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A Career in Healthcare

Healthcare Career Highlights The following are some of the many highlights of a career in the field of healthcare.

  • With nearly 15 millions jobs nationwide, healthcare is one the largest and most stable career fields in the United States.
  • Of the 20 fastest growing jobs in the U.S., ten are in the field of healthcare.
  • Due to an aging population and advances in healthcare technology over 3 millions jobs will be added to the field of healthcare over the next 10 years.
  • Healthcare professionals are highly educated, many having a college degree. However, there are a myriad of job opportunities for those without a college degree.

Nature of The Industry


Careers in healthcare offer aspiring health professionals the opportunity to be involved in direct patient care, diagnose and treat illness, learn new healthcare and medical technologies, and assist individuals throughout the world who are ill or struggle with various health conditions ranging from minor injury to the terminal illness.

Industry organization. There are nearly 600,000 organizations (both professional and volunteer) in the medical and healthcare industries in the United States. Healthcare organizations vary in size, specialty and location – but they all strive to improve the quality of life of the people they treat and serve. The majority of healthcare organizations include dental, physician, and medical clinics that serve the general public. Roughly 35 percent of healthcare workers are employed by hospitals, even though hospitals comprise only 1 percent of healthcare organizations nationwide.

Table 1. Percent distribution of employment and establishments in health services by detailed industry sector, 2014.

Industry segment

Employment

Establishments

Total

100.0%

100.0%

 

Ambulatory service professionals

42.6%

87.3%

Doctors offices

17.0%

36.0%

Home healthcare providers

7.2%

3.7%

Dental offices

6.2%

20.4%

Healthcare practitioner offices (other)

4.7%

19.6%

Outpatient care centers

4.0%

3.6%

Ambulatory healthcare providers (other)

1.8%

1.4%

Medical and diagnostic laboratories

1.6%

2.4%

 

Hospitals

34.6%

1.3%

General medical and surgical hospitals

32.5%

1.0%

Specialty hospitals (other)

1.4%

0.2%

Psychiatric and substance abuse clinics

0.7%

0.1%

 

Residential care facilities

22.8%

11.4%

Nursing care facilities

12.2%

2.8%

Community care facilities for the elderly

5.2%

3.5%

Residential mental health facilities

4.1%

4.0%

Residential care facilities (other)

1.3%

1.1%

SOURCE: BLS Quarterly Census of Employment and Wages, 2014.
The healthcare industry is composed of an array of organizations ranging from small medical clinics staffed by a single physician to hospitals in major metropolitan areas that employ thousands of healthcare professionals. Just under half of all medical facilities (other than hospitals) in the United States have less than 5 employees. Conversely, nearly three quarters hospitals in the United States have over 1,000 employees.

The healthcare industry is made up of the following types of organizations:

Hospitals. Hospitals employ the largest number of healthcare professionals of any organization in the United States. General hospitals are comprehensive healthcare providers offering nursing care, surgical, and diagnostic services. Some hospitals only offer highly specialized healthcare services and medical treatments for cancer patients, the mentally ill, or for children. The majority of people who visit the hospital receive outpatient care (in and out the same day). However, many patients who check into the hospital will end up staying overnight (inpatient care). More and more hospitals are encouraging outpatient treatments. Hospitals have varying employment needs based on their specialty, organizational goals, size, location, budget, and management.

Nursing and residential care facilities. Nursing and residential care facilities and clinics offer inpatient nursing care, rehabilitation and other forms of health care for patients that require ongoing medical care not provided by a hospital. Nursing care facilities often employ a large number of nursing aides who work under the supervision of registered nurses and physicians as they provide direct patient care. Other residential care facilities, including convalescent homes and assisted living centers, serve patients will less critical health care needs. Nursing care facilities for the elderly, disabled, and children unable to live independently offer 24 hour around the clock medical services and healthcare monitoring. Other types of residential care facilities, including substance abuse centers, halfway houses, and group homes also employ nurses and nursing aides on a part-time basis as patients typically have more limited health care needs.

Physicians' offices. Physician's offices make up just over 35 percent of all medical clinics in the United States. Physicians include doctors, general practitioners, specialists and surgeons who practice independently. To cut costs, provide backup coverage, and increase flexibility, many physicians will work in group practices or collaborate with other medical professionals. There is a growing number of physicians who now work as salaried employees at clinics or as members of group practices.

Dental offices. Dental offices make up about 20 percent of all medical clinics in the United States. The majority of dental offices employ general practitioners. A minority of dental offices and clinics offer specialized dental services, including emergency, cosmetic, and preventative procedures. Dental specialists include periodontists, orthodontists, and oral surgeons.

Home healthcare services. Home healthcare service is becoming more and more popular among an aging population of American citizens. Home health services administer limited medical and nursing care in private residences under the supervision of a registered nurse or physician. The majority of home healthcare services cater to the elderly but they also provide medical services and nursing care to the disabled. A growing population of aging Americans, increases in home-care healthcare technology, a growing preference for home treatment, and decreasing costs has caused home healthcare to become the fast growing sector of the healthcare market.

Offices of other health practitioners. This sector of the healthcare industry includes the offices of psychologists, speech language pathologists, dieticians, physical therapists, chiropractors,podiatrists, optometrists, and other related medical specialists. Other health practitioners also include the clinics of complementary and holistic medicine practitioners, including naturopaths, homeopaths, hypnotherapists, and acupuncturists. Demand for the services of these professionals is influenced by patients' ability to pay for their services, whether directly or via insurance.

Ambulatory healthcare services. This sector of the healthcare industry is comprised of (1) outpatient facilities and (2) diagnostic and medical laboratories. Examples of ambulatory healthcare providers include blood and organ banks, laboratories where blood is analyzed and diagnostic imaging and clinical tests are performed, kidney dialysis facilities, outpatient mental health clinics, and substance abuse centers, to name just a few.

Recent developments. Never ending advances in technology continue to change and mold the landscape of the healthcare industry. Technological improvements have led to new and improved ways of fighting cancer through gene therapy, performing non-invasive surgeries, controlling infectious diseases, improving reproductive health, and treating a myriad of medical conditions. Advancements in technology have also led to higher survival rates among the elderly, those seriously injured in accidents, and people recovering from serious illnesses and trauma. Advances in technology continue to improve the overall quality of life and longevity of American citizens.

Information technology specifically has had a tremendous positive impact on healthcare systems and services by enhancing the efficiency of healthcare workers and the direct patient care they provide. Tablets and other mobile devices are now routinely used to keep track of patient medical records, histories, prescriptions, schedules, treatments, and much more. These devices are also used to transmit patient data (vital signs, etc.) to supervising nurses, doctors, hospitals and other healthcare facilities.

There is a growing focus and emphasis by healthcare providers and facilities to reduce healthcare expenditures and costs. For this reason more doctors and clinics are now promoting preventive care and outpatient treatments. Managed care enrollment, via health maintenance organizations, point-of-service providers, joint plans, and preferred provider companies, continues to grow in scope and popularity among patients and providers. Cost reduction efforts including prepaid health insurance plans that emphasize preventive care, integrated healthcare delivery systems, and streamlined managerial and financial functions continue to influence how healthcare is administered.

Ongoing debate and uncertainty over the affordable care act could affect who receives medical insurance, how many people receive healthcare coverage, healthcare costs, and the quality of medical procedures and healthcare treatments provided.

Working Conditions


The healthcare industry is very diverse. Working conditions vary by employment sector, employer and location. Healthcare workers are employed on both a part-time and full-time basis. They may work long shifts around the clock providing direct patient care or a standard nine to five work schedule. They are employed in both nonsupervisory and supervisory positions. Healthcare workers employed in dental offices average work weeks of about 30 hours. Workers at psychiatric hospitals, substance abuse centers and medical clinics work about 35 hours a week, as do healthcare workers employed at private practices.

Part-time labor in the healthcare industry is quite common. In fact, just over 20 percent of healthcare workers are employed on a part-time basis. About 40 percent of workers at dental offices and 32 percent off workers at doctor's offices are employed on a part-time. Medical clinics and hospitals, that operated 24 hours a day, require staff around the clock. Nurses, nursing aides, technicians and even physicians often work long shifts for 3 or 4 days straight before receiving a break. Healthcare workers that are employed on a part-time basis often hold multiple jobs.

Work environment. Notwithstanding advances in technology and public health care systems, rates of illness and injury are still high. The rate of illness and injury is particularly high with the nursing care sector of the health care industry.

The work of healthcare employees involved in direct patient care and treatments can be emotionally and physically demanding. They are often required to lift people and heavy equipment. Healthcare workers must be in good physical condition to avoid back, neck and muscle strain. They must also be careful to avoid exposure to dangerous substances (chemicals, blood, radiation, etc.) and infectious disease. Healthcare specialists, including home care specialists, CRNAs and other medical professionals, are often required to travel as part of their job. They have to be careful to avoid hazardous road conditions and traffic accidents.

Industry Careers and Occupations


Healthcare organizations, including hospitals, clinics and nursing care facilities, hire hundreds of thousands of medical professionals and healthcare service workers each year. Together, professionals (doctors, nurses, etc.) and service workers (technicians, staff, etc.) comprise nearly 80 percent of all workers employed in healthcare in the United States. The remaining 20 percent of workers are made up of administrative and office support staff, including finance, business and administrative professionals.

Medical professionals, including physicians, surgeons, registered nurses, dentists, and physical therapists, usually hold a bachelor's degree, master's degree and/or Ph.D. However, registered nurses in some instances can find employment opportunities with only an associate's degree or professional certificate. Medical professionals are at the forefront of medical care and technology and are responsible for fulfilling complex duties and technical roles which require advanced knowledge and training. In addition to direct patient care and administration of medical services, these professionals often conduct research, manage facilities and supervise staff. A few medical professionals, such as hospital and health services administrators, have very little, if any, interaction with patients.

Some of the fastest growing employment opportunities in healthcare include health technologists and technicians. Technologists and technicians provide the support and technical expertise medical professionals require in order to diagnose and treat disease, illness and injury. These professionals include dental hygienists, diagnostic medical sonographers, radiologic technicians and technologists, health information technicians, and medical record specialists, to name just a few. Earning bachelor's degree, associate's degree or professional certificate is usually the minimum require to become a technologist or technician.

Below we'll explore the employment make up of the various service sectors within the healthcare industry:

Hospitals. Hospitals hire healthcare workers of all education levels and backgrounds. Compared with other segments of the healthcare industry, hospitals provide greater career opportunity for aspiring healthcare workers and professionals. Almost a third of healthcare workers employed at hospitals are registered nurses. Hospitals also employ physicians, surgeons, physical therapists, psychologists, and social workers. Approximately 20 percent of hospital jobs are filled by service specialists, including home health aides, janitors, administrators, nursing aides, office staff, managers, and finance specialists.

Nursing and residential care facilities. The majority of jobs at nursing and residential care facilities are held by nursing, home health and psychiatric aides. These aides typically work under the supervision of a registered nurse or physician. While residential care and nursing facilities employ other professionals, including administrators and support specialists, compared to other sectors of the healthcare industry they employ far fewer. To ensure patients receive proper care, Federal law requires that nursing and residential care facilities are staffed by licensed healthcare professionals and support specialists 24 hours a day.

Physicians' offices. Doctors, surgeons and registered nurses fill most positions at physicians' offices in the United States. A little over a third of positions are filled by administrative specialists, including receptionists and clerks.

Dental offices. Just over a third of positions at dental offices are filled by dental support specialists, such as dental assistants and hygienists. The majority of dental offices employ only one dentist who is supported by several dental assistants and hygienists. Larger dental offices may also employ office managers and administrative specialists.

Home healthcare services. Just under 60 percent off positions in the home health services industry are held by home health specialists, including home health aides, home care aides, and nursing aides. This sectors also employs a large number of registered nurses and therapists. Very few doctors are employed exclusively by home health service organizations.

Offices of other health practitioners. 42 percent of positions in this sector of the medical industry are filled by chiropractors, dispensing opticians, and occupational and physical therapists. Additionally, technical specialists account for 31 percent and administrative specialists account for 35 percent of workers in this sector of the medical industry.

Ambulatory healthcare services. Ambulatory health care services provide health care and medical services to ambulatory patients usually on an outpatient care basis. These outpatient service organizations employ registered nurses, physicians, paramedics, emergency medical technicians, health services managers, medical assistants, and counselors.

Table 2. Employment of wage and salary workers in healthcare, 2008 and projected change, 2008-2018.
(Employment in thousands)

Occupation

Employment, 2008

Percent Change,
2008-18

Number

Percent

All Occupations

14,336.0

100.0

22.5

 

Management, business, and financial occupations

614.6

4.3

16.8

 

Professional and related occupations

6,283.9

43.8

22.5

Counselors

171.3

1.2

22.6

Social workers

206.7

1.4

19.5

Dietitians and nutritionists

35.5

0.3

9.8

Pharmacists

67.5

0.5

14.0

Physicians and surgeons

512.5

3.6

26.0

Physician assistants

66.2

0.5

41.3

Registered nurses

2,192.4

15.3

23.4

Clinical laboratory technologists and technicians

278.8

1.9

14.0

Emergency medical technicians and paramedics

142.1

1.0

9.2

Licensed practical and licensed vocational nurses

619.1

4.3

21.9

 

Office and administrative support occupations

2,540.3

17.7

19.7

Billing and posting clerks and machine operators

194.8

1.4

19.7

Receptionists and information clerks

386.3

2.7

16.1

Secretaries and administrative assistants

770.7

5.4

26.5

NOTE: Columns may not add to total due to omission of occupations with small employment.
SOURCE: BLS National Employment Matrix, 2008-18.

Career Training and Education


The healthcare and medical industries employ a diverse group of professionals with varying levels of education and professional backgrounds. While some healthcare professionals have completed advanced graduate degrees in medicine, others have pursued specialized training that qualifies them to become medical technicians, technologies, aides or assistants. The minimum entry-level qualification for many healthcare positions is a bachelor's degree but the majority of positions are filled by individuals with a professional certificate or specialized training.

Many vocational schools and colleges now offer specialized training programs designed to prepare workers to hold specific positions within the fields of medicine and healthcare. These focused training programs can typically be completed within 1 to 2 years. However, a graduate degree and several years of specialized training after college is required for those seeking to become diagnostic and treatment specialists, including physicians, surgeons, audiologists, physical therapists, optometrists, and radiologists, among others. A bachelor's degree is the minimum requirement to become a registered nurse, social worker, or health services administrator. A two-year associate's degree or professional certificate (with clinical and classroom training) from an accredited school is usually sufficient for becoming a medical technologist or technician.

For individuals without a formal education or college degree, there are several post-high school programs that provide specialized training that will qualify for various entry-level jobs in healthcare and medicine. In fact, just under 50 percent of workers at nursing and residential care facilities and 20 percent of workers at hospitals hold only a high school degree.

Some hospitals and medical clinics offer classroom, on-the-job training programs and continuing education courses to help their employees qualify for new job opportunities and pursue career advancement. Most healthcare organizations that have employees without college degrees, including aides, assistants, orderlies, and technicians, offer on-the-job training. Hospitals, in particular, often have the resources to offer advanced on-the-job career training programs designed to help their employees climb the career ladder.

It's not uncommon for larger hospitals and medical facilities to offer tuition reimbursement programs or formal training to current and prospective employees who are willing to commit to work at these institutions for set number of years following graduation. Many nursing care facilities offer similar programs for their employees. A few hospitals offer cross-training programs, where current employees are provided with on-the-job-training, continuing education, or even a college education.

Individuals thinking about pursuing a career in healthcare should have a strong desire to interact with others on a regular basis, be genuinely concerned with the wellfair of others, be empathetic, and have the ability to work in stressful situations. The minimum entry-level requirement for many healthcare careers is a bachelor's degree, associate's degree or professional certificate in a relevant field of study. Many aspiring healthcare and medical professions possess an advanced professional degree (MD), Phd or master's degree. Most licensed healthcare positions require workers to complete continuing education courses on a routine basis to keep their skills honed and knowledge current.

Career advancement opportunities in healthcare vary by sector, position and employer. Lower level positions, including healthcare service aides and assistants, typically qualify for promotions by acquiring experience, on-the-job training, or additional schooling. Technologists and technicians can advance their careers by obtaining specialized training. Health specialists, including nurses, can qualify career advancement opportunities and administrative positions through specialized training and by earning advanced degrees.

Employment Outlook


The employment outlook for the healthcare industry couldn't be brighter. More new jobs are being added in healthcare than in any other career field. It's predicted that over 3 million new jobs will be added to healthcare over the next decade. This growth in the job market for healthcare workers can be attributed to an aging population of baby boomers who can afford the cost of healthcare services.

As current healthcare workers retire, hospitals, clinics and nursing care facilities will be looking to hire new workers to fill the vacancies.

Employment change. Growth in the job market for healthcare professionals is projected to grow at a rate of 22 percent through 2018. This is substantially faster than the national average for all other jobs which is projected at 11 percent growth. Within the field of healthcare job groth will vary greatly between individual sectors. For example, job growth in the home health services sector is projected to grow at a rate of 46 percent while job growth at hospitals is projected to grow at only 10 percent.

Table 3. Employment in healthcare by industry segment, 2008 and projected change, 2008-18
(Employment in thousands)

Industry segment

2008
Employment

2008-18
Percent change

Healthcare, total

14,336.0

22.5

 

Hospitals, public and private

5,667.2

10.1

Nursing and residential care facilities

3,008.0

21.2

Offices of physicians

2,265.7

34.1

Home healthcare services

958.0

46.1

Offices of dentists

818.8

28.5

Offices of other health practitioners

628.8

41.3

Outpatient care centers

532.5

38.6

Other ambulatory healthcare services

238.5

6.8

Medical and diagnostic laboratories

218.5

39.8

SOURCE: BLS National Employment Matrix, 2008-18
There are several factors that are driving job growth in the healthcare industry. The largest factor is a growing population of elderly baby boomers who are seeking preventive health care services in order to live more fulfilling, healthier lives during retirement. Additionally, as the baby boomer generation grows older, gets sick and is injured more frequently, they'll require longer periods of time and more healthcare services in order to heal. These factors will drive the demand for health care at an increasing rate over the next twenty years. During this time gerontological and home health services will be in particularly high demand.

Improvements in medical treatments, technology and health care systems is leading to longer life expectancy rates for the elderly, injured and ill. Advances are also making it possible to detect and treat medical conditions before they become life threatening. As life expectancy rates continue to climb, and more families are unable to care for their aging loved ones requiring contant care, the demand for qualified health care professionals, including doctor's, therapists and home health provides will grow.

With improved diagnostic testing and improved, less invasive surgical procedures, more emphasis is now being placed on outpatient and home health services. This industry wide transition is generating additional demand for healthcare workers to provide medical care in the home.

Many healthcare career fields are projected to be among the fastest growing careers in the nation over the next ten years. For example, growth in the number of home health aides is projected to grow by over 50 percent, 39 percent for physician assistants, 34 percent for medical assistants, and 33 percent for physical therapists.

The high and increasing cost of healthcare is also impacting the growth of several career fields in healthcare. Both medical clinics and hospitals are cutting labor overhead to decrease costs. Much of middle management is being laid off or re-trained to fill other positions. Medical clinics and hospitals are now cross-training employees to fulfill various functions in order to cut down on personnel and decrease labor costs. Outpatient medical services and providers are on the rise and career opportunities outside traditional inpatient hospitals are growing in popularity. In fact, job growth in hospitals, compared to job growth in outpatient medical clinics and facilities, is projected to be slower.

With respect to job growth, hospitals are projected to be among the slowest segments of the healthcare industry due to increasing use of outpatient medical clinics and the ongoing campaign by hospitals to lower costs.

The demand for dental work and cosmetic dental procedures continues to grow as the middled-aged and elderly try maintain their their natural teeth through old age. More people can now afford dental work as well. This renewed interest in dental hygiene will continue to spur the demand for dentists, dental assitants and hygienists for years to come.

Job prospects. As healthcare workers retire and transition into new careers, job opportunities will open up at hospitals, medical clinics and residential care facilities. As the President and congress enact stricter immigration laws, the number foreign-born workers employed in medical fields in America will decrease and the availability off jobs in various sectors of the healthcare field will increase.

Healthcare jobs that experience high turnover usually have minimal training requirements, low barriers to entry, are low paying, part-time, and provide limited benefits. Jobs that experience higher than average turnover include medical assistants, home health aides, and orderlies. Not suprisingly, these are also some of the healthcare sectors with highest job demand. In comparison, jobs with low turnover, including physicians, surgeons and nurses, typically require higher levels of education and training, are full-time, and are higher paying.

Experts project that the position of registered nurse will continue to be one of the most indemand healthcare jobs over the next ten years and that job opportunities will abound for licensed nurses with advanced training and specialized skills sets. Many seasoned nurses will be retiring in the near future and hospitals, medical clinics and nursing care facilities are scrambling to fill vacancies and retain the best nurses they can.

For the forseeable future, demand for licensed and trained workers, professionals and specialists is projected to be strong across all sectors of the healthcare and medical industries. Demand will be strongest for those with advanced medical training and work experience. Some clinics and hospitals will only hire professionals with advanced clinical training in specialized fields of medicine. Pay and promotion opportunities will greated for those with advanced training and qualifications.

Earning


On average, healthcare workers (in nonsupevisory and nonmanagement positions) earn more than the average for all other workers employed in private industry. Workers in hospitals earn more than the average while workers employed in home health services, residential care and nursing care earn less (see table 4). Average earnings for hospital workers exceed national averages due to the higher number of hospital jobs requiring advanced training and professional education. Sectors of the healthcare industry that offer workers lower earning potential typically have lower education requirements and work is part-time.

Table 4. Average earnings and hours of nonsupervisory workers in healthcare by industry segment, 2008

Industry segment

Earnings

Weekly
hours

Hourly

Weekly

Total, private industry

$18.08

$608

33.6

 

Healthcare

20.38

678

33.2

Hospitals, public and private

23.99

866

36.1

Medical and diagnostic laboratories

23.21

804

34.6

Offices of dentists

22.36

613

27.4

Offices of physicians

22.09

732

33.1

Outpatient care centers

21.13

718

34.0

Offices of other health practitioners

19.35

543

28.0

Home healthcare services

16.17

478

29.6

Other ambulatory healthcare services

15.76

571

36.3

Nursing and residential care facilities

13.70

439

32.1

SOURCE: BLS Current Employment Statistics, 2008.
Healthcare supervisors, managers and administrators typically earn more than healthcare workers. Earning potential within individual segments of the healthcare market can vary greatly based on job description, training and education requirements, employer, and position duties (see table 5). More established healthcare employers may offer their employees tuition reimbursement, paid training, day care services for their children, and flexible work schedules. Healthcare workers who are required to work long shifts, work around the clock, on weekends, late shifts, holidays, or are on call often received pay premiums and overtime pay.

Table 5. Median hourly wages of the largest occupations in healthcare, May 2008

Occupation

Ambulatory healthcare services

Hospitals

Nursing and residential care services

All industries

Registered nurses

$28.65

$30.71

$27.20

$30.03

Licensed practical and licensed vocational nurses

17.82

18.37

19.44

18.77

Dental assistants

15.53

16.17

14.46

15.57

Medical secretaries

14.31

14.21

13.49

14.27

Medical assistants

13.59

14.32

11.83

13.60

Receptionists and information clerks

12.33

12.75

10.64

11.80

Office clerks, general

11.96

13.33

11.91

12.17

Nursing aides, orderlies, and attendants

11.37

12.03

11.07

11.46

Home health aides

9.73

11.58

9.81

9.84

Maids and housekeeping cleaners

9.62

10.28

9.21

9.13

SOURCE: BLS Occupational Employment Statistics, May 2008.
Earning potential varys not only by industry segment and type of healthcare organization, it also varies by the size of the employer. For example, healthcare professionals and workers employed by larger hospitals and group practices typically earn more than their counterparts working in smaller hospitals and clinics.

Location is also a factor that influences earnings. Physicians, technicians, medical assistants and nurses working in a hospital in the Midwest will earn substantially less than their counterparts working in a comparable hospital located in a larger metropolitan city back east or on the West coast.

Benefits and union membership. Healthcare workers employed by established healthcare providers typically receive benefits, including sick leave, retirement planning, health insurance, and paid vacation time. However, benefits can vary from sector to sector and employer to employer within the healthcare industry.

While unions do exist within the healthcare industry, most healthcare professionals and workers do not belong to unions. About 20 percent of healthcare workers employed in hospitals are union members or are coverd by union contracts. In general, only about 14 percent of all healthcare workers belong to unions.

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