# Hi all, looking for a bit of help!



## medic 112 (Dec 21, 2009)

Hey,
I would like to hear from anybody that can help me out!

I'm an EMT here in Ireland and was thinking of going to Canada Or America to do my paramedic course? 
When i look it up on line it's not much help!

Also, if anyone know's if i would be accreted to work either in America or Canada. 
I have great experience but would like a change of scenery and new adventures. ^_^

looking forward to your reply. 

Bilko


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## EMSLaw (Dec 21, 2009)

In the United States, your licensure/certification is going to be determined by the state you want to practice in.  So, there are 50 different licensing bodies at least (apparently, California has 30 different licensing bodies just itself, but I don't understand how things work out there, either. ;p) 

If you have an idea of where you want to work, you can contact the state office of EMS in that state and find out what their requirements would be for someone in your situation.


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## akflightmedic (Dec 21, 2009)

sgt. bilko said:


> Hey,
> I would like to hear from anybody that can help me out!
> 
> I'm an EMT here in Ireland and was thinking of going to Canada Or America to do my paramedic course?
> ...



May I suggest a program that will save you a lot of money BEFORE moving and will enable you to be in a position to gain employment as soon as you do.

Several of my Aussie mates and some soldiers I know have attended or are attending this course and although I am NOT a fan of online education, it is the way of the future.

This program is pretty decent as I have seen the lectures, sat in on some of the classes with my coworkers to get a feel for it and it is ok.

Talk with Brad the owner/lead instructor and he may even give a discount based on the exchange rates of your country.

Towards the end of the program, you will have to come to the USA to do some clinicals and test out but at least you can get this course done without leaving your country and current employment.

http://www.southcoasttraining.com/


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## medic 112 (Dec 21, 2009)

Cheers to all for that info. 

Akflightmedic -- I don't think that an online course is for me, but i thank you for the link. 

I'm more looking into getting a job over in the states or Canada as an EMT. Then in time go to collage to gain my EMT-P certification.

I am on the national register in Ireland to practice to EMT-b level. So i would like to think i wouldn't need to go back to collage for a refresher, but would understand having to take some state/National exams to register to be able to practice to my current level. 

I would like to think the States would be a great place to work but feel getting Visa's etc would be hard. 
Which is why i mention Canada, Would be a little easier for me to be honest. A friend  of mine who work's in Canada and said something about IPS! 
Would like to know more info about that or better again, if someone works for them and can let me know the best route to get a job their/if any!!!

So anyone with more info i would be grateful.

Cheers Bilko.


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## Scott33 (Dec 22, 2009)

sgt. bilko said:


> I'm more looking into getting a job over in the states or Canada as an EMT. I would like to think the States would be a great place to work but feel getting Visa's etc would be hard.



It is going to be the biggest stumbling block for you.

You could apply for a student visa (F-1) in which you could come over and do your EMT-B / EMT-P courses, but it *does not * grant you a work permit, so you would basically need to provide your own funds for the duration. I have seen it done though.

The work visa would need to be a separate application, and is something which is made by an *employer*, not you. There are no visas available for the job of "paramedic", as it is not a profession in such demand, as to be included in the EB-3 visa criteria. In other words, work visas are job-specific, and those jobs are limited to those which are in short supply in the US.

http://www.uscis.gov/portal/site/us...nnel=74da83453d4a3210VgnVCM100000b92ca60aRCRD

The "points system" of immigration shared with many other countries (Canada, Oz, NZ, UK) does exist to a degree in the US, but is restricted to the likes of actors, athletes, PhD level scientists, and multinational CEOs.

http://www.uscis.gov/portal/site/us...nnel=cdfd2f8b69583210VgnVCM100000082ca60aRCRD

Can't speak for Canada, but it may be just as challenging.

http://www.cic.gc.ca/english/index.asp


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## MrBrown (Dec 22, 2009)

Why on earth would you want to go to the US for Paramedic education?  You do a search of this forum you will find many, many long posts about how inadequate and out of date thier system is.  

I've read a little about EMS in Ireland and from what I understand it's a developing concept but if I were you then I would stick to Canada specifically Ontario or Alberta *or* look at Australia or NZ.

In Ontario to reach Advanced Care Paramedic (ALS) is around four years
In the UK to reach Paramedic (ALS) is minimum of a three years.
In Australia to reach Intensive Care Paramedic (ALS) is four to five years.
In New Zealand to reach Intensive Care Paramedic (ALS) is four years.
In Israel to reach Intensive Care Paramedic (ALS) if around three years.
In most of Europe you are required to be an RN or a Physician to provide ALS.

In the United States you can become a Paramedic (ALS) in as little as 600 hours (literal clock hours) in Texas using a cirricula that was written 11 years ago and reads at about middle year of high school in complexity.


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## ExpatMedic0 (Dec 22, 2009)

It will vary very much from state to state. In my state its a 2 year degree that takes 3 years, but as stated it could be only 600 hours in other states. Check out nremt.org for info. This is our national registry.


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## MrBrown (Dec 22, 2009)

I would agree, Oregon requires a two year degree for Paramedic (ALS) likewise does Missouri for ALS which they call MICP (Mobile Intensive Care Paramedic).

Texas has some very good people coming out of *Brookhaven*www.brookhaven.edu and the cost of living is dirt cheap.  

New Zealand has a points immigration system and both Paramedic (ILS) and Intensive Care Paramedic (ALS) are recognised as qualified professions under that scheme.  

Remember that in the US tuition is weirdly based on "credit hours" which I have never understood and that for you as a "non resident" (just like somebody from across the state line) it's incredibly expensive *plus* you have to have health insurance *and* you need to take a minimum number of credit hours per semester (12) to qualify for an F-1 visa which if you're on a degree that has 11 hours one semester well you have to make it up with another class, meaning more work and it's going to cost more.  

Unless you've independantly wealthy it's going to be a tough ask probably somewhere in the neighbourhood of 15,000 Euro.

I don't know if Ireland is part of the UK still or if like Wales you've sawn it off out of embarrasment but you'd be better off sticking close to home; might not get the major gang trauma but you're gonna get a better education anway (at least in the UK, can't speak to Ireland).


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## medic 112 (Dec 22, 2009)

Thanks for that lads,

I would love to do it here also, but as of yet it is near impossible to get a place on a Paramedic course. 
They are reserved for current members of the Ambulance service and are run not near often enough to cope with the demand. 

I'm on a Parnell to get into the ambulance service but could be anything from 3yrs upwards,  and no guarantee of even getting a job at the end of it!!!

The market is flooded over here with EMT's and their is only so many private ambulance company's with positions! Which tend to be very rare. 

Any more info from the Canadian side of things in relation to work???


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## skivail (Dec 22, 2009)

Comming to Canada will be tough.  Each province is defferent but to work in Ontario you will most likely have to complete a 2 year degree.


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## Scott33 (Dec 22, 2009)

MrBrown said:


> Why on earth would you want to go to the US for Paramedic education?  You do a search of this forum you will find many, many long posts about how inadequate and out of date thier system is.
> 
> In Ontario to reach Advanced Care Paramedic (ALS) is around four years
> In the UK to reach Paramedic (ALS) is minimum of a three years.
> ...



Well, to a degree you are correct. But I feel you are giving a completely one-sided argument.

You and I both know that NZ rely heavily on the St John Volies. If you happen to live outside the more populated areas of the country (as my sister does) and need an ambulance, you are more than likely going to get an SJA volly first aider. 85% of NZ EMS are SJA according to their webpage. As with the home of the St. John Ambulance, the UK, they are primarily a first aid charity run on a volunteer basis. No degree needed to join or practice.

http://www.stjohn.org.nz/about/

Australia and Canada both have SJA vollies, but seem to have them in more practical proportions with their professional counterparts.

The UK has only just (in the last few years) started to roll out mandatory degrees for paramedics to practice. It is still in its infancy, and Scotland Wales, and NI are still in the process of getting the process off the ground. There is the option for current paramedics to do modules which will lead to a degree (just like as it has been in the US for years) but for the rest of the UK, paramedic courses are still being trained the traditional IHCD way. That can be as little as *12 WEEKS*, which equates to about 480 hours including clinicals. 

http://www.scottishambulance.com/UserFiles/file/WorkingForUs/Paramedic Training.pdf

http://www.ambulance.wales.nhs.uk/a...-4177-878a-94b8a8460e8a633689104710258750.pdf

As for the reading material being aimed at kids? The UK version of Nancy Caroline has only been out for a few years, and prior to that, the bible of the UK paramedic trainee was the US version - as is still the case with many other texts required.

I am not having a dig at any of those systems (my Brother is a UK Paramedic) but I think it is only fair that things are put into perspective. I could easily make it sound like Wake County NC, or Medic One Seattle are "typical" US systems, but that would not be true. But the fact remains, the degree medic has been around a lot longer in the US, than the UK - the difference is that the US does not make it mandatory in order to practice. 

The main problems with US EMS when compared to the rest of the world, evolve around the complete fragmentation in standards of training and education, failure to recognize a common overseeing body, and the completely unnecessary integration with other professions. Education ranges from tech school to batchelors degree, hours of training range from 600 - 3,000 hours, scope of practice ranges from having to call for any form of pain management, to standing order RSI and induction of hypothermia in the periarrest patient. 

On the whole, the US has as far from a perfect EMS system as you can possibly get. Can't deny it. But it is also, in certain parts of the country, way ahead of most other systems out there. 

To quote Alan Murray, the CEO of the Welsh Ambulance Service - _"If you want to see the best EMS system in the world, go to the US - if you want to see the worst, go to the US"_


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## MrBrown (Dec 22, 2009)

I could not agree more mate, I've been lucky to travel extensively and work in the US; you have some fantastic systems (Seattle, Wake Co., Boston, Tulsa/EMSA, Lee County FL, Reno/REMSA, Oregon and Kansas both require a degree etc) but if I have crushing cardiac chest pain in downtown Dallas I'm going to drive to Austin/Travis County likewise if I have life threatning asthma in Los Angeles, I'm gonna see if I can make it to Oregon or Reno.

My goal is not to run your systems into the dirt because you get a degree of fracture and difference anywhere; I simply felt it was important to highlight to our OP that he should be careful where he treads because as you say of the problems and places where you can get by with a 600 hour education and I doubt anybody except the Houston Fire Department would argue that is grossly, somehow negligently, inadequate.

That said we use the Bledsoe book here, it's OK, it's not the best, it's very light on the details when it comes to pharmo and patho and the A&P section is apalling but .... until we get a distinctly New Zealand cirricula for Paramedic and Intensive Care Paramedic then it's what we have to work with and it gets supplumented anyway.

Of note I am part of a consortium that is looking to develpp the first New Zealand Paramedic specific textbook which will hopefully be much, much more indepth than anything on the market at the moment.

As for your sister I don't know where specifically she is; but the days of the Johnno first aider on ambo's hasn't existed since at least the mid 90s.  Most of the volunteer Ambo's are now at or almost at the Ambulance Technician level which is between your BLS level and ILS level and really is quite good, even if I do find fault with it (but everybody will find fault with everything right?).

I don't want to turn this into a pissing or dissing match and that is not my intention but .... look twice, enrol once I spoze?


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## Scott33 (Dec 22, 2009)

MrBrown said:


> I don't want to turn this into a pissing or dissing match and that is not my intention but .... look twice, enrol once I spoze?



Me neither. It's all good. 

I have more than a casual interest in the UK system, having lived there for much of my life. I have a lot of respect for the system as a whole, but it is not without its problems. If you look on WWW sites like the BWTS, it doesn't take long to realise that they have the same burnout medics as you get anywhere else. What the likes of the UK gain with a one size (almost) fits all system for the entire country (as well as their clinical autonomy) they lose with other things. Again, the BWTS is a good place to read about the hatred the road staff have for their managers, and the continual problems with vehicles, ongoing training, and reshuffling of clinical roles. They have also taken a step backwards with the removal of the Ambulance Technician, in favour of the Emergency Care Assistant - basically, a driver with first aid training. OK in theory perhaps to have a driver in front, and a paramedic in the back - but there has already been instances of having double ECAs on 999 calls in order to stop the almighty ORCON clock. 

Clinical scope of practice can also be lacking in some areas. Ask your typical UK para what the standard of treatment is for symptomatic tachycardias (of any sort) and you will get a strange look. 

A little of many systems would make for the perfect system. Not going to happen in my lifetime though 

PS, she lives in Whangarei


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## MrBrown (Dec 23, 2009)

I agree, I constantly hear about UK ambo's *****ing at "ORCON" and "Call Connect".

Do you know [of] Malcom Wollard at all? He did a bloody great presentation on ECPs or the lack thereof and how Call Connect/ECAs has really put the UK service back 20 years.

JRCALC will hopefully pull thier head out thier bum sometime and introduce pacing and cardioversion, we've had it for at least 15 years.


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## Scott33 (Dec 23, 2009)

MrBrown said:


> Do you know [of] Malcom Wollard at all? He did a bloody great presentation on ECPs or the lack thereof and how Call Connect/ECAs has really put the UK service back 20 years.



I don't know of him, but suffice to say the ECA has not been most popular new grading among the road staff.



> JRCALC will hopefully pull thier head out thier bum sometime and introduce pacing and cardioversion,



...and Adenosine...and Cardizem...and Lopressor...and Amiodarone (other than in arrests).


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