Surgical Technician - Page 2
Surgical Technician - Page 2
Personal Information
Name
*
First
Last
Title / Specialty
*
Email
*
Phone
-
(###)
-
###
####
Gynecology
Cesarean section
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Colpotomy
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Dilation and curettage (D & C)
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Hysterectomy, abdominal
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Hysterectomy, vaginal
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Marshall - Marchetti
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Marsupialization, Bartholin cyst
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Ovarian cystectomy
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Radium insertion
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Sacral spinus fixation
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Shirodkar procedure
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Suction curettage
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Vaginal reconstruction
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Vaginectomy/vulvectomy
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Neurology
A-V malformation
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Anterior cervical fusion
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Anterior laparoscopic spine procedures
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Anterior lumbar interbody fusion (ALIF)
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Burr holes for subdural hematoma
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Carotid ligation
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Cervical sympathectomy
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Craniectomy for decompression fracture
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Cranioplasty/craniotomy
Clipping of aneurysm
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Tumor excision
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Using stealth equipment (stealth craniotomy)
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Discectomy
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Hypophysectomy
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Insertion nerve stimulators/medication pumps
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Laminectomy
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Myelomeningocele repair
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Pedicle screw insertion
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Posterior lumbar interbody fusion (PLIF)
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Shunt procedure/VP, VA/LP
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Spine Fusion - list systems you have used:
Ulnar nerve transfer
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Ventriculography procedure/ventriculoscopy
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Ventriculostomy
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Ophthalmology
Cataract extraction with IOL
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Corneal transplant
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Dacryocystectomy
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Dacryocystorhinostomy
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Iridectomy
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Lid and muscle procedures
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Orbital implant
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Phaco emulsification
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Pterygium repair
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Recession resection
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Repair orbital blowout fracture
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Scleral buckle
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Vitrectomy
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Oral
Closed reduction facial fractures/wiring
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Excision odontoma
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Extraction of deciduous teeth
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Extraction of impacted molars
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Fractured jaws, mandibular and zagomatic
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
LeFort osteotomies
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Maxillary procedure with graft
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Pediatric dentistry
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Sagittal osteotomy
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
Temporomandibular joint (TMJ) with arthroplasty
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
TMJ exploration
Proficient / Competent
Moderate Experience
Limited Experience
Theory Only / No Experience
