# Ambitious EMT



## Avid316 (Aug 14, 2015)

Hello, I am a new EMT and a pre-med student. I am a very curious student and I always want to know the "why's" and I love to read anything I can get my hands on. I was looking for some advice. I just recently began reading Dubins EKG book and I want to buy Dr. Guy's Pharmacology for Prehospital Providers in addition to a Paramedic text (either Dr. Bledsoe's or by Mosby) and begin reading it. I was wondering if youg guys thought I was over my head in studying these topics due to the fact they aren't EMT skills? In school normally I have classes that are of no interest to me, but emergency medicine is what fascinates me, so any advice on this would be greatly appreciated.

Thanks


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## CALEMT (Aug 14, 2015)

Avid316 said:


> I was wondering if youg guys thought I was over my head in studying these topics due to the fact they aren't EMT skills?



Never stop learning, thats the advice a preceptor told me once. Just because its not a EMT skill doesn't mean that you can't/ shouldn't have a understanding of it. It can only make you a better provider if you can understand the physiology behind something i.e. EKG's or how "this drug" affects the cells in the body.


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## Gurby (Aug 14, 2015)

I think learning EKG's and "pre-hospital" pharmacology (ie drugs for paramedics) as a basic is kind of a waste.  It won't hurt, of course, but you won't have much/any opportunity to put that knowledge to use as an EMT-B.

I think it would be better to dive into learning anatomy and physiology.  Make Anki flashcards as you go, so you don't forget the material.
To supplement that, go into depth learning about the various pathologies your patients have:  What is CHF?  What is COPD and why is it called that?  What is "inflammation" exactly?  Why do some patients need dialysis, how does it help them, what caused them to need it, etc?  What, exactly, is cancer?  What do all those lab values mean - what are abnormal values for K, BUN/creatinine, etc, and what does it mean for those to be too high/low?  What issues could come from those abnormalities, and why/how?

There is so much you can learn that will be directly relevant to what you do as an EMT-B, and that you can apply right away in your assessments.  EKG's are fun, but I think it would be more useful and relevant for you to understand the mechanisms that cause CHF patients to have edema in their ankles, for instance.


I would add... I don't think you're "over your head".  Learning EKGs and pharmacology to the level that paramedics learn them in school is not hard.  I just think it will benefit you more as an EMT and eventually as a med student/doctor to focus more on basic A+P and pathology, and building your assessment skills instead.

Also, don't buy a pharmacology book for medics, but learning about the drugs your patients take would be really really useful!  Learning about how aspirin works, how lisinopril works and why it would be prescribed, etc, will really help you out a lot as an EMT.  Learning ACLS drugs as an EMT-B would be mostly pointless.


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## CALEMT (Aug 14, 2015)

Gurby said:


> I think it would be better to dive into learning anatomy and physiology.



I would like to make a point with this statement. Things started to "click" and make sense when I took A/P.


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## Avid316 (Aug 14, 2015)

Thanks so much for all the kind remarks. I took anatomy and physiology as a junior in college (I am going to be a senior now) in my opinion we didn't learn anything in enough depth which is why I want to keep up on that. So is buying the medic book a good idea to learn the pathologies of disease?! The only reason I was going to buy the pharm book is because people who used it said it showed how each drug works on the cellualr level.


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## Avid316 (Aug 14, 2015)

I also want to add I want to be a scribe in the ED so learning EKGs may be useful in that regard and getting an idea of how the ED drugs work may help. Thoughts?


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## chaz90 (Aug 14, 2015)

Avid316 said:


> I also want to add I want to be a scribe in the ED so learning EKGs may be useful in that regard and getting an idea of how the ED drugs work may help. Thoughts?


Learning EKGs or pharmacology will have zero bearing on your role as a scribe. Being a scribe is invaluable as it allows you to see how an ER physician conducts assessments and navigates their workday, but it would be even more helpful with a bit more of a medical background first. 

The most important thing to take for being a scribe is medical terminology.


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## ERDoc (Aug 14, 2015)

I have to be the voice of dissent here. While it is always good that you want to learn more that what you learn in college, right now you should be focusing on your studies, getting the best grades you can and scoring well on the MCAT if you want to have a snowball's chance in hell of getting in to medical school.  Don't think that being an EMT is going to help you get in at this point.  Almost every applicant was an EMT during college so admission committees are not very impressed.  The exception would be that if you were an EMT/medic for a while before applying.  I'm not trying to discourage you from learning more, but time management is a huge skill you will need.  If you have time, you should be focusing on physics, biology, chemistry and orgo.  There will be plenty of time for EKGs and pharmacology once you get to med school.

As a scribe, you will need to know how to spell medical terms, not what they mean.  You will never need to look at an EKG and will never be asked to interpret one.  If you have to pick one (scribe vs EMT) go for the EMT.  It will not help you get in but it will help you get comfortable with speaking to and touching pts.  You cannot understand right now how difficult it is to be comfortable with touching people for many students.


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## Avid316 (Aug 14, 2015)

I appreciate that very much. As of right now I am taking the medical school pre-reqs. I want to go to paramedic school next summer because it's something I've always wanted to do. I have intentions of becoming a non-traditional student because I think it's the right path for me.


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## ERDoc (Aug 14, 2015)

Do you mind if I ask why you are going to paramedic school if your plan is to go to medical school?


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## Avid316 (Aug 14, 2015)

My plans were to go to paramedic school and spend at least 3-5 years doing that and while I was a paramedic finish up my science classes and study for the MCAT and apply and if I don't get in on the first go round then fall back on the paramedic and apply again. I want to see if I like medicine and like being in charge of situations before I devote a lifetime to the profession. If I choose a DO medical school their average age is around 25 and slightly more accepting of non-traditional students so if I got in I wouldn't be too separated from my counterparts. The fact is that once I graduate next year I am not ready nor qualified to apply. While I am studying the necessary sciences I could have a job (no companies around me fire EMT without fire certs) to pay for the courses.


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## Avid316 (Aug 14, 2015)

Paramedic school is something I've always wanted to do. The quote I sometimes use to explain it is from Steve Finley who was a medic in Oklahoma City and is now a physician "there is probably something else I could've done, but there is just something inside of me that drives me to it, I can't really explain it"


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## redundantbassist (Aug 15, 2015)

Avid316 said:


> In school normally I have classes that are of no interest to me, but emergency medicine is what fascinates me


Fellow pre med student here. Keep in mind, that what you are learning now is just as important as the medical aspect of your career as a student. It is important for a physician to have a strong understanding of the human body, including at the chemical and atomic level. When you go to med school, you will be building your medical knowledge off of your science knowledge, mainly biology and chemistry. So, my advice to you is to focus on the classes you have now, keeping in mind that you are building the foundation that will make you a great medical student, and ultimately, a great doctor.


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## Avid316 (Aug 15, 2015)

Thank you for all the information.


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## Gurby (Aug 15, 2015)

Avid316 said:


> My plans were to go to paramedic school and spend at least 3-5 years doing that and while I was a paramedic finish up my science classes and study for the MCAT and apply and if I don't get in on the first go round then fall back on the paramedic and apply again. I want to see if I like medicine and like being in charge of situations before I devote a lifetime to the profession. If I choose a DO medical school their average age is around 25 and slightly more accepting of non-traditional students so if I got in I wouldn't be too separated from my counterparts. The fact is that once I graduate next year I am not ready nor qualified to apply. While I am studying the necessary sciences I could have a job (no companies around me fire EMT without fire certs) to pay for the courses.



Typically the advice is to stay at EMT-B, go straight to medical school and forget being a paramedic.  This was a pretty influential post for me:  http://forums.studentdoctor.net/threads/should-a-pre-med-student-go-medic.238346/#post-3077481

On the other hand, if being a paramedic is something you've always wanted to do, and you aren't dead set on going to medical school... this actually seems like a pretty good plan to me.  

The barrier to entry for becoming a paramedic is relatively low.  You spend ~1 year in class and then you're out into clinicals (which will also show you many areas of the hospital and help show whether medicine is for you) and the field.  If you decide it's not for you, you just saved yourself a lot of pain at little time cost.  You lose out on a few years of attending physician salary (to the tune of at least $1 million, probably, if this delays your med school by 3-5 years), which is significant, but IMO it's more important to make sure that medicine is right for you.  If you go straight to medical school and ultimately find out that you don't want to do medicine, sucks to be you.  Now you're 300k in debt, 7-11 years older, and at this point pretty much have no option but to stick with it.

You definitely don't want to look back after going to medical school and have "what if's" in your head.

So, I think it's a reasonable plan.  But don't expect being a paramedic to help you get into med school and don't expect people to be impressed - even most physicians don't seem to have much of a clue about the differences between EMT-B's and EMT-P's.

I'll be curious to hear ERDoc's thoughts!


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## Avid316 (Aug 15, 2015)

Thank you for sharing that link. It has brought insight to my siutation. My idea behind it was it's a job I could that I was the pre-reqs. I have seen paramedics work in the field and then become medical students and for some reason it's the path I have always envisoned myself taking to medical school. I am not the type of student who envisions going right after I graduate from undergrad. I am the type who wants medical experience before I embark on an expensive journey into becoming a physican. I think the non-traditional route is best for me, but like you I am curious to what his thoughts are as well.


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## mgr22 (Aug 15, 2015)

I can't think of any disadvantages to reading and learning. It's not like you'll use up some finite quantity of brain cells. Regardless of your age, certification or future plans, you might as well read what interests you.


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## Avid316 (Aug 15, 2015)

I want to add that I've taken general chemistry and I am taking physics this semester so I am in touch with the sciences. After I graduate I will finish up the rest (Bio, orgo, and physics), the problem for me is that it's difficult for me to relate them to medicine which is why I try my best to apply them to medical situations so I can help myself remember them. I have the opportunity to get a paramedic text relatively cheap and I know it contains pathophysiology an undergraduate can understand. 
Thank you to those who have replied so far.


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## Flying (Aug 15, 2015)

Avid316 said:


> I want to add that I've taken general chemistry and I am taking physics this semester so I am in touch with the sciences. After I graduate I will finish up the rest (Bio, orgo, and physics), the problem for me is that it's difficult for me to relate them to medicine which is why I try my best to apply them to medical situations so I can help myself remember them. I have the opportunity to get a paramedic text relatively cheap and I know it contains pathophysiology an undergraduate can understand.
> Thank you to those who have replied so far.


Better idea: Invest in Guyton and Hall and read it. You will get the basic foundation needed at all levels of care. It will also be your primer to the size and depth of the textbooks you should be trying to develop study habits for.

Get the medic textbook when you're ready to embark onto medic school.

I'm with ERDoc on making your basic science studies outprioritize the other stuff. However, you seem to have a plan similar to Gurby's, and he seems to be doing well. Let's wait and see.


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## Avid316 (Aug 15, 2015)

Thank you. The reason why I think the non traditional path I right for me is because there are things I want to do before being a doctor. For example I want to go on medical mission trips, I want to go to spanish speaking countries to teach English, I want to get  involved in the medical profession prior to medical school. I know these aren't things that boost your application per say, but that's not the reason for me wanting to do them. I want to do these things because they are things I want to do in life. I want to apply to a DO program which is more accepting of non traditionals so I wouldn't be too far behind my counterparts.


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## ERDoc (Aug 17, 2015)

Here is my 2 cents (for what it is really worth).  Having been through the whole process I can't imagine drawing it out any longer than necessary.  I would not want to delay it any longer than I had to.  You are still looking at 4 years of med school and at least 3 years of residency (probably 4 if you are going to DO route).  In that time you are missing out on a lot, friends, family and income/investment building.  You may not think that getting to a point where you can start saving for retirement is important, but take from someone on the other side, it will become very important.  Add kids and a wife to it and it becomes even bigger.  Medicine is changing so don't expect those huge doctor salaries to exist in a few years.  I know physicians that have seen their pay cut by 40% over the last few years, screwed over by the insurance companies.  You will have huge debt and relatively small income.  Once you are done with school you will have time to do all of those other things you dream of and then some.  There are plenty of physicians that still work/volley in the field if that is something you are interested in.  The best thing about it is you don't have to call medical control.  My advice is to get the prereqs and MCAT done ASAP and get through school and residency as quick as you can.


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## Avid316 (Aug 17, 2015)

Thank you for your insight. I have shadowed a lot of doctors and most of them point me in the direction of PA. I have been told that profession will be a large part of the future medical care. I was wondering if I picked that route would paramedic be a good step to take. I'm not the type of person who wants to get married and have a family so that won't be an issue for me.


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## Avid316 (Aug 17, 2015)

My thinking behind it was I was going to finish my pre-reqs immediately despite anything that happened. Taking a year of the science classes isn't something that goes relatively quickly. I wanted to shoot to get into medical school but if something were to happen and I didn't get in then by having been a paramedic would allow to to have the patient contact hours necessary to apply to PA school. If I finished the pre-reqs and apply and didn't get into medical school after multiple attempts I would have to start my patient contact hours later. By doing this I am also having a back plan in place in case things don't work out. I am definitely taking the advice of focusing on the sciences, but also having a back up plan in place where I am eligible to apply to a PA program if medical school didn't work out. I am NOT looking for comments about PA vs. MD so if you are here to bash PAs keep your comments to yourself please. I am just saying I want to have my first option as well as my backup option up to par so I don't waste more time. I am taking the advice of leaving the excess medical knowledge for some other time and taking the other pre-reqs as soon as I graduate, I just don't want to get to a point where if I didn't get into medical school and have no patient care hours to do a different profession.


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## SandpitMedic (Aug 17, 2015)

Avid316 said:


> I am NOT looking for comments about PA vs. MD so if you are here to bash PAs keep your comments to yourself please...




...
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.......


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## CALEMT (Aug 17, 2015)

Haha that was out of the blue. @Ewok Jerky would be able to give you some insight on PA (if you're worthy). I believe he was a EMT in PA school.


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## Avid316 (Aug 17, 2015)

The only reason I say that is because the previous forums I have been a part of whenever someone would talk about PAs there would always be negative opinions of the profession and I am just looking for advice.


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## Avid316 (Aug 17, 2015)

I was a part of SDN and it wasn't as helpful due to the fact most aren't accepting of any other route other than traditional medical student.


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## Gurby (Aug 17, 2015)

SDN is great but keep in mind that it's called "student doctor network" and most people there are shooting for MD/DO.  It would be useful to know what the rest of your application looks like - what is your cGPA, sGPA, what EC's do you do, any research or volunteering experience?

Also, don't take ERDoc's advice here lightly.  While I suppose I'm glad I took the path I took, I'm "old" now.  I'll be 33 when I finish medical school (assuming I get in on my first try), which means I'll be 40 by the time I finish residency if I go into surgery.  40 years old with $300k in debt, no house/equity/savings, and a beat up old car.  Meanwhile, a good number of my peers who went into computer science, finance, etc, will already be retiring or at least thinking about it.  Hopefully I'm a "young 40" and I still have energy and physical health to do medicine for a while (how healthy are your parents/grandparents?).

If med school is indeed the end goal, the sooner the better (maybe, depends I guess).  I'm kicking myself for not figuring it out sooner, and I'm only going to be ~4 years older than average matriculant age...  

Here is a path that might satisfy you:    Work as an EMT.  Finish undergrad.  Immediately begin paramedic program (typically 1 year didactic, 1 year clinicals).  During the 2nd half of your paramedic program, begin knocking out pre-med/PA requirements.  Finish your medic program and get a job.  At this point you're ~23, have a bunch of EMS experience and are ready to apply to med/PA schools.  You could work full time for a year, be 24, and apply to start at age 25 which is the average age.  Or, you could decide that you love EMS and stick with it, and do PA further down the line when you get sick of carrying people down stairs (IMO the older you get, the more sense it makes to go PA over MD/DO).


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## Avid316 (Aug 17, 2015)

Thank you for the advice. That was my plan. I planned on applying to paramedic school immediately after I graduated and begin to get the rest of the pre-reqs out of the way while I was in paramedic school. The program that is me is an 11 month program an highly recognized in my state which allows you to graduate with you NREMT which I could use to get into a high activity area. When I finish my pre-reqs I can apply with some experience instead of just doing the pre-reqs and not seeing if I like medicine. Thank you for all your input.


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## Brandon O (Aug 17, 2015)

You can hit the hour requirements for most PA programs without too much trouble, i.e. within maybe 1 year working full-time. It's nice to have a real career behind you when you apply but not necessary and frankly no longer the norm.


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## Ewok Jerky (Aug 17, 2015)

CALEMT said:


> Haha that was out of the blue. @Ewok Jerky would be able to give you some insight on PA (if you're worthy). I believe he was a EMT in PA school.


PA as a backup plan to Med school is not a good idea.


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## ERDoc (Aug 21, 2015)

I don't think you will find anyone here that is going to put you down for considering PA school.  Now if you said DNP, that might be a different story, lol.  I work with some great PAs and I work with some idiot MD/DOs.  You will find good and bad in each field.  As for your best option, only you can figure that out.  One thing I would mention though is paying attention to how medicine is transforming right now.  There is a huge push for a bundled payment system and the large hospital systems love it.  It means they can decide how much of the bundled payment gets sent to each provider.  This gives the hospital system the power and control, taking it away from the providers.  Many systems are using their power to force physicians to become hospital employees.  The system sees them as no different from every other employee.  It's getting to the point where you have non-medical people dictating how to practice medicine.  Some systems are even trying to get away from calling them patients and instead use the term clients.  If we are all just going to be employees in the future, seriously consider if you want to go to medical school and rack up $300k+ in debt.


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## Aelinu (Aug 26, 2015)

<3 . That's what it's all about.


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## Aelinu (Aug 26, 2015)

Avid316 said:


> Thanks so much for all the kind remarks. I took anatomy and physiology as a junior in college (I am going to be a senior now) in my opinion we didn't learn anything in enough depth which is why I want to keep up on that. So is buying the medic book a good idea to learn the pathologies of disease?! The only reason I was going to buy the pharm book is because people who used it said it showed how each drug works on the cellualr level.



It sounds like you are well on your way towards a career in (emergency) medicine.  Never lose the drive to learn.  Education is what matters.


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## Chris07 (Aug 30, 2015)

Seriously consider finishing your pre-reqs while you are still in your four year university. Stall your degree by leaving a class or two, finish the pre-reqs, and then graduate. It's so much easier to get them done while you're in a university. Once you graduate it's harder to get back in to take the classes you need.

I had near the same plan as the OP but decided that getting my medic was a colossal waste of time. I ended up getting my degree in an unrelated field (Computer Science) and left like 2 classes until I had my pre-reqs done. Once I did them I took my last two classes and graduated in June.

Not sure how true it is, but I've heard that PA school is as competitive (if not more competitive) than getting into medical school nowadays. It seems like an overwhelming majority of my peers are pursuing PA over medical school.


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## StCEMT (Oct 3, 2015)

Gurby said:


> 40 years old with $300k in debt, no house/equity/savings, and a beat up old car.


Kind of sums up why MD became a giant nope for me. PA school though sounds like the perfect solution.


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