Orthotist/prosthetist

Orthotists design and fit surgical devices (orthoses) including neck collars, spine supports, braces and callipers. These support parts of the patient’s body, for example, taking over from paralysed muscles or relieving pain. Prosthetists design and fit artificial arms and legs (prostheses), making them look and work as much like a real limb as possible.

Work activities

Prosthetists design, supply and fit artificial arms and legs (prostheses). People might have lost a limb in an accident or had an amputation following a disease or injury. Sometimes, people are born without a limb. Orthotists supply and fit surgical appliances (orthoses) that are used to help movement, compensate for paralysed muscles, relieve pain and correct disfigurements. Typical orthoses include:

• Collars for the head and neck.
• Braces, corsets and trusses for the spine and abdomen.
• Splints for fingers and hands.
• Callipers for legs.
• Special shoes or insoles.

Both orthotists and prosthetists manage their own case load of patients. They are also very much part of a team, working alongside people such as doctors, nurses, physiotherapists and occupational therapists. Orthotists/ prosthetists concentrate on helping patients to carry on leading as normal a life as possible, at work, in the home and during leisure activities. When they first meet a patient, they must assess their challenge and then decide on the best type of device to meet their individual needs. Orthotists and prosthetists use their clinical knowledge of things such as anatomy and physiology, matching this with their knowledge of the most suitable device to use. Next, they take detailed measurements, and, often, a plaster cast or digital image. Orthotists and prosthetists may use computers, for example, to model the shape a limb needs to be. The measurements will provide sizes for the technician, who will make the prosthesis or orthosis, enabling them to create a safe, comfortable fit for the device.

During fitting sessions, orthotists/prosthetists show the patient how the device works, what its limits are, and how to put it on and take it off. They ensure that the device is comfortable and the patient is happy with it. The orthotist/prosthetist closely monitors how well the prosthesis or orthosis works. They make adjustments, repairs or renewals at regular intervals. They build a close relationship with the patient, helping them to adjust to their changed situation. Orthotists and prosthetists work with patients of all ages. They also work with a wide range of impairments from simple bone fractures or loss of a toe to complete paralysis or loss of limbs. They work in hospitals, clinics and specialised rehabilitation centres.

Personal qualities and skills

To be an orthotist/prosthetist, you’ll need:

• A high level of technical knowledge in areas such as biomechanics and movement.
• An interest and ability in scientific areas such as anatomy, pathology and physiology.
• An interest in materials and the parts used to make devices, so you can choose the best ones to meet your patients’ needs.
• Strong practical skills.
• The ability to work carefully and accurately, with an eye for detail.
• Problem-solving skills.
• The ability to explain things clearly.
• Patience, tact and sensitivity. You must be able to reassure and encourage patients.
• Teamwork skills to work alongside other medical and health professionals, such as technicians, surgeons, physiotherapists, nurses, biomedical engineers and social workers.

Pay and opportunities

Salaries for orthotists/prosthetists vary depending on the organisation they work for. In this NHS, orthotists/prosthetists start on band 5 of the Agenda for Change payscale, beginning on £28,407. Higher salaries are available for people in senior positions such as principals and consultants. They typically work a 37.5-hour week.

Other employers include orthotic/prosthetic manufacturers. Opportunities for orthotists and prosthetists occur in towns and cities throughout the UK. There are also opportunities to work in other countries, in either a paid or voluntary post.

Where are vacancies advertised?

Vacancies are advertised on the NHS Jobs website, and on specialist job boards for medical careers. The government’s Find a Job and Find an Apprenticeship services are also good places to look.

Entry routes and training

There are BSc (Hons) degree courses in prosthetics and orthotics, which are offered by a few UK universities. Courses combine academic learning, in areas such as anatomy, physiology, pathology, biomechanics and materials science, with clinical tuition. Completion of these degree courses leads to state registration with the Health and Care Professions Council (HCPC).

You could also do a level 6 (degree) apprenticeship in the role. This way you will carry out more of your learning on the job, while studying at university on day or block release. Alternatively, you could start off with a level 3 (advanced) prosthetic and orthotic technician apprenticeship and progress on completing this programme.

Rehabilitation of Offenders Act: This career is an exception to the Rehabilitation of Offenders Act 1974. This means that you must supply information to an employer about any spent or unspent convictions, cautions, reprimands or warnings, if they ask you to. This is different from other careers, where you only have to reveal information on unspent convictions if you are asked to.

Qualifications

For entry to a degree course in prosthetics and orthotics, the usual minimum requirement is two to three A-levels. Other equivalent qualifications, such as the International Baccalaureate (IB) diploma or Edexcel (BTEC) level 3 Nationals, may also be acceptable for entry. Please check all requirements with the universities.

To begin a degree apprenticeship, you’ll need:

• Two relevant A-levels.
• GCSEs in English and maths.

Adult opportunities

Age limits: It is illegal for any organisation to set age limits for entry to employment, education or training, unless they can show there is a real need to have these limits.

Relevant experience includes working in areas such as nursing, engineering and mechanics.

If you don’t have the qualifications you need to enter a degree in prosthetics and orthotics, you might be able to start one after completing a college or university Access course, for example, Access to Science. You don’t usually need any qualifications to start an Access course, although you should check this with the course provider.

Many students apply for either a student loan or receive additional financial support from the Learning Support Fund. Candidates can also apply for funding from relevant charities.

Related careers

• Dental technician
• Medical physicist
• Rehabilitation worker – visual impairment