# Vague medic school question



## griffithsgriffin (Jan 22, 2014)

those who got their Basic and eventually went into medic school w/little ems experience: was medic school "do-able" for you? took me almost a year and a half to get a job w/my emt-b cert. as posted previously, doing most exclusively wheelchair transfers. would like to go on to medic school, but am obviously a little rusty/out of practice. thanks!


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## STXmedic (Jan 22, 2014)

You don't have to be a basic for years to be a medic. I went straight through, and didn't start working until 2 months into school. 

What's more important for medic school is your ability to be studious and comprehend the material. You're not going to throw what you learned in Basic out the window. You're going to review it and expand on it.


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## DesertMedic66 (Jan 22, 2014)

I honestly can't say. For my medic school you have to have at least 6 months of working as an EMT to get in. We can tell the difference between the EMTs who have worked on 911 ALS units and EMTs who work on BLS IFT units.


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## Brevi (Jan 22, 2014)

I know several great providers who went straight from b to p. They were intelligent, hard working people and very driven. They most likely would of been successful in whatever they chose to pursue.

Bottom line is you are only limited by yourself. Don't let anyone tell you what you are and are not capable of.


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## gotbeerz001 (Jan 22, 2014)

I would seriously consider getting at least 6 months (preferably 1 year) of solid 911 experience as an EMT before attempting medic school. There is already a HUGE learning curve going from 911 EMT to managing the scene, deciding appropriate treatment and owning every decision. Trying to make that jump before you've even seen the types of calls that you'll be responsible for is a tremendous leap. I'm not saying that you can't do it, I'm just saying that to really do it well would be difficult. In any other field, failure results in a lost client or substandard sales. A bad day on the ambulance means a lost life and possibly the end of your career.

As for a paramedic school that is "do-able", that is the wrong attitude. The job is the job. Paramedic school (ideally) prepares you to do the job. If you attempt to get your P-card with minimal experience on a BLS rig doing IFT, I would be looking for the best (maybe toughest) school around since you are bringing very little to the table.

I am not being harsh, the advice is sound. Best of luck.


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## Brevi (Jan 22, 2014)

Here is a relevant article written by Thom ****. I usually like Thom's work, but I don't much care for this one.


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## gotbeerz001 (Jan 22, 2014)

Brevi said:


> Here is a relevant article written by Thom ****. I usually like Thom's work, but I don't much care for this one.



That's actually a pretty good article.


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## STXmedic (Jan 22, 2014)

It's a played out argument, but it's a played out topic:

Do RNs have to be LVNs or CNAs before becoming an RN? No, and nobody says anything about it.

Do PAs have to do anything at all prior to becoming a PA? Nope.

Do MDs have to be PAs, NPs, medics, nurses, etc prior to becoming a physican? (Hint: again, no.)

So why must a paramedic go through a glorified first aid program prior to going through paramedic school? If you go to a good school, you will have enough clinicals to get your "scene management" down. Also, your employer should be providing you with an appropriate orientation period for that as well (though I know that's not always the case)

The only reason I can see to potentially need to work as an EMT first is if you are unsure if this is actually the field you want. If you're already pretty sure you enjoy this type of work, and paramedic is a goal, go to paramedic school.

Again, there is _nothing_ taught in basic that isn't taught again in paramedic, and in more depth.


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## DesertMedic66 (Jan 22, 2014)

STXmedic said:


> Again, there is _nothing_ taught in basic that isn't taught again in paramedic, and in more depth.



Depends on the program. No BLS skills are taught for my medic program. Our first day of skills we were tested out on the BLS skills.


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## gotbeerz001 (Jan 22, 2014)

STXmedic said:


> It's a played out argument, but it's a played out topic:
> 
> Do RNs have to be LVNs or CNAs before becoming an RN? No, and nobody says anything about it.
> 
> ...



I don't think anyone is saying it CAN'T be done. Just saying that in order to do it well, a little bit of time in the trenches can help with the transition.

Last I checked, RNs are generally a shoulder tap away from help when at pt takes a bad turn. MDs spend years in residency (also a shoulder tap away) before they are the top dog on the floor.

Furthermore, I'm not sure what the job outlook is like in your area. I do know that here in CA, getting a medic job almost requires that you have real medic experience (beyond your internship) or that you upgrade from 911 EMT.

Practically speaking, getting that 911 EMT job should help pave the way to a 911 medic job.


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## STXmedic (Jan 22, 2014)

Ours were re-covered, and still emphasized during scenarios.

So OP, don't live in Cali


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## Medic348 (Jan 22, 2014)

*Please*

Get some experience and then go to school. It will help you in the big scheme of things.


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## STXmedic (Jan 22, 2014)

gotshirtz001 said:


> Furthermore, I'm not sure what the job outlook is like in your area. I do know that here in CA, getting a medic job almost requires that you have real medic experience (beyond your internship) or that you upgrade from 911 EMT.
> 
> Practically speaking, getting that 911 EMT job should help pave the way to a 911 medic job.






STXmedic said:


> So OP, don't live in Cali



Further proving this, OP

Ask Chase how accessible the physician always is. I know my wife sure doesn't feel like the physician is always right there to grab for every little problem, especially at night. And what's preventing you from calling your physician? Isn't that one of the reasons for med control?


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## gotbeerz001 (Jan 22, 2014)

STXmedic said:


> So OP, don't live in Cali



Sadly, I think WA may be a tougher market than CA (wtf is "Cali"?)


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## STXmedic (Jan 22, 2014)

Everyone likes to throw out the need for 911 experience. If you can get quality 911 experience, great. It will absolutely be beneficial.

Unfortunately, quality 911 programs are few and far between. Most EMTs will be at a private system playing the dialysis derby game, and the ones that do end up at 911, many will end up being the equivalent of a stretcher fetcher and driver. Most will not get a ton of experience running a scene, if any at all. 

So if you can get good, quality experience as an EMT, the go for it. The vast majority will not get much of anything worthwhile, though. Nothing that couldn't be learned during your rideouts during class anyway.


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## STXmedic (Jan 22, 2014)

gotshirtz001 said:


> Sadly, I think WA may be a tougher market than CA (wtf is "Cali"?)



Oh, I'm sorry. I didn't know I needed to spell things out for you. Cali is one of the ways the rest of the country, except apparently you, refer to California. Since we're explaining things, what the heck is "wtf"?*


*I don't care. It's the irony that I'm alluding to. (Since apparently I have to spell things out...)


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## gotbeerz001 (Jan 22, 2014)

STXmedic is obviously speaking from his experience.
I am obviously speaking from my experience.

I really appreciated getting good EMT experience prior to medic school.
I did work in a system where I got to tech the majority of the calls.
That being said, there were things that I needed to un-learn that I had been shown.
Those in my class who were really smart and were coming from IFT generally aced the tests and did well in clinicals, but really struggled in their internship.
The real test is the first 120 hours of internship.
This is where you realize that your assessments aren't as solid as you thought.
This is where you realize that you need to take charge of your scene or someone else will do it regardless of your "Intern" badge. 
This is where you find that NREMT helps, but that treating people is not a series of check boxes.

Your level of comfort in the role is the X-factor that can not be taught in class.


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## STXmedic (Jan 22, 2014)

OP, will you be doing clinicals throughout school, or an internship after class is finished? I'm just curious. I've never seen a program like that.


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## gotbeerz001 (Jan 22, 2014)

We had a guy in our class who went from IFT to medic but somehow had an amazing story for every lesson covered. He now works in Texas.

Enrico? Is that you?


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## STXmedic (Jan 22, 2014)

gotshirtz001 said:


> Those in my class who were really smart and were coming from IFT generally aced the tests and did well in clinicals, but really struggled in their internship.


Sorry to quote you again, but you're the only one posting now.

OP, don't take this quote as the blanket statement it sounds. This may have been his experience, but it was the polar opposite in my program. The students that went straight through and shined in class, also shined in clinicals. Of the guys that had previous experience, most had bad habits to unlearn, and many struggled in clinicals.

The point is, people are different. Like I said in my first post, what matters is how you are as a student. Are you able to comprehend the material, and dedicate time to study the material you can't? If so, go for it. If not, sure, get some more experience. It may or may not help you comprehend areas you may have struggled with.


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## STXmedic (Jan 22, 2014)

gotshirtz001 said:


> We had a guy in our class who went from IFT to medic but somehow had an amazing story for every lesson covered. He now works in Texas.
> 
> Enrico? Is that you?



No, but he left Cali, so he sounds like a pretty smart guy.


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## gotbeerz001 (Jan 22, 2014)

STX is right. At the end of the day, it's how you treat your pts and whether or not your partners like working with you.

I can tell that STX is very good at pt care.


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## gotbeerz001 (Jan 22, 2014)

OP, last thing I have to say:
Be wary of anyone who says that they "rocked their internship".
There is no "rocking" your internship.


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## STXmedic (Jan 22, 2014)

gotshirtz001 said:


> OP, last thing I have to say:
> Be wary of anyone who says that they "rocked their internship".
> There is no "rocking" your internship.



How does this relate to what (s)he was asking?


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## DesertMedic66 (Jan 23, 2014)

STXmedic said:


> Ours were re-covered, and still emphasized during scenarios.
> 
> So OP, don't live in Cali



Ours are still emphasized during scenarios. Programs can be built differently (especially here in CA). 

We had to show proof that we passed A&P 101 class (with lab) and EMT class. We then had to pass written tests for EMT and A&P with an 80% to get accepted. So at the start of class they can start right into paramedic info and not have to go over EMT or basic A&P.

Other programs will start off at "Well the heart has 4 chambers..."


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## teedubbyaw (Jan 23, 2014)

I went straight through. It has been a lot of hard work, but doable if you put into it what you want to get out of it. 

And I disagree with getting experience first. We do somewhere around 7-800 clinical hours. Couple that with a prn emt-b job, and having the right mentality to begin with is essential.


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## NomadicMedic (Jan 24, 2014)

I don't believe that paramedics need to be an EMT to become better paramedics. I believe they need to be an EMT first, to learn those very important foundation EMT skills. How to move patients, how to talk to nurses, How to take a blood pressure in the truck... Can these skills be taught in the field during the paramedic internship? Sure. But, the student will have more experience with paramedic level assessment and treatment modalities if they're not learning the basics as they go. We frequently have students that come through the Del tech program fail their clinical portion because they're thrust onto the truck with no experience and immediately start to fail calls. I think it's a flawed system, but it's the way they do things here.


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## Tigger (Jan 24, 2014)

gotshirtz001 said:


> That's actually a pretty good article.



I don't know how he expects everyone to get two years of "street" experience prior to going to medic school. Given that there just aren't that many 911 EMT jobs out there, it's going to take time to just get enough experience to get one of those jobs. We aren't doing ourselves any favors by putting these burdens on prospective medics, they'll just find other jobs. 



STXmedic said:


> It's a played out argument, but it's a played out topic:
> 
> Do RNs have to be LVNs or CNAs before becoming an RN? No, and nobody says anything about it.
> 
> ...



I agree in principle. However all these other programs do not have such crappy mentoring programs like EMS does.


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## gotbeerz001 (Jan 24, 2014)

As has been said before, you do not have to get experience before becoming a paramedic. However, by almost all accounts, it will only serve to benefit you.

I worked 7 years as an EMT in fire-based (911 BLS) EMS and one year as an EMT in a busy metropolitan ALS system before I made the commitment to increase my skill set and go to medic school. For the first 7 years I was competent, I did not kill anybody, assisted well and would have told you I was a good EMT. I learned and saw more in the last year than I did in the first 7. Even with 8 years of practical experience as an EMT, I was surprised at how disorganized I actually was in my assessments. It was eye-opening to go from feeling very confident and competent to realizing that you actually are not. I had an excellent preceptor who kept the standards very high. 

For the record, I am not a problem child. I was not my class valedictorian, but that was not my goal either. I made a strong commitment to fully understanding everything that I was doing and why I was doing it. I maintained an A average throughout my schooling. I finished my internship in the minimum number of hours with 2.5x the number of contacts required. I greatly benefitted from my time as an EMT, a wonderful paramedic program and an excellent preceptor. Not everybody can have that, but it sure was nice.

From experience, you can usually tell right away those who do not have much experience. Either they appear lost or they completely overcompensate, barking orders to 30-year firemen. At least those who are lost are genuine, I can empathize with that. Paramedic knowledge is 1/3 of being successful at the job. Handling yourself and others on-scene is 2/3 of it. It is difficult to obtain that without actually being there for some time.

So, to clarify what I have been saying throughout this thread:
YES, you can make it through paramedic school without a lot of experience. However, if you can get some practical experience beforehand, it will be very beneficial to you. 

Remember, there is a lot to be said for time-in-position. The one who chose to be a fireman for 15 years before promoting is probably a better choice than the one who cut every corner to find the fastest way to the top.


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## Carlos Danger (Jan 24, 2014)

griffithsgriffin said:


> those who got their Basic and eventually went into medic school w/little ems experience: *was medic school "do-able" for you?*



Of course. Why wouldn't it be? 

The first time I ever worked inside of an ambulance was my first day of paramedic clinical. I did just fine, despite having preceptors who made things decidedly harder for me because they didn't like the idea of someone becoming a paramedic with no BLS experience. 

Does experience as a basic help? Of course it does. Things like talking on the radio, giving reports, filling out run sheets, taking BP's, etc are all pesky little things that you have to learn sometime, and it's easier if you don't have to learn them the same time you are trying to learn the ALS stuff. 

Learning to be a paramedic is just like anything else. You study and work hard and get through it. It isn't rocket science. If you graduated high school you've probably done much more challenging academic work than what paramedic school requires.


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## triemal04 (Jan 26, 2014)

I do love when people make arguments about how other medical professions don't require time at a lower level as as it shows a fundamental lack of understanding of both paramedic education, and the education that other medical providers go through.

With the new standards there isn't a hard hour requirement for clinical hours (both within the hospital and in the field); the "recommendation" is for about 250 hours of in-hospital time, and 250 hours of field time.  Which isn't to far off from what most schools do; around 500 or so hours total of clinical time. 

Contrast that with RN's; anywhere from 800 to over 1000 hours seem pretty standard.  (and just listen to the complaints about new nurses not being competent...lot's of those going around)

Or PA's; 12-14 months of full or near fulltime experience.  (and just listen to the complaints about new PA's not being fully competent...it's why the PA "residencies" are starting)

Or MD's; the shortest way to be board-certified is a 3 year residency of fulltime work. 

Then you get paramedics...after 3 months or so of the equivalent of working fulltime (half of which will not involve treating patients in the field but more job shadowing) you are good to go. 

So no...these other professions don't require someone to work at a lower level (though the PA kind of does), but they do require a much longer time to be spent actually learning how to perform their job than paramedic's do.  And many would argue that they don't spend enough time on it either.

The time spent in the field internship during a paramedic class is not meant to be spent perfecting the things that you should have learned and perfected as an EMT, but all the new things that were just learned in class.  And the list of non-medical skills that can be learned before starting is extensive; being skilled at those only makes it easier to learn how to function as a paramedic.

Can you successfully become a paramedic without working as an EMT?  Absolutely.  Can you make it much easier to become a paramedic and likely learn more at the same time by working as an EMT first?  Absolutely.


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## Handsome Robb (Jan 26, 2014)

gotshirtz001 said:


> OP, last thing I have to say:
> 
> Be wary of anyone who says that they "rocked their internship".
> 
> There is no "rocking" your internship.




You should talk to my preceptor then.

Call me an arrogant prick or cocky or a paragod all you want.

Not everyone struggles in their internship. This job isn't rocket science.


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## griffithsgriffin (Jan 26, 2014)

[/QUOTE]
Can you successfully become a paramedic without working as an EMT?  Absolutely.  Can you make it much easier to become a paramedic and likely learn more at the same time by working as an EMT first?  Absolutely.[/QUOTE]

This pretty much sums up how i feel about all the great responses. My overall takeaway: like most things, if you work hard enough and apply yourself, you can be successful at medic school with little to no 911 experience. BUT, how could said experience hurt? If you have the opportunity to, take advantage of any 911 exposure time. 

Thanks for all the great replies!


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## gotbeerz001 (Jan 27, 2014)

Robb said:


> You should talk to my preceptor then.
> 
> Call me an arrogant prick or cocky or a paragod all you want.
> 
> Not everyone struggles in their internship. This job isn't rocket science.



I didn't struggle in my internship either. Some might say I even "rocked" it.
I had some calls where I learned a lot and I never made the same mistake twice.
That being said, I don't like to think about it that way.
Bottom line is, internship gets you to the point that you learn the basics and are able to safely practice at the minimum standards. While an internship can usually be a strong indicator of a quality provider, I feel like it is the equivalent of a recruit coming out of Fire Academy and thinking they know exactly what to do on the line. There's a fine line between confident and cocky.


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## Handsome Robb (Jan 27, 2014)

griffithsgriffin said:


> This pretty much sums up how i feel about all the great responses. My overall takeaway: like most things, if you work hard enough and apply yourself, you can be successful at medic school with little to no 911 experience. BUT, how could said experience hurt? If you have the opportunity to, take advantage of any 911 exposure time.
> 
> 
> 
> Thanks for all the great replies!




Experience can definitely hurt, can result in bad habits, learning to cut corners and continuing to do so at the paramedic level.

Does this always happen? Absolutely not. Just trying to point out that experience isn't the end all be all and isn't already good.

One thing I had to deal with is when I'd get uncomfortable of revert to acting as an EMT...grabbing gear, focusing on a specific skill or task rather than the whole picture. I still catch myself doing it from time to time.



gotshirtz001 said:


> I didn't struggle in my internship either. Some might say I even "rocked" it.
> 
> I had some calls where I learned a lot and I never made the same mistake twice.
> 
> ...




I agree. I also think that this job takes a bit of cockiness. There's a point where a line is crossed though.

I like to think that someone confident is cocky and knows what they're doing and knows when to turn it down. Whereas someone who is purely cocky has no idea what they're doing and compensate for that by inflecting their  "awesomeness" on those around them to make it appear as though they know what they're doing.

Like I said, I've been called cocky plenty of times. My FTO and clinical department tried to clear me 3 weeks early (out of a 6 week FTO period) as a medic and I said no. I'll leave it at that.


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## NomadicMedic (Jan 27, 2014)

FWIW, the kind of people that post on this forum are the kind of medics that "rocked" their internship. We care about the medicine. We're interested in EBM. We're a good mix between cocky and confident. We're not cookbook medics. Some of us can even tell you what an anion gap is.


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