MATC SURGICAL TECHNICIAN PROGRAM REGISTRATION APPLICATION
SURGICAL TECHNICIAN REGISTRATION PACKET Please read through this entire packet very carefully and fill out all forms completely. Incomplete forms will not be accepted. Packets must be received in Student Services by Friday, November 13, 2015 at 5:00pm. Applicants may be interviewed after packet is received and will be notified of acceptance by December 1, 2015. Application Information 1. Applications for the fall 2015 Program start date will be accepted from September 1, 2015 until November 13, 2015. 2. Your completed application must be received by the MATC Student Services Office no earlier than September 1, 2015 and no later than 5:00 pm on November 13, 2015. 3. Incomplete applications received at any time will be returned to the sender without being considered or scored. 4. You must complete the application in its entirety and provide all required supporting documents in order for your application to be considered and scored. 5. Prior to completion and submission of the application for this program, you must take the MATC Career Ready 101 Math and English Assessment. This exam is free to take and can be completed during normal testing hours on a walk in basis at the Thanksgiving Point Main Campus. There is a waiting period of 24 hours for any repeat attempts. Please call the MATC Testing Center for more information at 801-753-4110. 6. To submit your application packet you may: a. Hand deliver your completed application to the Thanksgiving Point Student Services Office Monday through Friday from 8 am to 5 pm. b. Mail your completed application to the following address: Mountainland Applied Technology College ATTN: SURGICAL TECHNICIAN 2301 Ashton Blvd. Lehi, UT 84043 All mailed applications must be postmarked prior to November 14, 2015 7. Submitting an application does not guarantee admission to the program. 8. Entry into the program is determined by a competitive, points-based process. 9. There will be a waiting list in order of application point value until the 1 st day of class. After that you must reapply during the next application period. 10. The application process will not discriminate based on race, color, national origin, religious background, sexual orientation, age or disability. 11. This is a 1314 clock hour program, including a 500 hour externship. By signing here I agree that I have read and understand the information on this page. Signature: Date:
SURGICAL TECHNICIAN PROGRAM INFORMATION MATC Surgical Technician Mission Statement To provide a program of excellence and quality training for students to become competent entry-level surgical technologists that assist in surgical operations or procedures. To be prepared as a vital and integral part of the surgical team and have a foundation for continued professional development. PROGRAM DESCRIPTION The Surgical Technician program prepares individuals to work primarily in the operating room. Students will be placed in clinical facilities at the discretion of the program coordinator and the clinical coordinator. Students must provide their own transportation to and from the clinical sites and may be required to take public transportation. Upon completion of the program, the Surgical Technician student receives an MATC Program Certificate and is required to sit for the National Board of Surgical Technology and Surgical Assisting (NBSTSA) Exam within one year as mandated by ARC/STSA (Accreditation Review Council on Education in the Surgical Technology and Surgical Assisting. Enrollment in the Surgical Technician Program is limited to the number of available clinical sites. JOB DESCRIPTION The Surgical Technician is an individual with specialized education who functions as a member of the surgical team in the role of scrub person, assisting with surgical procedures, creating and maintaining the sterile surgical field, and setting up and handing the instruments, sutures and other equipment needed to do the procedure. This person is also responsible for care of the instruments before and after the procedure. Employment opportunities are available in hospitals, surgical centers, labor and delivery, and physician s surgical suites. PHYSICAL REQUIREMENTS The Surgical Technician must be in good physical and mental health to withstand the rigors of the job. Requirements include: o Manual dexterity o Pushing/pulling o Good vision o Good communication (hearing, listening, and speaking skills) o Standing for long periods of time without breaks or stopping for meals o Mobility o Must be able to lift 50 pounds. DRUG SCREENING Surgical Technician students must undergo a drug screen test within 48 hours of starting an externship rotation. The student will be held accountable for this out-of-pocket expense. If further test(s) are needed by the physician to determine safe level(s) (if a controlled substance is found) the student will be accountable for this additional cost as well. All students must understand that over the course of this program, if at any time the program coordinator, clinical coordinator, instructors, or facility personnel become suspicious of illegal drug or alcohol abuse that said student must submit for an immediate drug test (out-of-pocket). If a student declines such a request, or tests positive for any misuse of a substance, they could be dismissed from the program.
BACKGROUND CHECKS Surgical Technician students must complete a background check through the Utah Bureau of Criminal Identification prior to admission to the Surgical Technician Program. The student is required to pay for this application fee. See application instructions with this application for admission. Appendix Form must be completed before application for program is accepted. EXTERNSHIP POLICY Upon satisfactory completion of all exams and payment of all college costs and fees, students are eligible for an externship. The externship/clinical portion of the program can only begin if the student has passed all three final competencies (instrumentation final, written final, mock Surgery final). All students must be fully prepared, able, and willing to appropriately represent MATC. Clinical placements are arranged at appropriate facilities. The student is responsible for transportation to and from the externship and clinical sites. No concession or guarantees can be made in regard to distance, day, time, instructor, facility or other student preference. The externship/clinical experience is a period of learning, observing and practicing the skills learned in the student s program. Upon completion of an externship/clinical site rotation, the extern/clinical supervisor will complete an evaluation report of the student s performance. Failure to perform professionally while on externship/clinical including speech or demeanor which reflects poorly on the college or affiliated extern/clinical site may result in dismissal from the site and/or college. Students are expected to complete their externship experience within the time frame allotted. Students must not schedule breaks or vacations or large life events during their externship nor schedule a break between the end of the classroom portion and the externship period. It may be necessary to assign a student to an externship/clinical site training facility that is up to 100 miles one way from the student s home. Each Surgical Technician student is required to fulfill the National Board of Surgical Technologist and Surgical Assistants externship requirements. The requirements are 500 hours of clinical experience and 120 required procedures. These procedures are broken down into general and specialty procedures and scrub roles required. These requirements will be explained when the student is eligible for externship training. CERTIFICATION EXAM Effective August 1, 2011 all students are required to participate in the Certified Surgical Technologist (CST) examination as mandated by The Commission on Accreditation of Allied Health Education Programs (CAAHEP). This is an accreditation requirement that all MATC Surgical Technician students must adhere to for course completion and to be eligible to graduate. The CST is administered by the National Board of Surgical Technologists and Surgical Assistants (NBSTSA). All students must sit for this examination at the college approximately three-fourths of the way through their externship. This exam will be given at the college and it is mandatory that all students return to the college on the scheduled examination date. No exceptions. BASIC LIFE SUPPORT CARDIO PULMONARY RESUSCITATION (BLS for the Healthcare Provider) Students must be BLS CPR Certified before going out on externship. All participating surgical facilities and hospitals require that each student be BLS CPR certified prior to entrance into the surgical facility for externship training. If a student does not have a current BLS for the Healthcare Provider card, an opportunity will be given during the program to get it. Progression Procedure All students must maintain progress at a rate of 70% (C grade) or better, evaluated quarterly. Failing to do so will result in the student being placed on probation by the instructor or school counselor. These students must raise their progress to 70% by the end of the following quarterly evaluation period or be withdrawn from their program due to lack of progress.
STUDENT ATTENDANCE POLICY Due to the hands-on nature of the training received, attendance is very important in all MATC programs. It is very difficult to make up missed training and as a result, 85% attendance is required in all MATC programs. However, due to state licensure requirements, some programs have stricter attendance rules that must be met in order to receive the license. These rules will be explained by the instructors of those programs. It is the responsibility of the students to notify the instructor, as soon as possible, as to upcoming absences or emergencies that may arise causing them to miss class. DRESS CODE POLICY Surgical Technician students are required to wear scrubs. Maroon top and maroon pants are the approved color. The MATC insignia patch is to be sewn on the left sleeve approximately 2 inches above the bottom of the sleeve. These scrubs and patches are to be purchased in the MATC Bookstore. Closed toe shoes, in good repair, that are liquid repellant, are to be worn at all times. No opentoe shoes canvas shoes, flip-flops, or sandals are allowed. Students will wear their school uniform scrubs to and from clinical externship sites. Students may be required to change from their school uniform scrubs into the facility externship site approved scrubs. Students dressed inappropriately for class or for an externship site will be asked to leave the site. If a student fails to comply with the dress standards after being counseled by the program coordinator or instructor the student will meet with the Guidance Counselor. An improvement will be made by the student or the student will be dismissed. Jewelry of any kind is prohibited in the classroom and while in externship. This would include visible piercings of the ear, eyebrow, cheek, tongue, lip, and surface piercings. Failure to adhere to this college standard could result in the dismissal from the program. Nails are to be kept short and free of polish.acrylic and gel nails are prohibited, as they harbor copious amounts of microbes. Failure to adhere to this college standard could result in the dismissal from the program. PROGRAM STUDENT LEARNING OUTCOMES 1. Prepare competent entry-level surgical technicians in the cognitive (knowledge), psychomotor (skills), and affective (behavior) learning domains. 2. Prepare surgical technician students to sit for the National Board Exam for Surgical Technologists and Surgical Assistants. 3. Prepare surgical technologists to scrub in the primary role in Endoscopy, General, Obstetrics and Gynecology, Otorhinolaryngology, Genitourinary, Orthopedic, Oral and Maxillofacial, Plastic and Reconstructive, Ophthalmic, Peripheral Vascular, Cardiovascular and Neurological specialties. 4. Engage students in a clinical experience under the supervision of an experienced surgical technologist. Produce evidence of a minimum of 120 surgical cases. Show 30 cases in General Surgery, of which 20 must be in the First Scrub Role. Show 90 cases in various surgical specialties, of which 60 cases must be in the First Scrub Role and evenly distributed between a minimum of 5 surgical specialties. However, 15 is the maximum number of cases that can be counted in any one surgical specialty. Demonstrate progression in First and Second Scrubbing surgical procedures of increased complexity as he/she moves towards entry-level graduate abilities. 5. Develop effective communication skills including reading, writing, speaking and listening as necessary in the surgical setting. 6. Develop reasoning, problem solving, and anticipation and prioritization skills in the surgical setting in order to effectively create and organize the sterile field for efficiency, safety and conservation of financial resources. 7. Prepare students to serve various patient populations with an ability to meet their individual needs including those of diverse ethnicity, religion, disability, gender, age, and sexual orientation. 8. Develop a strong surgical conscience in students, placing the patient first always.
I have read and understand Surgical Technician Program Information pages. Signature MATC SURGICAL TECHNICIAN PLAN OF STUDY TOPIC HOURS INTRO TO SURG TECH 37 MICROBIOLOGY AND INFECTION CONTROL 60 ASEPSIS 60 SURGICAL TECHNIQUE 45 SURGICAL PHARMACOLOGY 45 SURGICAL ELECTRONICS AND ROBOTICS 60 INSTRUMENTATION 60 SURGICAL CORE PROCEDURES 165 SURGICAL SPECIALTY PROCEDURES 165 FINAL COMPREHENSIVE 53 CERTIFIED SURGICAL TECHNICIAN (CST) REVIEW 34 WORKPLACE READINESS 30 EXTERNSHIP 500 Date MATC SURGICAL TECHNICIAN CLASS SCHEDULE (EXTERNSHIP TIMES WILL VARY) DAYS Monday Tuesday Wednesday Thursday Friday TIMES 7:30 am-2:00 pm with a one hour lunch break 7:30 am-2:00 pm with a one hour lunch break 7:30 am-2:00 pm with a one hour lunch break 7:30 am-2:00 pm with a one hour lunch break No class MATC SURGICAL TECHNICIAN COSTS This cost breakdown covers the entire program TUITION ($2.00 X 1314 Enrollment hours) $2628.00 FEES $900.00 TRAINING MATERIALS AND TEXTBOOKS $642.00 MATC REGISTRATION FEE $40.00 TOTAL $4,210.00 Please Note: 1. Tuition and Fees are paid once admitted to the Surgical Technician Program. 2. If you are accepted you will be notified, by letter, of the due dates for the fees. 3. Tuition rates generally change annually on July 1 st, and may increase from current rates. 4. The above costs are estimates only. The cost for fees, tuition and any other associated costs are subject to change at any time and without notice.
By signing here, I agree that I have read and understand the information on this page. Signature Date WHAT TO INCLUDE IN YOUR : (required) o o o Completed and signed Application for Admission form A one page essay on why you want to be a Surgical Technician. Times New Roman, 12 point font, double spaced. A transcript showing Human Anatomy and Physiology with a B- or better, taken within the last five years OR an institutional record documenting enrollment in Human Anatomy and Physiology to be complete by the end of the first semester of the Surgical Technician Program Please see the included list of acceptable Human Anatomy and Physiology pre-requisites. Any other pre-requisites will need to be reviewed and approved by the MATC Director of Programs and the Surgical Technician Program Coordinator o A copy of immunization records showing the student has received: o TB Test (PPD) o Hepatits A/B Series o Tetanus (TDAP) o Proof of chicken pox (varicella) a written and signed statement saying you have had the chicken pox is sufficient o 2 MMRs Documentation that the Hepatitis B vaccination series has been started and the other tests and vaccinations have been completed must be furnished with this application. Students may obtain tests and vaccinations from their personal physician or through the County Health Department. It is the responsibility of the student to pay for these injections and tests. Pregnant students need to consult their physician before beginning the vaccinations and tests. Please note: If any student signs a waiver form that he/she accepts the risk of possibly contracting Hepatitis or waives other required vaccinations, it is the right of MATC s participating surgical facilities to deny the student entry into their operating room or facility. WHAT HAPPENS AFTER YOU APPLY: Once the application period is closed, the Surgical Technician Program Coordinator will contact the applicant to make an appointment for an interview. All applications will be scored on a point system used to select candidates based on your Career Ready 101 Math and English Assessment, your interview with the Program Coordinator, and your grades for the pre-requisites of Anatomy and Physiology. The top 20 applicants will be contacted for a personal interview. The 12 applicants with the highest overall scores following the interview will be offered seats in the program. The Surgical Technician faculty and Program Director reserve the right to interview additional qualified applications if the initial interviewees do not meet minimum standards. A maximum of 12 students will be conditionally accepted into the program. All other qualified applicants will be placed on the alternate list.
Applications are only good for one application period. If you apply, but are not accepted, you must reapply. Admission to the program is not guaranteed. ADDITIONAL INFORMATION YOU WILL NEED IF YOU ARE ACCEPTED: Interview and alternate notices will be sent out no later than December 1, 2015. Acceptance notifications will be made available after the interviews are conducted and scored. If you are an alternate you can be notified of an available seat as late as the first day of class. NOTE: Admission to the program is contingent on: Full payment of tuition, fees and registration with Student Services. I understand that if I am accepted into the MATC Surgical Technician Program that all the items listed above must be received by the due date listed in my acceptance letter. If I fail to submit required documents by the due dates given or I fail to attend the first week of classes, I will be dropped from the program but may reapply for another class at a later date. I further agree that I have read and understood all of the information on this page. Signature Date
APPLICATION FOR ADMISSION PERSONAL INFORMATION Please print neatly. Please complete all information requested. Application Date: Name: Date of Birth: Last First MI 00/00/0000 Home Address: Street City State Zip Code Telephone: Home Cell Email: Are you a previous applicant: YES NO If yes, when did you last apply: Please list name, address, and phone number of your nearest relative or friend NOT living with you who will always know how to reach you: Name: Last First Home Address: Street City State Zip Code Telephone: Home Cell