Approaching a Career in Bioengineering or Biomedical Engineering. 20 Years of Bioengineering Education in Iasi, Romania

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1 Approaching a Career in Bioengineering or Biomedical Engineering. 20 Years of Bioengineering Education in Iasi, Romania Hariton Costin 1,2, Liliana Verestiuc 1 1 Grigore T. Popa University of Medicine and Pharmacy, Faculty of Medical Bioengineering, Iasi, Romania 2 Institute of Computer Science of Romanian Academy, Iasi Branch hncostin@mail.umfiasi.ro Dan Zaharia 1, Radu Ciorap 1, Cristian Rotariu 1 1 Grigore T. Popa University of Medicine and Pharmacy, Faculty of Medical Bioengineering, Iasi, Romania Abstract The existence of so many terrible and incurable diseases, among which cardiovascular, neurodegenerative and psychic diseases, cancers, even a newcomer obesity emphasizes the permanent need of very skilled staff in health care. Besides medical and pharmacy specialists, the engineering branch has a main role in modern health care, characterized by high medical technology, powerful software programs for data analysis, and top management tools to increase efficiency of the health care system. Among many engineering specialties, bioengineers and biomedical engineers, even if somehow different, have a main common feature: the strong inter-, multiand transdisciplinarity of their work. The paper analyses some characteristics of the specific education process in both fields, shows their sub-domains of activity, presents opportunities related to designing a career, presents specific aspects of 20 years of medical bioengineering education in Iasi city, Romania, and concludes that medical bioengineering and biomedical engineering belong to the top jobs, with a constant growths in demand, and are highly appreciated jobs, mainly in western countries. Keywords: education, bioengineering, biomedical engineering, career development. I. INTRODUCTION Two definitions refer to our topics: (i) Bioengineering (BE), which integrates physical, chemical, mathematical, and computational sciences and engineering principles to study biology, medicine, behavior, and health. It advances fundamental concepts, creates knowledge from the molecular to the organ systems levels, and develops innovative biologics, materials, processes, implants, devices, and informatics approaches for the prevention, diagnosis, and treatment of disease, for patient rehabilitation, and for improving health. (NIH, USA, Working Definition of Bioengineering - July, 1997, [1]). In other words, BE is a relatively new and vast branch of engineering in which the engineering principles are applied to define and solve problems in biology and medicine. It is basic research oriented activity carried out using tools and principles of the physical sciences to develop a better understanding of biological systems. BE is the application of engineering principles to living structures, such as creating artificial organs, medical devices, chemicals, drugs and tissues. BE includes the study of cellular engineering, tissue engineering, cell signaling, cell imaging, bioinformatics, molecular engineering, bioacoustics, biomaterials, genetic engineering etc. Examples of the concrete applications of the BE are sequencing of eukaryotic genome, creation of the anterior crucial ligament and study of the effects of zero gravity on mechanical signal transduction pathways of bone cells, creation of artificial organs, creation of biosensors by using biomembranes and genetic modification of plants and microorganisms. (ii) Biomedical engineering (BME) is the application of engineering principles and design concepts to medicine and biology for healthcare purposes (e.g. diagnostic, therapeutic or preventive). This domain seeks to close the gap between engineering and medicine, i.e. combines the design and problem solving skills of engineering with medical and biological sciences to advance healthcare treatment, including diagnosis, monitoring, and therapy. It is multidisciplinary, i.e. brings together concepts from different branches of engineering like electrical, mechanical, chemical and computer science. Prominent examples are biomedical devices and instrumentation, biomechanics and biotransport, biomaterials, biomedical optics, neural engineering, etc. A concrete application of the BME is the development and manufacturing of biocompatible prostheses like prosthetic eye, which uses principles of the mechanical, electronics and computer engineering, and of the biocompatible materials. Medical devices can be used for the diagnosis, treatment or prevention of the diseases. Medical imaging equipment such as tomography are generally used for the scanning of human body and represent the application of many engineering fields to diagnostic imaging.

2 The main difference between BE and BME is that BE is a global term which encompasses the BME and it is applied to all life sciences and medicine while BME more focuses on medical domain and healthcare. However, few stakeholders adhere strictly to the above definitions and, in practice, the terms are often used interchangeably. A major aim of BE and BME is to provide integrated approaches to the solutions of biological and biomedical problems, mainly for healing and eradicate complex diseases. The general strategy is to provide engineering approaches to enhance the power of the scientific methods, and to maintain a balance between experimental observation and quantitative analyses. While the development of theory and of mathematical models is strongly endorsed, these should be evaluated wherever possible using biological data from experiments that test specific hypotheses. II. MOTIVATION AND EDUCATION IN BE AND BME The U.S. Department of Labor's Occupational Outlook Handbook states that employment opportunities for bioengineers were better and are also expected to grow faster than the average for all occupations in the coming years. In fact, BME is expected to be the fastest-growing job market in the United States during the next seven years, according to the U.S. Bureau of Labor Statistics (BLS) [1]. Between 2010 and 2020, the number of biomedical engineers is projected to rise by about 62 percent in the U.S. [1]. The aging of the population and the focus on health issues will increase the demand for better medical devices and equipment designed by bioengineers. For example, rehabilitation engineering is growing rapidly to meet the increasing needs of aged patients and patients with disabilities. Also, current advances in computer-assisted surgery and molecular, cellular, and tissue engineering designed to minimize patients hospitalization time boost the demand for bioengineers. In May 2013 (updated in April 1, 2014), the same U.S. Bureau of Labor Statistics belonging to the U.S. Department of Labor stated that national estimates for biomedical engineers (a top occupation) reach 19,890 persons (but these estimates do not include many self-employed workers), and their mean hourly/annual wage is $45.18/$93,960, respectively, significantly more than median value of U.S. top salaries [2]. This is a pragmatic motivation for a job in BME. Combined with a continuous growing job market and financial reward, bioengineers and biomedical engineers have the gratification that comes from working to meet the needs of society. They choose the bioengineering field to be of service to people, to be a part of the excitement of working with living systems, and to apply advanced technology to the complex problems of biology and medicine. include researching, designing and developing medical products and services, such as joint replacements or robotic surgical instruments, designing or modifying equipment for clients with special needs in a rehabilitation setting, or managing the use of clinical equipment in hospitals and the community. Biomedical engineers are employed by health services, medical equipment manufacturers, universities and research departments/institutes. Job titles vary depending on the exact nature of the work. As well as biomedical engineer, other terms that are used are bioengineer, design engineer and clinical engineer/scientist (in a hospital setting/clinical situation). The type of activities carried out varies depending on the type of employer and seniority of the post held. Tasks may involve: using computer software and mathematical models to design, develop and test new materials, devices and equipment. This can involve programming electronics, building and evaluating prototypes, troubleshooting problems, and rethinking the design until it works correctly; liaising with technicians and manufacturers to ensure the feasibility of a product in terms of design and economic viability; conducting research to solve clinical problems using a variety of means to collate the necessary information, including questionnaires, interviews and group conferences; liaising closely with other medical professionals, such as doctors and therapists as well as with end-users (patients and their careers); discussing and solving problems with manufacturing, quality, purchasing and marketing departments; assessing the potential wider market for products or modifications suggested by health professionals or others; arranging / performing clinical trials of medical products; approaching marketing and other industry companies to sell the product; writing reports and attending conferences and exhibitions to present their work and latest designs to a range of technical and non-technical audiences; meeting with senior health service staff or other managers to exchange findings; dealing with technical queries from hospitals and GPs and giving advice on new equipment; testing and maintaining clinical equipment; training technical or clinical staff; investigating safety-related incidents; organizing service and maintenance activities of the equipment in hospital; keeping up to date with new developments in the field, nationally and internationally. A. Typical Job Description In general, biomedical engineers apply engineering principles and materials technology to healthcare. This can

3 B. Who Hires Bioengineers? Manufacturing industries employed 38 percent of all bioengineers, primarily in the pharmaceutical and medicine manufacturing and medical instruments and supplies industries. Others were employed in universities, hospitals, research facilities of education and medical institutions, teaching, governmental regulatory agencies, health assurance companies or as independent consultants. In Europe, Japan and the new emergent countries from Asia, a similar situation occurs, even during a relative economic crisis in which we live. In this respect one may emphasizes that big international companies, like 3M, Boston Scientific, Inc., Eli Lilly, FDA, General Electric Medical Systems, Johnson & Johnson, Medtronics, Merck, NASA, Phillips Medical Systems, Siemens Medical, to cite only few of them, permanently hire bioengineers. C. General Educational Aspects Fields of specialization within undergraduate BE and BME programs usually include: Bioinformatics, Bioinstrumentation, Biomaterials, Biomechanics, Biomedical devices, Bio- Micro/Nano-Electro-Mechanical Systems, Biosignal and biomedical image processing, Biotechnologies, Cellular, tissue and molecular engineering, Clinical engineering, Medical imaging, Medical electronics, Molecular imaging, Rehabilitation engineering. Some universities include healthcare management into the above list of specialties, but the fact is the specific management for healthcare may be studied within different educational programs. D. International Associations Nowadays technology plays a key role in changing the world for the benefit of humanity. IEEE (Institute of Electrical and Electronics Engineers) continues to be a global leader in this scenario. With the extraordinary expertise that IEEE technology-centric communities can offer, those interested can face this challenge and enhance our profession by: (i) Being the trusted source for high-quality innovative and timely knowledge in current, interdisciplinary and novel fields, increasing responsiveness to the needs of scientists, practicing professionals and students, and attracting new communities and the general public; (ii) Promoting inclusive internationalization and preserving diversity of technological expertise, profession, culture, geographical origin, gender, and age, while acting holistically in the evolving international scenarios and nurturing local identities and communities; (iii) Empowering technology-centric communities worldwide by addressing their needs with a human-centered approach, seeking for more networking opportunities through social networks and new media sources, broadly engaging the young generations, and intensifying synergic alliances with local and international associations. The IEEE is heavily involved in bioengineering through the IEEE Engineering in Medicine and Biology Society (EMBS), which has been active since The IEEE EMBS publishes both several technical journals like IEEE Transactions on Biomedical Engineering, IEEE Transactions on Neural Systems and Rehabilitation Engineering, and publications oriented towards the general public like IEEE Pulse. From formalized mathematical theory through experimental science, from technological development to practical clinical applications, IEEE EMBS members support scientific, technological, and educational activities as they apply to the concepts and methods of the physical and engineering sciences in biology and medicine. IEEE and EMBS organize every year important and useful scientific events, beginning with the International Conference of the Engineering in Medicine and Biology Society (EMBC). Another very active international association in BE and BME is the Int. Federation of Medical and Biological Engineering (IFMBE), which organizes every 3 years MBEC conferences. Together with the International Organization for Medical Physics IOMP set up the International Union for Physical and Engineering Sciences in Medicine (IUPESM; IUPESM organizes every 3 years its World Congress, that may be considered the most important scientific event in BE and BME. The European Alliance of Medical and Biological Engineering and Science (EAMBES), founded in 2003, has as main objective to improve the health, wealth, and wellbeing of the citizens of Europe by the application of Medical and Biological Engineering and Science (MBES), to support and promote MBES education, training and accreditation programs, research, development and innovation, and better contacts with industrial companies, also to establish and maintain liaison with national and European governments and agencies. It is noteworthy involvement of two staff members of our faculty, dr. Dan Zaharia and dr. Radu Ciorap, in this top level European association. III. BE AND BME IN ROMANIA. 20 YEARS OF BIOENGINEERING IN IASI In Romania BE and BME directions are developed as undergraduate programs as follows: bioengineering, in Iasi, at University of Medicine and Pharmacy and medical engineering that is implemented in Cluj and Timisoara at Technical University, Bucharest at Politehnica University, Aurel Vlaicu University of Arad, Transilvania University of Brasov, Oradea, Constanta. These programs are typically derived from science departments in engineering faculty with widely different areas of emphasis in specializations that reflect the expertise and the availability of resources. The BE/BME qualification and competencies in BE/BME are included in RNCIS (National Higher Education Qualifications Registry): qualification title, graduation title, identification elements for the qualification, qualification summary (professional and transversal competencies, possible occupations for the owner of the diploma. The programs are

4 included in Fundamental domain Engineering sciences, and the study domain is Applied engineering sciences). The Master Degree in BE/BME is conferred in two years of study after the BEng or BSc were obtained; at present the curricula and syllabi are varied and diverse. During the years of study, elective courses are offered in packages (modules) for more specialization in the domain of medical engineering [3]. The Faculty of Medical Bioengineering at Grigore T. Popa University of Medicine and Pharmacy in Iasi offers academic programs and research in health and applied engineering fields. The undergraduate program in bioengineering (BE) was initiated in 1994, and is among the pioneering programs of this kind in East-Europe. With top resources and facilities, our programs in bioengineering provide an ideal, stimulating environment to develop the necessary foundation for a career in Medical Bioengineering. The Faculty s major objectives are: implementation of the Bologna system in order to improve activities and outcomes and increase their competitiveness; increase the positive impact of the Faculty upon the country s technology and health; a significant participation in the dynamics of knowledge, in the transfer of knowledge and in the development of skills that are indeed competitive on the global market. The Faculty of Medical Bioengineering continuously adapts and diversifies its academic structure to achieve a suitable education and research environment, according to the European educational reforms, the scientific research and workforce strategy, and the existing university human and material resources and the prospective ones. Also, our faculty has developed a wide network of international collaborations, being not only a partner in cooperation programs, but also the initiator of regional and continental partnerships. A. Educational Programs in Faculty of Medical BE in Iasi Our main educational programs and offer is related to the following domains. (1) Bachelor in Bioengineering, 4 years, 240 ECTS Based on broad bioengineering competencies, that must be profound in selected topics, the B.S. program teaches and develops the ability for basic and application oriented research in bioengineering and promotes analytical, creative and constructive skills for the development and improvement of complex biomedical systems and methods. Curriculum Sciences: Mathematics, Physics, Chemistry Biomedical Sciences: Anatomy, Physiology, Biochemistry, Histology, Biophysics, Cell Biology, Internal Medicine and Surgery, Paraclinical Function Testing Techniques. Core and in-depth topics of Bioengineering: Physiological Measurements and Biomedical Instrumentation, Modeling and Simulation in Bio-engineering, Biomedical Electronics, Transducers and Biosensors, Biosignal Processing, Medical Imaging, Biomechanics, Biomaterials, Bioactive Substances, Medical Biotechnologies, Computer Assisted Design in Bioengineering, Clinical Engineering and the Management of Medical Technology, Robotics, Health Economics and Marketing, Health Management, Medical Devices for Diagnosis and Therapy. (2) Bachelor in Balneo-Physio-Kinetotherapy and Rehabilitation, 3 years, 180 ECTS The mission of this program is to train specialists for: techniques of physical therapy, kinetic health; techniques of electrotherapy, hydrotherapy, thermotherapy and massage; individual treatment plans and the sequencing programs based on static and dynamic exercise in accordance with the clinical diagnosis; application of programs and physical therapy rehabilitation in order to achieve compensatory mechanisms by restoring growth of diminished function and an optimal functional level in patients treated in this manner. Curriculum: Anatomy, Physiology and Physiopathology, Biochemistry, Histology, Biophysics, Ergo-physiology, Hygiene and Epidemiology, Medical Psychology Core and in-depth topics: Physiotherapy, Nursing, Biomechanics, Balneology, Pharmacotherapy, Rehabilitation in Orthopedics, Rehabilitation in Neurological Diseases, Rehabilitation in Postoperative Neurosurgery, Ergotherapy, Rehabilitation in Cardiovascular and Respiratory Diseases, Rehabilitation in Endocrine and Metabolic Disorders, Rehabilitation in Geriatric Diseases, Rehabilitation in Pediatrics, Special Techniques of Rehabilitation, Pain Management. (3) Master Degree Programs The Faculty of Medical Bioengineering offers the following Master Degree Programs (2 years, 120 ECTS): Medical Biotechnologies and Advanced Biomaterials; Advanced Medical Biotechnologies; Clinical Bioengineering; Prosthetic Bioengineering; Medical Rehabilitation; Health Care Management. Master degree studies assure additional skills in bioengineering and rehabilitation, practical and theoretical knowledge, which allow graduates to continue their professional growth with the doctoral studies or to obtain research positions. B. Research activity a key issue The optimization of scientific research results in all domains and the technological transfer towards the corresponding industries represent major objectives for the programs financed by the EU. The Faculty of Medical Bioengineering assumed scientific research as a priority,

5 which defines the profile of the faculty at national and international levels. Research directions Biomedical instrumentation and physiological measurements(physiological measurements relating to diagnostic, therapeutic, and monitoring; principles of operation of the medical devices associated with biological functions; physiological measurements methods and techniques; design of measurement systems and biomedical instrumentation; architecture of electronic instruments used to measure physiological parameters). Biomedical signals and imaging processing (principles and algorithms for processing both deterministic and random signals; data acquisition, imaging, filtering, coding, feature extraction, and modeling; basic signals analysis, the processing of biomedical signals). e-health and telemedicine (telemedicine and technologies supporting diagnosis; e-clinical decisions support systems; e-health and telemedicine e-technologies for clinical trials; virtual telemedicine; mobile e-health services; home monitoring and homecare applications; wireless homecare; personalized medicine). Bioelectromagnetism (measurement of electric and magnetic field from living bodies; nervous, sensory and muscle cells as bioelectric and biomagnetic sources; bioelectric and biomagnetic signals and their use in clinical diagnosis). Tissue engineering (scaffolds for tissue engineering - bone, cartilage, skin, blood vessels). Biotechnology (special bioreactors and biomass processing). Nanotechnology (blood detoxifying, advancing nanoparticle - based imaging and therapy); polymeric nanocarriers as drug delivery systems; nanostructured materials with application in prosthetic devices biocompatibilization). Rehabilitation (electric and magnetic functional stimulation; assistive technology; biomechanical analysis of the posture and locomotion). Research Facilities With modern research centers and laboratories, which are fitted with modern equipment and located in a new building, the Faculty of Medical Bioengineering offers an excellent environment for research. Research Centers and Laboratories in our faculty are: Laboratory of Bioelectromagnetism; Laboratory of Biomedical Instrumentation; Laboratory of Biomedical Signal Processing; Center for Design, Testing and Maintenance of Medical Devices(DM-TEST); Regional Center of Telemedicine; Laboratories of Biotechnology and Biomaterials; Training and Research Center in Tissue Engineering, Artificial Organs and Regenerative Medicine; Center of Physiokinetotherapy and Rehabilitation International collaborations The values promoted by the Faculty are: innovation, dynamism, excellence, multiculturalism and intercultural dialogue. Research activity illustrates the sound idea that efficient learning, in any field, but especially in new fields, requires a sustained scientific research activity with interdisciplinary implications as well as a strong collaboration with other universities or research groups. International collaborations (mobilities and scientific projects) are mainly related (but not limited) to Universitat Politecnica de Catalunya, Barcelona (Spain); University College London, Technical University of Denmark, Universite Paris XII Val de MARNE, Universite de Technologie de Compiegne, Universite Clermond Ferand (France); University of Ghent, Katholike Universiteit Leuven (Belgium); University of Portsmouth, University College of London (England); Politecnico di Torino, Universita degli studi di Napoli Federico II (Italy); Czech Technical University in Prague (Czech Republic); Johannes Gutenberg Universitat Mainz (Germany); University of Applied Sciences, Jena (Germany). IV. WORKING IN BE / BME in ROMANIA As a result of the developments in industry and the health care systems, there is a rapidly increasing need for the educational systems to provide the necessary human resources that satisfy the needs of the employers, also implying the need for patient safety in health care delivery. The Faculty of Medical Bioengineering database includes 91% of BE graduates from 2000 to 2013 who are working in various areas such as: hospitals, research, higher education, prosthetic departments and companies, public health institutions, home health insurance, medical representatives for companies of medical equipment, drugs or pharmaceutical plant and other categories of companies with related activity profiles. The Bioengineering graduate specialization insertion in the labor market is presented in Figure 1. Master students, PhD students, 25% Research and education, 7% Non-medical companies, 5% Health system and medical companies, 63% Figure 1. Insertion in labor market of BE graduates from Faculty of Medical Bioengineering in Iasi

6 Medical Bioengineers who work in hospitals are involved in technical departments for medical equipment manipulation and maintenance, in medical technology management. They are involved in selection of the devices for patient care. These devices vary from simple external components to marvelous imagistic sophisticated equipment that allows physicians to look inside the body. Bioengineers also work carefully to ensure that all of the hospital's equipment is safe and reliable. Some bioengineers work in design and research laboratories in companies for designing monitoring equipment, medical dedicated software, or processes to deliver therapeutic drugs safely and effectively. Rehabilitation bioengineers are medical bioengineers who work with technology and computers to help individuals with disabilities reach toward their maximum potential for an enjoyable and productive life. Helping the mentally disabled to learn, providing a voice for those who cannot speak, and transportation for the physically disabled are some of the activities of the rehabilitation bioengineer. Other bioengineers work in research laboratories located in medical schools, universities and government facilities. Here, they learn more about the workings of the living body. Their studies range from the microscopic biological building blocks of life to whole body interactions. Some bioengineers study molecular interactions and cells as collections of molecules and other are studying organs composed of collections of cells. Still others make mathematical models of how parts of the body work together. Some bioengineers make man-made materials to repair and replace damaged organs. These materials may be used for contact lenses, dental implants, replacement hip joints, and replacements for limbs. Medical Bioengineers work spans all of engineering and medicine domains. The great potential, challenge, and promise in this endeavor offer not only significant technological outcomes but humanitarian benefits as well. REFERENCES [1] IEEE, [2] BLS, [3] Report-Bioengineering and Biomedical Engineering in Europe - Overview, Education, Standards and Professional Competences E- Learning in Biomedical Engineering, Project RO1-LEO , Contract LLP-LdV/ToI/2011/RO/008, 2012