# WEMT certification, getting hired as an EMT in urban setting



## evelknielle

Hello all, 

I'm new to this forum and the world of EMS, so please bare with me. 

I'm looking to enroll in an EMT Basic course here in Las Vegas, with the intent of getting hired as an EMT. However, having always been infatuated with the outdoors, I've been researching Wilderness EMT courses. One of them is the NOLS Wilderness EMT course. They say that:

"Successful completion of the course and both written and practical examinations will certify the student as a National Registry of EMT's Basic EMT and as a Wilderness EMT."

And the program "combines wilderness medicine with urban medical care practices, including time at a hospital and in an ambulance."

If I'm reading correctly, by taking this course I'd basically get the same education as a local, semester-long class at a community college, PLUS wilderness training. 

My question is this: by taking a Wilderness EMT course like NOLS, would I be at any disadvantage when trying to get hired compared to those who were trained at a regular EMT basic course?

Thanks everyone!


----------



## Jon

I don't know.

the WEMT course is the NREMT-B course + a whole bunch of other stuff.

If you think the wilderness portion would be useful... go for it.

As for a disadvantage when hiring... as long as you have whatever cert you need to have (in many states, you need to transfer your NREMT credentials into a state cert) I don't know what else might hold you back.


----------



## passpartout

I don't think there's any disadvantage to having a WEMT cert in addition to an EMT.

However, the "3+1" format (EMT for 3 weeks, followed by WEMT for 1 week) is very intense.  You will be burnt out by week 4 and therefore not at your best for the WEMT part.  Also, you'll be learning wilderness skills at a time when you're a VERY novice EMT and don't have much, if any, perspective on what you're learning and how it relates to regular EMT protocols.

My advice would be to do the regular EMT cert course first, then give yourself a break, go out and work in the field, THEN take a WEMT 1-week course.


----------



## KEVD18

if at the end of it you have a nremtb ticket, your good to go. if you plan to work in a high turnover service area, not much stock will be placed in where you attended school. a pulse and a ticket are the only requirements for some services.

now, a word of caution. the course your describing is what we like to call a "shake and bake" course. they ahve a pretty high fail rate, since you dont really have adequate time to absorb and really understand the material. those that do pass dont really have a great chance at being good emts. its just not enough time to really graps the concepts. so caveat discipulus...


----------



## HeONdiver

I took the NOLS/WMI WEMT course 3.5 years ago. I was hired shortly thereafter by a private ambulance company with ALS contracts in the Denver Metro area (Colorado). The only disadvantage I can think of is the strong focus on using wilderness first aid equipment ie. a small first aid kit, tent poles, backpack stays, sleeping bags, rope, etc. for treating patients. You will learn how to use "urban" equipment as well, though the focus is on wilderness EMS (hence the course title). Your potential employer will (should?) be mainly concerned with you having a state certification and/or Natl Registry (this course will finish with the NREMT exam), having a professional appearance, and your ability to express yourself and communicate your thoughts in an effective manner. Not coming off like a total jerk helps too 
The course taught in a "this is what you do in the city" vs. "this is what you do in the backcountry" style. There is lecture for a bit then you go outside and practice what youve learned. Everything is taught concurrently so it is not "urban EMS" for 3 weeks than 1 week of "wilderness EMS".  It is very hands on with a strong focus on patient assessment. Be prepared to eat, breathe, sleep wilderness EMS. You will be in class 5 days a week for most of the day (split inside and oustside practicing skills) and nights will (or should) be spent studying. Your fellow students will be outdoor leaders (people trying to be NOLS/Outward Bound instructors), park rangers, wildland firefights, backcountry enthusiasts, etc.
I liked the intensity of the course as I wanted to begin work ASAP instead of dragging the course out for a semester as most community colleges do. If you learn well under a focused intense environment then you will do well. There was an extremely high pass rate in our course (only 1 person failed their Nat'l Registry exam out of 28 of us). 
I was very impressed with level of instruction from the NOLS/WMI staff. They had a wealth of experience working in both urban and wilderness settings (downtown Seattle ambulance, flight nurse experience, backcountry guide, etc) I felt prepared when first starting my job on the ambulance. Another colleague of mine took this course at a different time and is one of the strongest EMT's I know. I dont think it matters (more or less) where you go to school, but how you go to school. If you are smart, motivated, compassionate, and are a dynamic thinker, you will be a "good EMT"...even if you take a "shake and bake" course. Having a knowledgeable partner/supervisor and a willingness to learn helps too. Having said that, nothing substitutes for hands on experience and having patient contacts. Good luck.


----------



## BossyCow

It sounds like you are trying to accomplish as much as possible with as little effort as possible. Like the "one sizes fits all" concept, it really ends up not fitting any size well. Wilderness EMT is based on the concept that you will be providing care in a wilderness environment. The emphasis is on triage, recognizing and treating infection and otherwise preparing for a long cozy relationship with your patient that may last for days as opposed to the short transport time of a more urban practice.

If you are planning on a career that will require those skills, then wilderness EMT is a good choice for you. I use mine in SAR in a very remote wilderness area. But I also work in a more residential (though still quite rural) environment. I have found some crossover in treatments between the two, but they are not interchangable. 

If you want to be a good EMT, then take a good EMT class. If you want to be strictly a wilderness EMT then take a wilderness class. If you want both, take both classes. You will never go wrong by getting 'too much' information.


----------



## backcountrymedic

BossyCow said:


> It sounds like you are trying to accomplish as much as possible with as little effort as possible. Like the "one sizes fits all" concept, it really ends up not fitting any size well. Wilderness EMT is based on the concept that you will be providing care in a wilderness environment. The emphasis is on triage, recognizing and treating infection and otherwise preparing for a long cozy relationship with your patient that may last for days as opposed to the short transport time of a more urban practice.
> 
> If you are planning on a career that will require those skills, then wilderness EMT is a good choice for you. I use mine in SAR in a very remote wilderness area. But I also work in a more residential (though still quite rural) environment. I have found some crossover in treatments between the two, but they are not interchangable.
> 
> If you want to be a good EMT, then take a good EMT class. If you want to be strictly a wilderness EMT then take a wilderness class. If you want both, take both classes. You will never go wrong by getting 'too much' information.




Based on my experience up to this point, I would like to point out a couple things. The WEMT course taught through Remote Medical International would more than prepare you for urban-emt. The course books, reading materials, and lectures cover all topics for urban emt, but with much more. In addition you also learn how to make use with very little. RMI's program has many benefits as well also certifying you with a MPIC, under which certs you can initiate IV therapy, a certification which will help out in getting into a paramedicine program. Most all scenarios are, at the very least, comparing the similarities of the two applications seem to not only enable you through a powerful knowledge of the NREMT standards and urban EMT practices, but also prepare you to be able to work, think, and have some experience in a minimalist, wilderness setting.


----------



## BossyCow

backcountrymedic said:


> Most all scenarios are, at the very least, comparing the similarities of the two applications seem to not only enable you through a powerful knowledge of the NREMT standards and urban EMT practices, but also prepare you to be able to work, think, and have some experience in a minimalist, wilderness setting.



The focus is on wilderness however and I stand by my original statement that if you want to do both, you should take both. Too much education is never a bad thing!


----------



## rescuerich

If you plan on joining the local SAR unit,then it will help get the job. If you are going to sign up on local EMS then its just a lot of extra that you will not use over the years and eventualy loose track of. I would say you should do the EMT course, get a job and then decide if you would like to go with the wilderness cert. I work rural EMS and SAR and find that it helped having an EMS background when I decided to take the wilderness course, and I saved a ton of money.


----------



## Claren

KEVD18 said:


> if at the end of it you have a nremtb ticket, your good to go. if you plan to work in a high turnover service area, not much stock will be placed in where you attended school. a pulse and a ticket are the only requirements for some services.
> 
> now, a word of caution. the course your describing is what we like to call a "shake and bake" course. they ahve a pretty high fail rate, since you dont really have adequate time to absorb and really understand the material. those that do pass dont really have a great chance at being good emts. its just not enough time to really graps the concepts. so caveat discipulus...



Actually, they have an excellent NR pass rate. This is in part to their policy of not being allowed to challenge the NREMT-B exam if you don't maintain an 80% average throughout the course. Of my class (July '06) only one failed the NR, and only one wasn't allowed to challenge it.

I agree that short courses should raise red flags, but this course is excellent. The pace is not for everyone, and there are those that will not absorb everything, but the amount of material presented is not deficient or inferior when compared to a typical community college EMT-B class.

OP: No, it won't hurt your chances of getting hired. It's a fun, effective (but very expensive) way of getting your EMT-B. I suggest you hit the ground running, and buy the text and do all the suggested advance reading (about 5 chapters worth before you show up, if I recall).


----------



## backcountrymedic

When you're referring to a generalized group of individuals, especially those who are NREMT, perhaps looking at the statistics would prove beneficial to your argument. In 2007, the NREMT First Time pass rate for the NREMT-B exam was 70%, while RMI for instance, has roughly a 98% first-time pass rate for their students taking the NREMT. Be reminded that this month-long intensive course not only covers EMT & WEMT Curriculum, but also the US Coast Guard MPIC. It does take a great deal of energy and dedication, but in the end, I feel it was very much worth it. Im sure your encouragement is very much appreciated by those who inquire....



KEVD18 said:


> if at the end of it you have a nremtb ticket, your good to go. if you plan to work in a high turnover service area, not much stock will be placed in where you attended school. a pulse and a ticket are the only requirements for some services.
> 
> now, a word of caution. the course your describing is what we like to call a "shake and bake" course. they ahve a pretty high fail rate, since you dont really have adequate time to absorb and really understand the material. those that do pass dont really have a great chance at being good emts. its just not enough time to really graps the concepts. so caveat discipulus...


----------



## KEVD18

holy mary mother of god another mpic. shoot me in the head, right now please. if we have to do this again, i quit.

back to the shake and bake emts programs: sure, there are a few diamonds in the rough. but by and large, overnight emt schools provide awful education and produce sub par emt's.


----------



## Claren

KEVD18 said:


> back to the shake and bake emts programs: sure, there are a few diamonds in the rough. but by and large, overnight emt schools provide awful education and produce sub par emt's.



I agree with you entirely. However, the question was not about short-term, high-intensity programs in general, but specific to the NOLS/WMI (not RMI) WEMT-B course, with which I have direct experience. It is indeed one of the few good fast-track programs. I hear SOLO is also above average.


----------



## BossyCow

Claren said:


> I agree with you entirely. However, the question was not about short-term, high-intensity programs in general, but specific to the NOLS/WMI (not RMI) WEMT-B course, with which I have direct experience. It is indeed one of the few good fast-track programs. I hear SOLO is also above average.



Above what average? I have a lot of personal experience with the graduates of that program since the national park uses them almost exclusively during the summers here. They are purchasing a piece of paper and in my experience, turn out mediocre EMTs who are able to pass tests. Very few of the EMTs from that program that I have seen work beyond their intial summer job with the park. Maybe they move on to some other park but in many years of doing this, I've only seen one who was anything other than a FR.


----------



## JPINFV

Claren said:


> Actually, they have an excellent NR pass rate. This is in part to their policy of not being allowed to challenge the NREMT-B exam if you don't maintain an 80% average throughout the course. Of my class (July '06) only one failed the NR, and only one wasn't allowed to challenge it.



Pass rate= Students who pass the certification rate/[People who enroll in the class - people who drop out for non-academic reasons] 

If the high pass rate is due to them not letting people who score score low but still pass the course take the test, then they are committing statistical fraud. It's no different than the EMS systems who have a high cardiac arrest "save" rate because they either count a save as ROSC regardless of discharge status (i.e. discharged from the hospital neurologically intact) or simply don't count patients who are worked, but not really viable when everyone else counts them (isn't it Seattle that does something like this?).


----------



## KEVD18

even more important than the actual pass rate is the quality of the practitioner produced. 

i can teach a beagle enough to pass the test, but will he retain that information over time(the hallmark of understanding and not memorization)?


----------



## Claren

BossyCow said:


> Above what average?



The average "Shake + Bake" program. Being fair, the bar is pretty low with the shorter programs.



BossyCow said:


> I have a lot of personal experience with the graduates of that program since the national park uses them almost exclusively during the summers here. They are purchasing a piece of paper and in my experience, turn out mediocre EMTs who are able to pass tests. Very few of the EMTs from that program that I have seen work beyond their intial summer job with the park.



Then that is more experience than I have had with them. I said that I had -Heard- it was an adequate program (from comments on another EMS forum, and an alumnus I knew in a non-professional capacity). Although, to be fair, even including the community college programs, how programs produce completely proficient Basics immediately following certification? In my entirely anecdotal experience, quite few. On-the-job experience is important, and if  you get a new crop of dilettantes every summer, then yes, you're going to see a lot of mediocrity.



JPINFV said:


> Pass rate= Students who pass the certification rate/[People who enroll in the class - people who drop out for non-academic reasons]
> 
> If the high pass rate is due to them not letting people who score score low but still pass the course take the test, then they are committing statistical fraud.



I agree that "bragging" about your NR pass rates after you manipulate the pool of students challenging the test is questionable. However, I think the high pass-fail rate is a secondary concern to NOLS/WMI. 

I think the main reason they do things this way is to keep unprepared individuals from becoming EMTs. Not for the sake of the students, but for the sake of future potential patients. 



KEVD18 said:


> even more important than the actual pass rate is the quality of the practitioner produced.
> 
> i can teach a beagle enough to pass the test, but will he retain that information over time(the hallmark of understanding and not memorization)?



I agree. For what it's worth, I got my NREMT-B in august of '06, between two college semesters. I finished college, and didn't work in the field (I'm an ED technician) until May of this year. Entirely subjectively, my knowledge base didn't fade appreciably in that time; although my interest and informal CE was strong between my cert and getting my job.

I don't really think we're of different minds on this one. Most of the quick programs are diploma-farms that will not prepare students for the NR, much less actual clinical practice. Longer periods of training and education can only benefit any student, in any field.

I'm only being contentious because the OP was asking about the quality of a specific program, but got a bunch of blanket responses condemning accelerated programs in general. Yet, As silly as it may sound to some, the NOLS/WMI program really is different, and I believe that if the student comes to it prepared to work hard, it will prepare him as well as longer courses to be an EMT-B.


----------



## NorthCoastChick

I took the NOLS WMI Wilderness First Responder class and my instructors are what inspired me to become an EMT. Granted, it was a little intense having to pick up medical vocabulary on the fly with very little prior knowledge, but having the WFR training really helped in my EMT class. 

There were elements of the WFR class that stuck with me even through a semester long urban EMT class. For example: scene safety, patient assessment + environment, and general trauma.


----------

