# UK Paramedic heading to CA



## ShockableAsystole (Jun 6, 2012)

Hello there, I have been lurking for a while now trying to get as much information as possible but I am left with a few questions. I am a UK HPC Paramedic and will be moving to Southern California toward the end of the year. The qualifications side of things seems to be relatively sorted with CA-EMS being very helpful. 

Am I going to struggle to find a job? There is the obvious split between fire and private, I don't mind working for Fire as long as I'm still involved in EMS. Would I have to pay to go to a fire academy or do FD's recruit EMT-Ps and train you up? Do you earn more in a FD? Is it harder to find a job within FD? 

Some threads seem to indicate that most places will not have you doing 911 work... how many transfer calls can there be? What does you day consist of without 911 work? In the UK we have our 999 work and then very occasionally we'll do a hospital transfer, I can't imagine a company dedicated solely to that. 

I do have lots of other questions, mostly random, trying to picture my day to day work out there so it's not a shock when I come over. Many thanks for any responses.


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## terrible one (Jun 6, 2012)

Where in SoCal are you moving?

Yes, you may struggle to find a job depending on where you are headed.
Yes, it is extremely difficult to get a job in CA with a fire department.
Yes, fire pays almost 3x more than privates.
Depending what FD you apply to will determine if you need an academy as a Pre-Req to apply. Even then you will most likely go through their academy.
Yes, privates can run a full day of IFTs. Even some emergency dedicated units will run more transfer calls then emergency runs.

EMS is far different in the US v. the UK, with CA being the worst state to work within EMS. If you don't have to move here I wouldn't. And if you do research the area and apply before moving. If you can find another state to live in I'd recommend that.
CA EMS for most privates involves pay just above the poverty line while being undervalued and under appreciated. Sorry to be the bearer of bad news, if you feel lucky you can play the FD lotto, but you will be competing against 1000s for that one spot.
Good luck.


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## ShockableAsystole (Jun 6, 2012)

Thanks for your reply. I'm moving to CA for family reasons, it seems it wont be for the work! I appreciate the honesty! 

It does seem strange, all the education that goes into becoming a Paramedic, along with the various other qualifications and certifications, along with the responsibility... where is the motivation for Paras in CA if it's as bad as you say?

As a HPC Para, EMT-P, a fire qualification, and an unrelated Bachelors degree... Am I likely to at least get an interview? (I realise this is a vague question, sorry). Would working for a Private alongside volunteering for the FD (presumably this is one way to get fire qualifications) be a good way of eventually working for the FD?

One problem I foresee is most privates are only BLS, are there many ALS privates out there. I see only AMR out of SD. I'm going to be living around Laguna Niguel/San Clemente area.


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## terrible one (Jun 6, 2012)

The US standards to become a paramedic are lower than the UK, which is what most privates use to justify low pay and demeaning work. In CA there is no reciprocity for a 'fire qualification' if you want your FF1 or any other fire certs in CA you must volunteer and/or go through the appropriate courses.

Most private paramedics in CA apply to fire departments, nursing school, PA school, or some other career. Very few work their entire career as a paramedic. As far as getting an interview you need to review the departments testing process. The fire culture in CA is much different than the UK (I'm assuming). Look up what departments you are interested in and go talk to them. Each department is different.

In San Diego County (where you mentioned) most of the Northern cities are all transporting departments. AMR and R/M are the two private transporting companies in the county. Look up their EOAs to see what cities they transport in.


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## Imacho (Jun 7, 2012)

In OC all the ambulances are BLS with OCFA providing ALS. The primary provider being Doctors Ambulance.  As far as your certs... You may be overqualified for a medic spot, but without fire experience it will be difficult without a network connection. Hope It works out for you.


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## AnthonyM83 (Jun 7, 2012)

What part of California are you moving to? There are large differences in how EMS is run in different parts of the state.

In some places I've been told it's an average of 6 years to get hired as a firefighters, plus academy time, plus probation time, then some other times, then finally you get put on the ambulance or paramedic squad. In some areas the fire departments aren't even hiring for a few years so it doesn't matter what your qualifications are. So, it wouldn't make sense to go into another profession just work as a paramedic.

Then in other areas, you might just apply, get yourself on a waiting list, eventually get an interview, and start working as the 911 provider. What many people do in the meantime is work at a company that uses paramedics for interfacility transports (they don't have a 911 contract). Or work as a basic technician in an emergency department.

What county/city are you looking at?


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## ShockableAsystole (Jun 7, 2012)

I am looking for work anywhere between northern San Diego and southern OC though willing to travel up to an hour. I can only assume its similar to here in that a registered Paramedic can't legally work as a Basic/Advanced (tech or ECA here) so I'm guessing all EMT-B jobs are off the cards. 

Going from emergency work to IFT doesn't sound too exciting but I'll do what I have to do. OCFA is the fire authority presumably (not able to access their site from outside the US!), do they hire 911 work out to any privates? Can't see me being overqualified for a medic, our paramedics are extremely similar to EMT-P's, we have one or two less drugs but a lot more autonomy. About equal. 

Are there just not many EMT-P's working in So-CA outside of a FD then? 

I suppose my only real options without going back to school are to work for someone like AMR doing IFT until a FD takes a look at me. :unsure: Who covers San Diego's 911? Any ALS opportunities down there?


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## Imacho (Jun 7, 2012)

AMR and rural metro both cover 911 response in SD County.


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## DPM (Jun 7, 2012)

Once you have your National Registry / California Paramedic card you should be able to challenge the EMT-B... either way, I think you'll be able to work as an EMT-B if you really wanted to.

Rural Metro and AMR are going to be your best bet job wise. Some of the Fire Departments down there will have an ALS capability but might not transport... which is a concept that I didn't quite understand at first.

There's a few of us from the UK on here, if you've got any questions then feel free to DM me.


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## m0nster986 (Jun 7, 2012)

Moving down here for family reasons  is one thing, but to find a career in EMS is another. Otherwise stay far away from EMS in Cali.


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## ShockableAsystole (Jun 7, 2012)

Working as an EMT-B would most likely be very frustrating though. 

Whats the pay like with AMR and Rural Metro? Looks like Rural and AMR both are recruiting for Paramedics. 

Another question, on their requirements, they list "Paramedic Accreditation from the San Diego County EMS Agency", how does one go about getting that?


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## DPM (Jun 7, 2012)

ShockableAsystole said:


> Working as an EMT-B would most likely be very frustrating though.
> 
> Whats the pay like with AMR and Rural Metro? Looks like Rural and AMR both are recruiting for Paramedics.
> 
> Another question, on their requirements, they list "Paramedic Accreditation from the San Diego County EMS Agency", how does one go about getting that?



Once you have your National Registration you take proof of that and a few other things down to your county EMS office. They take a look at all your stuff and give you your State / County Paramedic card. It's not hard or anything, takes an hour or so.


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## terrible one (Jun 7, 2012)

ShockableAsystole said:


> Whats the pay like with AMR and Rural Metro? Looks like Rural and AMR both are recruiting for Paramedics.



$11-13/ish an hour starting. FYI they always say they are hiring, but that doesn't actually mean they are


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## ShockableAsystole (Jun 7, 2012)

Yikes. 

Sorry for the endless questions but some day to day questions... In the UK, were, er, run into the ground. We do 12 hour shifts and any longer than that would kill you as most days are spent going from one job to the next. I notice most places do 24hr shifts so I can only imagine the work is slightly different. 

Typically, how many jobs do people do on a shift working for a company like AMR or RM? Ie is there down time? Do you sleep on nights?

Does billing get in the way of patient care? For example, going out to someone in pain with a # arm, do you discuss how much things are going to cost before cannulating and giving morphine? For the more serious patients, surely emergency care and billing people are incompatible?


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## DPM (Jun 7, 2012)

Where do you work back home? Most privates do 12 hour shifts, with Fire tending to do the 24s, and I've not seen anything as busy as the LAS gets... but it depends on where you are. I also found that a larger proportion of calls here didn't require an ambulance at all, so on busy days you might only have 2-3 real ALS calls.


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## ShockableAsystole (Jun 7, 2012)

Ah sorry, missed the part about you being from the UK. Im with WMAS so probably not as bad as LAS to be fair. I'm on the outskirts so tend to stay busier with my fair share of proper jobs but most of what we see doesn't need an ambulance. 

If they're only 12hrs then that's fair enough, 24 just seemed crazy.


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## DPM (Jun 7, 2012)

As far as I know, 24 hour shifts will be more like 'fire' shifts. Instead of posting at a car park somewhere you'll be working out of your station where you'll be able to get your head down / have a piss when you're not on a call. I've not done that here though but I'm sure someone will be along soon that will be able to shed some more light on this.


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## RocketMedic (Jun 7, 2012)

Billing really doesn't affect care, but your documentation does. In many systems, billing is handled by third parties or prepaid by taxes or subscription.


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## subliminal1284 (Jun 8, 2012)

ShockableAsystole said:


> I am looking for work anywhere between northern San Diego and southern OC though willing to travel up to an hour. I can only assume its similar to here in that a registered Paramedic can't legally work as a Basic/Advanced (tech or ECA here) so I'm guessing all EMT-B jobs are off the cards.



Im not sure how it is in CA but here in WI if youre a paramedic you can work at any level below paramedic, basic, advanced EMT, intermediate etc.


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## AnthonyM83 (Jun 8, 2012)

If you get your paramedic license in California, there's no need to challenge the EMT (Basic). It's automatically part of your scope. There are dozens and dozens and dozens of people in the SoCal working as EMTs even though they have Paramedic licenses. The hardest challenge I see for you getting all your documents and syllabi from your paramedic program in the UK transferred over to get your P-license. Definitely call up the state EMS Authority to ask for details.

Then, most counties around here require an additional accreditation. You just take a day class on local scope of practice and take a test. It's to teach you local variances in protocols (and sometimes double check your skills).

If you're working in OC, you'll be working for a private ambulance company as an EMT. They'll basically be just transporting units, which FD Paramedics hop onto if patient needs ALS. 

If I were you specifically, I'd start hunting for any EMT job at first (ER, IFTs, or 911) while you get your medic stuff sorted out and apply to FDs if that's your route.


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## Steveb (Jun 9, 2012)

Firstly you will need to have your training recognized, and then probably do some retraining (at your cost) before you an get a paramedic job in Canada. Your best bet would be to get a feel for what province would give your current qualifications the most credit and look at moving there. Your issue will be, nursing is not on the recognized shortage list, so, you would need to get your training recognized, and topped up, before you can apply for a job, which would then need to apply for a labour market option (LMO) to hire you and you would get a temporary work permit (TWP). 
From Wikipedia, Paramedics In Canada:
"Paramedic wages in Canada vary depending on province or territory. Paramedics in Alberta will be earning comparable wages to paramedics in the United States, ranging from $35,000 to $40,000 yearly starting out. However, paramedics in Ontario in such regions or cities as Ottawa, Toronto, Peel Region, or Durham, will have an annual salary starting from $60,000 to $75,000 as a Primary Care Paramedic, an Advanced Care Paramedic salary can on average range from $80,000 to $90,000, and Critical Care Paramedics range from $95,000 to $120,000. Education background, experience, and level of practice all are contributing factors to which salary is established."
Posted on http://www.expatforum.com/expats/ca...03-paramedic-england-looking-move-canada.html


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## Medic Tim (Jun 9, 2012)

Steveb said:


> Firstly you will need to have your training recognized, and then probably do some retraining (at your cost) before you an get a paramedic job in Canada. Your best bet would be to get a feel for what province would give your current qualifications the most credit and look at moving there. Your issue will be, nursing is not on the recognized shortage list, so, you would need to get your training recognized, and topped up, before you can apply for a job, which would then need to apply for a labour market option (LMO) to hire you and you would get a temporary work permit (TWP).
> From Wikipedia, Paramedics In Canada:
> "Paramedic wages in Canada vary depending on province or territory. Paramedics in Alberta will be earning comparable wages to paramedics in the United States, ranging from $35,000 to $40,000 yearly starting out. However, paramedics in Ontario in such regions or cities as Ottawa, Toronto, Peel Region, or Durham, will have an annual salary starting from $60,000 to $75,000 as a Primary Care Paramedic, an Advanced Care Paramedic salary can on average range from $80,000 to $90,000, and Critical Care Paramedics range from $95,000 to $120,000. Education background, experience, and level of practice all are contributing factors to which salary is established."
> Posted on http://www.expatforum.com/expats/ca...03-paramedic-england-looking-move-canada.html



the OP isn't moving to Canada . They are moving to Cali


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## Steveb (Jun 10, 2012)

Woops my bad thanks.


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## fortsmithman (Jun 10, 2012)

Actually He might just be able to get certified as am ACP here in Canada with some additional training.


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## airborne2chairborne (Jun 10, 2012)

Sadly IFTs in Cali tend to get paid more than the 911 companies do. tend to is the key word there's some that start at minimum wage. Well maybe not all that sadly since the only thing I've ever seen AMR EMTs/Paramedics do when responding with fire is tear off pieces of tape for them. That's another thing about cali, private 911 companies dont really work alone. They respond with the fire department, who's paramedics do all of the work. You might want to look into an ER tech position at different hospitals, they pay more.


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## thegreypilgrim (Jun 10, 2012)

Well looks like I'm a bit late to the party here and terrible_one and Anthony have provided you with some really good information.

I will, unfortunately, add to the bad news. Sorry, mate but it's only fair to you.

First of all, here are some links to some organizations that you need to become familiar with:

CALEMSA: state government body regulating EMS for California.
Orange County EMS: regulatory agency for Orange County
San Diego County EMS: regulatory agency for San Diego County
National Registry of EMTs: national level certification and standardizing organization

Look over those sites and familiarize yourself with the information within them. Please feel free to direct questions to anyone here on the board.

So, back to the bad news. As previously stated California is the worst, most backwards state in the US for EMS. It is split up into about 55 county-level regulatory agencies that all operate with near-complete autonomy. That is, they set their own scope of practice, clinical practice guidelines (protocols), policies & procedures, and so on. There is a state-level standard for all of that, but each county is able to add or detract from it to meet their needs. You have to get "accredited" in each one separately in order to work there, which means you have to pay a fee each time.

It is unlikely that the state will recognize your UK qualifications (at least I am unaware of anyone from outside the US who has had success in recognition of prior learning) so you may have to go through one of the local paramedic programs. This by itself would be enough to discourage me from proceeding but it seems you don't have much of a choice. I would contact CALEMSA and see what they can do for you. Be advised, however, that they are grossly understaffed and subject to furloughs due to state budget issues.

Beyond that, you have two options for employment: Fire Departments and Private Ambulance companies (as you have discovered). It is possible to work as an ED tech in a hospital, but this is at the BLS level only. Paramedics are prohibited by state law from working in hospitals at the ALS level (thank the nursing associations for that).

*Private Sector:* Probably the largest employment sector, and where most new medics start out. AMR and Rural/Metro are the largest companies but the state is dotted with smaller operations. Most privates are IFT-only (yes, our wonderful healthcare system generates an absolutely enormous amount of transfers every day - most of which are completely medically unnecessary and are nothing more than insurance repatriations). Some privates have 911 contracts, but in Orange County this is at the BLS only level. In San Diego Rural/Metro and AMR both have EOAs (exclusive operating areas) for ALS 911 service in the southern part of the county. Regardless you will always be doing transfers as this is the primary source of revenue for these companies.

Pretty much all the privates are rather poorly managed, very unprofessional, very disorganized, and full of disgruntled, burnt-out staff. Wages typically start around $13-14/hour even for paramedics. You are under appreciated and looked down upon by supervisors, hospital staff, and fire dept. personnel whom you respond with. The ambulances themselves are often poorly maintained, with many hundreds of thousands of miles logged on the odometer, and equipment provided is often cheap and of suboptimal quality. Often management is stingy with resupplies and will restrict access to stock rooms. If you are lucky to have stations they are often unhygienic and lacking in basic amenities. Many private companies utilize a staffing system called System Status Management which means you don't respond from a station or fixed-location but are assigned to various "posts" supposedly strategically located throughout the response area. So, basically you get to sit in the ambulance all day bouncing around from post to post in between calls.

*Fire Departments:* The only employer of any desirability for paramedics, and the reason most people become paramedics in the first place. Pay is about 3-4x what you would see as a private medic. Excellent benefits. No IFTs except for the occasional instance where the hospital itself activates 911 because they have an unstable patient they can't manage and there is no time to call a private to transfer them. Top of the line equipment, ambulances, and immaculate multimillion dollar stations that are nicer than many people's homes. No System Status Management. Management is much more professional and organized and not out to justify its existence by finding infractions with which to exert disciplinary action.

Problem is, literally thousands of people will apply for maybe a handful of positions. Years pass between recruitment periods. If you do get passed the written exam (usually just a civil service exam) and get called in for an interview there are many things that can disqualify you. People have been disqualified before even getting to the interview room for not helping a secretary pick up papers she "accidentally" dropped (a common ruse). Should you be offered a position the probationary period is usually at least a year where you are treated like a slave often to the point of abuse, and can be terminated for any or no reason at all.

Then there is the "firehouse culture" aspect of things. This is difficult to describe. Maybe when you come out to visit schedule a ride along with one of the local departments and just observe the social dynamics of what's going on. Most of these guys do not care about medicine, and really only put up with it because it's what justifies their existence. Some departments are worse than others - indeed, getting assigned to an ambulance or squad is often used as punishment for some mistake you've made. Just something to be aware of.

Honestly, mate, this is not a desirable situation. As much as it sucks to hear this it might be best for you to look into nursing school. Nursing in the US is much different than the UK & Europe and is a much more developed and professional career path. You can even do a lot of work in EMS as an RN such as ground and flight CCT and 911 helicopter medevac. You can even challenge the paramedic qualifying exam as an RN and work as a medic if you wish. You might have more luck with universities here recognizing your qualifications so you can apply to an accelerated BSN program.

Hope this is helpful. Feel free to ask any more questions. PM me if you wish. Good luck.


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## AnthonyM83 (Jun 10, 2012)

thegreypilgrim said:


> *Fire Departments:* The only employer of any desirability for paramedics, and the reason most people become paramedics in the first place.



Overall agree with GreyPrilgrim, except for the above. There are paramedics in some parts of the state that don't do to bad. In some areas, private ambulance can break $100K/yr with only a few OT shifts per month.

I also agree with his conclusion. If I were you, I'd try to get an EMT Basic certification from the state (or take one of those accelerated 3 week programs they have in LA). Start working as an ER tech or other like jobs, while you get more education. Getting a phlebotomy cert can also increase your pay at a number of ER jobs. These might help you out financially and give you networking connections while you figure out your next step.


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## thegreypilgrim (Jun 10, 2012)

AnthonyM83 said:


> Overall agree with GreyPrilgrim, except for the above. There are paramedics in some parts of the state that don't do to bad. In some areas, private ambulance can break $100K/yr with only a few OT shifts per month.


 $100k?? Best paying private service I know of is AMR-Ventura and it's nowhere near that. I would be quite happy to be wrong about this though!


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## ShockableAsystole (Jun 10, 2012)

Thank you so much for those replies. 

I'm at work at the moment writing this on tapatalk so I'll have to revisit this with a proper reply later. 

Contacted California EMS who have had a HPC para come over recently so were very helpful. They will accept my qualification as a equivalent training program making me eligible for the Nremt-p exam which I can then take, then go back to them and allow me to register as a paramedic. 

I am definitely thinking that my career progression in the US will be slightly different than if I was staying the UK. The paramedic role here is developing quickly, but Para to RN is impossible without starting over. There aren't really any pathways once you qualify as a paramedic. The US seems much better for this.. RN, PA, medical school. I'll be keeping my options open. 

Hadn't considered the 'fire mentality' but surely people who sit through hours of medic school leave with a modicum of passion for patient care! 

Do Emt-Ps ever find themselves working HEMS or is that usually nurses then? Over here nurses lack the autonomy for most prehospital work unless they are dual registered ECP's.


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## NomadicMedic (Jun 10, 2012)

ShockableAsystole said:


> Hadn't considered the 'fire mentality' but surely people who sit through hours of medic school leave with a modicum of passion for patient care!



Just wait. You'll be amazed at how little some of those people care. (it's not just California. It's the same in Washington state.)


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## thegreypilgrim (Jun 10, 2012)

ShockableAsystole said:


> Thank you so much for those replies.
> 
> I'm at work at the moment writing this on tapatalk so I'll have to revisit this with a proper reply later.
> 
> Contacted California EMS who have had a HPC para come over recently so were very helpful. They will accept my qualification as a equivalent training program making me eligible for the Nremt-p exam which I can then take, then go back to them and allow me to register as a paramedic.


 Ah, well this is most surprising! But a good surprise no less.



> I am definitely thinking that my career progression in the US will be slightly different than if I was staying the UK. The paramedic role here is developing quickly, but Para to RN is impossible without starting over. There aren't really any pathways once you qualify as a paramedic. The US seems much better for this.. RN, PA, medical school. I'll be keeping my options open.


 This is a good mentality, because you'll have no other choice! Just to be clear, paramedic licensure counts for very little outside EMS here too. If you end up going RN, PA, MD/DO you're going to be starting completely over. Your bachelor's degree will help you in this regard though, as you may be able to jump into an accelerated BSN program depending on what your coursework was.



> Hadn't considered the 'fire mentality' but surely people who sit through hours of medic school leave with a modicum of passion for patient care!


 Hahaha...oh I wish this were the case. I guess you just have to see it first hand before you'll believe it. The apathy can be palpable.



> Do Emt-Ps ever find themselves working HEMS or is that usually nurses then? Over here nurses lack the autonomy for most prehospital work unless they are dual registered ECP's.


 Yes, but it usually requires 3-5 years experience in order to be competitive. Pay is not much better than ground EMS. The state is currently working on a Critical Care Paramedic scope to permit flight medics to provide advanced scope interventions, but as of now only the flight RN can do any of that. The flight medic is limited to whatever scope of practice and protocols are in place at the county in which the service's base of operations is located.


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## ShockableAsystole (Jun 10, 2012)

I should clarify my Paramedic sciences is the equivalent of an AA, my bachelours is in Mechanical Engineering ... Like i said, unrelated and unfortunately not even healthcare; Is this adequate for an accelerated BSN program? 

I've got some decisions to make anyway, RN or wait for a position in fire.


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## ShockableAsystole (Jun 11, 2012)

Apologies also for making a thread "all about me".


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## RocketMedic (Jun 11, 2012)

Shockable, you could move your family out here to Southern New Mexico. The Gilas are beautiful when they're not on fire, and paramedic jobs are really, really easy to find (pay is comparable to SoCal)


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## thegreypilgrim (Jun 11, 2012)

ShockableAsystole said:


> I should clarify my Paramedic sciences is the equivalent of an AA, my bachelours is in Mechanical Engineering ... Like i said, unrelated and unfortunately not even healthcare; Is this adequate for an accelerated BSN program?


 It's difficult to say as UK and US undergrad degrees are quite different. Our degrees have "prerequisites" which is basically a list of courses (I think you would call them "modules") that have to be completed prior to starting the main degree coursework. For nursing there are a host of basic science modules (mostly life science) that have to be done prior, which I'm not sure Mechanical Engineering would cover.

Here is a list of all accelerated BSN programs in the nation. You may want to contact the admissions departments of each one in your area (which for you would be CS-Long Beach, CS-San Marcos, Concordia, and maybe National...Azusa Pacific and Loma Linda might be doable but that would be a significant commute).

If all else fails, you can look for work in the engineering field which would certainly be more gainful than anything you'd find in EMS. Engineers are in high demand and make good money. See here: median salary of $79k.


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## fortsmithman (Jun 11, 2012)

thegreypilgrim said:


> It's difficult to say as UK and US undergrad degrees are quite different. Our degrees have "prerequisites" which is basically a list of courses (I think you would call them "modules") that have to be completed prior to starting the main degree coursework. For nursing there are a host of basic science modules (mostly life science) that have to be done prior, which I'm not sure Mechanical Engineering would cover.



That's because Canadian high schools and possibly British high schools teach the prerequisites as part of the standard high school curriculum.


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## DPM (Jun 11, 2012)

fortsmithman said:


> That's because Canadian high schools and possibly British high schools teach the prerequisites as part of the standard high school curriculum.



This is correct. By the time you get to University in the UK you are only required to study topics / subjects that are actually related to your degree.


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## thegreypilgrim (Jun 11, 2012)

fortsmithman said:


> That's because Canadian high schools and possibly British high schools teach the prerequisites as part of the standard high school curriculum.


 Yeah that's pretty much the entire developed world outside the US does it this way.

Because of the failure of the American education system, you basically have to repeat high school for the first 2 years of your undergraduate studies.


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## fortsmithman (Jun 12, 2012)

In Canada until the late 1990's the province of Ontario used to have grade 13 which was pretty much first year university.  Ontario removed grade 13 to get inline with the rest of Canada.


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## AnthonyM83 (Jun 12, 2012)

ShockableAsystole said:


> I've got some decisions to make anyway, RN or wait for a position in fire.


Do both. If you get hired by a FD and start making big bucks, spending the time/money on the RN stuff won't be so bad. And likely you might  finish RN school before getting hired by FD. In which case, you'll be able to make two incomes. I know a few people who have followed this route.



thegreypilgrim said:


> $100k?? Best paying private service I know of is AMR-Ventura and it's nowhere near that. I would be quite happy to be wrong about this though!


I always tell people never believe it unless you hear it from the source. I'm not the source...but I have heard this from 2 unrelated medics who used to work up there. Could be exaggeration of course.


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## Monkey (Jun 12, 2012)

I know medics here that claim to make 100k, and I believe it, as they work 7 days a week, and have no life.

Shockable, if not already mentioned ( I scanned through this pretty rapidly ) Check into Mercy Ambulance as well.  They do ALS in Northern San Diego County rural areas, around the I-15 corridor near the temecula border to escondido and east.  They are really the only other option to AMR or Rural Metro in SD county for ALS outside of Fire.


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## ltjohnson1979 (Jun 12, 2012)

There is a company called Schaffer/Gold Cross, they do hire EMT-P's along with EMT-B's. They run 911 and IFT's. If you want 90% 911 then you need to apply with Gold Cross in Imperial County. They do alot of 911 calls and they are the only ambulance company in Imperial County. your shift will be 48 on 72 off then 72 on and 48 off. This shift will allow you to be a volunteer ff in Orange County or North County Fire Protection District in North San Diego County. You can also check out Firemedic.com that wbsite covers all of San Diego County. But I would suggest contacting Gold cross in Imperial County. Good Luck.


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## ShockableAsystole (Jun 12, 2012)

Thank you all for the many replies!

Looks like my options keep expanding. My goal is to be doing emergency work in the same way I am now, while earning what I feel I deserve... So however I achieve that I am happy. Whether that be waiting for a place with a FD or furthering my education.

Few points, as stated degrees are focused entirely on your major in the UK, prereq's come in the form of something called A-Levels which are subject exams prior to Uni. I'll have to contact the programs themselves to see if I am eligible. This was a good site for anyone else looking into this. 



Monkey said:


> I
> Shockable, if not already mentioned ( I scanned through this pretty rapidly ) Check into Mercy Ambulance as well.  They do ALS in Northern San Diego County rural areas, around the I-15 corridor near the temecula border to escondido and east.  They are really the only other option to AMR or Rural Metro in SD county for ALS outside of Fire.



Can't find much info on Mercy Ambulance. Do they do 911 work also?

If medics are making 100k Private, anyone care to PM who they are working with 



ltjohnson1979 said:


> There is a company called Schaffer/Gold Cross, they do hire EMT-P's along with EMT-B's. They run 911 and IFT's. If you want 90% 911 then you need to apply with Gold Cross in Imperial County. They do alot of 911 calls and they are the only ambulance company in Imperial County. your shift will be 48 on 72 off then 72 on and 48 off. This shift will allow you to be a volunteer ff in Orange County or North County Fire Protection District in North San Diego County. You can also check out Firemedic.com that wbsite covers all of San Diego County. But I would suggest contacting Gold cross in Imperial County. Good Luck.



Imperial county is a good distance from where I want to be, but the hours at and away from work make Gold Cross an option. 48 and 72 on... this leads me back to one of my original questions... what does a shift consist of like that. Looking at the area I imagine it's an entirely different way of working with presumably some down time. I like the idea of working more rural. 

The future of EMS in California... people have painted a pretty grim picture. Are things developing? Are there changes being made? 



			
				firefightermedic.com said:
			
		

> There are many different ways to deliver fire and medical services, and with a large number of fire departments in San Diego, depending on which community you live in you may see a vast array of service deliveries. It’s very hard therefore, to accurately describe what happens when you call 911, because it depends on where in the County you are when you call for help.



http://sandiego.firefightermedic.com/general/911-calls-explained/

It can't really be the most cost effective way to deliver EMS, can it? I don't want to rave about our NHS system as it does have its flaws..but here, you get an Ambulance to a medical call, you get a fire to a fire, and both agencies call on each other when cross service support is needed or will be responded when likely to be needed. We have specialist teams if a medic is needed in a hazardous area and the Paramedic is in charge of the patient. Perhaps it's what works best as both countries have their own challenges. ...That said, I imagine working as a firefighter and medic is pretty rewarding so if possible, this will be my first choice.


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## rescue1 (Jun 12, 2012)

ShockableAsystole said:


> It can't really be the most cost effective way to deliver EMS, can it? I don't want to rave about our NHS system as it does have its flaws..but here, you get an Ambulance to a medical call, you get a fire to a fire, and both agencies call on each other when cross service support is needed or will be responded when likely to be needed. We have specialist teams if a medic is needed in a hazardous area and the Paramedic is in charge of the patient. Perhaps it's what works best as both countries have their own challenges. ...That said, I imagine working as a firefighter and medic is pretty rewarding so if possible, this will be my first choice.



It's a holdover from when EMS, specifically ALS, was first delivered through the fire department. Los Angeles County Fire started their ALS program through fire department paramedics who assisted the basic life support ambulance companies. While in many areas this paradigm has changed, CA is still big on fire medics responding to calls to assist the ambulance. 

Its also a way to justify fire staffing and budget. It's unfortunate that effective fire protection has to be justified through EMS runs, but thats how it is these days. 
There are also different levels of fire department response -- some companies roll an engine on every medical call, some run only on priority calls, and some only run for lift assists and arrests.

All of this from a East-Coaster, so this might not be 100% accurate, but this is generally how fire department first response happens.


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## ShockableAsystole (Jun 14, 2012)

I see. It seems to work but it's probably also the reason a private medic gets paid a quarter of a FD medic. I would think with the wildfires CA has to deal with they wouldn't need to justify anything!

Could someone suggest a study guide(s) that will help with the Nremt-P exam? An often asked question I know but as a Para already, trained to a different hymnsheet I need a guide that will identify what I need to pass the US standard. Thanks!


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## catskills (Jun 15, 2012)

*Check out UK 999Medic which visited SF in USA*

Google search UK Paramedic 999Medic Mark Glencorse who was involved in Chronicles of EMS .  Lots of YouTube vides made my Mark for Chronicles of EMS showing differences between UK paramedics and San Fransisco paramedics.  I bet if you email Mark Glencorse he will respond and give you more information then you would ever need.  

Check it out
http://www.youtube.com/watch?v=nuLYC16MFFU


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## DPM (Jun 15, 2012)

catskills said:


> Google search UK Paramedic 999Medic Mark Glencorse who was involved in Chronicles of EMS .  Lots of YouTube vides made my Mark for Chronicles of EMS showing differences between UK paramedics and San Fransisco paramedics.  I bet if you email Mark Glencorse he will respond and give you more information then you would ever need.
> 
> Check it out
> http://www.youtube.com/watch?v=nuLYC16MFFU



Thanks for that! I know what I'm going to be doing 'at work' tomorrow


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## BeachMedic (Jun 16, 2012)

thegreypilgrim said:


> $100k?? Best paying private service I know of is AMR-Ventura and it's nowhere near that. I would be quite happy to be wrong about this though!


 
I think in general Northern CA medics near and around the San Francisco Bay Area have it much better than our So Cal counterparts in terms of both pay and autonomy. I have worked with many LA  and San Diego transplants that had no idea about it until they moved here either. We do not do any of the la county style bls units with a for medic jumping in the back. Transport medic is highest medical authority and responsible for patient care after turnover. 

AMR was the biggest player up here until Paramedics Plus took over Alameda county and Rural Metro snagged Santa Clara county. 

AMR still has county 911 contracts for San Mateo, Napa, Contra Costa, San Joaquin, Stanislaus, San Benito, Santa Cruz, Monterey(separate union contract Iaff) and some other small counties I am not as familiar with.

Pplus medics still have the same union contract as the bay area amr core.

When I left Alameda County starting hourly for a daytime medic was $23/emt $18 per hour topping out at around $32. A night shift (strike shift) medic started at around $30 per hour/emt $26 and topped out around $42. heavy seniority people gravitated towards nights. 24 units started around $20 and topped out around $30 but did very well with the built in overtime. We did not do IFTs in Alco unless it was a 911 stemi, trauma, or LnD transfer. (that was a rare once every few months type of deal. We did have a bls system that did ifts unless they were needed for a 5150 or the rare mci.

With over time, a lot of medics and even emts cleared 100k. A couple cleared 200k but they never went home.

so the salary is still the same in alco but the system is very different since pplus took over.

Here in Santa Cruz it's a good deal. dual medic system(sorry no 911 emts) run almost entirely out of 24 hour stations. Great working relationship with fire and decent protocols. starting medic rates are maybe a dollar or 2 less than alco hour starting but we actually top out higher.we're short staffed currently so there has been a lot of over time and mando shifts.

San Mateo probably has some of the best compensated private medics in the country. They have a different contract than us that allows them built in over time after 8 hours. They work 12 s so they get 4 hours time and a half each shift. They also have 15 steps of annual increases as opposed to the 10 in most other counties around here. I wouldn't be surprised if a topped out medic in San Mateo county with amr cleared 100 k without extra shifts.

oh and you guys don't want to know what the 911 medics/emts for SF fire are making. Makes my wages look like peanuts.

With all that said.It is just as competitive to get on here as it is in so cal.

Sorry for the poor form I typed all this on a cell phone. 

To the original poster, we had a few transplants working for amr in alco. Two irish men. a dutch lady, and a gent from england. Some of the fire guys had accents as well.


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## thegreypilgrim (Jun 16, 2012)

BeachMedic said:


> I think in general Northern CA medics near and around the San Francisco Bay Area have it much better than our So Cal counterparts in terms of both pay and autonomy....


 This is no doubt true, and I've always known things to be generally better in NorCal vs. SoCal. 

It's not all that surprising though given cost of living in the Bay. Median income for San Jose is the highest in the nation at ~$70k. Median home price is ~$500k for Santa Clara County. Both of those values are significantly higher than anywhere in SoCal. There's just no way anyone could live in the Bay Area without wages like those you're quoting.


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