My story (part of it)....
I strive for the top, always. Those who are happy with status quo do not belong in HEMS. If you cannot find ways to constantly challenge yourself, allow others to challenge you and also keep a degree of humbleness when you do not know something then you will/should fail at trying to enter flight. You simply are not what the business wants or needs.
After 10 years or so as a ground Paramedic and having dabbled in CCT ground, I decided I wanted to fly. This mostly developed as a result of me taking a job in a Level 1 Trauma Center and being part of the in house responding team. I was exposed to a level of care I had never experienced or been a part of before. I was making rounds on patients, seeing results of our prehospital work and it's outcomes, rubbing elbows with the brightest, educated and most skilled providers I had ever seen. I felt like I was a fake among them. I could not believe I was right there beside them, like I was cheating the system and would be ousted as soon as they knew how little I knew. I was qualified to be there and they knew I was light on knowledge... but they challenged me, I allowed them and welcomed them to do so and I challenged myself. Classes, courses and questions...lots and lots of questions.
I became certified as a Flight Paramedic on my own dime. I tried and tried to get on the local programs however it was very competitive and most of the closest providers already knew who they would hire IF an opening occurred as those people have been on the roster for years. It is a tight community but do not let that discourage you. It can be done. I wanted to fly, so I did what was necessary. I looked out of my state. I decided I was willing to move to accomplish what I wanted in my professional life.
I moved from Florida to Alaska for my first flight job. I was a paycheck to paycheck paramedic with a wife and three kids, however I made the move through research and planning. I saved up some money as best I could and I researched the heck out of the place I was applying. I knew they were desperate for help so I negotiated a sign on bonus and moving assistance. This was AFTER they flew me up for an in person interview and site visit. I made myself look good on paper and then I did what I do in person. It worked and I finally got my first job. It was extremely challenging and a rewarding experience.
After a year at that gig, I then put feelers out to other companies. I now had my pick of where I wanted to go as I had multiple offers and top notch experience. Very few Flight Medics get the opportunity I had...long flight times, remote, limited resources or no resources. I could very easily have a critical trauma or STEMI for HOURS....throw in the harsh environment and it was insane times.
I then took a flight job for a company opening a new location in a nicer, less harsh part of Alaska. So in addition to my flights, I got a taste of management, leadership, business development and marketing. I paid attention. I was in the community teaching classes, doing public inservices, and "selling" our company to the public. This job broadened my experiences as it was FW, RW, Float Plane and Boat all rolled into one.
I then went to work for an outfit on the Indian reservation in Arizona. While interesting, I was NOT a good fit for them and we parted ways after a couple months. Ironically, that company a few years back purchased the above company. They have since been bought out now as well.
After this gig I then experienced military contracting for the first time. I took a job in the remote Philippines performing RW HEMS supporting the US Military. I added some new skill sets which included the use of NVGs and Hoist. America was neck deep in Iraq and Afghanistan and were tapping out on resources and many people are not aware there are still many Al Qeuda friendly training camps in the southern remote islands of the PI which has a split population of Catholic (thanks Spain) and Islam.
While on this gig I learned about other opportunities in other parts of the world and I eventually put myself out on those as well. I went to being a remote medic and basically all my prior critical care and flight experience assisted me with this transition. There was a distinct difference between the medics on site who were just ground medics versus those of us with hospital or flight background.
After a few years, I started my own company, opened my own facilities and then started a second company (a Medevac company). So I now own and operate those enterprises and all my prior flight experience and knowledge have helped tremendously.
Set no limitations for yourself...never take no as an answer and when you get a no, ask yourself why and how you can change yourself in order to get a yes next time.