# Remote Medical International



## Zethra09 (Aug 17, 2011)

Anyone here have any experience with RMI? I'm a paramedic student curretly and plan to go off the beaten path for a few years while I'm young and single. I'd like to go through their RMAP course after I get some ALS time in. Any advice?


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## usafmedic45 (Aug 17, 2011)

Zethra09 said:


> Anyone here have any experience with RMI? I'm a paramedic student curretly and plan to go off the beaten path for a few years while I'm young and single. I'd like to go through their RMAP course after I get some ALS time in. Any advice?




My advice is not to get yourself into a "deployed" situation with limited to no backup unless you have a _lot of experience_.  This is not something to jump into after a simple training course because of the diagnostic acumen necessary to operate more or less independently (or even with a doc who isn't a specialist).  A lot of these organizations (especially the ones that make you pay them in exchange for your volunteering with them) tend to take anyone they can get with the idea of training them a little and then turning them loose.  This is a bad idea for several reasons.

Having to manage an unstable or even a stable but complicated patient when you know it's going to be a day or more before you hand them off or are otherwise relieved is a taxing and trying experience that will even make someone with 15+ years of in- and out-of-hospital experience (read as: yours truly) uneasy.  If you aren't unnerved by the prospect, you're either not thinking it all the way through or you have ice water in your veins.

Get some experience, don't rush into getting married and if you still feel the interest in going overseas to remote areas after you have five to ten years of full time experience and a lot more medical education under your belt (both formal and on your own by reading, etc) then go and do it.  Otherwise, you strongly risk getting yourself into a situation that is not good for you and certainly potentially disastrous for the patient.


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## Zethra09 (Aug 17, 2011)

Thanks for the advice! I wasn't planning on jumping into remote practice right away as tempting as it sounds. Though I do plan on taking every opportunity to continue my education be it through my own funding or via FD along with some volunteer rural work on my off days. See you on the other side


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## usafmedic45 (Aug 17, 2011)

When I say "continue your education" it really has to be more in terms of academics.  Relying on experience alone (or the half-*** things that pass for EMS directed education in this country) is simply going to give you a basic understanding of things that you need to know like the back of your hand and possibly result in you becoming ever more confident at making the same mistakes or misjudgments.


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## Zethra09 (Aug 17, 2011)

So what specifically would you recommend? Something like a WEMT course or more advanced studies?


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## Handsome Robb (Aug 17, 2011)

I'd say advanced studies and some experience in CCT couldn't hurt. The way EMT-Ps are trained in the U.S. is for direct life threats and emergent conditions not extended patient care. We stabilize the patient then transport them to definitive care which as usaf pointed out isn't always possible in the field your talking about.


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## usafmedic45 (Aug 17, 2011)

Zethra09 said:


> So what specifically would you recommend? Something like a WEMT course or more advanced studies?



WEMT is a joke for the most part.  It's another one of the dumbed down courses I mentioned.  Learn as much as you can about the sciences underpinning medicine: physiology, biochemistry, pharmacology, histology, etc.  Study up to the level approaching what one would learn in medical school.  That is what I have done over the years and you can ask most people on here what they think of me.  Most will say I'm a bit blunt, sometimes rude but few will question my knowledge of the medical aspects of discussions.  You can get there too if you're willing to put in the effort.


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## Zethra09 (Aug 17, 2011)

That actually works out great since I started out pursuing a biology degree. I'm about 40 credits shy of my BS and have taken courses in anatomy, physiology, microbiology, general and organic chemistry, exercise physiology, cellular biology, and the basics. Sounds like I should work on finishing my degree and go from there.


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## usafmedic45 (Aug 18, 2011)

Pretty much.  If I can be of any help, feel free to PM me.


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## EMT11KDL (Aug 19, 2011)

not sure how old you are, what your views are, but you can also look at going into the military as a medic.  I am not sure what your future goals are, but look at all the branches they will give you some great training, and some crappy training at the same time.. its another option and the one i took


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## Zethra09 (Aug 23, 2011)

There's 3 68W's in my class that have all been talking about their time in Iraq and Afghanistan the past few days and it sounds pretty epic. I mean where in the civilian world will they let you do a cricothyrotomy as an EMT-B in the back of a helicopter?! Like I said, I'm young (23) and single so I want to get a piece of the action while I'm still able.


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## akflightmedic (Aug 24, 2011)

Yeh, sounds a bit too epic.

The helos are staffed with flight nurses, flight paramedics, flight docs and on a lot of the missions, the SOF medics (18D, PJ) will go because they need the medical exposure constantly and they have the skill set for hot extractions.

68W are a dime a dozen over here and they are in their unit clinics, on the ground with their unit on patrol or assisting in some of the smaller medical facilities (Role 1 and Role 2). 

Currently, the Navy is in charge of the Role 3s (Full hospitals/surgical and trauma).

I have yet to see a 68W climb off a helo with a patient in my 5 years in Afghanistan. Not saying it has never happened or never will happen but am definitely saying the odds of it occurring are exceptionally low when there are already much higher skilled providers doing those missions.


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## usafmedic45 (Aug 25, 2011)

> I mean where in the civilian world will they let you do a cricothyrotomy as an EMT-B in the back of a helicopter?!



The 68Ws are well above the level of an EMT-B.  



> There's 3 68W's in my class that have all been talking about their time in Iraq and Afghanistan the past few days and it sounds pretty epic.



As a military medical veteran (not to usurp AK's massively more significant level of experience in that regard), I call bull:censored::censored::censored::censored:.  Among the guys who have done "epic" things for real, 99% of them don't talk about it outside of those with similar experiences.


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## RocketMedic (Aug 28, 2011)

akflightmedic said:


> Yeh, sounds a bit too epic.
> 
> The helos are staffed with flight nurses, flight paramedics, flight docs and on a lot of the missions, the SOF medics (18D, PJ) will go because they need the medical exposure constantly and they have the skill set for hot extractions.
> 
> ...



Depends- most Army medevacs are staffed by 68WF6 (I think), which is an ASI open to E4 and above. It's a 68W who gets an extra three weeks of aeromedical training and is generally considered to be a choice assignment (after all, Army Flight Medic is pretty cool). We don't generally send our medical officers on high-risk missions because it's a lot easier to train a new sergeant than a PA or MD. The Navy does the same thing with corpsmen. 

The scope of practice for a helicopter flight medic is generally wider than their ground-bound counterparts for two reasons: more training (generally) and less need to pack for war. Flight medics also tend to have more experience then the younger enlisted medics they receive from. That being said, there's no extra NR education for a flight medic.

Fixed-wing is a different beast though, but that's more like a flying ICU than an ambulance.


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## Tagsburton (Aug 28, 2011)

I would highly recommend RMI. They are a fantastic company with a lot of experience in remote medical support. Highly professional and very fun to work with. 

Back in 2008, I took their WEMT course. Having been in search and rescue in Washington since 2003, I thought it was time for me to step up my skills. The course was fantastic and honestly one of the best experiences of my life. I learned heaps.

Now I'm in paramedic school in Australia and am so glad I took the RMI course. Their scenario-based approach to teaching was immensely helpful. RMI does get into a bit of the science behind things, which is really useful. I have not taken the RMAP course, but I can say that the WEMT course is at a very high level. The instructors have tons of experience in remote settings, and it shows when they teach. I was very impressed with the course. A lot of the scenarios were long-term care, as you would expect with a remote setting. In one scenario, we had to bag a patient for 3 hours! The training I got from RMI has put me at a huge advantage down here in Aus; some transports are 2+ hours and I am often the only student comfortable with caring for a patient for that long. We also got to do some advanced skills with RMI, like suturing and casting. 

RMI hires paramedics to work in remote locations; however, you have to have 2 years of experience working as a paramedic before they will hire you. I plan on working for them myself in a few years, because my experience with them as always been phenomenal. I am acquainted with quite of few of RMI employees and every one of them loves working for RMI. 

I'm so with you on the whole, get out and do it while you're young idea. I plan on being remote for several years, then getting employed in the city. Part of what draws me to RMI is the length of jobs. You either rotate something like 6 weeks on, 6 weeks off. Or it can be a solid 3 month deployment, like Wake Island. So if you decide you don't like it, it's not like you're stuck somewhere as the only medical support for months on end. You're also supported by doctors back in the states via their telemedicine program. So it's not like you're all on your own out there.

Hopes this helps!


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