Based on the name “clinical engineering,” it was not surprising that the process that was
used as a model for certification in the United States was that used by the states in the
registration of professional engineers. Engineering was a common element in the skill
sets of the group first certified. It was a focus for credentialing by the ABCE. In addition,
Canada required that any individual who was designated an “engineer” must be a
registered “Professional Engineer” (PE). Thus, being certified as a PE became a prerequisite
for Canadian certification. In an international context, it would have been difficult for the United States to be a leader without a credibly analogous focus on engineering
(albeit lacking the PE registration requirement).
Three basic elements were involved in the ICC program: The application, written
examination, and oral interview. Under the ICC, from 1983 through 1999, the process of
becoming certified involved a lengthy application, including documentation of education
(i.e., transcripts and diplomas, with a Bachelor of Science degree the minimum acceptable
credential), and a listing of inventions, books, patents, journal articles, and meeting
presentations. There was also a review of work history and evaluations by at least three
supervisors or managers. A written statement of why certification was of value to the
applicant, and ways in which certification would benefit the hospital or employer, was
required. An application fee (in U.S. dollars) was necessary to offset the cost of administration.
A history of at least five years in medical-related engineering work was another
minimum requirement.
Information was conveyed to, and documented by, the certification applicant on the
multipage application form. The preface to the actual data form contains sections addressing
general information (including the definition of a clinical engineer), eligibility
requirements, the certification process, certification renewal, available readings (reference
books), and sample questions. Required data focused on the applicant’s formal education
and relevant professional experience. The experience section calls for references (from
which written response is to be solicited by the Board of Examiners) and essay responses
detailing experience and accomplishments.
Applicants who satisfy the eligibility requirements of the application, as determined
by review of the submitted information by a panel of three members of the Board of
Examiners, could request scheduling of the written examination. While most frequently
these examinations had been administered in conjunction with the AAMI Annual
Meeting, other arrangements were sometimes made to offset travel hardships or logistics
problems. The test included 150 multiple-choice and true/false questions covering
a number of subjects in the basic areas of medical science, clinical engineering, and
engineering. Questions were drawn from a question bank on areas ranging from
anatomy and physiology to regulatory issues, hospital practices, and engineering. The
United States Board of Examiners (USBE) was responsible for the maintenance of this
question bank, continuously updating it to keep pace with changes in technology, regulations,
and practice. Three and a half hours were allowed for this portion of the examination.
The last portion of this examination consisted of essay responses to five
questions out of eleven. Two and a half hours are allowed for this portion. Correct
multiple-choice questions carry a point value of one; the essay questions carry a maximum
point value of ten. The minimum overall passing grade is 60% with a minimum
of 50% in any one area.
Successful completion of the written examination qualified the applicant to take the
oral interview. Like the written exam, this interview was most frequently administered
in conjunction with the AAMI Annual Meeting. At least two members of the Board of
Examiners conducted this interview, evaluating the candidates’ experience, their thinking
skills, and their ability to demonstrate good judgment in hypothetical scenarios. The
interview usually lasted an hour and focused on the applicant’s ability to make judgments
on engineering issues. It also was partially devoted to clarifying abilities that
appeared to be notably weak on the written exam. This last element was perhaps the
most important, and the least objective to evaluate. Each examiner prepared an independent
recommendation for certification, following the interview. If both examiners
agreed, certification was recommended to the chair of the Board for subsequent submission
to the ICC for granting of certification. If both concurred negatively, certification
is not recommended. Lack of agreement between the two examiners required
review by the full Board of Examiners. On rare occasions, re-interview by a different
interview team conducted.