# How long in the field before medic school?



## ErinCooley (Oct 11, 2008)

I've been in the field, full time on a 911 ALS truck for 6 months.  

I've been eyeing a paramedic program offered at a tech school about 1 hour from home.. heard so many great things about the program and some of the better medics I know went thru their class.

Anyway, I've just found out that the same instructor will be doing a private class in my town  (the town were I live, not work!) beginning in February.  I'm not positive that I will even be able to get in, I'm thinking about trying

that will give me 1 year in the field before I even begin paramedic school.

Thoughts?

Both my partner and supervisor that I ride with regularly are encouraging, saying that I will be ready, I admit that I'm a little worried about being too green.


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## marineman (Oct 11, 2008)

I'm fresh out of basic school, been working as a first responder for 5 years but no experience on the rig and I'm currently top of my class for medic. Don't get yourself psyched out about needing to know everything before you start class, that's what class is for. I think you'll be fine as long as you're willing to put the effort into learning the material.


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## firecoins (Oct 11, 2008)

try and get in.  you got enough experience.


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## Ridryder911 (Oct 11, 2008)

Personally, if possible by-pass the Basic level altogether and go to Paramedic. There is NO reason why one would should have to pursue a basic first, if the program was a decent one. 

Find an accredited program that has rigorous clinical sites. You will do fine and as everyone else has done, gained experience working. Rather you will obtaining experience as a Paramedic and will be there superior others will still be at the same spot gaining experience. 

R/r 911


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## Hastings (Oct 11, 2008)

Go straight from Basic to Medic School.

Any experience you need will be obtained once you start the program.


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## Medexpresso (Oct 13, 2008)

I waited about three years after working on the trucks as an EMT-B before going to Paramedic school. I'm glad I did because even fresh out of Paramedic school it took me a while to be comfortable and confident with the whole concept. Sometimes, and I'm guilty of this myself, a lot of Paramedics forget the "basics" once they become ALS. you can't perform good ALS if you can't perform good BLS. Hope that helps some!


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## KEVD18 (Oct 13, 2008)




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## marineman (Oct 13, 2008)

ha, kev you should just put that picture into your sig so you don't have to keep posting it all the time.


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## JPINFV (Oct 13, 2008)

Medexpresso said:


> a lot of Paramedics forget the "basics" once they become ALS. you can't perform good ALS if you can't perform good BLS. Hope that helps some!



If a paramedic forget the "basics" because he's all "ZOMG I GET TO START AN IV!!!!!1111!!11!!," then he needs to find another line of work.


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## MSDeltaFlt (Oct 13, 2008)

Amen, KEVD18.  Amen.


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## stephenrb81 (Oct 13, 2008)

Working for a hospital based system prepared me for when we hit pharmacology in our Medic program.  I already knew a majority of the drugs trade/generic names and the primary indications, so I had to work more on memorizing dosages and mechanisms of action while everyone else was working on just the names.   I also had a grasp of electrolytes, blood gases, etc...   But that wasn't solely because I waited and worked in an ER, I *wanted* to learn so I was always asking "What's that" and researching on my own time


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## Medexpresso (Oct 13, 2008)

just trying to be helpful, I've seen it in happen, I'm not saying it happens in a bad way it just happens....just something to consider as you enter paramedic school, as paramedics know it can be overwhelming what you have to cram into your head in a short period of time...most overcome it though


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## Outbac1 (Oct 13, 2008)

We have had people here go from their year long (1500hr), PCP class, work casual the summer, then roll right into the ACP (EMT-P), program for another year. They come out with 1000hr experience on the trucks as a student. Half as a PCP, half as an ACP and some casual hrs as a PCP. The vast majority do OK when they hit the streets as an ACP. Others will do several years as a PCP or ICP before going to ACP school. They also tend to do OK when they come out. The ones that don't do OK are the ones who don't work at it or slide by with a poor preceptor. Some are just book smart but don't have common sense and can't put theory into physical practice. 

  Bottom line, its constant learning, from books, good instructors, Drs., medics(good and bad), past calls, everything. You can be what ever kind of medic you want to be, really good, bad or so so. If you work at it, hard, you will probably do OK. 

  Best of luck whichever you choose.


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## fortsmithman (Oct 14, 2008)

In alberta Canadaone has to be at a lower ems designation before they can be admitted to a higher one.

to be admitted to an emt program one has to be an emr which is equal to a emt-b in the us

to be admitted to the emt paramedic program you have to be a emt 

that's because the licensing body in alberta the Alberta College of Paramedics will only license those who have held the lower designation to be eligible to be a emt and to write the emt exam and to be licensed you have to be an emr
to be a paramedic you have to be a licensed emt the only designation that does not require this is emr since thats the lowest ems designation.


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## mikie (Oct 14, 2008)

Sorry KEV, it seems like this thread has been revived.     
---
I think that a basic should have SOME field and patient experience before perusing medic.  Maybe some sort of internship the medic schools offers beforehand for those who can't get an EMS job.

At my school, people are in basic class right now and they'll go straight to medic within another semester.  I think it's too soon (especially for some of them).


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## moonfire197 (Oct 14, 2008)

I worked 4 years full time as an EMT-B before going to Medic School.  I am what I am calling a 99% Paramedic because I passed the written and 11 of 12 practical stations.  Have to retake my seated immobilization because I forgot to say BSI yes the dumbest reason to fail and I did it.  I felt in four years I had a good base knowledge to make the class a little bit easier. Get good a basics and then worry about learning and doing the advanced stuff.  I have seen medics forget about the basics and jump right to the advanced care.  It has nothing to do with getting excited about getting to start and IV or do and advanced treatment.  It is just because they forget the basics and go right to advanced treatment.  It doesn't make a medic bad it is just getting ahead of yourself.  I don't really think an EMT-B should be telling a medic to find another field of work because they forget on a call to do a basic skill.  It happens nobody is perfect.


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## reaper (Oct 14, 2008)

Maybe there was a reason they skipped the "basic skill"?


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## KEVD18 (Oct 14, 2008)

every time this comes up, i die a little inside.

i would venture a guess this one is either tied with, or running close second too, "vollie v. paid" in terms of new threads...........


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## JPINFV (Oct 14, 2008)

moonfire197 said:


> It doesn't make a medic bad it is just getting ahead of yourself.  I don't really think an EMT-B should be telling a medic to find another field of work because they forget on a call to do a basic skill.  It happens nobody is perfect.



Isn't there word used to describe a treatment plan that neglects something so basic that would result with an EMT-B "saving" a paramedic? I think it starts with an "m" and ends with "alpractice." 

/no illusions that he has ever "saved" an EMT-P, RN, or RT that he has worked with.




reaper said:


> Maybe there was a reason they skipped the "basic skill"?




Oh, pleeaaasssee. Everyone knows that emergency rooms always start with an OPA and the ER tech bagging the patient and only move on to an advanced airway only if the patient isn't getting adequate oxygenation. Similarly, patients with fractures only get morphine (or other pain medication) only if an ice pack doesn't work. [/sarcasm]


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## reaper (Oct 14, 2008)

See, I always forget about the ice paks!!


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## moonfire197 (Oct 14, 2008)

There is nothing malpractice about it I think you are blowing what medexpresso was trying to say way out of the water.  There are times where things don't get done in order from basic to advanced.  I have seen medics who are absolutely great do this.  It happens it is part of EMS and if you have never seen it done then I can tell you 100% that you are lying to everyone.  They don't make mistakes that are harmful to pt care.  The pt is 100% ok it is just simple little things.  I never said a word about not bagging and going straigt to intubation or a dual lumen airway or skipping everything and doing a surgical chric.  But every medic misses little non harmful things.  Just as EMT's do.  If you are telling me that you treat 100% of pts perfectly then you are FOS and can stop replying to anything I say.  Everyone misses things it happens it is human nature and I get the feeling you believe you are better than everyone and don't make mistakes.  That my friend is a lie and you are a liar.


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## reaper (Oct 14, 2008)

moonfire197 said:


> There is nothing malpractice about it I think you are blowing what medexpresso was trying to say way out of the water.  There are times where things don't get done in order from basic to advanced.  I have seen medics who are absolutely great do this.  It happens it is part of EMS and if you have never seen it done then I can tell you 100% that you are lying to everyone.  They don't make mistakes that are harmful to pt care.  The pt is 100% ok it is just simple little things.  I never said a word about not bagging and going straigt to intubation or a dual lumen airway or skipping everything and doing a surgical chric.  But every medic misses little non harmful things.  Just as EMT's do.  If you are telling me that you treat 100% of pts perfectly then you are FOS and can stop replying to anything I say.  Everyone misses things it happens it is human nature and I get the feeling you believe you are better than everyone and don't make mistakes.  That my friend is a lie and you are a liar.



Never stated that I don't miss things. You talk about medics not doing something BLS. You may not know the reason why a medic skipped over a simple skill, because the Pt needed something more advanced, right away.

This is the most recurring statement from EMT's. Most do not have the education to understand why a medic is doing things a certain way. Yes, there are bad medics, that like to play. Most medics are doing assessment and treating accordingly.

Don't come here accusing people of lying, when you know nothing of them or their education. Which is way past 120 hrs!


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## moonfire197 (Oct 14, 2008)

Your right but education doesn't make you not a liar.  I am not saying you are I was just trying to get my point across and went about it the wrong way for sure.  I see what you are saying now that you put it that way.  I also have enough training to know why things are done a certain way but there are still times when advanced skills are completed before basic.  Like starting and IV before getting a bp that is all I am trying to say.  I doesn't mean you should switch fields or anything.  I believe you should have some time in the field interacting with pts and crews before starting into an NREMT-P class.  That is all.  I apologize if I offended you just went about things the wrong way. :blush:


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## JPINFV (Oct 14, 2008)

How about we go back to my original post because I think we're missing sight on what I was responding to.



JPINFV said:


> Medexpresso said:
> 
> 
> > a lot of Paramedics forget the "basics" once they become ALS. you can't perform good ALS if you can't perform good BLS. Hope that helps some!
> ...



I'm responding to someone who is explicitly talking about the BLS before ALS cliche, and thus implicitly referring to the "EMTs save paramedics" cliche. For the record, my view is that both of those cliches need to die. This isn't about the order of treatments or assessments. This isn't about a paramedic saying "Damn, this patient is about to die. As such, there is absolutely no reason to start at treatment option A when I can clearly see, due to my education, training, and assessment that the patient needs the more advanced treatment option C." 

This is about basics saying "ZOMG YOU SKIPPED TREATMENTS A AND B AND THOSE ARE BLS! I SAVED THE PATIENT BECAUSE I REMEMBERED TREATMENTS A AND B." 

There are two situations that give rise to that. 

Situation A (hopefully rare): The patient really did need steps A and B and the patient would have suffered because steps A and B were skipped. The assumption being made by the basic that "saved" the medic is that a second medic would have missed the importance of steps A and B as well. The medic who failed to realize that he needed to do steps A and B is a danger to patients. 


Situation B (most likely): Basic fails to realize that the medic understands that steps A and B are important, but that both takes a back seat to step C in terms of importance. Basic "saves" medic by "reminding" him of steps A and B. Medic does steps A and B for no other reason than to shut the basic up. Basic can now go and claim to all of his other basic friends that he "saved" the medic. 

Analysis. The basic really saved the medic in step A. Basic life support is about the furthest that patient care can get from rocket science and is taught to preteens through out the country every year in first aid and CPR courses. If the medic really did fail to do something so basic that only an EMT-B would have seen it, then the medic needs to be retrained, but more likely, probably needs to be fired. Scenario two is a justification of having dual paramedic teams on ambulances and not basic/paramedic teams. 



PS Nice personal attack. Stay classy.


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## JPINFV (Oct 14, 2008)

moonfire197 said:


> I believe you should have some time in the field interacting with pts and crews before starting into an NREMT-P class.  That is all.  I apologize if I offended you just went about things the wrong way. :blush:


Why don't you see physicians or nurses required to spend time at a lower level if it was so important?


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## Ridryder911 (Oct 14, 2008)

Here let's start a new policy. You can't criticize another EMT or Paramedic unless you have been or at that level. Wow! That will quite things down. 

Unfortunately, you see most basics do not understand in *real medicine* there is *NO* such thing as BLS or ALS. Medicine is medicine and only in EMS we have to create multiple levels so naive and the dumb would understand their role. Even at least CNA's know their role. 

Alike we have said many times before. Unless you are at that level or equal .. How do you really know and what is right and do you have the authority to even criticize? 

This is something I never understand with the lower levels. One takes a whopping 100+ hour course, and many assume it makes them the authority in EMS. When in fact, it barely allows them on a ambulance. Some really do have "delusions of grandeur". 

R/r 911


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## el Murpharino (Oct 14, 2008)

Erin, what kind of reputation does this instructor have?  It would be a real disservice to you to take a class that's closer to home but with a lousy instructor.  If you're going to take the jump to the paramedic level, try to find a reputable and accredited program that won't cut corners and education just to boost their graduation numbers.


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## Anu (Oct 14, 2008)

Hello Everyone,

I have been told by many professional medics in the field that one must wait and gain at least one year's experience as an EMT-B before going on to Paramedic School.  I realize that this seems to be the general consensus among experienced personnel, but is this really necessary?  Particularly if one has acquired college experience prior to working as a basic, and is certain about wanting to become a medic?  It just seems a lot more sensible to go directly into a paramedic program, utilizing and building upon the knowledge that one gains from the basic program.  In this way, one could accomplish the educational requirements and necessary field experience at the same time.


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## Ridryder911 (Oct 14, 2008)

Luvadea said:


> Hello Everyone,
> 
> I have been told by many professional medics in the field that one must wait and gain at least one year's experience as an EMT-B before going on to Paramedic School.  I realize that this seems to be the general consensus among experienced personnel, but is this really necessary?



No! Who told you this.. other basic EMT's that became Paramedics? Experience is nice, but way over rated. There is very little EMT experience that will help as a Paramedic. Two different jobs and responsibilities. 



Luvadea said:


> Particularly if one has acquired college experience prior to working as a basic, and is certain about wanting to become a medic?  It just seems a lot more sensible to go directly into a paramedic program, utilizing and building upon the knowledge that one gains from the basic program.  In this way, one could accomplish the educational requirements and necessary field experience at the same time.



Get your basic education especially anatomy/physiology and some other general education such as Psychology and English. Seriously, you will obtain all the experience you will need when you become a Paramedic and think of the time you saved!

R/r 911


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## Hastings (Oct 14, 2008)

I am a medic that went straight from Basic to Paramedic with no prior experience before or in between. Best decision I made. I highly suggest just doing it all at once (Basic and Medic). Don't stop in between.


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## mikie (Oct 14, 2008)

Hastings said:


> I am a medic that went straight from Basic to Paramedic with no prior experience before or in between. Best decision I made. I highly suggest just doing it all at once (Basic and Medic). Don't stop in between.



are there medic programs that don't require basic first?


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## Hastings (Oct 14, 2008)

mikie said:


> are there medic programs that don't require basic first?



Not that I know of.

You still want to do Basic. I'm just saying not to stop in between Basic and Medic.


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## mikie (Oct 14, 2008)

From what I've heard from some programs, the basic curriculum is basically (no pun intended) retaught in the begining....is there truth to this?


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## KEVD18 (Oct 14, 2008)

every state i know of required you to be a basic to sit for the medic exam. 

now, that doesnt mean you have to be a basic with even one day of experience on a truck, just that you have to have the ticket. the ink doesnt even have to be dry.

there was a woman in my medic class that had been a basic a while back but had lapsed, not long maybe three years. 

they let her into the program without a basic ticket, with the caveat that she had to have a basic ticket to test. she basically did basic and medic concurrently and by the time the class ended, she had her bls ticket and then of course her medic ticket.


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## Hastings (Oct 14, 2008)

mikie said:


> From what I've heard from some programs, the basic curriculum is basically (no pun intended) retaught in the begining....is there truth to this?



Unofficially, yes.

But only because you have these Basics coming in after a year or two in the field remembering nothing of the proper ways to do things.

Thus, more reason to not take that time in between.




Edit: In regards to the comment above, several students in my class didn't have their Basic license (though they had finished the class) until days before the Paramedic final tests.


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## AlaskaEMT (Oct 15, 2008)

I'm in paramedic school right now and came straight from EMT-I without any experience.  I'm doing fine because I exert effort and ask questions.


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## marineman (Oct 15, 2008)

Ridryder911 said:


> Get your basic education especially anatomy/physiology and some other general education such as Psychology and English. Seriously, you will obtain all the experience you will need when you become a Paramedic and think of the time you saved!
> 
> R/r 911



I think that's the best advice in the thread. Like I said before with no experience it's still possible to do really well but without A&P it's incredibly difficult to even get by much less do really well. I wish I would have found this site sooner and read that advice before class started, I honestly buckle down for at least 3-4 hours each night reading not only our text book but several other textbooks relating to A&P or pharmacology in order to honestly understand how each body system works and how drugs interact with a particular system. Knowing these things is required for every part of the medic program as everything we do relates somehow to A&P and or pharmacology.

The experience on the other hand is just that experience on the rig taking vitals and histories. I don't know what the average is or if there's a national standard but we do over 650 hours of field work during the program in addition to classes so I have faith that I'll be able to take a history and BP.


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## KEVD18 (Oct 15, 2008)

Hastings said:


> Unofficially, yes.
> 
> But only because you have these Basics coming in after a year or two in the field remembering nothing of the proper ways to do things.
> 
> ...



and since there two side to ever story:

they also repeat a lot of the information to make sure that people who have never actually used these skills are appropriately trained.


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## Hastings (Oct 15, 2008)

KEVD18 said:


> and since there two side to ever story:
> 
> they also repeat a lot of the information to make sure that people who have never actually used these skills are appropriately trained.



Not so in this case. Any Basics that had not worked in the field were fresh graduates of the Basic program at this same school, and as such, the instructors were very familiar with what the students knew. The issue were those who were not fresh graduates.


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## Sasha (Oct 15, 2008)

Hastings said:


> Not so in this case. Any Basics that had not worked in the field were fresh graduates of the Basic program at this same school, and as such, the instructors were very familiar with what the students knew. The issue were those who were not fresh graduates.



Same here.

Im a strong believer in the fact you are either a good Medic or you arent. You can learn the basics on how to be a medic in school, but if you are a good medic or a bad medic, that cant be learned. That is just skill and personality. And no amount of experience as a basic will change that.


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## Anu (Oct 15, 2008)

Hastings said:


> I am a medic that went straight from Basic to Paramedic with no prior experience before or in between. Best decision I made. I highly suggest just doing it all at once (Basic and Medic). Don't stop in between.



I just want to make sure that we're on the same page.  By going straight from Basic to Medic, do you mean transitioning from the emt-basic program straight into the Paramedic Labs/Clinicals?

The school where I am currently taking the basic course offers two degrees for Paramedics; an AAS and certificate.  The AAS is two years long, and for the first year you are basically fulfilling general education requirements and some EMS courses in research and distaster preparedness.  The second year consists of pretty much only the laboratory/clinical coursework, and Pharmacology.  I took the course during the summer and wanted to jump in directly to the certification program, since I had just completed as AS degree just a few months before.  However, when I spoke to the program directors, they seemed pretty strict about having at least several hundred hours of experience in an ambulance before getting started as a medic.  The director of my local ambulance company told me the same thing.  I had no experience in an ambulance prior to this, and so I took their advice.  

I loved the basic class, and felt that it would have been a great introduction to the Paramedic program.  But towards the end of the course I started to feel a little more than disillusioned.  I thought that working as a Basic for an entire year would have been a waste of time, and completeting another degree seemed improbable.  I felt the certification program would have been more than adequate, but there seemed to have been a great deal of resistance since many in the community kept overemphasizing the 'experience' factor.  Considering my previous educational background, I don't think that going straight to the certification program would have been an unrealistic endeavor.  I partially regret not being clear about this to my instructors in due time.  

I'm starting to think the only purpose of the EMT-B is to let pre-medical and nursing students make some extra money while they go to school.  <_<


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## stephenrb81 (Oct 15, 2008)

NREMT requires you to be a current Basic or Intermediate for Paramedic certification.  And requires you to be a basic to become and Intermediate, So how can one skip being a Basic all together and jump straight to Paramedic?

Copy & Pasted from the NREMT website (http://www.nremt.org/EMTServices/reg_para_history.asp#Paramedic_Entry_Requirements)


> Paramedic Entry Requirements
> 
> All individuals applying for NREMT-Paramedic certification must meet the following requirements to be eligible for national certification:
> 
> ...


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## jlynn (Oct 15, 2008)

Hey there.  I am new to this forum.  I was reading through this thread and have a question.  A lot of you are saying to jump right from one to the other.  This is what I wanted to do but the program director would not let me.  Has anyone else ever run into that?

That said I have now worked for 10 months as a basic.  8 of that were for a private company doing strictly transports.  My plan is to start medic class in January but my supervisors here keep saying that "being a good medic comes from first being a good basic and a good intermediate."  Either way I plan to take the class.  I already have an associate degree.  It is only liberal arts but I have all my basics.  I also have Anatomy and Physiology and medical terminology because I had planned to go into radiography and changed my mind.  Those of you that are medics, do you think it would be ok and I would do well if I went for my medic now instead of waiting and/or doing intermediate like my supervisors keep pushing?  Thanks for any replies.


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## Hastings (Oct 16, 2008)

Ok, let me clear up the misunderstanding about what I tried to explain.

*Step 1* ... Basic school. Anyone can join that if they meet the requirements and are accepted.

*Step 2* ... ----- Graduate Basic School -----

(Optional: Get Basic license) - Not necessary. Can move onto step 3.

(Optional: Work in field) - Not necessary. Can move onto step 3.

*Step 3* ... ----- Take Medic School Requirements: A&P, Medical Terminology -----

*Step 4* ... ----- Apply to Medic School -----

*Step 5* ... Down here is Medic School. It comes after Basic school. After you graduate Basic School. When you graduate Basic School, you can apply to Medic School. Again, you have to graduate Basic School up there before you apply for medic school. However, you do not have to have a medic license. The rule was that you had to have a Medic license before testing for a medic license. Requirements for entry into Medic school is graduating the Basic school up there, doing Anatomy and Physiology requirements, applying, and being accepted.


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## Ridryder911 (Oct 16, 2008)

Most states (especially those that utilize NREMT) requires one to complete and pass the NREMT EMT exam before acceptance and definitely before clinicals are performed at advance level skills. 

Go to school, obtain your basic, take NREMT exam and state license, apply for medic school if applicable. Some states do require length of experience before going forward. 

R/r 911


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## Jon (Oct 16, 2008)

stephenrb81 said:


> NREMT requires you to be a current Basic or Intermediate for Paramedic certification.  And requires you to be a basic to become and Intermediate, So how can one skip being a Basic all together and jump straight to Paramedic?
> 
> Copy & Pasted from the NREMT website (http://www.nremt.org/EMTServices/reg_para_history.asp#Paramedic_Entry_Requirements)



You can't skip it completely. I have seen Zero to Hero programs that take someone off the street, ram EMT-B down their throat 40 hours a week, then go right into medic. I would assume that the syllabus doesn't call for as much BLS review in the class.


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## Hastings (Oct 16, 2008)

Ridryder911 said:


> Most states (especially those that utilize NREMT) requires one to complete and pass the NREMT EMT exam before acceptance and definitely before clinicals are performed at advance level skills.
> 
> Go to school, obtain your basic, take NREMT exam and state license, apply for medic school if applicable. Some states do require length of experience before going forward.
> 
> R/r 911



^ That.

What I listed above is how my school works. All schools are different. Some have different prerequisites and requirements, some require experience in between Basic and Medic, so on. However, if available in your area, follow the advice,

"Go to school, obtain your basic, take NREMT exam and state license, apply for medic school if applicable."


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## Emtgirl21 (Oct 16, 2008)

I spent two years as an EMT on a truck before I went to Medic school. From what I've seen from the people at my service that never worked as an EMT before they became a Paramedic. Spend some time in the field as an EMT first. Those of us who did transitioned and completed our requirements fast than those who didnt.


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## ptemt (Oct 16, 2008)

My accredited paramedic program required one year of work as a basic before acceptance.  I would say go when you are ready, but do not delay.

Can you walk the rice paper and leave no trace......then you are ready?

http://www.youtube.com/watch?v=6p9NTo6BWvs


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## medic_chick87 (Oct 16, 2008)

*Been There, Done That*

So I see benifits to both sides of the argument.

I'm a medic who went actually straight from high school to EMT to Medic school. Didnt work as an EMT before I went to Medic school. I wanted to, but no one could hire me because I was too young for insurance.

Now that I'm working in the field, I am glad that I knew what I wanted and didnt waste time with extra schooling. But I see how working as an EMT would have helped. BLS maybe not as much, but at least I would have learned how the ambulance was set up and how things work in the slower setting and on in a BLS setting you definitely get you basic assessment down _really_ well. And if you get the chance to work on a ALS unit as an EMT, you get to see Medics in action, learn how to run a scene, learn how to deal with the chaos without having all of the pressure on you. So I definitely wish I had had the opportunity to work as an EMT, even for 6months or so before being thrown out there trying to learn everything all at once.

That being said, I'm still glad that I did things the way I did. I'm the youngest medic around but I can still hold my own and I love my job, so it is definitely do able. Just make sure you know what you're getting yourself into if you decide to skip working as an EMT and know that it's going to be _a lot_ of work.


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## traumateam1 (Oct 16, 2008)

Here in BC with the wonderful Justice Institute the old rules were 2 years of PCP-IV, or 1,000 Code 3 patients before they would even consider you in the ACP program. However, now they are revamping the guidelines.
Old Rules:

Valid PCP license or equivalent credentials from an accredited training agency 
Valid (within the previous year) C level CPR certificate 
Minimum of 1,000 patient exposures 
Valid BC Class 4 driver's license 
Criminal record check. No conviction for a criminal offence related to the job of a paramedic will be accepted 
Proof of immunization for Diphtheria & Tetanus, Measles, Polio, Rubella, Hepatitis B (HBV), Influenza 
Physically able to perform the required tasks of a paramedic 
IV Endorsement 
Successful completion of the ACP Independent Study course*

However under the new rules (which aren't in effect yet...)
Liberal Studies:


3 credits of first year Mathematics (for example, TRU-OL: Math 150) 
3 credits of first year English (for example, TRU-OL: English 106 ) 
3 credits of Critical Reading and Writing (for example, TRU-OL: English 110 Critical Reading and Writing) 
6 credits of first year introductory Psychology (for example, TRU-OL: PSYCH 101/102 Intro to PSYC I and II ) 
3 credit course in research (for example, TRU-OL: Research PSYC 220 Statistics in Social Science)
Medical Sciences:

6 credits of Human Anatomy & Physiology (for example, TRU-OL: HLSC 159/169) 
3 credits of Pathophysiology (for example, TRU-OL: CEHS 202) 
3 credits of Pharmacology (for example, TRU-OL: CEHS 204)
Recommended Courses:


Medical Terminology (for example, TRU-OL: CEHS 198: 2 credits)
EMS Courses:


Emergency Medical Responder JIBC – EMR 100

I know this is making a lot of people mad in BC because some of the old timers who actually had to do the 2 years or 1,000 p/t contacts are upset that they had to wait this whole time, where as someone off the street can walk in take those Liberal, and Medical Sciences courses and start the ACP program.


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## paccookie (Oct 16, 2008)

KEVD18 said:


> every state i know of required you to be a basic to sit for the medic exam.
> 
> now, that doesnt mean you have to be a basic with even one day of experience on a truck, just that you have to have the ticket. the ink doesnt even have to be dry.
> 
> ...



The program I'm in has the option to do both intermediate and medic at the same time (most GA services won't hire basics, so it's rare to find a basic program).  The program started in May and the fast track students will test for intermediate in December, then everyone will test for medic next May.  So, yes, they will have their intermediate card before testing for medic, but they will have everything done within one year.

My suggestion is the same as r/r911...take your A&P, psych, English and all the other core classes first.  LEARN the A&P, you will appreciate it when you get to pharmacology and cardiology.  Then when you get to medic, you can concentrate on that and not have to worry about the other stuff.  Find a good program, not a quickie sort of program.  Make sure that the clinical aspect of the program is intense as you will appreciate that when you go to work.  There's a HUGE difference between a real patient and a mannikin.  Study, study, study.  It will be hell while you're going through it, but if it's the right career for you, you will also love it (strange to think of it that way LOL).  And don't let anyone else try to make your life choices for you.  Only you can do that.


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## jochi1543 (Oct 26, 2008)

1000 hours of calls (not simply on-shift time) is the minimum here - if you have less, you are not even allowed to apply to paramedic school.


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## marineman (Oct 26, 2008)

jochi1543 said:


> 1000 hours of calls (not simply on-shift time) is the minimum here - if you have less, you are not even allowed to apply to paramedic school.



wow, 1000 hours of actual call time could take a decade here on one of our rigs.


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## jochi1543 (Oct 26, 2008)

marineman said:


> wow, 1000 hours of actual call time could take a decade here on one of our rigs.



LOL, yeah, my station is in the middle of nowhere and averages only about 200 calls a year. I don't think I'll be staying there after I get my EMT-A, though.


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## VentMedic (Oct 26, 2008)

marineman said:


> wow, 1000 hours of actual call time could take a decade here on one of our rigs.


 
That is why there is little way to compare clinical hours within the U.S. system.

The majority of the healthcare professions require no less than 1000+ hours of patient contact with many of the minimums starting at 2000 hours.

U.S. EMS has too many places that offer coffee clincials or ALS engine ride time with minimum patient contact and no transport time.


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## Ridryder911 (Oct 26, 2008)

And that is exactly why those of us that have performed thousands of hours of clinicals get amused of those exclaiming their experience and knowledge level. 

Personally, the minimum level of clinical (real patient exposure) should be at least two years in length in addition to the didactic classroom setting for the Paramedic level. 

The Basic EMT should be at the bare minimum of three months. This would at least reduce the numbers of those individuals  that proclaim : "I want to be an EMT only to be a firefighter" mentality. 

R/r 911


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## rhan101277 (Oct 26, 2008)

Ridryder911 said:


> And that is exactly why those of us that have performed thousands of hours of clinicals get amused of those exclaiming their experience and knowledge level.
> 
> Personally, the minimum level of clinical (real patient exposure) should be at least two years in length in addition to the didactic classroom setting for the Paramedic level.
> 
> ...



I wish I had to do more clinical work than just 10 hours.  I am going to go again just to get more work in even though it isn't required.  Just because you are a basic doesn't mean you working on a ALS truck, at least in my area.  The basic's drive ambulance and the paramedics work the patients.  But you are still expected to help the paramedic with whatever he needs.  Also if there is more than one patient you are expected to know what to do.

I think that EMT-Basic should at least have 100 hours clinical work.


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## Ridryder911 (Oct 26, 2008)

rhan101277 said:


> I think that EMT-Basic should at least have 100 hours clinical work.



Albeit it be better than the 10 you are required, you do realize that is only about 9 shifts? 

The Basic EMT course I teaching requires 48 ER and 48 EMS. 

R/r911


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## Hastings (Oct 26, 2008)

16 hours clinical, 16 ride-along in my program.

And then many, many hours of everything in Medic school.


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## Foxbat (Oct 27, 2008)

I don't quite understand the usefulness of humanities and science prerequirements.
I have taken 5 semesters of maths, 2 semesters of chemistry, 2 semesters of physics, technical writing, physical anthropology...  And I don't think it made me a better EMT and I doubt it would make me a better paramedic if I decide to become one (although it was pretty interesting to see real human skeletons). From what I heard about "maths for paramedics", it does not involve anything more complicated than dimensional analysis (and they teach it in high school).
A&P - sure, this is another story, and I am considering taking it if I decide to pursue a minor in bioengineering and/or enter a paramedic program (yeah, I'm then going to continue volunteering and bring medics' salaries down, I'm a bad person, I know), but all the other stuff?


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## Ridryder911 (Oct 27, 2008)

Foxbat said:


> I don't quite understand the usefulness of humanities and science prerequirements.
> I have taken 5 semesters of maths, 2 semesters of chemistry, 2 semesters of physics, technical writing, physical anthropology...  And I don't think it made me a better EMT and I doubt it would make me a better paramedic if I decide to become one (although it was pretty interesting to see real human skeletons). From what I heard about "maths for paramedics", it does not involve anything more complicated than dimensional analysis (and they teach it in high school).
> A&P - sure, this is another story, and I am considering taking it if I decide to pursue a minor in bioengineering and/or enter a paramedic program (yeah, I'm then going to continue volunteering and bring medics' salaries down, I'm a bad person, I know), but all the other stuff?



Well the reason you don't understand it is simple. You don't understand medicine nor the profession of healthcare. Period. 

R/r 911


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## Foxbat (Oct 27, 2008)

Thanks, that was very helpful and informative. Now I understand reasoning behind gen. ed. requirements so much better


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## VentMedic (Oct 27, 2008)

Foxbat said:


> Thanks, that was very helpful. Now I understand it so much better


 
You seem to have already made up your mind that education is useless for the Paramedic.  So, as long as the company you work for has "easy to follow" recipes and they show you what knobs to turn on the technology, you will probably get by without knowing much about medicine.  Since you already have closed your mind to the advantages of being an educated Paramedic, you'll probably even miss how the college classes you have obtained could be of use.


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## Foxbat (Oct 27, 2008)

VentMedic said:


> You seem to have already made up your mind that education is useless for the Paramedic.  So, as long as the company you work for has "easy to follow" recipes and they show you what knobs to turn on the technology, you will probably get by without knowing much about medicine.  Since you already have closed your mind to the advantages of being an educated Paramedic, you'll probably even miss how the college classes you have obtained could be of use.


When did I say education is useless? If the paramedic is educated in anatomy and physiology, cell biology, pharmacology, psychology, history of medicine, perhaps sociology - this is one thing.
But could you please explain me how would, say, physics or inorganic chemistry (it would require much deeper knowledge to start understand effects of toxins and drugs on body) help me help my patients?


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## VentMedic (Oct 27, 2008)

Foxbat said:


> When did I say education is useless? If the paramedic is educated in anatomy and physiology, cell biology, pharmacology, psychology, history of medicine, perhaps sociology - this is one thing.
> But could you please explain me how would, say, physics or inorganic chemistry (it would require much deeper knowledge to start understand effects of toxins and drugs on body) help me help my patients?


 
Then let me open your eyes to just the world of Cardiopulmonary medicine.

Physics: Very few people know enough gas laws to operate even the most basic O2 equipment. Then, for just breathing, you should be able to understand more than just the over simplified blurb in the EMT and Paramedic texts. How about altitude changes? Dive medicine? 

Ever try to explain CPAP to someone who has not clue about flows, restitance, work of breathing and pressures either applied to the equipment or how they cause physiological changes in the body? Or how about ventilators? Usually you end up just showing them what knob to turn and give them a recipe which may or may not be appropriate for the patient. Bad Bad Medicine when you don't understand how a piece of equipment works and its relationship to the body. It is also why some EMS agencies get sold some crap for equipment because no one is EDUCATED enough to make an informed purchase and end up with way more equipment or too little. Example: Paramedics trying to do interfacility CCT with an ATV (automatic transport ventilator). 

How about understanding the various medical gases used: HeliOx, Nitric Oxide, Nitrogen, Carbon Dioxide that are commonly used besides Oxygen? 

How about the heart? Do you understand the flow and pressures within the heart or vascular system? If someone says resistance, velocity or mmHg or cmH20, are those "just terms" or do you actually have an understanding of the relationship? 

Chemistry: We recently has a thread about Albuterol and Xopenex. If one is knowledgable in chemistry they would know the difference in formulation between the two drugs. With knowledge of chemistry, you would also be able to know more about what meds are not compatible or compatible. One of the most common mistakes CCT Paramedics make is trying to use one line for everything. Thus, RNs must either set up their meds for them before departure or accompany the patient. 

More chemistry: how about acid-base of the body? Wow! That's a huge area and most Paramedics struggle with that subject. Some never get it. Nutrition? Diabetes? 

All of these classes will enable you to read and understand the latest articles in medical journals instead of the watered down JEMS. You may even be able to establish research in EMS at a scientific level where very few Paramedics participate due to lack of education. It is very hard to write a scientific paper that will withstand various validity tests or even get it noticed when your education is 700 hours of training.

Now, I used just examples from Cardiopulmonary medicine. Read articles from the medical journals of any medical profession or just look at the text books from other medical professionals such as RN, RRT, PT, OT, SLT, RT etc. They are not written at a 10th grade level like the Paramedic text because those entering these professions are EXPECTED to have completed those prerequisites before starting the classes of their profession.


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## Foxbat (Oct 28, 2008)

You mean they don't teach that in medic school - flow, resistanse, pH and pOH, buffers, compatibility of drugs???


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## VentMedic (Oct 28, 2008)

Foxbat said:


> From what I heard about "maths for paramedics", it does not involve anything more complicated than dimensional analysis (and they teach it in high school).


 
You already said most of it yourself.

In the FEW hours (500 - 1100 total) of training in many Paramedic programs, the "whys" of medicine are rarely discussed more than a brief introduction.


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## Ridryder911 (Oct 28, 2008)

Again, if one truly understood medicine this debate would not even occur. So I close by saying it again. 

R/r 911


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## Hastings (Oct 28, 2008)

Foxbat said:


> You mean they don't teach that in medic school - flow, resistanse, pH and pOH, buffers, compatibility of drugs???



No to all except the last.


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