# US EMT-IV needing information before moving to Canada



## TattooedMommy139 (Sep 30, 2010)

Hi! I am currently an EMT-IV in Tennessee, but am in school for Paramedic/Registered Nurse. My family and I are discussing a possible location change to Canada. I have done a little research on my own and found the general pay scale from 2006-2009, but after reading the threads and replies, Im not sure where it stands now. We are looking at possibly Nova Scotia or British Columbia, but from my research I see BC has a higher cost of living than the other parts of Canada. So, what I am looking for is more updated information on wages, cost of living and crime in Canada. Or at least some links to do my own research, but personal opinions would be wonderful! I need all the information I can get before moving 3 children to a new country! So thank you in advance for any information given!


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## akflightmedic (Sep 30, 2010)

Will you be done with your nursing prior to the move?

Your EMS education will not transfer, do more research on that it has been discussed many times on this site and other sites.

Most likely you are wasting your time in medic school currently if you are moving soon.


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## Outbac1 (Sep 30, 2010)

The cost of living varies depending on where you go. BCs lower mainland, Vancouver, is very expensive to buy a house vs Halifax in NS. Are you planning on working as a paramedic? It is very hard to get into full time work in BC, NS is easier although full time jobs are hard to get. Our casuals seem to get full time hours or close to it most weeks. If you are a nurse you should be able to get a job almost anywhere, especially if you have a degree and  experience.  An EMT won't get you anything in Canada, you'll need at least Paramedic.
 I do not know the pay scale in BC but rural medics get a stand by rate they are very unhappy with. I think they were on strike last year. In NS a PCP makes about $21.00/hr and an ACP $24.00 to start.

Look at some real estate sites to get an idea on housing. Have you looked into Canadian Immigration?  Look at some posts in the international section for more info of Canadian paramedics.
Here is a link to the NS EHS paramedics for some info on registration; http://www.gov.ns.ca/health/ehs/paramedics/policies.asp


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## MrBrown (Sep 30, 2010)

Simply put, you would have to go back to school for anytwhere up to two years.

Primary Care Paramedics in Canada have years not hours of education; as per the National Occupational Competency Profile a PCP can insert an LMA and administer a number of autonomous medications; adrenaline, GTN, ASA, salbutamol and glucagon.

In Alberta they can perform comprehensive 3 lead ECG interpretation and obtain a 12 lead while both AB and BC allow them to cannulate and infuse.

Advanced Care Paramedic (ACP) requires another two years of education or one year if you are in Ontario and includes a range of typical ALS interventions while some provinces allow RSI and thrombolysis, again Alberta being an example.

Many provinces have Paramedics recongised as a regulated and restricted health disclipine, again Alberta being example with its own College of Paramedics.

The difference is that the Canadian education system for Parmamedics is much more comprehensive than the US and includes indepth cognitive knowledge of dexterious skill rationale and critical thinking rather than just monkey see monkey do.

But what would Brown know, after all heck he is no expert on Canuckistanada


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## aewin90 (Sep 30, 2010)

Unless you plan on completing your nursing education prior to moving, it is not a good idea.  Your EMS education simply will not transfer.  If you want to do EMS work in Canada you will find yourself hitting the books again, although it will probably be a breeze after having gone through most of it in the U.S.

Those pay rates don't sound too bad at all.  I live in a fairly rural area with a high cost of living and paramedics start at about $13.80.  Yes, $13.80.  Then again this is also an area where a master's degree in education will get you about $20,000 a year to start...

Not many mansions out here.  :unsure:


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## jjesusfreak01 (Sep 30, 2010)

A Canadian PCP sounds like a US EMT according to scope of practice...at most an EMT-IV (or C) while ACP sounds like a US paramedic. I understand the whole cognitive knowledge thing, but if you are in school for years, you ought to be able to do a little more than apply band-aids.


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## WolfmanHarris (Sep 30, 2010)

jjesusfreak01 said:


> A Canadian PCP sounds like a US EMT according to scope of practice...at most an EMT-IV (or C) while ACP sounds like a US paramedic. I understand the whole cognitive knowledge thing, but if you are in school for years, you ought to be able to do a little more than apply band-aids.



Frig people, stop using skill set to define a provider. It's not the toys in the toy box. Thinking like this is what causes the backlash against pulling prehospital intubation in the face of mounting EBM that EMS sucks at it, has limited opportunities to perfom it in the field, and less opportunities for practice in a clinical setting. Proper education creates the difference between a clinician and technician.

To mirror what's been said at best you could receive equivalency from EMT-P to PCP (in Ontario anyways) but that is by no means automatic and from my understanding quite rare. At this point even RN's (BscN) are finding that the province is not instantly allowing them to write their A-EMCA to become a medic and I know more than a few RN's that have had to go to PCP school to work on the road (though with exemptions from some credits). A quick check of Ontario's Ministry of Health site specifically lists the following as part of the guidelines when considering application for PCP equivalency:
- Theory component (800+ hours)
- Practical lab and hospital clinical (300+ hours)
- Land Ambulance field placement (450+ hours)

Bear in mind that as per the MOH all of these cases involve a two stage process and are reviewed case by case. 

Also worth mentioning is that their is no abundance of jobs in most places. Programs are usually oversubscribed and competitive to get in to. Attrition during programs is high. Service hiring is competitive and often favours students who precepted in that area. The IFT industry is separate from EMS, in Ontario are not considered ambulances, do not require Paramedics and pay crap.

Nursing is probably your best bet for equivalency.

Also look very carefully at the requirements for registration as an RN with the various provincial colleges. The Ontario College of Nurses has made it clear that they will only accept four year BscN degrees for registration of new RN's within Ontario. They may not accept some of the shorter programs available in the US. I don't know this for sure, but it certainly demands more research to avoid disappointment.

Your best bet is to contact the respective licensing bodies directly as a quick search on my part did not yield great answers.


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## TattooedMommy139 (Sep 30, 2010)

Ton of information! I DO plan on having my RN degree before we move ( I have 2 semesters left, and 1 left for my Paramedic licenese). One person summed it up pretty much to the T. It sounds like (according to at least TN  scope of practice) Canada's PCP is equal to our EMT-IV and the ACP  is equal to our medic.  Weird. Only took 2 years to get EMT-IV AND Medic :/. Ok, what about tattoo acceptance in the work place? What are the rules in Canada on that? I know here, I have to cover them with a long sleeve shirt/jacket.


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## Outbac1 (Sep 30, 2010)

EMTs are far removed from PCPs. That is why they are not considered anywhere for equivalency. In Nova Scotia a US "Paramedic" can apply for ACP equivalency. If they can pass the test they will be registered as an ACP. If not then they are registered as a PCP.

 I don't know how the equivalency works for nurses. I do know there are many US trained nurses working in Nova Scotia and Canada.

 Many medics here have tatoos they do not cover up.


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## MrBrown (Sep 30, 2010)

Brown should add Canada is awesome! 

... but most here knew that already


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## medicRob (Sep 30, 2010)

TattooedMommy139 said:


> Ton of information! I DO plan on having my RN degree before we move ( I have 2 semesters left, and 1 left for my Paramedic licenese). One person summed it up pretty much to the T. It sounds like (according to at least TN  scope of practice) Canada's PCP is equal to our EMT-IV and the ACP  is equal to our medic.  Weird. Only took 2 years to get EMT-IV AND Medic :/. Ok, what about tattoo acceptance in the work place? What are the rules in Canada on that? I know here, I have to cover them with a long sleeve shirt/jacket.



Our EMT-IV is the equivalent of i/85, their lowest level provider is the equivalent of a paramedic here plus some, and I believe the title of that provider includes, "Paramedic" as well. Unfortunately, you are out of luck. You would have a better chance of transferring your licenses if you were in a degree seeking paramedic program I would think.

It is good to see another Tennessean on here.


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## TattooedMommy139 (Sep 30, 2010)

medicRob said:


> Our EMT-IV is the equivalent of i/85, their lowest level provider is the equivalent of a paramedic here plus some, and I believe the title of that provider includes, "Paramedic" as well. Unfortunately, you are out of luck. You would have a better chance of transferring your licenses if you were in a degree seeking paramedic program I would think.
> 
> It is good to see another Tennessean on here.




Yeah its pretty much looking like I need to finish out my nursing before even attempting, which is a bummer, but, patience, I guess lol. The only thing Ive read on here that is some what promising is what the one said they do in NS. I see you are in Nashville. We've considered moving there also, (have family from there). Lol, wanna share what they have to offer? LOL we just HAVE to get out of Chattanooga.


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## medicRob (Oct 1, 2010)

TattooedMommy139 said:


> Yeah its pretty much looking like I need to finish out my nursing before even attempting, which is a bummer, but, patience, I guess lol. The only thing Ive read on here that is some what promising is what the one said they do in NS. I see you are in Nashville. We've considered moving there also, (have family from there). Lol, wanna share what they have to offer? LOL we just HAVE to get out of Chattanooga.



Check your inbox later today. I am about to head into the University to teach, I was just logging into the forum before I headed in to see what everyone was up too.


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## CAO (Oct 1, 2010)

TattooedMommy139 said:


> we just HAVE to get out of Chattanooga.



If I may without intending to derail the topic, why is that?  I kind of like the area.


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## Outbac1 (Oct 2, 2010)

I'm curious. Why do you want to come to Canada? Family connection? Although Mr. Brown and I agree Canada is awesome. Everywhere has its problems and nowhere is perfect.


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## fortsmithman (Oct 2, 2010)

Outbac1 said:


> I'm curious. Why do you want to come to Canada? Family connection? Although Mr. Brown and I agree Canada is awesome. Everywhere has its problems and nowhere is perfect.



I also agree that Canada and we Canadians are awesome.


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## TattooedMommy139 (Oct 2, 2010)

Honestly...Chattanooga IS beautiful. The weather is great, jobs (IF you have a college education) are pretty promising, its rather expensive to live here, but not as expensive as other places Ive looked. It definatly has its appeal....unless youve lived here your whole life..which I have. I have background here and Im ready for a fresh start. Now leaving the question, WHY in another COUNTRY opposed to another STATE...Honestly..I am very....upset...I guess would be the best way to say it...with America.  There have been things that Ive learned over the years that..just leave me really not liking the US. Plus, its somewhere Ive always wanted to live. Its beautiful there, cold, but beautiful, they offer healthcare ( Im aware with also higher taxes), its affordable, jobs are still promising (again with education), higher wages...I mean. It just SOUNDS great right now, which is why Im doing my research to see if it REALLY IS that great. Im just not happy with the US and the way the run the country, or the way it has been ran over the last ohhh...10 years or so...


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## TennesseeMedic (Oct 29, 2010)

*Tennessee Paramedic to Canada*

Ok. I thought I should offer my two cents because I am an A-EMCA from Ontario and a Tennessee Paramedic. An ACP in Ontario is equivalent to a Tennessee paramedic (e.g. EMT-P), and/or any U.S. EMT-P graduating from a U.S. DOT approved program.
If you want to reciprocate as a Tennessee paramedic to Ontario, you have to go through the Ministry of Health and Long-term Care Equivalency process--it is a drawn out process, but it is designed to ensure that you have the necessary understanding of the Ontario system to function safely and effectively. The goal of a Tennessee paramedic to reciprocate to Ontario is to obtain an A-EMCA certificate/license and then obtain ACP certification. First, you must apply for equivalency at the entry level--known, when employed, as a PCP (Primary Care Paramedic)--This requires an application, fees, and practical and written testing—this results in an A-EMCA certificate being issued. The applicant then applies for ACP (Advanced Care Paramedic) which entails another application, fees, and practical and written testing. 

Here is the direct link to MOHLTC
http://www.health.gov.on.ca/english/public/program/ehs/edu/equiv_qa.html

Canada has inter-provincial agreements to allow transfer of skills from province to province and it is still not perfect—Alberta is very difficult transfer to for example.  

Now, let me say something about this nonsense regarding U.S. EMT-P’s versus Canadian ACP's. Both are professionals and highly knowledgeable. Assessment skills are paramount to both training systems and I can tell everyone from experience (Ontario and Tennessee in my case) "monkey-see monkey-do" is NOT practiced in either system. I hear this unsubstantiated criticism most often from Canadian paramedics reflexively denigrating their U.S. counterparts--this is blatant anti-Americanism and it is, quite frankly, embarrassing. The reality is, U.S. paramedics are among the highest trained pre-hospital providers in the world and our ALS systems are among the oldest. Regarding paramedic education, it is required in 14 states to complete a 2 year AAS or AS in Paramedic Care prior to initial licensure as an EMT-P and the AAS is offered in all states with the exception of Maryland where the only education based Paramedic program is a 4 year BS from UMBC. It is also normal practice to require licensure at the entry level (in Tennessee, this is currently the EMT-IV which takes 8 months to complete at community college) and at least one year of road experience prior to entrance to a Paramedic program (There is a current trend in Tennessee schools to allow entrance immediately after graduation from EMT-IV, but there is a high drop-out rate and this trend is not looked upon favorably by experienced medics in the field). Regarding the education of certificate program paramedics, national accreditation is the norm, and soon to be required across the U.S., and these programs are typically 3 or 4 full-time semesters in length at community college. As for the practice environment, I can say unequivocally, that the U.S. offers a more open practice environment than is typical of the Canadian systems. 

Taking Wake County EMS and the King County Medic One systems as examples, the U.S. leads the world in survival from cardiac arrest, and we collectively have the best trauma, stroke and cardiac systems available anywhere.  U.S. EMT-P’s are central to that success and are often “wagging the dog” regarding advancements in emergency care and the implementation of technology.

--on a side note, what’s up with Ottawa EMS removing IV initiation from their PCP skill set—gee wiz!! They are acting like IV initiation is equivalent to neurosurgery!! THAT is one blatant example of CRAZY that is not experienced in the US.


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## Outbac1 (Oct 29, 2010)

Now said:
			
		

> I believe the EMT-P is sometimes maligned as there are a large variety of ways it is taught. Some courses are taught in only a few months while others are done over a couple of years. This leads to a great difference in knowledge in people with the same cert. The lower educated ones tend to drag down the others. Canada just has a more level educational field as to the quality of the courses. This just means that the discrepancy between our good and not so good medics is not as large as in the US. This is an area the USA needs to address if it wants to be better recognized around the world. This is not to say the USA does'nt have good medics, there are some very good medics in the US. Unfortunatly there are some, shall we say not so good medics. It is this large difference in quality that drags down the US. If you can ever get 50 states to agree on a national standard, then you will have something to work forward from.


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## akflightmedic (Oct 29, 2010)

TennesseeMedic said:


> Now, let me say something about this nonsense regarding U.S. EMT-P’s versus Canadian ACP's. Both are professionals and highly knowledgeable. Assessment skills are paramount to both training systems and I can tell everyone from experience (Ontario and Tennessee in my case) "monkey-see monkey-do" is NOT practiced in either system.



Since when did Tennessee become "one" system?  




TennesseeMedic said:


> The reality is, U.S. paramedics are among the highest trained pre-hospital providers in the world and our ALS systems are among the oldest.



Please quantify this statement. How are you making this judgment, what criteria are you comparing?



TennesseeMedic said:


> Regarding paramedic education, it is required in 14 states to complete a 2 year AAS or AS in Paramedic Care prior to initial licensure as an EMT-P and the AAS is offered in all states with the exception of Maryland where the only education based Paramedic program is a 4 year BS from UMBC.



Would you list or link where it is required in 14 states because this is news to me. I can only name 2, one of which has been that way since 1998 or 99. Aside from these two I know of, no other state "requires" it.


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## MrBrown (Oct 30, 2010)

Come on mate, stop smoking crank as it is making you embarass yourself by saying silly things.

As we all well know, American EMS has the lowest education and professional standards in the developed world and its just plain sad.

Brown will once again point out that ....

New Zealand and Australia require a Bachelors Degree for Paramedic (ILS) and a Post-Graduate Degree for Intensive Care Paramedic (ALS)

The UK requires a proper two year University FDSc for State Registered Paramedic (ALS) not a two year half-Paramedic, half useless gen-ed class "associates" degrees down at the local college

South Africa requires a two year Degree/nCert for Emergency Care Technician (ILS) and a four year Bachelors Degree/BTech for Emergency Care Practitioner (half ALS, half CCT)

Canada requires three years of education for Advanced Care Paramedic

Yet in the US it is possible to become a "Paramedic" in twelve weeks in Houston, Texas and about fifteen weeks at some patch factory in Idaho.  Most programs run about 8 months to one year and very few have any real knowledge and experience as a pre-req.

Then there are the non-education side of system design and delivery; look at working conditions, pay, clinical modalities and dexterious independant practice, continuing clinical education, funding and a host of other isssues .... and it just makes Brown sad.


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