Unless you come into medical transcription through another medical field, postsecondary training is a requirement for employment.  There are one and two year certificate and associate degree programs available.  Coursework includes: anatomy, medical terminology, some legal training, word processing and data transfer using the internet. 

While certification is not necessarily required for employment, possessing a CMT (Certified Medical Transcriptionist) credential will boost your employment prospects.  Continuing education is a condition for renewal. 

About 60% of medical transcriptionists work for hospitals and many others are self employed; working without benefits for a higher hourly rate.  Transcriptionists also find contract work through independent agencies.