Lise Kaye, executive director of the Biomedical Science Careers Program, a non-profit organization housed at the Harvard Medical School in Cambridge, Mass., says the maturing American melting pot demands more diversity in biomedicine. "As the demographics of the population of the United States changes, the patients are going to be looking more and more to receive care from those who are the same culture as they are or from physicians and providers who have been trained with sensitivity on the subject," says Kaye. She adds that it is all cultures seeking diversity in biomedicine, not just ethnic groups such as African Americans and Hispanics, but European immigrants as well. "When you go to the hospital, you are going to find that in the emergency rooms many patients speak many other languages but English. So you look for people to provide care who're similar to them, who are used to their culture, and who understand their culture," comments Kaye.

The increasing number of America’s elderly and recent advances in technology and pharmaceutical research have coincided with an increase in the number of biomedical careers. Key reasons biomedical careers are expanding include a shortage of healthcare workers in rural and inner-city areas for underserved populations; a national trend toward preventative and primary care; new forms of information technology related to healthcare; and a growing need for culturally competent multi-skilled healthcare workers. African Americans, Hispanics and American Indians make up about one quarter of the population, but only 10 percent of the nation’s health workforce. Listed as follows are the fastest growing health occupations by level of education and training for 1996-2006, according to the National Health Council.

* Medical Scientist includes medical doctors (M.D.s and D.O.s), and those research scientists in medical fields. Source: Bureau of Labor Statistics, 1998

This list includes only a few of the many careers available in biomedicine. Given the enormous variety of possibilities, these careers are grouped into three categories:

1. Research-related (which include clinical, basic science and public health-related research),

2. Clinical health professions (which include professions in medicine, dentistry, nursing, public health and allied health, etc.) and
3. Technology-related professions (i.e. engineers, information technology specialist, or lab technologist).

Additionally, there are many other careers that can be pursued that will allow you to be connected to science without directly entering into traditional careers in healthcare and research.

Biomedical research scientists are researchers who are interested in medicine and health. They study drugs, genetics, diseases, the environment and other areas related to human or animal health. They have been responsible for the creation of new vaccines, development of new treatments for diseases, environmental safeguards, and new diagnostic equipment. For example, basic science researchers may specialize in: anatomy, bacteriology, biochemistry, genetics, immunology, etc.. Clinical research involves the study of the effects and outcomes of new technology, descriptive studies of populations (i.e. epidemiology) and procedures or pharmaceutical inventions in a clinical setting. Clinical testing trials of new drugs by the National Institutes of Health (NIH) check the effectiveness and side effects of new interventions and medications.

Most research scientists have bachelor’s degrees in science-related fields. Advanced degree programs include classroom and fieldwork, laboratory research, and a dissertation or thesis. The Ph.D. degree in science is the minimum education required for most senior-level research science positions. However, many biomedical research scientists start with a master’s degree. In conjunction with formal education, research scientists usually spend several years gaining work experience before they are offered permanent jobs. Salaries vary depending on level of education, experience, accomplishments and employer, ranging from $25,000-$100,000 per year.

Public health or health services researchers are those interested in research that assures the public’s health through health protection, health promotion and disease control. Public health careers can include epidemiologist, biostatisticians, and environmental health specialist. They may focus on the study of infectious diseases (i.e. HIV/AIDS, tuberculosis, and vaccine-preventable conditions), chronic illnesses (i.e. diabetes, heart disease or cancer), diseases related to specific environments or occupations, and societal issues that affect the public’s health (i.e. domestic violence and access to healthcare). Health services researchers are those interested in the delivery of healthcare services to the population or specific subgroups and may do research on the quality of healthcare delivery and health outcome measures. Researchers in public health or health services must have a master’s or doctoral degree. Most researchers work for universities; federal, state, and local health departments; major health organizations (i.e. hospitals, foundations); and large medical corporations (i.e. pharmaceutical companies, medical centers). Annual salaries range from $25,000-$90,000 plus.

The field of medicine encompasses a broad range of health providers. In general, these providers (physicians and physician assistants) perform examinations of patients, diagnosis illness, and treat disease and injury. There are two types of physicians: the Doctor of Medicine (M.D.) and the Doctor of Osteopathic Medicine (D.O.). Both M.D.s and D.O.s may practice general medicine or concentrate within a medical specialty.

Another fast growing biomedical career field is physician assistance. Physician assistants (P.A.s for short) work closely with a physician and perform a wide variety of healthcare services. For example, their services range from taking medical histories and performing physical exams to assisting in surgery and applying casts/bandages. P.A.s are a relatively new healthcare profession.

Physicians must train for at least 11 more years after high school before they are qualified to practice medicine. Individuals may apply for medical school after three years of college. Prospective medical students can major in any subject area as long as they successfully complete required courses in math and the sciences. Applicants also must take the Medical College Admission Test (MCAT). Individuals considering medicine should begin preparing in high school and college by taking a wide range of science, math and liberal arts courses. Specialty certification (in areas like pediatrics, obstetrics and gynecology, or internal medicine) is earned through residency training programs that require three to five years of study beyond medical school. The salary range for physicians starts at about $80,000 to $150,000 or more. For physician assistants, the range is $48,000-$65,000.

The nursing field is another area vital to biomedicine. Nurses have a range of career opportunities from providing care for patients, to doing research science, to teaching preventative healthcare. Nurses are currently needed in nearly every setting but especially in home healthcare, public health, nursing homes, hospitals, the community and in education. Recent studies have demonstrated that given the current aging nurse workforce and an enlarging elderly population (that will require more healthcare), there may be a shortage of nurses in the new millennium, according to the Pew Health Commission.

As part of their education, nurses learn to address the emotional as well as physical needs of their patients. Nurses may enter research, teaching, or work in nurse management positions. There are several levels of education, certification and specialization for nursing personnel

(i.e. registered nurse, licensed practical nurse, nursing assistant, and certified registered nurse anesthetist). Within these categories, there are also options for specialization depending on the field. There are multiple avenues on which to pursue a career in nursing but the areas in greatest need are nurses with master's and/or doctorate-level training. The shortage of graduate degree nurses is worsening. Since they typically take senior-level positions in hospital administration and leadership roles in nursing education (i.e. nursing schools) and public health, their shortage is of great concern. Salaries for nurses range from $20,000-$85,000, depending on specialty choice, level of certification, experience, accomplishments and employer.

The practice of dentistry deals with the treatment and prevention of problems related to oral health (e.g. mouth, teeth and gums). However, dentists are involved with basic science research as well public health and health services research. The prevention of dental problems through education about good oral hygiene and nutrition is increasingly becoming a main focus of dentistry. Admission to dental school requires a minimum of 90 semester credit hours from an accredited college. Most applicants (95 percent) have a bachelor’s degree in a scientific field.

Graduation from an accredited school of dentistry usually takes about four years and specialization requires additional years of training.

Dentists usually work in private practice or with a dental group. Typically, their office staff includes a team consisting of a dental hygienist, dental assistant and dental laboratory technician. You can become a dental assistant by attending a college with an accredited program that usually takes 9-11 months for completion. Dental laboratory technicians attend two-year accredited programs at a community college, vocation school, or a university dental program. Most students receive a certificate or an associate degree upon completion of the program. Dental hygienists attend two years of college at an accredited school. The salary range for dentists is $105,000-$175,000 plus, while the average for dental assistants is $17,000 and $36,000 and $23,000 for dental hygienists and dental technicians, respectively.

Dr. Joseph L. Henry, the former dean of Harvard Dental School in Cambridge, Mass., and dean emeritus at the Howard University Dental School in Washington, D.C., said there appears to be "a better consciousness of the outcomes of training minorities in biomedical affairs." He added "they are competing quite well and opening doors that were just de facto closed years ago, and I think that's going to continue to rise," said Dr. Henry. He further stated while affirmative action programs have been attacked as unfair to whites, there remains pressure on educational institutions to train minorities in the field. "There is a pressure, even though they have not been enforcing the law like they did at first," according to Dr. Henry.

Aside from the careers in public health research, other career fields include health education, environmental health and safety, epidemiology, international health, health service administration, and occupational health. A four-year bachelor’s degree in health studies and or community health is usually required. However, people from a host of other occupations (i.e. doctors, dentists, nurses, environmental specialist, demographers, and community activists) do work in public health. The salary average for all specialties in public health is $70,000.

Careers in allied health complement many areas of biomedicine. The term "allied health" applies to a diverse group of health professionals who perform essential work in healthcare delivery in collaboration with those in medicine, nursing and dentistry. Allied health consists of various fields such as physical therapy, speech/language pathology and audiology, and respiratory care.

Physical therapists and speech/language pathologists and audiologists all require a four-year bachelor’s degree from an accredited university and a master’s-level degree. Respiratory therapists may complete a two-year associate degree or a four-year bachelor’s degree. Thereafter, candidates may have to undergo specific training for each field (i.e. 12-18 months for respiratory care therapist). Salaries range from $30,000-$50,000 or more in the field.

Rapid developments in medical technology over the past few decades have created new surgical techniques, medications, treatments, diagnostic and disease prevention methods, which have opened a wide variety of new career fields that require special technical training and knowledge. Some examples of these career fields include electrocardiographic technology, surgical technologist, cardiovascular technologist, and optometrist. The majority of the these fields require an associate degree or one-two year certificate in addition to specific hands-on training from six months to two years, depending upon the field. Salaries range from $20,000-$80,000 or more.

Keeping up with current biomedical trends and how technology will affect the field in the next five to 10 years are a must for students. Information can be gleaned from following the media and reviewing journals in the particular discipline. But more importantly, valuable information can be gained from talking to someone currently in the field. Pursuing a career in biomedicine raises the importance of identifying mentors and the key role that mentors can play in your career decisions and future career development. Another way to prepare for a career in biomedicine is to focus on personal growth activities. Many programs offer opportunities to work with leaders in various fields of biomedicine during summer breaks, after school and weekends, and sometimes provide financial assistance and/or stipends during your involvement with the program. Programs such as Project Success, Health Policy Summer Internships at Harvard Medical School or the Summer Research Fellowship at Cornell University Medical College can provide exposure to various aspects of healthcare. Another personal growth program that continues to expand is the Biomedical Science Careers Project (BSCP), founded in 1991 by the Harvard Medical School Faculty Development and Diversity, Massachusetts Medical Society and the New England Board of Higher Education.

Networking opportunities may be found in career fairs, scientific meetings, conferences, and summer programs. Many associations affiliated with various biomedical careers (i.e. National Medical Association-www.natmed.org, National Dental Association-www.natdent.org, American Public Health Association Black Caucus-www.apha.org) are interested in students who want to participate in organizational activities and networking with members.

An enormous amount of information about biomedicine can be gathered from libraries and health professions' institutions like medical, dental, nursing, or public health schools. With the advances in information technology, surfing the Internet provides instant access to an enormous amount of information. Here are just a few helpful Web sites: American Association of Medical Colleges (www.aamc.org), American Association of Dental Schools (www.aads.jhu.edu), American Association of Colleges in Nursing (www.aacn.org), Association of Schools of Public Health (www.asph.org), and the National Science Foundation (www.nsf.gov).

The combination of diversity, technological advances and medical/social challenges set the stage for many new and exciting careers in biomedicine. Regardless of what career you decide to pursue, make sure you are adequately prepared, make yourself visible and take advantage of all opportunities that come your way.

Roderick K. King, M.D., M.P.H., is a pediatrician and instructor at the Harvard Medical School. He is also a senior health policy fellow at the Health Resources and Services Administration of the U.S. Department of Health and Human Services.