# US vs. Canada Education Requirements



## WolfmanHarris (May 27, 2009)

I'm glad stable IFT's are a separate industry around here. It keeps the yahoo wannabes from confusing their job with EMS rather than the horizontal taxi service. With the exception of a bariatric treat and return which the IFT companies can't handle, the only IFT's I've done are urgent if not emergent transfers from the local hospital ED to the regional hospital or for an ICU admit. Have learned a tonne from reading these charts or from the escorts on the times we have them.


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## JPINFV (May 27, 2009)

WolfmanHarris said:


> It keeps the yahoo wannabes from confusing their job with EMS rather than the horizontal taxi service.



Sorry, are my knuckles dragging a little bit? Yahoooo!


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## WolfmanHarris (May 27, 2009)

Perhaps my brush was too wide. See above for criteria to compare against and make your own self-evaluation I suppose.


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## JPINFV (May 27, 2009)

Compare with what? You talk about the seperation of IFT and 911 and yahoo wannabies only working for IFT companies. Please don't tell me that you're one of those people who thinks that they get to boss around other providers of the same level simply because of the company you work for.


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## WolfmanHarris (May 27, 2009)

No. I come from a system where EMS is staffed with providers with a 2 years of education for BLS and 3 for ALS and where stable IFT exists in the private sector staffed by drivers with first aid or perhaps First Responder and where their vehicles are not considered Ambulances under the law. What I meant was that those without the inclination to professionally practice prehospital care are unlikely to go through two years of school. There are of course exceptions (as there is with anything), but education seems to keep the whacker and wannabes numbers low in EMS.

The criteria I referred to was directed largely to the concept of forging documents to pad bills and otherwise operating in a way that was no providing professional patient centered care.


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## JPINFV (May 27, 2009)

Ahh, gotcha. I'm going to place money that you're up in Canada based on the education requirments.


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## exodus (May 28, 2009)

WolfmanHarris said:


> No. I come from a system where EMS is staffed with providers with a 2 years of education for BLS and 3 for ALS and where stable IFT exists in the private sector staffed by drivers with first aid or perhaps First Responder and where their vehicles are not considered Ambulances under the law. What I meant was that those without the inclination to professionally practice prehospital care are unlikely to go through two years of school. There are of course exceptions (as there is with anything), but education seems to keep the whacker and wannabes numbers low in EMS.
> 
> The criteria I referred to was directed largely to the concept of forging documents to pad bills and otherwise operating in a way that was no providing professional patient centered care.



Please let me know what system this is, because 2 years of education for BLS is absolutely STUPID!


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## JPINFV (May 28, 2009)

exodus said:


> Please let me know what system this is, because 2 years of education for BLS is absolutely STUPID!



Why?
10characters


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## WolfmanHarris (May 28, 2009)

Ontario, Canada. It's my hope though that one day we'll catch up with Australia and switch to a Bachelor's degree as the entry-level. However, to avoid hijacking this too much away from the IFT world, I'm going to leave it there. If you'd like, feel free to PM me.

Cheers.

Edit: I forgot that our levels don't quite match up at ALS. After the three years start to finish to become a Primary Care Paramedic and then an Advanced Care Paramedic, one requires a further 18month to obtain first their flight classification and their Critical Care Paramedic. It's only at those final levels where lab value interpretation, blood products, ventilators, intraortic balloon pumps and all the CCT skills come into play.


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## exodus (May 28, 2009)

JPINFV said:


> Why?
> 10characters



Because EMT-B is pretty much advanced first aid, and even if you recognize a true medical problem, all you can do is give them O2 :/


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## Sasha (May 28, 2009)

exodus said:


> Because EMT-B is pretty much advanced first aid, and even if you recognize a true medical problem, all you can do is give them O2 :/



With more education comes an increased scope of practice. You want to do more? Learn more.


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## exodus (May 28, 2009)

Sasha said:


> With more education comes an increased scope of practice. You want to do more? Learn more.



For 2 years education as a basic you can't do more.  For 2 years education for medic, you can do a lot more. For 3 years Educations as RN you can do a hell of a lot more.


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## VentMedic (May 28, 2009)

exodus said:


> Because EMT-B is pretty much advanced first aid, and even if you recognize a true medical problem, all you can do is give them O2 :/


 


> Please let me know what system this is, because 2 years of education for BLS is absolutely STUPID!


 
EMT-B is first-aid and shouldn't even be thought of as "BLS".   An entry level provider should have no less then 1 year of education by full time college standards, not tech school hours.  That should qualify you for these gurney transports. 

Our Paramedic should be no less than a minimum of 2 years of college with an additional year for CCT or Flight.  There should be no back room 2 hour or 80 hour CCEMTP PDQ certs or titles allowed.   

Someday EMS is going to think in terms of medicine and providing quality patient care rather than "certs".


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## Sasha (May 28, 2009)

exodus said:


> For 2 years education as a basic you can't do more.  For 2 years education for medic, you can do a lot more. For 3 years Educations as RN you can do a hell of a lot more.



Who says? Since no US EMT program is 2 years, how do you know that if that was the standard that the scope wouldn't increase? Have you taken a look at Canada's scope?


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## WolfmanHarris (May 28, 2009)

exodus said:


> For 2 years education as a basic you can't do more.  For 2 years education for medic, you can do a lot more. For 3 years Educations as RN you can do a hell of a lot more.



You're right. Two years for EMT-Basic would be excessive. BLS here = Primary Care Paramedic with a scope that includes (with some variation service to service, but all of this is taught) 3 and 12 lead ECG interpretation, IV starts and maintenance, ASA, Glucagon, NTG, Salbutamol and Epi on top of the usual American BLS scope. Our 80-100 hour long EMR course is more in-line with EMT-Basic, though it's a level that is not used in EMS in Ontario. Some FD's use the level as they provide first response and assistance at some calls, in some areas. (Largely arrests and MVC's) That being said, it's a mistake to be defining how you practice by the toys in the bag; it's the knowledge that's essential and most important.

I feel I may have horribly derailed this, which is a less than illustrious start for a new member. Perhaps someone in charge would prefer moving these last few posts into a new thread before it gets locked or something?


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## Novocaine (May 28, 2009)

*thread jacking*

is rampant


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## Sasha (May 28, 2009)

WolfmanHarris said:


> I feel I may have horribly derailed this, which is a less than illustrious start for a new member. Perhaps someone in charge would prefer moving these last few posts into a new thread before it gets locked or something?



Didn't even notice you were new. Welcome to the forum


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## VentMedic (May 28, 2009)

WolfmanHarris said:


> You're right. Two years for EMT-Basic would be excessive. BLS here = Primary Care Paramedic with a scope that includes (with some variation service to service, but all of this is taught) 3 and 12 lead ECG interpretation, IV starts and maintenance, ASA, Glucagon, NTG, Salbutamol and Epi on top of the usual American BLS scope. Our 80-100 hour long EMR course is more in-line with EMT-Basic, though it's a level that is not used in EMS in Ontario. Some FD's use the level as they provide first response and assistance at some calls, in some areas. (Largely arrests and MVC's) That being said, it's a mistake to be defining how you practice by the toys in the bag; it's the knowledge that's essential and most important.


 
Why is a "cert" only measured by the number of skills?   Can you imagine if RRTs and RNs counted their skills that they are required to have as well as those that they can potentially have?

It is about the education!  A monkey can be trained to do most of the skills EMS providers do.  It is the education that helps you tell the two apart.


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## WolfmanHarris (May 28, 2009)

Sasha said:


> Didn't even notice you were new. Welcome to the forum



Thanks. We've met a few times before online. I frequent a couple of other EMS forums under a similar screen name.

Vent, agreed. Though sometimes I wonder if_ some_ of the LTC RN's are doing the rest of their profession a disservice by sharing titles.


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## Sasha (May 28, 2009)

You wouldn't happen to be Doc Harris, would you?


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## VentMedic (May 28, 2009)

WolfmanHarris said:


> Vent, agreed. Though sometimes I wonder if_ some_ of the LTC RN's are doing the rest of their profession a disservice by sharing titles.


 
Do you know the expertise many LTC RNs have in wound care and medications that some ICU nurses do not? Time management? Quad programs for whole body function? Long term airways? TBI and stroke rehabilitation? RNs also start with the same basic level for entry either at 2 or 4 year degrees and build from there. They don't come out of school "counting" skills. They know what is expected at entry level and acquire more training and education as they go. 

In many healthcare professions, a two year degree is called a "tech" or "assistant". Example: Physical Therapy Assistant (Therapist is now a doctorate level), Occupational Therapy Assistant (Therapist - Masters degree preferred). Even Physician's Assistant is just a mere Masters or 6 year degree. 

Once you have a solid educational foundation, it can be expanded upon.


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## WolfmanHarris (May 28, 2009)

VentMedic said:


> Do you know the expertise many LTC RNs have in wound care and medications that some ICU nurses do not? Time management? Quad programs for whole body function? Long term airways? TBI and stroke rehabilitation? RNs also start with the same basic level for entry either at 2 or 4 year degrees and build from there. They don't come out of school "counting" skills. They know what is expected at entry level and acquire more training and education as they go.
> 
> In many healthcare professions, a two year degree is called a "tech" or "assistant". Example: Physical Therapy Assistant (Therapist is now a doctorate level), Occupational Therapy Assistant (Therapist - Masters degree preferred). Even Physician's Assistant is just a mere Masters or 6 year degree.
> 
> Once you have a solid educational foundation, it can be expanded upon.



Note the italics on "some." The internet is poor instrument for subtlety, in fact that's what got me into this mess. It was just trying for some sarcasm on some of the staff I have had the misfortune of dealing with at some very very bad long term care facilities. How about this, I'll just avoid poor attempts at wit from here on in?

And ya Sasha, that's me. Dropped the old awful screen name.


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## Shishkabob (May 28, 2009)

WolfmanHarris said:


> You're right. Two years for EMT-Basic would be excessive. BLS here = Primary Care Paramedic with a scope that includes (with some variation service to service, but all of this is taught) 3 and 12 lead ECG interpretation, IV starts and maintenance, ASA, Glucagon, NTG, Salbutamol and Epi on top of the usual American BLS scope. Our 80-100 hour long EMR course is more in-line with EMT-Basic, though it's a level that is not used in EMS in Ontario.



I'll have to disagree here.  Going solely off of your post, the only difference between your 2 year medic and our 2 week basic skill wise is 3/12 leads and IVs.   It's not even quite equal to an I.... it's somewhere in the middle.


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## VentMedic (May 28, 2009)

Linuss said:


> I'll have to disagree here. Going solely off of your post, the only difference between your 2 year medic and our 2 week basic skill wise is 3/12 leads and IVs. It's not even quite equal to an I.... it's somewhere in the middle.


 
But, their two year degreed Paramedic should know the medical terms for where they are sticking the IVs and may even know why.


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## Shishkabob (May 28, 2009)

VentMedic said:


> But, their two year degreed Paramedic should know the medical terms for where they are sticking the IVs and may even know why.



You mean it takes more than "Stick the sharp thing in the blue line on the arm to put drugs into the body"?!?!


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## WolfmanHarris (May 28, 2009)

Linuss said:


> I'll have to disagree here.  Going solely off of your post, the only difference between your 2 year medic and our 2 week basic skill wise is 3/12 leads and IVs.   It's not even quite equal to an I.... it's somewhere in the middle.



And two full semester credits of A&P, one of pharmacology, one of legal and ethical issues, one on human growth and development, two on psychology, two english credits (don't ask), two elective credits and the two full years of Patient Care theory and lab and our Ambulance operations class.


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## Shishkabob (May 28, 2009)

WolfmanHarris said:


> And two full semester credits of A&P, one of pharmacology, one of legal and ethical issues, one on human growth and development, two on psychology, two english credits (don't ask), two elective credits and the two full years of Patient Care theory and lab and our Ambulance operations class.



Did I not say "skill wise"?


I'm not debating that they have to get more educated to do the same things.


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## WolfmanHarris (May 28, 2009)

VentMedic said:


> But, their two year degreed Paramedic should know the medical terms for where they are sticking the IVs and may even know why.



And to be clear, we don't have degrees from this program. Universities grant degrees for three or four years, Community Colleges grant diplomas for two years and certificates for one year programs. Associates Degrees don't exist in Ontario.

Linuss: Oh in reference to skills please see above. I mentioned their limited relevance earlier, but Vent did a much better job arguing the point.


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## Sasha (May 28, 2009)

The same thing??? 

I'm not familiar with an I level as florida doesn't have one, but I was under the impression that the only difference was an I can start some IVs, give a little fluid and maybe a 4 lead. 

When are we going to stop thinking of EMS in levels and just thinking of it as prehospital care???


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## Shishkabob (May 28, 2009)

WolfmanHarris said:


> And to be clear, we don't have degrees from this program. Universities grant degrees for three or four years, Community Colleges grant diplomas for two years and certificates for one year programs. Associates Degrees don't exist in Ontario.
> 
> Linuss: Oh in reference to skills please see above. I mentioned their limited relevance earlier, but Vent did a much better job arguing the point.



I was just correcting something that I viewed as a misconception... don't bite my neck off.


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## Shishkabob (May 28, 2009)

Sasha said:


> The same thing???



Considering he was stating that they can do ASA, nitro, glucose and albuterol that are "above" the US BLS level, I had to remind him that no, it's not above the level.  Some states maybe, but not all.


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## WolfmanHarris (May 28, 2009)

Linuss said:


> I was just correcting something that I viewed as a misconception... don't bite my neck off.



Not biting your head off. Just no need to repeat what's already been said well.


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## Sasha (May 28, 2009)

Linuss said:


> Considering he was stating that they can do ASA, nitro, glucose and albuterol that are "above" the US BLS level, I had to remind him that no, it's not above the level.  Some states maybe, but not all.



It should be.


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## Shishkabob (May 28, 2009)

Sasha said:


> It should be.



I'll leave that call up to the doctors who make a bunch more money and have way more gray matter then I do.


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## Jon (May 28, 2009)

So... As Wolfman Harris suggested, I've spun this off as a new thread to alleviate confusion in the dialysis transport thread.




Linuss said:


> I'll have to disagree here.  Going solely off of your post, the only difference between your 2 year medic and our 2 week basic skill wise is 3/12 leads and IVs.   It's not even quite equal to an I.... it's somewhere in the middle.


Linuss,

If you mean the actual psycomotor skill... then yes, perhaps. HOWEVER... their students actually understand WHY things work. I've asked currently functioning medics the difference between left and right heart failure... and they look at me with blank stares.


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## JPINFV (May 28, 2009)

Damn it, I don't need none of that thar ed-u-ma-kation stuffins to know when I gotta push that periwinkle box!


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## VentMedic (May 28, 2009)

WolfmanHarris said:


> And two full semester credits of A&P, one of pharmacology, one of legal and ethical issues, one on human growth and development, two on psychology, *two english credits (don't ask),* two elective credits and the two full years of Patient Care theory and lab and our Ambulance operations class.


 
These classes are only the beginning of what should be required of the Paramedic at any level. Even the lack of expectation of those in EMT or Paramedic school to even have more than a GED or high school diploma has keep the text books written at a 10th grade or less level. Many can barely do simple math, have little reading comprehension or could not write a one page report on why they want to be an EMT(P) if they own life depended on it. Once I found out what it was like to teach nursing and RTs students, it is very difficult to teach a cert program for Paramedics. I sometimes make the mistake of using medical terminology or discussing actual disease processes. Sometimes I even required Paramedic students to tell me what a particular med does as it relates to a body system. 

As you can see from some of the posts, microbiology and infection control is not a strong point in U.S. schools either at both levels. Yet, some wonder why hospitals are cautious about invasive procedures done in the prehospital environment and will change the IV. We have already banned Paramedic students from intubating at some of our hospitals and even IVs are getting scrutinized. When some students are asked why you clean a site before sticking their reply is "to get the dirt off". (???!!!!)


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## fortsmithman (May 28, 2009)

Here in Canada Ontario is the only province that has a 2 yr program for primary care paramedic.  The average is 6 to 10 months.  Alberta calls their primary care paramedics EMTs and that program is 6 months.  Most of the other provinces go 10 months. In Alberta for advanced care paramedic it's 2 yrs.  I would prefer if the rest of Canada did it the way Ontario does it.


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## Wee-EMT (May 28, 2009)

fortsmithman said:


> Here in Canada Ontario is the only province that has a 2 yr program for primary care paramedic.  The average is 6 to 10 months.  Alberta calls their primary care paramedics EMTs and that program is 6 months.  Most of the other provinces go 10 months. In Alberta for advanced care paramedic it's 2 yrs.  I would prefer if the rest of Canada did it the way Ontario does it.



I just finished my EMT (PCP) and it took 10 months.


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## Shishkabob (May 28, 2009)

Jon said:


> Linuss,
> 
> If you mean the actual psycomotor skill... then yes, perhaps. HOWEVER... their students actually understand WHY things work. I've asked currently functioning medics the difference between left and right heart failure... and they look at me with blank stares.



Wasn't saying they didn't get more education, I just wanted to correct a misconception that I saw.


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## Jon (May 28, 2009)

Linuss said:


> Wasn't saying they didn't get more education, I just wanted to correct a misconception that I saw.


Right... but it's the same question of the difference between an I99 and an EMT-P. They have almost the same skillset... but one went to school for much longer, and actually is on their way towards being a clinician and not just a technician.


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## xlq771 (May 28, 2009)

Something else to consider is the use of the drugs, when comparing the US EMT-Basic or Intermediate to the Canadian Primary Care Paramedic.

To state that the scope of practice is similar, because both give Epinephrine, Salbutamol, or Nitroglycerine, would be inaccurate.  A US EMT Basic gives Epinephrine via an Epipen, and only for anaphylaxis, while an Canadian PCP Paramedic gives it via drawing from an ampule, not only for anaphylaxis, but for severe asthma (silent Chest) and croup, as well.  Nitro is given not only for chest pain, but for pulmonary edema.


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## fortsmithman (May 29, 2009)

Wee-EMT said:


> I just finished my EMT (PCP) and it took 10 months.



One of my services EMTs took her course at Portage College and it was around 6 months.


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## Melclin (May 29, 2009)

I'm doing the bachelor degree that you mentioned wolfman. There are a lot of kinks to work out and alot of moaning about the youngn's from the older paramedics (they need to remember that they were young and inexperienced once too), but it seems clear that when its all sorted out, the system will churn out very good paramedics. 

Entry to the degree last year required you to be in the top 10 percent of school leavers. (I had a friend who scored slightly lower than me and did medicine, lol, but that's rare). The university also requires an essay on why you want to be a paramedic and why you will be a good one. Entry is extremely competitive (for my year there were about 600-700 applicants for approx 70 spots, from memory).

The degree is three years long and includes (currently) about 12 weeks of ride alongs, with various degrees of involvement depending on experience, and hospital rotations. Followed by a 'probationary' year on the road, in which you are supposed to be mentored by an experience medic (although this doesn't happen the way it should).

After three years you can qualify for intensive care training, a masters degree, to work on the Mobile Intensive Care Ambulances. 

With exception for the new curriculum which needs to be adjusted, some time to change the attitudes of the older medics, and the service a little (the system may need to expect that university won't churn out ready made medics and we may need to adjust its expectations, as with medical school and interns), I think we'll be providing some truly world class pt care here in Melbourne soon enough (current union disputes with the ambulance service notwithstanding).


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