In the 70-plus years of clinically applied cardiopulmonary bypass, the training of that specialist operator, or perfusionist, has been through several stages. Perfusion was not a field that was easily identified as a possible career path when students were studying in secondary school or college. Established curricula found in physician and nursing training did not exist in extracorporeal technology education when the field was born. Many of the early operators of the heart-lung machine were often selected by cardiac surgeons to support their existing institutional program. These individuals acquired the skillset by sitting next to the technician who assembled and ran the pump. The goal was to learn the mechanics of the machine and follow the surgical commands during operations. Many of the goals were simple: maintain a set blood flow rate, blood pressure, and administer sufficient anticoagulant empirically so the large volume circuit did not develop clots. Often blood gases were optional. Those individuals could have been a nurse, lab technologist, or even someone without a science background, but eager to learn a new skill.

Many of these “on-job-trained” or OJT technicians embraced their new role and eventually formed the American Society of Extracorporeal Technology (AmSECT). AmSECT provided a place to exchange ideas and embrace the quickly expanding field. A few years later, AmSECT approached the American Medical Association seeking recognition of extracorporeal technology as a new field in health care, but what to call it? After many iterations of using the term “technologist”, the term “perfusionist” was adopted as a more creditable description than a technologist due to limitations in skills, education, and ability than a technician, which had been used earlier.¹ Since that time the term perfusionist has been the identity of practitioners in this field and has been adopted and integrated into all educational curriculum and credentialling.

Formal perfusion training programs, as one might associate with a medical school or nursing program, were slow to evolve. This was in part because of the small numbers that would be required to provide care relative to significantly larger numbers of physicians and nurses, not to mention the financial commitment to formalize a training process. Didactic education was limited, for most training was done in the operating room and teaching was absorbed within the department, and was secondary to the clinical schedule of the day. The process of formulating a formal curriculum was also difficult, because many of the physiologic parameters widely understood today were not understood or even measured in contrast to today. Certificates of completion or institutional letters acknowledging on-site training allowed the field to expand to other institutions and were the first steps in acknowledging the skillset that a perfusionist could provide.