There are only four college orthotics and prosthetics programs in the country, and one of them is hidden at the center of Spokane Falls Community College's campus. Surrounded by buildings dedicated to arts education, the technical program teaches students how to build orthotics, the types of tools that help a limb function properly like shoe insoles or knee braces, and prosthetics, the tools meant to replace limbs.
Though this technical education is the only of its kind west of Minnesota, there are just five students enrolled in the program, which can host 16 students at capacity. Beginning in fall 2024, the orthotics and prosthetics program transitioned from a two-year degree to a one-year technician certificate program.
While this is a relatively small sector in the health care industry, the demand for these technicians is higher than ever, says Ambrose Cavegn, the program's director. While many might think of amputations being needed as the result of accidents, military service or birth defects, Cavegn says diabetes is the leading cause of amputations in the country. The chronic disease has become more common, rising from 200 million people living with diabetes globally in 1990 to 830 million in 2022, according to the World Health Organization. The U.S. Centers for Disease Control and Prevention estimates more than 10% of the U.S. population is living with the disease.
"Part of the impetus for us to change the program's technical portion down to one year was to get as many of these students ready for the workforce as quickly as possible," Cavegn says. "When we used to run the technical program as a two-year associate's program it was almost impossible to get students to come back for a second year, because they would go out after their first year and get job offers."
Responding to that demand is complicated for a college program, as these types of technicians aren't required to be certified, so Cavegn says the right response was to simplify what the college offers.
"If they require all technicians to be certified, that comes with a whole lot of expense and a whole lot of support, and I don't think the industry has ever really got to the point you felt like they needed to provide that," Cavegn explains.
Under the streamlined program, students spend time learning about the basics of lab safety and foundational fabrication skills. Then, in the second and third quarters, students learn about biomechanical principles and the technologies behind orthotics and prosthetics. In the fourth and final quarter, students spend time working in a functioning lab to fulfill their final certificate requirements.
"As their instructor, it's amazing for me to watch how the students come in their first quarter, and they're so timid with their hands, they don't really have the confidence to do any of this stuff," he says. "Then here we are towards the end of winter quarter, and these guys have fabricated multiple devices that could actually go on people. By the end, they'll be walking out of here talking and acting like technicians, it's really a cool transformation to see."
When students complete the program and receive their certification, Cavegn says they'll find work either at medical facilities working individually with patients or in a factory-like setting at central fabrication facilities. Some program graduates even take their knowledge into related, but still developing industries, such as pet prosthetics.
Angela Boncz graduated from Spokane Falls Community College with a degree in orthotics and prosthetics technology in 2002, and soon after she began working in the field on the East Coast. She spent five years helping humans in her work, but after adopting a puppy with a cranial cruciate ligament tear (similar to an ACL tear in humans) she began wondering how her knowledge could be applied to her four-legged friend.
She built a brace for her dog, and after a while the injury healed without any invasive surgery. That moment was eye-opening as Boncz realized that all of her experience could be used to help animals, too. In 2010 she decided to join a developing field of custom animal orthotics and prosthetics.
"We're all still kind of learning this industry because it's so new," she explains. "You're dealing with more legs and different types of animals that you know might move differently, so I think that might have something to do with it as well."
Once Boncz moved back to the Inland Northwest about five years ago she began her own company, Specialized Pet Solutions. Located in Spangle, she says much of her time is spent working with animal sanctuaries and local farmers to address injuries or deformities that make life more complicated for furry friends.
While her lifelong love of animals drove her into this career, Boncz says the amount of out-of-the-box thinking she does with each project is what she loves the most.
"I have one patient who has a full-size donkey that has one leg that continues to grow because the growth plate never closed, so the one leg is probably eight inches longer than the others and it kind of folds over," she says. "So I came up with this kickstand design that puts all the pressure on it instead of [the donkey's] bent-over leg. That everyday brainstorming is why I love this job so much." ♦
