# Opinions/experiences on EMS training



## Phoenix (Apr 7, 2009)

Hello all, 

I have been visiting and reading here for several months now, and finally decided to register for an account. A big thank you to everyone who posts here, as it has been great insight into the challenges and day to day of what you all do. 

I will try to keep it brief - I am 36 years old, living outside of Austin, TX,  have had my life do a 180 turn over the past year (divorce, single dad with 2 kids, a memeber of the walking wounded from this recession), and I have been considering my options and what I want to do with my life, at least career wise. EMS is very much at the top of the list, for various reasons, none of them any belief thatthis is a "cool" job or I'm going to be a hero. I would really just like to do something where I can help people, have always had an interest in medicine, and feel that this field is something I can come home from every day and feel good about - despite all the politics, frustrations, long hours, etc that I have come to understand come with it. 

Because of my life situation in being a provider for my family, I have been looking at several training options, and one that has really appealed to me is a school called Training Division outside of Dallas. There program is in 3 parts, EMT-B, I, and P, and is mainly online and self paced. Each segment concludes with 1-3 weeks of fulltime, onsite, hands on skills training (depending on the level), and then clinical rotations. The exam pass rates they post are extremely high, but of course, I write that off as potential marketing copy. I am not concerned about the independent study, as I am very disciplined and have gone that route before with success in the past. My questions are this:


 - Does anyone out there have any experience with this school, and able to provide feedback?

 - I do understand that the ideal situation is a longer term program ( college program ), but with my personal situation, I would like to at least get in the door at an entry level (EMT-B) even if the pay isn't all there, or the work isn't interesting. But I need to work while going to school, so opinions: is it better to be working in the field I am moving into?

 - This has been on other threads, but I would like a sound off on going from EMT-B to Paramedic without any significant breaks in between for "experience" in the field. I have seen differing opinions on getting to one level, working in the field for 6-12 months, then approaching the next, and so on, versus staying focused on training and education to the highest level. Opinions?

- Does anyone have any information on the job market right now for EMS in the Austin area? At any level (B, I , or P)? Are there any major employers that I could start doing some research into?

Just a final comment. I do require some level of speed in training, just to keep my family from starving, but I am a 100% behind the side of more education being needed in this field. I am planning on attending the community college here even while going through this training (if I decide this is the right way to go) to take as many science classes as possible (A&P I think is a priority). Dual purpose - one, I want to be as well prepared as possible for what I do. Honestly, in this field, I don't see how training can be taken for granted. Secondly, I believe there will be something beyond EMS someday - nursing, PA, etc. I enjoy learning and staying challenged, and I think there are excellent opportunities out there for those that want to get after them.

Excuse the rambling first post, but thanks again to all who post here, and any who respond to this one. 

P


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## AJ Hidell (Apr 7, 2009)

1.  Forget speed.  There is no expeditious route to becoming a well educated and competent provider.  Shortcuts will only shortcut your education, resulting in you doing very poorly as a provider and on pre-employment testing.

2. Training Division provides a good quality of training for the well disciplined.  So does www.techproservices.net.  However, neither of them would be recommended above the EMT-B level, as they are not Nationally Accredited.  Two years from now, a paramedic certificate from either source is going to be worth nada, and it is going to take you longer than that to get there.  Forget distance learning for paramedic.  Limit your paramedic school choices to ONLY those that are Nationally Accredited and result in a degree.  There is only one in all of Central Texas, and that is ACC.

3. Anatomy & Physiology should be taken BEFORE EMT-B, not after or during.  All other prerequisites (microbiology, psychology, developmental psych, sociology, algebra, English, speech communications) should be taken BEFORE paramedic school, not after or during.  Yes, it does make a huge difference in the quality of provider you will become.

4. There is NO good reason to wait for "experience" between EMT and paramedic school.  In fact, it is just a bad idea all the way around.  Would it be a good idea to wait for a couple years of life experience between junior high and high school?  Of course not.  Same principle.  If there is one place that you should cut time and go the speedy route, this is it.  Plus, Austin doesn't hire EMTs.  Paramedics only.  The only job you're going to be able to get as an EMT around Austin is non-emergency transfer work with a private company, that pays less than ten bucks an hour.  That's not experience.  That's not even exposure.  And it sure won't support a family.  So really, "experience" is a moot point.  That said, it should take you at least a year between EMT school and paramedic school just to get your prerequisite classes completed.  In that year, you will forget everything you learned in EMT school.  Consequently, the best course of action is to get all of your college prerequisites out of the way first, then go to EMT school, then go to paramedic school.  Otherwise, you're looking at an extended down-time where your knowledge deteriorates.

5. The job market is extremely limited in the Austin area.  One provider covers all of Travis county, and they have among the highest standards and most competitive hiring process in the nation.  Mail order medics aren't likely to get hired.  That means that you are going to spend over two years in college getting this done, and then have to go to another county, like Hays, Comal, Blanco, or if you're lucky, Williamson County, to get a job.  Doesn't sound like your family and financial situation is conducive to that.

6. If healthcare is your broad goal, and nursing remains a possibility, then nursing is the way you should go first.  The prerequisites for nursing and medic school are (or should be) the same.  Take all those and apply for both nursing and medic school.  Go to which every one lets you in first to avoid wasted time.  But it is MUCH, MUCH easier to make a great medic out of a nurse than it is to make a decent nurse out of a medic.  Medic to nurse transition is going from specialization to generalization.  That's just backwards.  Plus, most of all, it's a heck of a lot easier to go to medic school on a nurse's schedule and salary than vice versa.  Don't fall into the mistaken view that medical education is a ladder to be climbed.  Just because EMS education progresses in steps should not lead you to believe that is how the world of real medicine works.  It isn't.  If you want to be a nurse, be a nurse.  If you want to be a PA, be a PA.  But they are all separate and very, very different professions with no relation to each other.  Trying to get to one by using the other as a "stepping stone" is a recipe for teh fail, and wastes a lot of time and money, which you say you don't have.

None of those three jobs are closer than two years away for you, if not longer.  The only thing you are going to get "speedy" is EMT-B, and again, there just are no jobs for an EMT-B that will make you a living.  Stocking groceries at night would pay you a lot more money, and give you a more school-friendly schedule.  And the experience stocking groceries would be just about as relevant to a paramedic as driving a transfer car, so that's a no-brainer.

I love seeing more mature adults, who are family oriented, well disciplined, and have their wild oats sown come into EMS.  It improves our overall level of professionalism.  But it just doesn't work out well very often because rarely are they at a place in their life where they can devote the time to do it right, due to family and financial concerns.  While I think your attitude is a great candidate for becoming a great medic, I have to honestly say that, if you are not in a position to spend the next two or more years doing it right -- and then not be guaranteed a job in your area -- then just move on to something else.  We already have more than enough undereducated, in a hurry medics.  The schools in just your area are cranking out another couple of hundred a year.

Good luck!


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## Phoenix (Apr 7, 2009)

*Aj....*

Thank you - that is one of the clearest responses I could have asked for. Before I delve into what you wrote, a quick question, if you know or can explain further. You had written the following: 

Training Division provides a good quality of training for the well disciplined. So does www.techproservices.net. However, neither of them would be recommended above the EMT-B level, as they are not Nationally Accredited. Two years from now, a paramedic certificate from either source is going to be worth nada, and it is going to take you longer than that to get there. 

and their site has the following: 

Upon successful completion of each course, you will receive a certificate. All of our courses have been approved through Texas, an IFSAC state, which allows transfer to other IFSAC states and Canada. All of our courses, including our EMT Basic, have been written to exceed the National Registry of Emergency Medical Technicians (NREMT) and the National Fire Protection Association (NFPA) standards. 

I assume that this approval they are speaking of is not what is needed. I should know better and done further research on that....

But....

Just about everything you wrote made perfect sense. I am NOT interested in pursuing a training path that will be worthless in a couple of years for the sake of speed. And your point on determining what the end goal is ( RN, PA, etc) and just pursuing that directly.... well, I guess I always knew that was the direction to go in, but have tried to convince myself differently. 

Looks like I have some thinking to do....

Thanks again


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## Veneficus (Apr 7, 2009)

Forget about EMT-I

The difference in time between I and P is so minimal that all you are doing is wasting your time and money as you will most likely not get excluded out of any P hours.

Any program that gives you credit towards paramedic hours for taking EMT-I is extremely suspect and should be regarded as substandard. 

It would be like me getting credit for med school classes for being a medic. Absolutely unacceptable, a paramedic must be a decision maker and critical thinker. Getting time off for learning a few skills is a minset you don't want to be part of if you care about your patients or your future profession. 

A skills based approach is the way to low pay and no job satisfaction.


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## Phoenix (Apr 7, 2009)

*Emt-i*

It is funny you have mentioned that. I have looked at other training courses, and noticed several have EMT-B, then straight to a Paramedic program. Browsing through job openings, I have found -B and Paramedic positions, but very rarely anything even mentioning -I. A friend of mine (EMT-B, LVN) had also mentioned that EMT-I is a thing of the past. Very interesting.....thanks!

P




Veneficus said:


> Forget about EMT-I
> 
> The difference in time between I and P is so minimal that all you are doing is wasting your time and money as you will most likely not get excluded out of any P hours.
> 
> ...


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## AJ Hidell (Apr 7, 2009)

Paramedic schools that are not Nationally Accredited by the agency that accredits healthcare educational programs (www.caahep.org) will no longer be valid for National Registry, which is required in Texas, as most states, beginning in 2012.  If you can get a non-accredited certificate and get certified before that deadline, it will remain good.  But you're starting from scratch right now, so it's not likely that you'd be done before then.

However, many currently un-accredited schools are in the process of being reviewed for accreditation, which is a long process.  You can expect Temple College to be accredited in the near future, I suspect, as it is a quality school.  I don't think any of the distance learning schools are going to make the cut.


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## Phoenix (Apr 7, 2009)

That brings to mind another question that I have not been able to answer. I have been through the textbook for EMT-B, and have begun researching topics on my own to expand my knowledge in areas that I think it lacks. But EMT-B does not seem overly challenging or difficult. 

What I do not know at this point is what is the depth and breadth of Paramedic training? I understand that most programs are two years through a CC, but is 6 months, in an intensive program, realistic? Based both on the amount of material that needs to be covered, and of course, the retention ability of what is being covered. 

P



AJ Hidell said:


> Paramedic schools that are not Nationally Accredited by the agency that accredits healthcare educational programs (www.caahep.org) will no longer be valid for National Registry, which is required in Texas, as most states, beginning in 2012.  If you can get a non-accredited certificate and get certified before that deadline, it will remain good.  But you're starting from scratch right now, so it's not likely that you'd be done before then.
> 
> However, many currently un-accredited schools are in the process of being reviewed for accreditation, which is a long process.  You can expect Temple College to be accredited in the near future, I suspect, as it is a quality school.  I don't think any of the distance learning schools are going to make the cut.


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## AJ Hidell (Apr 7, 2009)

EMT-I is very much a thing of the past.  It is a failed experiment from the 1970s that never proved it's worth, and resulted in inadequate education, inadequate system staffing, and the deaths of a lot of people.  There is zero evidence based justification for the existence of an intermediate level in EMS.  Unfortunately, EMS as a whole is still stuck in the first aid mindset we developed from.  There are few true educators in EMS, so there is very little understanding of how education is structured for optimal results.  Consequently, we get the perpetuation of this "stepping stone" mentality, where education is viewed as nothing more than an aggregate of "skills" handed out one by one until you are suddenly a paramedic.  If you understand how ignorant that is right now, then you are already smarter than most of the EMT instructors in the country.


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## AJ Hidell (Apr 7, 2009)

Phoenix said:


> That brings to mind another question that I have not been able to answer. I have been through the textbook for EMT-B, and have begun researching topics on my own to expand my knowledge in areas that I think it lacks. But EMT-B does not seem overly challenging or difficult.


It was never intended to be.  It is an advanced first aid course written and presented at the 8th grade level.  It was developed as a way of taking the lowest common denominator of society and preparing them to render first aid, on the model of military medic training.  Because of that mindset, and the people it produces, even paramedic training is seen in the same light by about half of the schools and systems in the country.  So no, there is nothing hard or challenging about EMT-B.  And it is not much more challenging in the accelerated, technical certificate paramedic programs.



> What I do not know at this point is what is the depth and breadth of Paramedic training? I understand that most programs are two years through a CC, but is 6 months, in an intensive program, realistic? Based both on the amount of material that needs to be covered, and of course, the retention ability of what is being covered.


The difference is night and day.  The technical certificate programs tend to cover only the bare technical essentials of practice, necessary for you to perform monkey skills and pass a standardized test.  They produce the illusion of competence, but the shortcomings of that education are very obvious.  You can usually easily tell just by reading posts here who has a college education and who went to a 13 week tech school.  The tech school medics are the ones that are always referring to what their protocols "allow" them to do, but have a difficult time articulating why they are doing it, the physiological implications of doing it, and more importantly, why they should NOT be doing it.  One is a medical practitioner.  The other is just another level of advanced first aid provider.

Yes, you can get a paramedic patch in 6 months.  Heck, you can commute down to College Station and get it in 10 weeks.  But without a full year of college preparatory courses, you will not be an intelligently functioning medic.  And you will be completely lost when it comes to discussing or practicing advanced concepts.

Unlike other states, in Texas you can tell just by looking at their shoulder who is a tech medic and who is a professionally educated medic, because the patch is different.  While not necessary for certification to practice, that degree will make a lot of difference to you in trying to land one of the very few available jobs in competitive systems like Travis or Williamson County.


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## Phoenix (Apr 7, 2009)

*Being prepared*

AJ, 

Makes sense. I will be honest - the thought of going out on calls, to someone who is sick or hurt, without as much training as possible (at least medic level), makes me very, very uneasy. Ok, I know most calls are non-life threatning, but what about the one that isn't? At the risk of insulting any EMT-B's out there, and I do NOT want to do that because it is one hell of a tough job, the level of training there is very short. Myself, I would want to have as much training as I can before having a situation that is critical. 

That is my rationale for going straight through to Paramedic training. If I did make a career stop along the way at a B level, it would be drawing blood at the local blood bank to practice that. 

P




AJ Hidell said:


> EMT-I is very much a thing of the past.  It is a failed experiment from the 1970s that never proved it's worth, and resulted in inadequate education, inadequate system staffing, and the deaths of a lot of people.  There is zero evidence based justification for the existence of an intermediate level in EMS.  Unfortunately, EMS as a whole is still stuck in the first aid mindset we developed from.  There are few true educators in EMS, so there is very little understanding of how education is structured for optimal results.  Consequently, we get the perpetuation of this "stepping stone" mentality, where education is viewed as nothing more than an aggregate of "skills" handed out one by one until you are suddenly a paramedic.  If you understand how ignorant that is right now, then you are already smarter than most of the EMT instructors in the country.


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## AJ Hidell (Apr 7, 2009)

Phoenix said:


> Ok, I know most calls are non-life threatning, but what about the one that isn't?


Exactly.  Too many people in EMS -- managers included -- seem to spend a lot of time preparing their system for the mundane, and providing for whatever they can get by with.  That's not what the public expects from us.  They expect that EMERGENCY Medical Services exists to be prepared for true emergencies, not just the mundane stuff.  That's why the arguments that _"most patients don't need ALS"_ are so ignorant.  Most patients don't even require a stretcher!  But we have to be prepared for those that need the most, not just the ones that need the least.



> That is my rationale for going straight through to Paramedic training. If I did make a career stop along the way at a B level, it would be drawing blood at the local blood bank to practice that.


It's a good plan, for sure.  Phlebotomy usually pays better than transfer ambulance driving, has better hours, better conditions, and better benefits, including many hospitals that will pay your tuition for medic school.  Along those same lines, job as an ER tech are better preparation for paramedic school than most ambulance jobs, even more so than 911 jobs.  Unfortunately, they are often hard to get because there is such a glut of unemployed EMTs in any metropolitan area.  They're not impossible to find though because of the turnover.  A lot of EMTs are just in it for the thrill of the uniform and the siren, so an ER tech job doesn't do it for them for very long.


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## Phoenix (Apr 7, 2009)

*Thrills*

If I want thrills, I will go skydiving... or maybe mistakenly call my girlfriend by her sister's name at a very intimate time. Talk about hearing a siren.... 

I agree though - this is a job, and an important one, and should be treated as such. 

P



AJ Hidell said:


> Exactly.  Too many people in EMS -- managers included -- seem to spend a lot of time preparing their system for the mundane, and providing for whatever they can get by with.  That's not what the public expects from us.  They expect that EMERGENCY Medical Services exists to be prepared for true emergencies, not just the mundane stuff.  That's why the arguments that _"most patients don't need ALS"_ are so ignorant.  Most patients don't even require a stretcher!  But we have to be prepared for those that need the most, not just the ones that need the least.
> 
> 
> It's a good plan, for sure.  Phlebotomy usually pays better than transfer ambulance driving, has better hours, better conditions, and better benefits, including many hospitals that will pay your tuition for medic school.  Along those same lines, job as an ER tech are better preparation for paramedic school than most ambulance jobs, even more so than 911 jobs.  Unfortunately, they are often hard to get because there is such a glut of unemployed EMTs in any metropolitan area.  They're not impossible to find though because of the turnover.  A lot of EMTs are just in it for the thrill of the uniform and the siren, so an ER tech job doesn't do it for them for very long.


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## AJ Hidell (Apr 7, 2009)

Phoenix said:


> ... or maybe mistakenly call my girlfriend by her sister's name at a very intimate time. Talk about hearing a siren....


Don't remind me.  :blush:


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