What Should I Look for in a Training Program?

Which Programs Are Typically Offered at Vocational Colleges? Adult Education Centers? Community Colleges? Hospital Based Programs?

What is an Internship and Why is it Important?

How Important Are Grades?

Is the Program Impacted?

Which Prerequisites are Required?

Which Schools Offer Credits that Transfer? Is this Important?

What is Accreditation and Why is it Important?

What is the Attrition Rate of My Program?

What Percentage of a Program's Students Pass the Certification or Licensing Exam? Is There Any Way to Obtain this Information?

What Should Clients Look for in a Training Program?

Programs vary greatly between institutions, perhaps most markedly in the areas of price, program length, curriculum, internship availability and quality of instruction.

Price and whether or not the program is on the ETPL are often major considerations for clients when choosing a training program. However, some programs that are not currently on the ETPL due to temporary contractual challenges or programs that will never be on the ETPL due to program length may still be important programs for clients to evaluate, particularly at the community college level where federal financial aid is often available and job prospects for graduates tend to be better. How much debt is appropriate to take on for an individual varies according to his/her financial situation, but a general approach is outlined on the site in the Financial Aid section.

In addition to considering factors such as the classroom environment and price when making a decision about a training program, clients should investigate which clinical sites have standing agreements with schools and programs as a significant percentage of new graduates gain employment through their internships. Click here for more information on internships.

Perhaps most important of all, clients must research the program and evaluate whether the educational institution has the students' best interest in mind. S/he should ask instructors, administrators, and admissions representatives to provide data about attrition, employment rates, certification rates, relationships with employers, and should ask to sit in on a class and speak with current students who can verify that the information provided is true. If the admissions individual does not provide data or is vague, s/he might be concealing something undesirable about the program, such as lack of internship availability, and the client should not pursue training within that particular institution. It is important to remember that every school is different and employers are aware of the "school stereotypes" associated with each institution. Individuals who are researching training programs should visit a number of programs, including community college programs, before making a decision. Click here to view the BPPVE tips for students interested in private vocational education.

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Which Programs Are Offered at Vocational Colleges? Adult Education Centers? Community Colleges?

Vocational colleges may offer the following healthcare training programs: Certified Nursing Assistant, Dental Assistant, Home Health Aide, Medical Assistant, Medical Biller/Coder, Medical Insurance Specialist, Health Information Technician, Dietetic Technician, Psychiatric Technician, Emergency Medical Technician, Licensed Vocational Nurse, Massage Therapist, Pharmacy Technician. Vocational college programs are generally shorter, more expensive, and seek to prepare individuals for the entry-level careers in allied health. The advantage to attending a vocational college is that there are typically many programs and locations to choose from, wait time is often nonexistent or minimal, programs are shorter, and more programs are on the ETPL. There are also disadvantages to consider when evaluating training programs at vocational colleges: vocational colleges may not have a reputation of being academically rigorous; vocational colleges are often for-profit businesses and that could lead administrators to make decisions not in the best interest of the program or students; internship space may be more limited; programs are usually more expensive; and employers do not always perceive a degree from a vocational college as highly desirable or equivalent to training received from a community college.

Adult education centers may offer some of the same programs offered at vocational colleges but due to funding limitations, most adult education centers are not able to offer the costly, longer programs such as LVN. Adult education centers most often focus their offerings on the administrative occupational programs (billing/coding/transcription) and entry level patient care programs (medical assistant, certified nursing assistant, home health aide). Advantages to attending an adult education program include: accelerated and/or flexible format; low and/or subsidized cost; most adult ed centers have nonprofit status and a community governing board; class size is usually smaller; and mentoring/tutoring is often available. The disadvantage of attending adult education programs are: credits do not usually transfer to four-year institutions, many institutions are using Boston Reed curriculum which is undesirable to some employers, and some individuals incorrectly perceive Adult Education to be inferior (NB: there is nothing concrete to suggest that adult ed programs are inferior; in fact, Fremont-Cupertino ACE is having great success with their allied health programs–as evidenced by low attrition and high certification exam passage rates).

Community Colleges typically offer the programs available at adult education centers and vocational colleges, as well as some of the more advanced allied health programs such as registered nurse, respiratory therapist, radiation therapist, dental hygienist, surgical technician, physician assistant articulation (rare), diagnostic imaging, etc. The advantages of attending community college include earning an associate degree, earning units transferable toward a bachelor's degree, better and often more prevelant internship opportunities, relatively inexpensive tuition (compared to vocational colleges), master's degree-prepared instructors, longer curriculum, and more mentoring/tutoring opportunities. Disadvantages include larger class size, registration and admissions challenges, and an increased wait time for classes/program entry.

Hospital based programs are typically used to train incumbent workers or a cohort of outside students for the purpose of working in the particular hospital. Hospital based programs are usually quite specific and are tailored to meet a need of the institution. Nursing and diagnostic imaging are occasionally offered as part of hospital-based training programs and the Mills Peninsula and Kaiser Allied Health School programs are examples of long-standing hospital based programs. Advantages of attending a hospital based program include reduced tuition due to work agreements, programs are usually accelerated, and admission to the program may be less competitive if the applicant is an incumbent worker. Disadvantages include possibly signing an agreement to work for the training institution and paying exorbitant penalties if the contract is broken, credits are not always transferable which could impede career ladder mobility. Individuals applying for admission to hospital-based programs may need to have healthcare work experience to be eligible to participate.

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What is an Internship and Why is it Important?

An internship–sometimes called an externship or practicum–allows the student to practice his/her new skills in a clinical setting under the supervision of a sponsor or designated employee at the sponsoring health organization. Internships vary in length, but are usually between 4 and 16 weeks long. During an internship, the student interacts with patients and performs many of the occupational duties of a full-fledged employee–the only difference is that the intern is closely supervised and the work is most often unpaid. Internships are designed to introduce students to new information not available in textbooks. Internships are also designed to give students the added confidence of taking the skills they have learned inside the classroom and putting them into practice in an unfamiliar environment and are a networking opportunity for the healthcare organization and the student.

Internships are an essential component of healthcare training programs and students must typically complete an internship to be eligible to graduate and to earn a specific credential. Internships are awarded credit (often nontransferable credit) and are graded on a pass/fail basis. Most internships are unpaid and since credit is awarded, the student may also be required to pay for the credits even though they are not attending class (community and 4-year colleges only). The internship is most often completed during the last semester or quarter of study.

It is often difficult for training programs to negotiate internships with healthcare organizations, largely because it is costly for the healthcare organizations to pay for a supervisor to monitor the interns, liability issues abound, and space is very limited. Regularly introducing new individuals to a healthcare team can be disruptive for patients and incumbent workers and morale and patient care sometimes suffer as a result. For this reason, health organizations restrict the number of interns that they will host in a given semester. Because many healthcare training programs exist in the Bay Area; the population needing care is high; the number of healthcare facilities is relatively low; much energy is being diverted into supervising nurses and less into other areas of allied health; and most healthcare organizations are constantly watching the bottom line; the number of internship slots in high quality, large volume health facilities is very limited.

The program chair or director usually negotiates the internship agreements between schools and health organizations. Training programs with strong administrative representation and a reputation of producing high quality graduates are more likely to have strong internship agreements. Community colleges tend to have the strongest internship agreements due to the reputation of the school, the relationships the program administrators have built with the sponsoring health organizations, and the tendency of healthcare organizations to prefer to hire community college graduates. However, even community colleges are not always able to place every student in an internship in certain programs, particularly phlebotomy and medical transcription.

Students with the highest grades are usually given priority in choosing internships. Students not awarded an internship may be placed on a waiting list that is ranked by grade–which could delay graduation by a semester. Some students may be given the option of finding their own internship–but it is usually difficult for students to find an internship independently because of insurance agreements (a triple indemnity agreement would have to be drafted among the school, student, and sponsoring organization). Some students are accepting internships at low-volume facilities, such as independent medical offices, and are graduating with less clinical experience than is desirable to employers. Not all internships are created equal and an internship with a large, well-known facility will mean more on a resume than working in an independent practice due to the sheer number of patients the intern came into contact with as well as the opportunity to perform more specialized occupational duties.

Patient care internships require that the student carry malpractice insurance generally purchased through the school (usually <$50 for phlebotomists, medical and dental assistants). Students can be denied internships on the basis of a criminal record. Students should contact the program chair of their training program BEFORE enrolling if they have a criminal offense. Click here to access the Healthcare Navigator's recommendations for clients with a criminal background.

It is imperative that students treat their internship as though it were an extended job interview. A student who has completed weeks of work in a particular medical facility is likely to be a highly desirable job applicant in that facility due to the reduced cost and minimal training required to make the intern a permanent employee. Employers seek to employ individuals that completed an internship in their facility because it is a return on a financial investment (the costs associated with sponsoring the intern); new testing and background check are not always required; the employer incurs none of the typical costs associated with holding an open recruitment; the risk of quick job turnover is reduced because the individual is already familiar with the work environment, job duties and coworkers; and finally, the employer has seen firsthand that the individual can perform the required occupational duties and can maintain an acceptable attendance record.

If the employer that sponsored the student for the internship is not currently hiring and the student performed exceptionally well in the internship, the student may be able to get a recommendation letter from the internship supervisor and use him or her as a reference for future recruitments within the organization–which would be a valuable networking tool.

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How Important Are Grades?

Students in certificated programs may think that they need only pass their classes to graduate and that grades do not matter. Not so! Many programs stipulate that all classes must be completed with a grade of "C" or higher or be repeated; and because most courses are in a sequence and are not necessarily offered every semester, not passing a single class could delay graduation by as much as a year.

Grades are also important because students with the highest grades often get their choice of internships (click here to read about the importance of internships).

Also, if a student graduates with a certain GPA (different at every school but usually not below 3.5), s/he may be eligible to receive some sort of acknowledgment on his or or diploma or documents, which may be desirable to employers.

In terms of a career ladder, if an individual graduated from a Certified Nursing Program with a 2.5 GPA and wants to be an LVN, s/he may have to take additional units to bolster his or her GPA to meet the minimum admissions requirements for certain LVN programs. The same principle applies for individuals attempting to access more advanced allied health occupations, such as nursing, through the career ladder approach. Because many programs stipulate that certain prerequisites must be completed with a certain GPA (to enter the lottery for nursing at the majority of the California Community Colleges, prerequisite classes must be completed with a 3.0 GPA), clients should focus on earning good grades in each step of the career ladder so they do not spend time repeating classes.

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Is the Program Impacted?

The California Community College System and California State University System designate programs as impacted when more applications are received in the initial filing period from eligible applicants than can be accommodated by the campus. Impacted majors/programs are authorized to use supplementary admission criteria and/or higher admission standards than the institution's minimum requirements in considering applicants to the program. These criteria are applied equally to continuing students and entering upper-division transfer students.

Click here to see a list of impacted programs within the California State Educational System. The following healthcare training programs are impacted at every California Community and State College as of 9/2006: Registered Nursing, Diagnostic Imaging, Respiratory Therapy, Dental Hygiene and Licensed Vocational Nursing (offered at California Community Colleges only).

Programs that are in high demand at California Community Colleges where students can anticipate a semester of wait-time without higher admissions standards are: Phlebotomist, Medical Assistant, and Surgical Technician.

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Which Prerequisites are Required for My Program?

Students should consult each institution. Each training program has a different set of prerequisites; and they change frequently. Many prerequisites must also be completed within a specified time period before beginning the program.

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Will My Credits Transfer?

Credits earned at WASC accredited institutions may transfer to other WASC regionally accredited institutions. In theory, this should make WASC accredited schools the logical choice for most students pursuing training at a vocational or community college who are possibly interested in a career ladder or lattice approach. However, each WASC accredited educational institution determines its own policy with regard to awarding transfer credit. When an educational institution accepts transfer credit, it is essentially certifying that credits accepted achieve educational objectives comparable to the institution's own courses, and certain institutions may be hesitant to do that if the reputations of the schools vary greatly. For example, Stanford University is WASC accredited, as is Heald College. Stanford University may not recognize a Business Communications class taken at Heald College to be comparable to any Business Communications class offered at Stanford University, and the credits would likely not transfer should the student be offered admission. However, a Medical Assistant who completed Medical Terminology 100 at Heald is looking to transition to an LVN program at a community college and discovers that West Valley College, like Heald, requires their healthcare students to complete a basic medical terminology class. Both schools are WASC accredited, and if the course content is deemed equivalent, the student receives credit.

Very few vocational schools in the Bay Area earn WASC accreditation, so it is important for students to be aware of the benefits and limitations of WASC accreditation and to learn which schools are accredited. Students should also meet with an admissions counselor at each institution to discuss discrepancies in curriculum as well as the destination institution's policy on accepting credit from a vocational or community college healthcare program. Because healthcare training programs are unique and admissions policies and transfer agreements for healthcare training programs may differ from the institution's general policies due to State or National requirements, it is imperative that students attempting to transfer credit request a curriculum audit from the destination institution of the attending institution's coursework. Check Wascweb.org for a list of WASC accredited schools.

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What is Accreditation and Why is it Important?

In the case of post-secondary education and training, there are two kinds of accreditation: institutional and programmatic (or specialized). Institutional accreditation helps to assure potential students that a school is a sound institution and has met certain minimum standards in terms of administration, resources, faculty and facilities. Programmatic (or specialized) accreditation examines specific schools or programs within an educational institution (e.g., the law school, the medical school, the nursing program). Accreditation in the health-related disciplines also serves a very important public interest. Along with certification and licensure, accreditation is a tool intended to help assure a well-prepared and qualified workforce providing health care services.

Attending an accredited program (preferred accrediting agencies vary by occupation) can be a requirement for certification or licensure. It is imperative that individuals be aware of the requirements for their intended profession and select a program accordingly.

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What is the Attrition Rate of My Training Program?

Most community college training programs have approximately 10-20% attrition rate. The most common reasons for attrition are financial stresses, a change in career interest, inability to pass classes, family obligations, or moving out of the area.

The attrition rate in healthcare programs is slightly reduced because students spend a great deal of time waiting to get into the program. Attrition does still occur, and sometimes students will leave one healthcare training program for another (e.g. a respiratory therapy student is accepted into the nursing program after the first semester and quits the respiratory therapy program).

A Web source on attrition rates for training programs does not exist. Individuals interested in pursuing training programs should ask admissions representatives for data. Community college instructors will provide approximate data to students upon request.

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How Many Graduates Pass the Certification/Licensing Exam Upon Graduation?

Individuals exploring training program options should ask instructors and program administrators how many students pass the national or state exam required for them to legally practice in the occupation (if applicable) and then verify that information with the organization that administers the credentialing exam. Data for select State examinations and national credentials is available in the occupational profiles section of this site.

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