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Surgical Technician

    Instruction

    Please rate your experience / frequency (within the last year) using the scale (check the appropriate boxes below)

  • 0 = No theory and/or experience
  • 1 = Limited experience/need supervision and/or support
  • 2 = Experienced/minimal support needed to perform)
  • 3 = Proficient/can perform independently
  • 4 = Expert/very experienced in the field
Recruiter Information

Recruiter TEEMA email

Personal Information

Full Name

Email

Phone number

Date

General Skills

AKA/BKA (amputation)

Abdominal-Perineal Resection

Cholecystectomy (Open)

Exploratory Laparotomy

Appendectomy

Laparoscopic Procedure

Cholecystectomy

Appendectomy

Hernia

Nissan

Colectomy

Gastrectomy

Inguinal / Ventral Hernia Repair

Spienectomy

Bowel Resection / Colostomy

Thyroidectomy

Rectal Procedures

Esophagascopy / Gastroscopy

Pediatric Case

Inguinal Hernia Repair

Pyloric Stenosis

Circumcision

Exploratory Laparotomy

E.N.T

Middle Ear Cases

T&A

Myringotomy

Tympanoplasty

Radical Neck Dissection

Septoplasty

Sinus Endoscopy

Cardiac / Thoracic / Vascular

Coronary Artery By-pass

Mitral Valve Repair / Replacement

Aortic Valve Replacement

Multiple Valve Transposition

Septal Defects

Ventricular Aneurysm Repair

Bring Back Heart

Pericardial Window

Intra-Aortic Balloon Insertion

Heartport or Similar CABG

Thoraco Approach Mid-Cab

Aortic Arch Replacement

Aortic Valve Conduit

Mechanical Heart / LVAD

Pediatric Hearts

Tetrology of Fallot

Chamberlin Procedure

AICD Insertion

Saphenous Vein Harvest

Endoscopic Vein Harvest

Gastric Artery Harvest

Radial Vein Harvest

Insertion Vena Cava Filter

Thoracotomy

Thoracoscopy

Insertion Chest Tube

Esophageal Repair

Pneurnonectomy / Lobectomy

Mediastinodcopy

Desendind Aortic Repair

Arterial Stenting

Intra-Operative Angioplasty

Vascular Surgery

Carotid Endarterectomy

Abdominal Aortic Aneurysm

Femoral

Popliteal By-pass Graft (Insitu)

Popliteal By-pass Graft (Graph)

Portacath, Tesio, Hickman Placement

AV Shunt

Thrombectomy

Pacemaker Insertion

Arterial Stenting

Intra-Operative Angioplasty

Subclavin / Carotid By-pass

Orthopedics

Total Hip Replacement

Bipolar Hip

Compression Hip Screw

Total Knee Replacement

Knee Arthroscopy

ACL Knee Repair

Harrington Rod or Similar

I.M. Rodding

Hand Procedures

Foot Procedures

Mini, Standard, Large Fragment

Screws & Plates

External Fixation

Shoulder Repair

Shoulder Arthroscopy

Spinal Fusion

Cast Application

Fracture Table Set-up

Drills, Saws and Reamers

Urology

Radical Prostatectomy

Radical Lymph Node Dissection

Ureteroscopy

TURP / TURST

Ultrasonic Lithotripsy

Hydrocelectomy

Cystoscopy

Insertion Penile Prosthesis

Gynecology

D & C

Diagnostic Laparascope

Laparoscopic Vaginal Hysterectomy

Abdominal Hysterectomy

Vaginal Hysterectomy

Anterior Repair

Posterior Repair

MMK (Marshall Marchetti Krantz)

Tuboplasty

BTL (Bilateral Tubal Ligation)

C-Sections

Neurology

Cervical Laminectomy (Anterior)

Cervical Laminectomy (Posterior)

Lumbar Laminectomy Discectomy

Percutaneous Micro Discectomy

Craniotomy For Tumor

Craniotomy For Aneurysm

Burr Holes

VP Shunts

Transphenoidal Hypothypectomy

Carpal Tunnel Repair

Harrington Rod or Similar

Trauma Surgery

Transplant Surgery

Organ Procurement (Harvest)

Plastics

ammoplasty

Facelifts

Skin Grafts

Rhinoplasty

Cleft Lip Repair

Abdominalplasty

Blepharoplasty

Otoplasty

Muscle Flaps

Age Specific

Infant (Birth - 1 year)

Preschooler (ages 2-5 years)

Childhood (ages 6-12 years)

Adolescents (ages 13-21 years)

Young Adults (ages 22-39 years)

Adults (ages 40-64 years)

Older Adults (ages 65-79 years)

Elderly (ages 80+ years)

Please read and agree to the statements below by marking the checkbox.

I attest that the information I have given is true and accurate to the best of my knowledge and that I am the individual completing this form. I hereby authorize the Company to release this Skills Checklist to the Client facilities in relation to consideration of employment as a Healthcare Professional with those facilities.

Thank you for your submission, we will look over your message and get back to you ASAP.

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