# Paramedic Courses Changing by 2013?



## Stephanie. (Aug 29, 2010)

I've heard by word of mouth that the nation will be changing the paramedic certifications, to where you have to receive a degree to become a paramedic. 
I was told that this change will take place in 2013 and you will have to go to paramedic school. No more online classes or tech schools. And there will only be certain colleges that you can attend throughout the nation. Has anyone heard anything similar?

Since, they are trying to omit Intermediate, I feel it will be a lot harder for basics to become paramedics, especially with certain accredited schools. But I also think that basics skills will advance throughout the nation. Allowing the basic to maintain all airway or start IVs, and let the medics handle drugs. 

Like I said this was just passed on by word of mouth, I was throwing my .02 in. I would like to hear if anyone else had heard anything.


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## Too Old To Work (Aug 29, 2010)

Unless you have a good source for any of this, I'd completely ignor it. While there are going to be some changes to the scope of practice and the curriculum, I haven't heard anything even remotely like what you are saying. 

Distance education is here to stay.


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## reaper (Aug 29, 2010)

It is not that they are requiring a degree. NREMT will require all Paramedic schools to be accredited or they can not test for NREMT.  This will exclude a lot of medic mills and on line schools that will not spend the time or money to become accredited. That will vastly improve the future of EMS.


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## 46Young (Aug 29, 2010)

My understanding is that it's up to the individual states to decide what they require for certification. Above that, it's really up to the employer. If enough require degrees to apply, it will then be the industry standard. Simple as that.


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## Too Old To Work (Aug 29, 2010)

reaper said:


> It is not that they are requiring a degree. NREMT will require all Paramedic schools to be accredited or they can not test for NREMT.  This will exclude a lot of medic mills and on line schools that will not spend the time or money to become accredited. That will vastly improve the future of EMS.



Or, under political pressure from the private companies and fire service lobby, more states will drop the NREMT. 

The problem is that other than a few well paid services, salaries are not high enough at most EMS systems to justify the increased costs. 

With the economy as bad as it is, I don't see initiatives that will add to business or education costs really being all that popular.


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## firecoins (Aug 29, 2010)

Accreditation is just a piece of paper saying the program covers what its suppossed to.  The CUNY BMCC is an accreditted program.  The CUNY Laguardia CC is not accreditted program.  Their coursework is set by CUNY and the NYS DOH. It is exactly the same course work.  Only difference is a piece of paper.


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## medic417 (Aug 29, 2010)

The quality online programs as well as the trashy diploma mills which sadly include some colleges will get certified.  It takes a few thousand dollars and some paperwork.  It is time consuming.  Some schools will have to ad a few pieces of equipment to qualify.  So accreditation and even NR pass rate prove nothing about the quality of education at a school.


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## MrBrown (Aug 29, 2010)

Accreditation, once the IAFF gets its desired two places on the Board, will mean nothing (not that it means much now)

The NREMT has no licensing power whatsoever and thier tests are barely acceptable enough to not be called criminally inadequate.

So .... yeah


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## 46Young (Aug 30, 2010)

firecoins said:


> Accreditation is just a piece of paper saying the program covers what its suppossed to.  The CUNY BMCC is an accreditted program.  The CUNY Laguardia CC is not accreditted program.  Their coursework is set by CUNY and the NYS DOH. It is exactly the same course work.  Only difference is a piece of paper.



Yeah, I noticed that. I went to NY Methodist, which is accredited. But LaGuardia, which has an EMS degree is not? This accreditation thing just sounds like another money making racket.


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## 46Young (Aug 30, 2010)

Too Old To Work said:


> Or, under political pressure from the private companies and fire service lobby, more states will drop the NREMT.
> 
> The problem is that other than a few well paid services, salaries are not high enough at most EMS systems to justify the increased costs.
> 
> With the economy as bad as it is, I don't see initiatives that will add to business or education costs really being all that popular.



One thing that hopefully would happen if non accredited schools are forced to close is that it will thin the supply of new medics.

Also, the fire service actually favors the NREMT. It may it easy for candidates to gain reciprocity. You can apply from anywhere, as long as you have the NR-P card. I was given a SC medic card when I moved from NY. I was given a VA card when I moved from SC. At one time I had P-cards from three states, with no testing required whatsoever. I haven't taken any recert exams in the 5 years I've been a medic, just the NYS original in 2005  and the NR-P.


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## Markhk (Aug 30, 2010)

Interestingly, Oregon already does require that paramedics have at least an Associate's degree. 

Per the DHS website, 

http://www.oregon.gov/DHS/ph/ems/certific/educate.shtml#paramedic

"For an EMT-Paramedic applicant submit proof that the applicant has received an associate's degree or higher from an accredited institution of higher learning the student must successfully complete all mid-course and final examinations and final practical examinations. "


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## courtellis (Sep 12, 2010)

*Heard somewhere*

I heard that somewhere....my fire department said there were some changes coming, but I think it was more curriculum based.  I have heard that at Ft Sam Houston you have to have an EMS Degree to be in the instructor programs.


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## Ridryder911 (Sep 13, 2010)

It is funny because this is NOT new. This has been discussed nationally for over 10-20 years now. It is those that want to demise and slow down the progress of EMS is raising questions and problems. Fear of change! 

This is how rumors start and promote as gospel. National EMS Educators (NAEMSE) in cooperation and association with NHTSA agreed decades ago to change the route EMS education was going. After decades of the same crap that had been contracted out and continuously watered down each time it was published, it was decided to allow the educators design the programs. 

It was over several years after meeting and designing the future outlook of EMS (http://www.nhtsa.gov/people/injury/ems/agenda/execsum.html) it was decided that remove the way of teaching EMS from objective base curriculum to the traditional methodology of education. (Wow! no more monkey see.. monkey do?) 

The NREMT which *IS * the largest testing agency for EMS and *most* acknowledge, and respected was part of the committee to decide and give advice of the future. No, they have no real authority per say; except many states utilize their testing as the license or certification authority; if not probably will soon due the expenditures and ability of reciprocity. Like it or not, that is just the way it is. 

One of the bold moves that the NREMT did do (and should be applauded) was to require in the future that they would only test applicants graduating from an accredited school. (*this affects Paramedic level only)*. 

I have read the B.S. about accreditation. Again, I doubt very few have even read the requirements or truly understand what accreditation is about. 

Myths vs. Reality. 

Myth-one has have offer a degree to become accredited. All of California Paramedic programs are accredited, as well as many other Fire base and private EMS programs and not all of them are associated with higher education. 

Reality- It does require the administrator or coordinator to possess at the least an undergrad or preferred graduate degree. (*allowance will be made that within 3 years, they will receive a degree)

Myth-Such programs are far superior than those that are not accredited No, but at the least those institutions have met the general  underlying requirements. This means that they have a program...not just a class. 

Reality- They are monitored. Clinical sites have a contract with institutions and students should be monitored by faculty, progress of students is closely monitored, follow up of post graduates of the program are performed to maintain quality. 

Myth- the costs to become accredited is astronomical .What a joke... the accreditation process is a few thousand dollars. Now; to ensure that one passes and meets the accreditation is much more... but; if you cannot fund such a program to be able to meet the basic standards, the program should not exist.. either do it right or get out! 

Really, would one want to go to a program that cannot even meet the basic standards?

Reality- We are the *only* healthcare that does not require the training and education to be accredited at a national level. It is a wonder, that Medicare and other payers pay EMS as much as they do. 

Reality - face it.. it's here. Yes, unions will huff and puff, EMT's in their ignorance will whine and groan, all over advancing the profession. 

EMS as a whole is a joke,.. why? Look at the base of it...  What other so called profession would not want some credibility? .. Yep only EMS. If we can do it half arse...that's good enough! 

R/r911


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## FLEMTP (Sep 13, 2010)

46Young said:


> Also, the fire service actually favors the NREMT. It may it easy for candidates to gain reciprocity. You can apply from anywhere, as long as you have the NR-P card. I was given a SC medic card when I moved from NY. I was given a VA card when I moved from SC. At one time I had P-cards from three states, with no testing required whatsoever. I haven't taken any recert exams in the 5 years I've been a medic, just the NYS original in 2005  and the NR-P.



Not always true. I applied for legal recognition of my MI & FL medic licenses in North Carolina. You cannot apply from anywhere with them. You have to be a resident of the state when you apply, or be affiliated with a NC EMS agency (for folks who live just outside the state but work IN the state) 

Its been a pain in my ***!


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## 46Young (Sep 13, 2010)

Ridryder911 said:


> Reality- They are monitored. Clinical sites have a contract with institutions and students should be monitored by faculty, progress of students is closely monitored, follow up of post graduates of the program are performed to maintain quality.
> 
> R/r911



No kidding. We need more of that. I've heard paramedic students bragging about all sorts of schemes. They would go into an ED for clinicals, a large ED, and have two different nurses sign of on different pages of their book. They simply change one date, and now they have 16 hours for the price of 8. Same thing by going between the main ER and the peds ER, which can be slow. They would tell the peds ER nurse that they were going to look for someone to stick and help draw labs on, when in reality they had a nurse or two evaluating them on the adult side. 16-24 hours for the price of 8. For the CCU, I've heard stories of going to the floor, attending rounds, and then getting signed off by the doc, who then disappears for much of the day. Then they can go downstairs and get a 2fer or 3fer as above.

Medics signing off on phantom intubations for their friends, crediting them for extra hours on the ambulance or letting them off early, as a few more examples.


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## Theo (Sep 13, 2010)

FLEMTP said:


> Not always true. I applied for legal recognition of my MI & FL medic licenses in North Carolina. You cannot apply from anywhere with them. You have to be a resident of the state when you apply, or be affiliated with a NC EMS agency (for folks who live just outside the state but work IN the state)
> 
> Its been a pain in my ***!



Oh yeah, NC makes you jump through a few more hoops to get their license. My family is moving to NC in another year or so. I plan on setting up temporary residence at a family member's home in order to meet the requirements to get the NC reciprocity process started. That way, I'll have it in hand by the time I start sending out my resume. 

It's a pain, but in a way I understand why they do it that way.


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## Ridryder911 (Sep 13, 2010)

46Young said:


> No kidding. We need more of that. I've heard paramedic students bragging about all sorts of schemes. etc...



Amazing still today there are schools that do not provide preceptors (employed per school) within the clinical environment. Then we wonder why more and more hospitals are becoming difficult to obtain clinical sites?... 

More amazing we do ..."hours".... instead of reaching objectives. Coffee house clinicals, those that students never respond or even see and perform are asinine. For example, just placing .."time".. in a student will usually get a "S" satisfactory or "O" unable to evaluate.. really? What good did that clinical do for that student? 

We flood the market in regards to Paramedic training. Seriously, most states could do very well with just a few institutions teaching and rotating students through quality clinical training and exposure. Would it costs more? Yes; but would it not be worth the price to ensure students to be exposed to, see and obtain clinical experience? Setting around playing the X-box is nice for down time events but for education?... The same as a non-busy ER, ICU/CCU.. were they exposed to respiratory failures, and those with  true coronary problems?...Were there instructors there to ensure they participated in patient care and met objectives.. or did the students sit and watch monitors and hide in the corner? 

If we restricted the number of students entering and those exiting, with quality graduates, we could defend the right to increase salary and anything associated with the profession. 

R/r 911


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## terrible one (Sep 13, 2010)

Ridryder911 said:


> It is funny because this is NOT new. This has been discussed nationally for over 10-20 years now. It is those that want to demise and slow down the progress of EMS is raising questions and problems. Fear of change!
> 
> This is how rumors start and promote as gospel. National EMS Educators (NAEMSE) in cooperation and association with NHTSA agreed decades ago to change the route EMS education was going. After decades of the same crap that had been contracted out and continuously watered down each time it was published, it was decided to allow the educators design the programs.
> 
> It was over several years after meeting and designing the future outlook of EMS (http://www.nhtsa.gov/people/injury/ems/agenda/execsum.html) it was decided that remove the way of teaching EMS from objective base curriculum to the traditional methodology of education. (Wow! no more monkey see.. monkey do?)





Intersting post R/r 911.
Other than what you did post what sort of changes do you see in the near future?


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## MrBrown (Sep 13, 2010)

Brown forsees absolutely no substantive, meaningful change and while Paramedics elsewhere in the world are out getting advanced degrees and practicing advanced prehospital medicine the US will remain in about 1990.

Its ok tho, I always did like the 90s.


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## courtellis (Sep 13, 2010)

Ridryder911 said:


> It is funny because this is NOT new. This has been discussed nationally for over 10-20 years now. It is those that want to demise and slow down the progress of EMS is raising questions and problems. Fear of change!
> 
> This is how rumors start and promote as gospel. National EMS Educators (NAEMSE) in cooperation and association with NHTSA agreed decades ago to change the route EMS education was going. After decades of the same crap that had been contracted out and continuously watered down each time it was published, it was decided to allow the educators design the programs.
> 
> ...



That was an outstanding reply, thank you!!


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## 46Young (Sep 13, 2010)

FLEMTP said:


> Not always true. I applied for legal recognition of my MI & FL medic licenses in North Carolina. You cannot apply from anywhere with them. You have to be a resident of the state when you apply, or be affiliated with a NC EMS agency (for folks who live just outside the state but work IN the state)
> 
> Its been a pain in my ***!



There aren't really any dual role medic/ff positions in NC as far as I know. That's why I didn't think of NC when I said thet the fire service likes the NR cert. I remember looking around the southeast in general at third service EMS agencies, and seeing that they weren't really paying all that well in NC. That's what led me to Charleston SC for a brief time. Easy reciprocity and a salary that was higher than anything you'd find, fire based or not, from Southern VA down to the FL border. I never even looked at what NC wanted for reciprocity, since they didn't pay enough to support a family of three. 

But I know what you're saying. While I was in the fire academy I was thinking about getting my foot back in the door at my old hosp based EMS job in NY, on a per diem basis, just in case I didn't make it through the academy. At over 30/hr, doing 24-32 hours on weekends would make it worth the trip. My NY cert had expired, and they required a challenge refresher, and I think residency. Not worth it. NR counts for nothing there.


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## 46Young (Sep 13, 2010)

Ridryder911 said:


> Amazing still today there are schools that do not provide preceptors (employed per school) within the clinical environment. Then we wonder why more and more hospitals are becoming difficult to obtain clinical sites?...
> 
> More amazing we do ..."hours".... instead of reaching objectives. Coffee house clinicals, those that students never respond or even see and perform are asinine. For example, just placing .."time".. in a student will usually get a "S" satisfactory or "O" unable to evaluate.. really? What good did that clinical do for that student?
> 
> ...



Accreditation and generally holding schools accountable for their educational standards and practices is an excellent place to start. Organization on a national scale is pretty much out of the question due to the transient and fragmented nature of EMS at the moment. In order for that to change, I feel that employers across the board need to require EMS degrees to be considered for employment, or at least give strong preference in hiring to the educated. If more employers, at least the quality and high paying ones do this, then more EMS professional will sekk out degree programs. How do we start a trend in that direction?


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## Veneficus (Sep 13, 2010)

MrBrown said:


> Brown forsees absolutely no substantive, meaningful change and while Paramedics elsewhere in the world are out getting advanced degrees and practicing advanced prehospital medicine the US will remain in about 1990.
> 
> Its ok tho, I always did like the 90s.



I agree with Brown on this.

I very much like and support Rid's opinion on this, but what I see and forsee is:

Schools will paying small community colleges to piggyback "accreditation."
Simply done by being an "offsite" facility. I even know of one class that is a "offsite campus" from a CC in another state.

Why I ended my tour in education is because the new curriculum is going to be taught by a large population of "instructors" with no basic science background. In order to meet the "objectives" in the "allotted time," in other words the same amount of time spent now. This "education" will be reduced to  series of bullet points from premade Mosby powerpoints that are simply a list of science facts to memorize that are in no way connected to the clinical sciences or demonstrated to be relavent in the patient care setting. It will be at least a decade before we should expect to see people with science undergrads in anything except nursing. 

If that is the case, I would rather see nursing make a play to take over EMS in the US.

There are definately not enough nursing educators to supply their own industry, much less make time for EMS. 

I doubt very much we will physics, biology, chemistry, or other science graduates with dual paramedic accreditation teaching ever.

Worse still would be a bunch of "EMS" degrees that were loaded with management and administrative courses and weak on basic science, it would be just more of the same as we have now.

Sorry to take the wind out of the sails, but there are many ways to resist change, and I think we are simply trading one way for another. 

I would start expecting to see many EMS providers applying for work experience as educationl credit in liberal studies, urban affairs, or other non medical fields in order to simply meet the degree requirements. 

Of course the national fire academy (another _fine example_ of an institution of "higher learning") could always offer a bridge course too.

Not pessimistic, realistic. I have been in the game a long time and the moves are predictable. I don't see states moving away from NREMT en masse. One or two will try, see the cost and effort involved and move back.

A truly stellar idea is that an EMS educator should have a license as a healthcare provider to teach. It would quickly narrow the field to those not only with an interest, but people who have had basic science prereqs.


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## FLEMTP (Sep 14, 2010)

Theo said:


> Oh yeah, NC makes you jump through a few more hoops to get their license. My family is moving to NC in another year or so. I plan on setting up temporary residence at a family member's home in order to meet the requirements to get the NC reciprocity process started. That way, I'll have it in hand by the time I start sending out my resume.
> 
> It's a pain, but in a way I understand why they do it that way.



yes, i have family there also. I now "live" there.. lol.

I guess after they approve my education ( had to request transcripts from my program.. crossing my fingers cuz its been 8 years ) then I have to go get fingerprinted for an FBI background check...then im sure a DNA sample and a retinal scan will be next lol


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## MrBrown (Sep 14, 2010)

Veneficus said:


> I agree with Brown on this.



In a recent double-blinded, placebo controlled, randomised trial it was found that 9 out of 10 people agreed with Brown.

Even more evidence that people should listen to Brown


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## rescue99 (Sep 14, 2010)

MrBrown said:


> In a recent double-blinded, placebo controlled, randomised trial it was found that 9 out of 10 people agreed with Brown.
> 
> Even more evidence that people should listen to Brown



choke, gag, cough cough...Um, sure..whatever Brown says


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## Emtpbill (Sep 27, 2010)

Is the National Registery a for profit organization that only has certification power the states allow them to have? There is talk in PA. to go back to just the state cert. And forget about NR.


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## jjesusfreak01 (Sep 27, 2010)

Emtpbill said:


> Is the National Registery a for profit organization that only has certification power the states allow them to have? There is talk in PA. to go back to just the state cert. And forget about NR.



The NR doesn't have any power other than the power to grant their certification. Because they have a high quality testing program, many states use the NREMT tests to certify their EMTs and Medics. Essentially, in those states, they make you take the NREMT tests, and when the NREMT certifies that you passed the exams then the state will give you your license or state certificate.


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## Melclin (Sep 28, 2010)

MrBrown said:


> In a recent double-blinded, placebo controlled, randomised trial it was found that 9 out of 10 people agreed with Brown.
> 
> Even more evidence that people should listen to Brown



I have serious methodological concerns


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## Melclin (Sep 28, 2010)

Vene: I feel sorry for you blokes and gals. I don't know how you fix those issues. 

With a bachelor's degree as standard entry level qualification we still have a range of problems. In some ways we might be lucky to have only those problems, but we have many problems none the less.

With a bachelors degree standard for first tier responders and a graduate diploma for second tier responders, as well as the commensurate responsibility, the majority of paramedics feel they are not paid enough. We're already paid as much as three times as much as some of our mates in the US. I wonder how this issue will progress.

There is also a strong clash between old and new cultures. Poorly educated providers with a wealth of experience vs well educated providers with very little experience. In addition, even after almost ten years, the degree is not yet particularly good at spitting out a large number of competent paramedics.

There is a profound shortage of paramedics in rural areas. As the required levels for paramedics rise, rural people who would once have been able to spend six months at the ambulance college and then return home for 2 years of vocational and distance education, are being largely excluded by a requirement to spend 3 years or more away from home. This is leading to an increasing amount of volunteer...well...EMTs..effectively. Oddly, raising the educational quota may mean that some communities actually end up with less qualified providers. Not that there aren't ways around that. My university is working on a number of distance education options.

I just thought I'd add a few words of ?wisdom from a system that has already instituted a a high level of education for both providers and educators.


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