surgical technology program information and … · the surgical technology department does not...

Coastal Alabama Community College

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SURGICAL TECHNOLOGY PROGRAM

INFORMATION

And

APPLICATION PACKET


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Revised April 2019

Dear Prospective Surgical Technology Student,

Thank you for your interest in the Surgical Technology Program at Coastal Alabama Community

College. For your convenience, please find enclosed in the application packet information

regarding the program, as well as an application for admission to the Surgical Technology

Program.

It is highly recommended that prospective students complete the general education course

requirements such as English Composition 101 and 102 (ENG 101 and 102), MATH 100

(Intermediate College Algebra or more advanced), and Biology 201 and 202 (Anatomy and

Physiology I and II) prior to entrance into the program. Anyone applying to the Surgical

Technology Program must take the ACT and obtain a minimum of an 18 composite score to

be considered for entry to the program.

Classes are admitted each Fall Semester. There is a class limit of 18 students. Prospective students

are rank-ordered using a point system to determine acceptance into the program. This point system

is outlined in detail in the enclosed Surgical Technology Program application packet.

We hope that you find this information, as well as information contained in the application packet

very helpful. However, if you have any questions, please contact staff personnel in the Allied

Health Department at (251) 580-2257 or e-mail Dr. Yvette Jackson at

[email protected] . We look forward to having you as a one of our students.

Again, thank you for your interest in the Surgical Technology Program at Coastal Alabama

Community College.

Sincerely,

Yvette Jackson

Dr. Yvette Jackson, CNOR, CST

Director of Surgical Technology

mailto:[email protected]


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ADMISSION CRITERIA

The following information details the admission requirements for the Surgical Technology Program:

1. ___ Student must be unconditionally admitted to Coastal Alabama Community College. [Note: The

Admissions Office must receive an applicant’s application for admission to the College by June

1st, which is the same deadline that the applicant’s special application to the Surgical Technology

Program must be received in the Allied Health – Surgical Technology Program’s Office.

Succinctly stated, both applications must be received in the respective offices by June 1st.]

Application to the college must be updated if the student did not attend Coastal Alabama

Community College the semester prior to application deadline. Official transcripts of all

college work attempted at any institution other than Coastal Alabama Community College and

high school transcript must be sent by the institution’s Registrar directly to Coastal Alabama

Community College’s Registrar.

2. ___ In addition to the special application for admission to the Surgical Technology Program, which

the Allied Health Department – Surgical Technology Program office must receive by June 1st,

the department must receive applicant’s Health Examination Form and Immunization Form by

the June 1st deadline, as well.

3. ___ A minimum of 18 ACT composite score (writing component not required), National or Residual,

is required, and ACT results must be attached to the application. There is no expiration date on

ACT for this surgical technology application. If the National ACT test was taken, print off results

from the ACT.org website. If ACT was taken in high school, an original high school transcript

showing ACT results may be attached. If ACT residual was taken at a Coastal Alabama Campus,

attach a copy of the score that was emailed to student’s email account. These are the only forms

of documentation accepted. SAT scores will not be accepted. The surgical technology

department does not obtain ACT scores from admissions or from the registrar.

4. ___ Student must have a minimum cumulative GPA of 2.0 on a 4.0 Scale.

5. ___ Student must meet ONE of the following requirements:

a. Completion of Anatomy and Physiology I (BIO 201) AND Anatomy and Physiology II

(BIO 202)

b. Completion of Anatomy and Physiology I (BIO 201) AND Microbiology (BIO 220)

c. Completion of Anatomy and Physiology II (BIO 202)

AND Microbiology (BIO 220)

Note: All courses in the program must be completed with at least a grade of ‘C’, prior to the

beginning of Surgical Technology Program course work.

6. ___ Upon admittance to the program, student must be eligible for enrollment in the following

courses (provided they have not already completed said courses):

a. MTH 100 (Intermediate College Algebra) or Higher Level Math

b. BIO 220 Microbiology

c. ENG 102 English Composition II (Note: ENG 101 is a pre-requisite course)

7. ___ Student must be in good standing with the college.


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8. ___ Student must meet the essential functions and technical standards required for the Surgical

Technology Program, as listed in this packet.

9. ___ Student must take a pre-entry surgical technology skills exam. Study

materials and testing date will be made available approximately 1 week after the application

deadline. Applications will be emailed to all students who have submitted an application with

ACT scores attached. Any student who has not submitted a complete application to the surgical

technology department will not be allowed to take the surgical technology skills exam.

10. ___ ANY STUDENT WHO IS ACCEPTED IN THE PROGRAM WHILE IN THE PROCESS OF TAKING ANY

OF THE REQUIRED PRE-REQUISITE COURSES, WILL BE ACCEPTED ON A “CONDITIONAL” STATUS. IF THE

STUDENT FAILS TO PASS, WITH A “C” OR HIGHER, ANY OF THE PRE-REQUISITE COURSES THAT WERE IN

THE PROCESS OF BEING TAKEN WHEN ACCEPTED TO THE PROGRAM, THE ACCEPTANCE WILL BE

RESCINDED, AND THE STUDENT WILL NO LONGER BE ELIGIBLE TO ENTER THE PROGRAM FOR THAT

YEAR.

Nondiscrimination Policy

It is the official policy of the Alabama State Department of Postsecondary Education and Coastal Alabama

Community College, that no person in Alabama shall, on the grounds of race, color, qualified disability,

gender, religion, creed, national origin, or age, be excluded from participation in, be denied the benefits of,

or be subjected to discrimination under any program, activity, or employment.


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COASTAL ALABAMA COMMUNITY COLLEGE

SURGICAL TECHNOLOGY PROGRAM APPLICATION

Date: _____________

I. PERSONAL DATA

Last Name: _______________________ First: ____________________ MI: ___ Maiden: _____________

Social Security Number: ______________________ Coastal Alabama Student Number: _______________

Mailing Address: ________________________________________________________________________

City: _____________________ State: ___ Zip Code: ___________ Telephone: (___) __________________

E-mail address: ______________________________

Emergency Contact: _____________________________________ Telephone: ( ) __________________

II. EDUCATION

High School Graduation Year: _______ High School Name: _____________________________________

GED (if applicable): _________________________________________ Date Completed: ______________

Are you currently taking college courses? Yes ___ No ___ If yes, what college: _______________________

List all colleges attended and the year(s) attended:

Name of College (DO NOT ABBREVIATE) Year(s) attended Degree (if completed)

III. EMPLOYMENT

Are You Currently Employed? Yes _____ No _____ Place of Employment:________________________

Employer’s Address: ___________________________________________________________________

Employer’s Phone Number: (___) ______________ Name of Supervisor:__________________________

Are You Employed Full-Time ____ Part-Time ____ Initial Date of Employment: ___________________

IV. ESSENTIAL FUNCTIONS

Each student in the Surgical Technology Program must be able to adhere to the essential functions that

are listed in this application packet. Please read thoroughly the essential functions. Are you able to meet

the essential functions with or without reasonable accommodations? Yes _______ No ________

If No, please explain ___________________________________________________________________

_____________________________________________________________________________________


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A COPY OF YOUR ACT RESULTS MUST BE ATTACHED TO THIS APPLICATION.

(There is no date limitation). Please note, only copies of an official high school transcript, official ACT

score, or official ACT residual score from Alabama’s Community College System are acceptable. Student

copies of transcripts, college transcripts, and unofficial transcripts downloaded from a website are not

acceptable forms of ACT scores.

Your name, as listed when tested: _____________________________________________________

Any student requiring accommodations must meet with the Vice President of Institutional Advancement

and Student Development at Coastal Alabama Community College. At any point during the course of the

program that a student fails to meet the essential functions, the student must withdraw from the program

until such time the functions can be met.

I understand that completion of this application is a component of the student profile and does not in

itself grant admission to the Surgical Technology Program. I understand a new application must be

submitted if I am not selected and wish to reapply. I certify that the information given in this application

is true and correct. I understand that providing false information may be deemed sufficient reason to dismiss

me from the Surgical Technology Program and/or deny my admission to said program. All application

materials become the property of Coastal Alabama Community College. It is the sole responsibility of

the applicant to ensure that the Allied Health Department – Surgical Technology Program has

received all of the requested documentation.

All information must be received by June 1st, or the application will be considered incomplete. It is

recommended that applicants check with the Admissions Office, at (251) 580-2111, to confirm ACTIVE

STATUS and confirm ALL TRANSCRIPTS are on file and up to date. All information must be received

by June 1st, or the application will be considered incomplete

___________________________________ ________________________________

Applicant’s Signature Date

Please mail or deliver in person to the Bay Minette or Fairhope campus (e-mailed or

faxed surgical technology applications are not acceptable), your completed Surgical

Technology Program Application, Health Examination Form, and Immunization Form

to the:

Allied Health Department

Surgical Technology Program


1900 Hwy 31 South

Bay Minette, AL 36507

For specific questions regarding the Surgical Technology Program, please contact the

Allied Health Department at (251) 580-2257 or (251) 580-2267. For general questions

regarding admission to the College, please contact the Admissions Office at (251) 580-

2111.


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STUDENT HEALTH EXAMINATION FORM

PART I: COMPLETED BY STUDENT

Name _____________________________ Soc Sec # __________________ DOB ________ Sex ______

Address_____________________________ City _______________________ State _____ Zip ________

Phone _____________________ Person to notify in case of emergency ___________________________

Address _______________________________________________ Phone _________________________

PART II: COMPLETED BY PHYSICIAN, NP, or PA

History (If any of the following are answered affirmatively, please give details).

Does this person have or has this person ever had any of the following?

Yes No Yes No

Operations ____ ____ Cancer ____ ____

Serious Accidents ____ ____ Diabetes Mellitus ____ ____

Seizures disorder ____ ____ Hearing Difficulty ____ ____

Cardiovascular Disease ____ ____ Visual Impairment ____ ____

Tuberculosis ____ ____ GI Disease ____ ____

Muscular-skeletal problems ____ ____ GU Disease ____ ____

Any other pertinent health issues ________________________________________________________

Allergies: __________________________________________________________________________

Physical Exam – Fill in All Blanks

Ht _______ Wt _________ B/P _________ P _______ Vision: Rt eye ________ Corrected __________

Nose, Mouth Throat ___________________________ Lt eye ________ Corrected __________

Chest/Lungs _________________________________ Hearing: Rt ear ________ Lt ear ____________

Heart _______________________________________ Abdomen ______________________________

GU _________________________________________ Extremities ____________________________

Reflexes _____________________________________ ROM _________________________________

Is this person able to perform essential functions such as reading fine print, lifting 25-50 lbs, pulling and

pushing 50-100 lbs, walking or standing for 12 hrs at a time, bending freely, hearing soft sounds, and

performing fine motor skills? Yes No (Please circle answer.)

If no, explain _________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

____________________________________________________________________________________


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STUDENT HEALTH EXAMINATION FORM (cont’d)

PLEASE LIST ALL MEDICATIONS TAKEN BY STUDENT:

Name of medication Dose of medication

1.________________________________ ______________________

2.________________________________ ______________________

3_________________________________ ______________________

4.________________________________ ______________________

5.________________________________ ______________________

Physician’s name __________________________________________ DATE ___________________

Physician’s signature ___________________________________________________________________

Address: _____________________________________________________________________________

Phone Number: ________________________________________________________________


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I certify that ____________________________________ has had the following:

(A printed copy of all test results is required and must be attached to this form)

MMR Vaccine: Date ______________________

Or Titer: ______________________

Varicella Vaccine: Date ____________________

Or Titer: ____________________

Tetanus Vaccine: Date _____________________

TB skin Test: Date __________________ Results _____________

Or Chest X-ray: Date _______________ Results _____________

Hepatitis B Vaccine Date 1st dose ___________

Date 2nd dose ___________

Date 3rd dose ___________

Flu vaccine will be required prior to fall clinical rotations.

Name of Practitioner (MD, NP, or PA) ___________________________

(Stamp or seal showing proof of credentials or healthcare office/ site required)

Signature of Physician or Nurse Practitioner___________________________

Any vaccinations that are more than 10 years old will require a titer and documentation of

the date and results of the titer.


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POINTS FOR ADMITTANCE TO SURGICAL TECHNOLOGY

After meeting all minimum admission requirements, applicants are rank ordered

using the following point system:

Core Courses Credit

Hours

Possible Points Student

Grade

Points

MTH 100 3 A=3 B=2 C=1

BIO 201 3 A=3 B=2 C=1

BIO 202 4 A=3 B=2 C=1

BIO 220 4 A=3 B=2 C=1

ENG 101 3 A=3 B=2 C=1

ENG 102 3 A=3 B=2 C=1

PSY 200 OR 210 3 1 = point for C or higher

SPH 107 3 1 = point for C or higher

HUMANITIES Elective (Select One)

Ethics

Philosophy

Religion

Foreign Language

Humanities

GPA- 10 points possible

3

1 = point for C or higher

2.0 or less= 0 points

2.1-3.0= 5 points

3.1-4.0= 10 points

Chemistry, Pre-

Calculus, Finite Math,

Statistics or other

higher level Math

1 = point for C or higher

Pre-entry skills

assessment

10 points

ACT Composite Score 18-36 possible points

TOTAL

POINTS

78 possible

A minimum composite score of 18 is required on ACT to apply to the surgical technology

program. The ACT composite score for Reading, Math, Science, and English must be

submitted with the surgical technology application. The writing component is not required.

There is no expiration date on ACT results for the purpose of applying to the surgical

technology program. Copies of college transcripts are not accepted for ACT score. The

admissions office and registrar do not provide ACT scores. ONLY the following are accepted

for ACT score:

Copy of score from ACT.org national website

Copy of official high school transcript with documented ACT results Copy of the ACT residual score from test given at Coastal Alabama Community

College, or another Alabama Community College.


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ACT EXAM Please check the college’s website, click on programs, majors and departments, then nursing

and choose appropriate campus for residual testing dates and testing information. Bring a

picture ID, #2 pencils, and a simple four function calculator for testing. Students may go to

the ACT website at www.ACT.org to register for a National ACT testing date as well.

National ACT scores may be sent to several colleges. Residual ACT scores may only be used

in the Alabama Community College System. Cost of testing is $47.50.

ESTIMATED PROGRAM COSTS

In-state Associate Degree at $160/credit hour (out-of-state tuition $291/cr hr) $9600.00

Additional costs such as books, supplies, uniforms, etc.:

Medical Insurance *$250.00 (per semester)

Scrub suits, Scrub jackets, shoes * $200.00

Goggles *$12.00

Immunizations & Physical *$400-$700

CastleBranch *$125.00

Certification Exam/AST Membership *$350.00

Lab tote/Lab testing kits *$850.00

Books *$1500.00

______________________________________________________________

Approximate total costs for Associate Degree *$13,587.00

*The figures above are approximate figures and are subject to change.

Internet access is required to complete the surgical technology program. A computer is not

included in the expenses. Each student must maintain medical insurance. A medical

insurance plan through Commercial Travelers Mutual Insurance Company is available.

More information is provided once students are admitted to the program.

After acceptance into the surgical technology program, students will be required to provide

current BLS Provider CPR from the American Heart Association (not Heart saver or

Friends and Family CPR and not CPR from the American Red Cross), health and

physical form, proof of medical insurance, a drug screen, and criminal background check.

More information is provided once students are admitted to the program.

HIV or HEPATITIS B REPORTING POLICY

Public law #102-141, Section 633, and “The Alabama Infected Health Care Worker

Management Act” require HIV or Hepatitis B infected healthcare workers to notify the State

Health Officer within 30 days of the time the diagnosis is confirmed. Physicians caring for

HIV or Hepatitis B infected healthcare workers are mandated to notify state health officials

within 7 days of the diagnosis. All students are required to comply with this law.

http://www.act.org/


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CURRICULUM MAP FOR SURGICAL TECHNOLOGY PROGRAM

Although there is more than one way to take the courses required for the Surgical Technology Program, the following schedule is recommended for program participants pursuing an Associate Degree. Students are advised to adhere to the following curriculum map:

ASSOCIATE DEGREE

Term Courses Credit Hour

Fall BIO 201 Anatomy & Physiology I (BIO 103 required if waiver not accepted) 4

MTH 100 Intermediate College Algebra 3

ENG 101 English Composition I 3

PSY 200 General Psychology 3

Spring BIO 220 General Microbiology 4

ENG 102 English Composition II 3

SPH 107 Fundamentals Public Speaking 3

BIO 201 Anatomy & Physiology I (If not already completed) 3

Summer BIO 202 Anatomy & Physiology II 4

Fall SUR 100 Principals of Surgical Technology 5

SUR 101 Intro to Surgical Technology 3

SUR 103 Surgical Procedures 5

SUR 107 Surgical Anatomy& Physiology 3

Spring SUR 104 Surgical Practicum I 4

SUR 105 Surgical Practicum II 5

Summer SUR 106 Role Transition in Surgical Tech 1

SUR 205 Surgical Practicum IV 5

SUR 210 Special Topics in Surgical Technology 2

Note: Orientation to College (ORI 101) is required for the Health Science Degree. Students may

begin classes during the Spring Semester or Summer Term, as well. All students accepted in the

program will be admitted into the Associate Degree program. A Certificate may be earned

by completing all but English Comp II and Psychology 200.


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PROGRESSION POLICY (Requirements for Graduation)

In order to continue in the Surgical Technology Program, the student must:

1. Maintain a minimum grade of “C” in BIO 201 and 202 (Anatomy & Physiology I & II),

BIO 220 (Microbiology), and in each Surgical Technology course; Maintain a “C” in all

courses. 2. Complete all required general educational courses in semesters as scheduled, unless

completed at a prior time; [Note: All exceptions must be approved by the Director of

Surgical Technology.]

3. Maintain the ability to perform essential functions;

4. Maintain current, health professional CPR, required immunizations, and medical

insurance;

5. Maintain the sequence of Surgical Technology Program courses; [Note: Withdrawals or a

grade of ‘D’ or ‘F’ in a Surgical Technology course will stop progression in the program

until the course(s) is (are) successfully repeated. Course repetition will be based on

instructor’s approval and program resources.]

6. Complete the required clinical rotation, surgical cases, and hours;

7. Adhere to clinical facility and program policies and procedures.

8. Maintain professional and ethical standards, professional patient care, and professional

interaction with clinical staff, physicians, and instructors.

NOTE: Failure to meet any of the above requirements may result in failure of a course

or termination from the program.


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THE ALABAMA COLLEGE SYSTEM SURGICAL TECHNOLOGY PROGRAM

ESSENTIAL FUNCTIONS The essential functions, delineated below, are necessary for Surgical Technology Program admission,

progression, and graduation, as well as for the provision of safe and effective surgical care. As specified,

the essential functions for the Surgical Technology Program include, but are not limited to, the ability to:

SENSORY AND PERCEPTION

Visual

Observe and discern subtle changes in physical conditions and the environment

Visualize different color spectrums and color changes

Read fine print in varying levels of light

Read for prolonged periods of time

Read cursive writing

Read at varying distances

Read data/information displayed on monitors/equipment, instrumentation, and supplies

Auditory

Interpret monitoring devices and any other applicable devices for functioning in the role of the

surgical technologist

Hear and discriminate high and low frequency sounds produced by the body and the

environment

Effectively hear to communicate with others

Tactile

Discern tremors, vibrations, pulses, textures, temperature, shapes, size, location, and other

physical characteristics. Work precisely, efficiently, and effectively with hands. Hold,

maneuver, pass, and operate instrumentation applicable to each surgical service.

Olfactory

Detect body odors and odors in the environment

COMMUNICATION/INTERPERSONAL RELATIONSHIPS

Orally and in writing, engage in a two-way communication and interact effectively with others

from a variety of social, emotional, cultural, and intellectual backgrounds

Work effectively in groups

Work effectively independently

Discern and interpret nonverbal communication

Express one’s ideas and feelings clearly

Communicate with others accurately in a timely manner

Obtain communications from a computer

COGNITIVE/CRITICAL THINKING

Effectively read, write, and comprehend the English language

Consistently and dependably engage in the process of critical thinking in order to formulate and

implement safe and ethical patient care decisions in a variety of health care settings


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Demonstrate satisfactory performance on written examinations, including mathematical

computations without a calculator

Satisfactorily achieve program objectives

MOTOR FUNCTION

Handle small delicate equipment/objects without extraneous movement, contamination, or

destruction

Move, position, turn, transfer, assist with lifting, or lift and carry patients without injury to patients,

self, or others

Maintain balance from any position

Stand on both legs for at least 2 or more hours at a time

Coordinate hand/eye movements

Push/pull heavy objects without injury to patient, self, or others

Stand, bend, walk, and/or sit for 6-12 hours in a clinical setting performing physical activities

requiring energy without jeopardizing the safety of the patient, self, or others

Walk without a cane, walker, or crutches

Function with hands free for patient care and transporting and lifting items

Transport self and patient without the use of electrical devices

Flex, abduct, and rotate all joints freely

Respond rapidly to emergency situations

Maneuver in small areas

Perform daily care functions for the patient

Coordinate fine and gross motor hand movements to provide safe effective nursing care

Calibrate/use equipment

Execute movement required to provide patient care and work with essential surgical equipment and

instrumentation in all surgical health care settings

Perform CPR and physical assessment

Operate a computer

PROFESSIONAL BEHAVIOR

Convey caring, respect, sensitivity, tact, compassion, empathy, tolerance, and a healthy attitude

toward others

Demonstrate a mentally health attitude that is age appropriate in relationship to the patient

Handle multiple tasks concurrently

Perform safe, effective care for patients in a caring context

Understand and follow the policies and procedures of the College and clinical agencies

Understand the consequences of violating the “Student Code of Conduct”

Understand that posing a direct threat to others is unacceptable and subjects one to discipline

Meet qualifications for Certification as stipulated by the National Board of Surgical Technologist

and Surgical Assisting.

Not pose a threat to self or others

Function effectively in situations of uncertainty and stress inherent in providing patient care

Adapt to changing environments and situations

Remain free of chemical dependency

Report promptly to clinical’s and remain for 8 ½ hours in the operating room

Provide patient care in an appropriate time frame


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Accept responsibility, accountability, and ownership of one’s actions

Seek supervision/consultation in a timely manner

Examine and modify one’s own behavior when it interferes with patient care or learning

No facial hair, beards, no hair of unnatural color, no hair with embellishments or adornments of

any kind. Hair must be pulled back away from face.

Upon admission, an individual who discloses a disability can request reasonable accommodations.

Individuals will be asked to provide documentation of the disability in order to assist with the

provision of appropriate reasonable accommodations. The College will provide reasonable

accommodations, but is not required to substantially alter the requirements or nature of the

program or provide accommodations that inflict an undue burden on the College.

In order to be admitted, one must be able to perform all of the essential functions with or

without reasonable accommodations. If an individual’s health changes during the program

of learning, so that the essential functions cannot be met with or without reasonable

accommodations, the student will be withdrawn from the Surgical Technology Program.

The Surgical Technology Program faculty members reserve the right at any time to require

an additional medical examination, at the student’s expense, in order to assist with the

evaluation of the student’s ability to perform the essential functions.

Requests for reasonable accommodations should be directed to: The Dean of Student

Development, (251) 580-2180.

Drug Screening

As stipulated by the agencies with which the Surgical Technology Program contracts for clinical

experiences, each student accepted into the program must test negative to drug screening, as a

precondition to beginning clinical rotations.

Background Check

As stipulated by the agencies with which the Surgical Technology Program contracts for clinical

experiences, each student accepted into the program must perform a background screening prior

to beginning clinical rotations. Positive results from the background check may prohibit a student

from being placed in clinical sites; thereby, prohibiting student from progressing in the program.

Miscellaneous

Students may be expected to travel outside of their immediate residential areas.

Students must have reliable transportation to meet program clinical requirements.

Students must maintain current CPR certification throughout the entire program.

Students must maintain current health insurance for program clinical experiences.

The Surgical Technology Program is a daytime program Monday – Friday.

surgical technology program information and … · the surgical technology department does not...

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