# Medic School Without Experience?



## Noctis Lucis Caelum (May 5, 2009)

Forgive me for posting or reposting this. I remember there was a thread on this subject but couldn't find any on the search engine.  I'm starting medic school on june 16th.  I just finished EMT-B last December of 2008.  With no job experience or any EMT-B experience except few ride alongs. I hear some people say "get some experience first" and some say dive straight into medic school.  It kinda "bugs" me just to hear one thing and another from time to time.  But I'm diving into medic school and dedicating my all into it.  Just want to hear what you medics have to say out there.


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## AJ Hidell (May 5, 2009)

Unfortunately, many schools in California will require experience before you can even apply.  However, it is the firm belief of many professional educators with decades of experience that EMT experience is not needed for success as a paramedic student.  In fact, many of us believe it actually hurts you as a student.  I subscribe to that theory.

And, with fire departments running all the real EMS, it's hard to even get EMT experience in California, and many other states, even if it were good for you.  If you can get in without it, blow it off.

What you DO need in order to get the maximum benefit from paramedic school, as well as to be the best medic you can be, is a solid foundation from which to build your education.  That means you should have two semesters of college anatomy & physiology done before you step foot into your first day of medic school.  Additionally, in order to be a truly competent practitioner, before practicing as a medic, you should have a couple semesters of psychology, sociology, algebra, composition, and communications courses, as well as microbiology.  You can get a patch without them, but you'll just be another protocol monkey.  If you want to kill a year before paramedic school, do the college thing instead of the ambulance driver thing.  It will make you a much, much, MUCH better medic.  And you never get a second chance to build a foundation.  Once you go to medic school, going back and taking those courses later is not the same thing.


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## EDAC (May 5, 2009)

Great question, I would be interested as well. I am in the EMT-B course because it is a neccesity to become a Paramedic. I would like to get right into Paramedic school before the ink dries on my NREMT certificate.


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## AJ Hidell (May 5, 2009)

If your paramedic school requires that you finish the above prerequisite courses first, then by all means, get on it before you even receive your card in the mail.  If your paramedic school does not require those prerequisites, it probably sucks.


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## Mountain Res-Q (May 5, 2009)

The only reason I would agree that a years experience as an EMT-B on Ambulance is a good thing (and required in most CA schools) is that without prior experience who knows if you really want to get into this mess or if you are really cut out for it.  Theoreticlly you could be 19 and have your medic without ever have really worked in the field and had sole care in your hands (except for those supervised hours during EMT/Medic school).  I know quite a few EMTs that got out in the field and said, "Wow, I've got to do that and deal with that... (Faint)... (lifted up by the FF's)...  I quit!"

Other than that, though, if you are really cut out for EMS, then a year running IFTs and "babysitting" your medic doesn't really prepare you anymore to be a medic, and, yes, I could see how it would hurt.

The college I was interested in going to medic school with years ago (before life held me down as a lowely EMT) required (minimum), in addition to your EMT and the one years experience, 2 semesters of A&P, 1 semester in basic Cardiology, and 1 semester of Pre-Paramedic.  7 weeks of First Responder was also required before teh semester of EMT, so if you planned it right, it would take you 2.5 years from start to finish to go from High Schooler to Medic.


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## Noctis Lucis Caelum (May 5, 2009)

AJ Hidell said:


> Unfortunately, many schools in California will require experience before you can even apply.  However, it is the firm belief of many professional educators with decades of experience that EMT experience is not needed for success as a paramedic student.  In fact, many of us believe it actually hurts you as a student.  I subscribe to that theory.
> 
> And, with fire departments running all the real EMS, it's hard to even get EMT experience in California, and many other states, even if it were good for you.  If you can get in without it, blow it off.
> 
> What you DO need in order to get the maximum benefit from paramedic school, as well as to be the best medic you can be, is a solid foundation from which to build your education.  That means you should have two semesters of college anatomy & physiology done before you step foot into your first day of medic school.  Additionally, in order to be a truly competent practitioner, before practicing as a medic, you should have a couple semesters of psychology, sociology, algebra, composition, and communications courses, as well as microbiology.  You can get a patch without them, but you'll just be another protocol monkey.  If you want to kill a year before paramedic school, do the college thing instead of the ambulance driver thing.  It will make you a much, much, MUCH better medic.  And you never get a second chance to build a foundation.  Once you go to medic school, going back and taking those courses later is not the same thing.




While the school I'm attending does requires prerequisites.  Had to show them my college transcript. I took all the prerequisites to get into nursing school.  But since its so pack here in California I decided to go for Paramedic. Don't get me wrong, I'm just jumping intro paramedic cause I couldn't get in Nursing.  It was my plan all along if I didn't get into Nursing.  Either one I'd be happy with.  I did take both anatomy and physiology in a quarter system so it was Bio 40A, 40B, and 40C which is the equivalent of a semester.  I also took microbio, 2 phlebotomy class with the 2nd teaching injections. I don't know what else to say but I pretty much finished all the college classes even went to take Pre-calculus which wasn't even needed.

I'm just hoping I won't get discourage because most of the students who's attending have experience out in the field so I won't be able to relate. :sad:


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## reaper (May 5, 2009)

What won't you be able to relate to? Driving an ambulance. Taking a BP. Backboarding a pt. All of these are not hard to do. If you are able to get into class and know that this is what you want to do, then go for it. EMT experience will get you nothing that will make you a better medic!


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## medicdan (May 5, 2009)

I happen to agree that academic pre-requisites are much more important before starting medic school then experience on the road, but have some qualms. 

I worked with a medic a few weeks ago, fresh out of a medic program, with no field experience, but whom the company required to work BLS for some time. Fine. Great. And they assigned him to me.

Aside from the fact he complained all day about not having "medic toys", having to play taxicab all day, and boasting, I found he had little or no patient care skills.

He had no rapport with patients-- didn’t talk to them, or interact beyond niceties. The one emergency we got I took, because he had the deer-in-the headlights look on scene. I took care of things on scene, and he actually did well with his role en route to the hospital. That is a perfectly normal reaction for an EMT-B (trainee), but something I found disconcerting in a medic who had completed countless hours of clinical and ride time. He needed to spend some serious time working on lifts (especially with the stretcher), and working on paperwork... 

The lifts and paperwork are normal problems for new employees (EMT or Medic), and he will learn soon enough. I could care less about them. Even the deer-in-the-headlights will fade, eventually (I hope!). What was most troubling to me was his poor rapport when talking to our patients. I hope his cockiness fades quickly, or I can promise, he won’t make it far in EMS. Remember, as a new medic, you are still spending an entire shift with another human being, just a few feet away, and you need to be able to talk respectfully to them while at work…

I guess what I am trying to say, is that, if possible, I highly suggest getting experience on a truck while in medic school. Even if it just means working a shift every other week, do it. It will make you that much better of a medic.


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## Onceamedic (May 5, 2009)

A lot depends on where you run and what the practice there is.  I was in a similar situation.  I had to wait 1 1/2 years to get into the paramedic school of my choice. (full classes, priority given to "affiliated" students, etc.)  I could not get an EMT job and truthfully, I wasn't that diligent about getting one.  My plan had always been to become a paramedic, and EMT was the hoop I jumped through to get there.  
I went to school in Wisconsin, and my first paramedic job was (and is) in Arizona.  In Arizona, 1 year as an EMT is a prerequisite for paramedic school.  I had a lot of difficulty with the others that I ran with.  They were of the firm opinion that one cannot possibly be a medic without being an EMT first.  I showed them otherwise, but it was by the grace of God.  I had EMTs actually gunning for me - think sabotage.  
I love my job, and I don't believe anyone I run with now would dispute that I do it well.  They still say "it would have helped you to be an EMT for a while."  
The positives - I had no pre-existing bad habits - no mentality of "that's not the way we do it in the field".  I did not resist the education or dismiss what I was learning as "book larnin"
Are things different in the field?  Only in that calls rarely run as textbook smooth as they do in school.  The anatomy, physiology, standard of care and proper technique is always the same as in school.  It gives me a standard to aim for - a benchmark to measure my performance against.
To summarize - It is not necessary to be an EMT before becoming a medic, but be prepared to get your b***s busted by those that think otherwise.
Good luck to you.


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## Noctis Lucis Caelum (May 5, 2009)

Damn, sabotage...? Hopefully I don't have any problems with things like that in the class.  Cause frankly if people won't disrespect me than I won't respect them.  I had my share of lots of fights verbal and physical.  Thanks for your input, I'll keep my guard up.


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## DrankTheKoolaid (May 5, 2009)

*re*

While I agree higher education before medic school is crucial, as i completed all my nursing pre-req's prior to medic school also.  I disagree with not working in a bls capacity first, specifically on a 911 truck. 

Working as an EMT either on a 911 truck or as a ER Tech will give you valuable experience on patient communication, call flow, a SOLID understanding of priorities and you will have mastered your BLS skills.  Skipping BLS and it's skill set may prove disasterous someday when your paired with a green EMT and need something done while your doing something else.  Just to find your EMT is incapable of completing it and you have to actually think about it as you havent already done it yourself.  Medic school is just that, there not going to be teaching you bls skills, so you better get them somewhere.  Also working in the BLS capacity assisting ALS is a great way to learn the the equipment and protocols, prior to you being the main provider.


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## triemal04 (May 5, 2009)

emt.dan said:


> That is a perfectly normal reaction for an EMT-B (trainee), but something I found disconcerting in *a medic who had completed countless hours of clinical and ride time*.


Unfortunately, that is not necessarily true, and it's the only justifiable argument that can be made for getting real word experience as an EMT prior to becoming a paramedic.  And most of the time it get's made wrong.

The amount of time that is required for clinical (in hospital) and the internship (field) varies widely, as does what the student/intern is allowed to do.  In some states the amount of time an internship lasts is as little as 200 hours with 40 ALS pt contacts...think about it, that's less than a month of full time work.  Do you really think that will help truly prepare someone to work in the field on their own?  Of course, that isn't necessarily a problem; some agencies expect this, and are willing to spend the time, effort, and money in getting their new hires up to speed before letting them loose on their own...strange, but it's usually these agencies that don't have a problem with people leaving...  Others expect people to come in fully prepared and throw them to the wolves right off the bat...not necessarily a problem if your internship consisted of well over 500 hours, but if it was short...could be a problem.  This is where prior EMT experience could help.  (and by EMT experience I mean working in a 911 system paired with a paramedic...though that doesn't always work out)

If you come into the internship already being comfortable in talking with pt's, police, nurses, doc's, family, bystanders, nut jobs, and everyone else we encounter, it makes things much easier; not having to learn how to gain a rapport with people gives you more time to focus on how to be a paramedic.  The same goes for the basic skills; backboarding, splinting and the like.  While it doesn't take much time to master those, it still takes time away from being able to learn other things, and, depending on where you go, you may not have the luxury of a lot of time.

Unfortunately, most of the jobs that people find as EMT's are not 911 related, or only a tiny percentage of the calls are; interfacility transports all the way.  While this can be a learning experience, more than likely it won't be, and will lead to learning poor habits, attitudes and lousy pt care.  So really, that isn't recommended.

There really isn't a perfect answer.  You need to look at your own comfort level in talking with random people and being able to function in stressful situations, the length of the paramedic internship, how the local services (or wherever you want to work) train their new medics, and the type of job you'd really get as an EMT.  For some it may be better to work as an EMT for a year, or during medic school.  For others it won't.


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## Sparky21 (May 5, 2009)

Kaisu said:


> A lot depends on where you run and what the practice there is.  I was in a similar situation.  I had to wait 1 1/2 years to get into the paramedic school of my choice. (full classes, priority given to "affiliated" students, etc.)  I could not get an EMT job and truthfully, I wasn't that diligent about getting one.  My plan had always been to become a paramedic, and EMT was the hoop I jumped through to get there.
> I went to school in Wisconsin, and my first paramedic job was (and is) in Arizona.  In Arizona, 1 year as an EMT is a prerequisite for paramedic school.  I had a lot of difficulty with the others that I ran with.  They were of the firm opinion that one cannot possibly be a medic without being an EMT first.  I showed them otherwise, but it was by the grace of God.  I had EMTs actually gunning for me - think sabotage.
> I love my job, and I don't believe anyone I run with now would dispute that I do it well.  They still say "it would have helped you to be an EMT for a while."
> The positives - I had no pre-existing bad habits - no mentality of "that's not the way we do it in the field".  I did not resist the education or dismiss what I was learning as "book larnin"
> ...




What part of AZ? When i went through my EMT-B class they taught us the book way "becasue they had to" and then taught us the way they did it in the field.

Does anyone know a good place to find a list of good medic schools?


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## Shishkabob (May 5, 2009)

We were always taught, and I quote;


"Only one of the many ways things can be done.  If you find a better way, do it.  What's done in the field is never done on the test, so keep that in mind"


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## 4mysins (May 20, 2009)

Get some time in as an EMT first. I have limited field time and I can tell a world of difference being in Paramedic school compared to some of the others that currently work in a truck as a full time job. It just motivates me to bust my butt and work harder. If you have time and age on your side, use it to get the experience on your side. Hands on experience does a world of good that you won't ever find from a book! I am telling you this from experinece. Good Luck! 

Jenn
68 days to Paramedic graduation!


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## Ridryder911 (May 20, 2009)

Linuss said:


> We were always taught, and I quote;
> 
> 
> "Only one of the many ways things can be done.  If you find a better way, do it.  What's done in the field is never done on the test, so keep that in mind"



What a horrible statement. Might as well also say, we will deny anything we told you in court! 

The education and information given and to be received from the curriculum are foundations to build upon. There is *NO* class way or field way, there is the best way for your patient. Remember, when what you will be held and be accountable to in a court of law. Yes, as in everyday real life one has to modify and adjust to accomodate to be able to deliver the best care possible. 

R/r 911


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## terrible one (Jun 1, 2009)

I can understand the rush to get through paramedic school, HOWEVER, the best way to sum it up is -
"BLS before ALS" 
if you do NOT have a foundation of BLS to put your ALS knowlegde on you will fail. maybe not in the classroom but in the field. I can not possibly imagine not being an EMT atleast for a year before jumping into a paramedic class. the information given is 100x more in depth. 
not only in the class but in the field, how is someone supposed to manage pt in a real life scenario without EVER being in the back of a rig? a text book can only teach you so much, having the real life experience is definitely needed. 

do yourself a favor, put in the time as an EMT before moving on. you will be a much better medic in the end


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## JPINFV (Jun 1, 2009)

^
Yet we somehow expect physicians to treat patients day in and day out without ever being a PA or RN first.


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## reaper (Jun 1, 2009)

People, Can we drop the "BLS before ALS" nonsense! It is called treating the pt. Yes, A paramedic can treat a pt better, because they have more knowledge and treatments avalible to them.

If your Paramedic school has great clinical experience. Then you will learn all you need know as an EMT, during clinicals. This also includes pt care and contact.

It is up to each induvidual to know if they can handle the responsiblity or not.


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## terrible one (Jun 1, 2009)

JPINFV said:


> ^
> Yet we somehow expect physicians to treat patients day in and day out without ever being a PA or RN first.



you have to have a 4 year degree to be a Dr. plus all the pre-reqs they take to get to med school. and how long does it take to be a Dr? 8 years?

EMT = one semester class, medic = one year class. is that really too much of a pre-req to take? 

IMO medic school should be atleast 2 years, and atleast one year of working as an EMT prior to attending. it is way too much information in a short one semester classroom. and ill tell you that all the people that failed or did poorly worked as an EMT less than 6 months in my class


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## terrible one (Jun 1, 2009)

reaper said:


> If your Paramedic school has great clinical experience. Then you will learn all you need know as an EMT, during clinicals. This also includes pt care and contact.



thats all you need huh? a couple weeks in the hospital and you've seen it all? hope you dont work where i live


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## VentMedic (Jun 1, 2009)

reaper said:


> People, Can we drop the "BLS before ALS" nonsense! It is called treating the pt. Yes, A paramedic can treat a pt better, because they have more knowledge and treatments avalible to them.
> 
> If your Paramedic school has great clinical experience. Then you will learn all you need know as an EMT, during clinicals. This also includes pt care and contact.
> 
> It is up to each induvidual to know if they can handle the responsiblity or not.


 
How true!  The clinicals for EMT-B are only 10 - 20 hours in most programs.  Often, the patient contact is so little it barely can be called as such.  Many spend their time watching TV with the others or hanging in background at the ED because they do not have enough knowledge on how to participate.  If they entered these clinicals, and the profession,  with a little more education, it might actually mean something.


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## VentMedic (Jun 1, 2009)

terrible one said:


> thats all you need huh? a couple weeks in the hospital and you've seen it all? hope you dont work where i live


 
No. The Paramedic program should be structured in a two year degree as other healthcare professions with no less than 1000  - 1500 hours of clinicals.   

Unfortunately, places like CA and FL have allowed the medic mills to do 2 week ALS engine sleepover clinicals to get a Paramedic patch.


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## terrible one (Jun 1, 2009)

VentMedic said:


> No. The Paramedic program should be structured in a two year degree as other healthcare professions with no less than 1000  - 1500 hours of clinicals.



as i said in post #20, i think it should be a two year program. and my class was 1500 hours for paramedic, not including emt and A&P pre reqs.
but I do agree there are wayyyyy to many medic mills in cali


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## 46Young (Jun 1, 2009)

terrible one said:


> I can understand the rush to get through paramedic school, HOWEVER, the best way to sum it up is -
> "BLS before ALS"
> if you do NOT have a foundation of BLS to put your ALS knowlegde on you will fail. maybe not in the classroom but in the field. I can not possibly imagine not being an EMT atleast for a year before jumping into a paramedic class. the information given is 100x more in depth.
> not only in the class but in the field, how is someone supposed to manage pt in a real life scenario without EVER being in the back of a rig? a text book can only teach you so much, having the real life experience is definitely needed.
> ...



I agree. This was taken from emtcity.com, from someone on the job at FDNY EMS, and is exactly how I feel:  I've seen too many what I like to call as Harvard Medics, there book smart but common scents,street smarts is out the window. To me doctors , nurses all work in controlled enviroments. Plus does't a doctor have to do some yrs residence work and get signed off by another established doctor. The pt's are coming to you. You decide if you see them now or they wait. If there a problem security handles it. 
In the street your now in the pt's turf. Talking down to them could cause a dangerous situation. It's just you and your partner. Your a psyc doctor, trauma doctor, medical doctor and labor and delivery in one. You deal with whatever is thrown at you. You can"t pass it on to another tech.
I also see alot of 20 yr old medic who think that emt's are all stupid. Yet they have less then 6 months as a EMT and fell there season profesionnals because there medics now. Yeah maybe 3 years is along time but look at this, Was it 3 years in a high volume system or a 2 to 3 call a day system.
My first time stepping into an ambulace was working 911. I never volley'd, never did transport. First call of my career was a shooting to the face in the south bronx. See what I mean


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## VentMedic (Jun 1, 2009)

terrible one said:


> as i said in post #20, i think it should be a two year program. and my class was *1500 hours for paramedic*, not including emt and A&P pre reqs.


 
I'm talking about *1500 hours* of just clinicals....not the whole program.  Other healthcare professions do 1000 - 1500 hours of clinicals in addition to the prerequisites and core classes.


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## VentMedic (Jun 1, 2009)

46Young said:


> I agree. This was taken from emtcity.com, from someone on the job at FDNY EMS, and is exactly how I feel: I've seen too many what I like to call as Harvard Medics, there book smart but common scents,street smarts is out the window. To me doctors , nurses all work in controlled enviroments. Plus does't a doctor have to do some yrs residence work and get signed off by another established doctor. The pt's are coming to you. You decide if you see them now or they wait. If there a problem security handles it.
> In the street your now in the pt's turf. Talking down to them could cause a dangerous situation. It's just you and your partner. Your a psyc doctor, trauma doctor, medical doctor and labor and delivery in one. You deal with whatever is thrown at you. You can"t pass it on to another tech.
> I also see alot of 20 yr old medic who think that emt's are all stupid. Yet they have less then 6 months as a EMT and fell there season profesionnals because there medics now. Yeah maybe 3 years is along time but look at this, Was it 3 years in a high volume system or a 2 to 3 call a day system.
> My first time stepping into an ambulace was working 911. I never volley'd, never did transport. First call of my career was a shooting to the face in the south bronx. See what I mean


 
I am almost speechless at how little sense (not scents) this post makes from many angles.   

This is probably one of the best examples as to why the education level of the Paramedic needs to be raised.  They truly need to be more educated and get more controlled clinical time with actual patient contact.  By the time they finish school they might be a little older and wiser.   They might also have the ability to think beyond the glamor of the street and figure out how to deal with such situations as well as that silly little thing called patient care which so many seem to forget about.   

If it takes 3 years for someone to master the few skills of EMT-B, then maybe EMS or medicine is not for them.


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## reaper (Jun 1, 2009)

VentMedic said:


> I am almost speechless at how little sense (not scents) this post makes from many angles.
> 
> This is probably one of the best examples as to why the education level of the Paramedic needs to be raised.  They truly need to be more educated and get more controlled clinical time with actual patient contact.  By the time they finish school they might be a little older and wiser.   They might also have the ability to think beyond the glamor of the street and figure out how to deal with such situations as well as that silly little thing called patient care which so many seem to forget about.
> 
> *If it takes 3 years for someone to master the few skills of EMT-B, then maybe EMS or medicine is not for them*.




That says it all right there!


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## 46Young (Jun 1, 2009)

It wasn't my grammar. In a perfect world, the new medic would be required to complete a field internship with a qualified FTO. Since that is not a reality at this time, the prospective medic student needs time on the street as an EMT. If your BLS is weak to begin with, how can you be a proficient ALS provider? Busy urban systems will allow the student to treat high acuity patients, as well as cultivate strong BLS skills. This is fine. In other systems, the student may be subject to significantly less pt contacts, resulting in less learning opportunities. In NYC, the call volume is typically high, with medics being dispatched for high priority jobs only. When I worked in Charleston, the students typically saw mostly low priority BLS, with true ALS calls few and far between. In many areas the new medic will be thrown to the wolves, as a single ALS provider, with only a basic to rely on. Fairfax Conunty currently requires medic pre-hires to complete a 16 week ALS field internship with weekly classroom sessions prior to starting the fire academy. It's a good start. Medic mills with 6-9 month programs scare me. Some give a condensed and watered down A&P section in house, which is an extremely important foundation for the entire program. A sad reality is that the typical medic student already works FT or PT, and struggles to stay awake in class, let alone absorb the material, especially with a condensed program. With the average program being indequate as it is, the prospective student needs to be a solid BLS provider by the end of the medic program, be it by prior experience, or through the program.


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## 46Young (Jun 1, 2009)

Also, I never agreed with the notion of three years as a basic prior to entry into a medic program, unless you work out in God's country, with maybe one call a day. Six months to a year tops in a busy urban system on a BLS bus should be plenty, or working FT for said system while attending medic school would be adequate.


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## terrible one (Jun 1, 2009)

VentMedic said:


> I'm talking about *1500 hours* of just clinicals....not the whole program.  Other healthcare professions do 1000 - 1500 hours of clinicals in addition to the prerequisites and core classes.



gotcha. and i agree but also i think 46young made a good point.
too many younger medics get their license and suddenly they are it. and this is coming from a young medic, but i also did 4 years of BLS. granted it was with LAcoFD, but running in places like inglewood, compton, so central, etc... you get a lot more street smarts. which is why i think people need BLS skills. they cant teach you how it is on the streets through a text book


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## reaper (Jun 2, 2009)

Medicine is the same, no matter where you practice it! I would love to get rid of every medic, that thinks they need street smarts. Yes, you do learn to improvise in this job, but it is nothing that can not be learned, while working.

If a person wants more experience, they can work as an EMT, while going through medic school. That is all the experience needed.

Remember, You choose where you work. If you go to work for a system, as a new medic, who throw you to the wolves. You chose to work there. Find a system that fits your needs and has a great preceptor program. Any system that just wants warm bodies on the truck, it a crap system to start with. Do you want to be associated with a system like that? The reputation will follow you for a long time!


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## 46Young (Jun 2, 2009)

reaper said:


> Medicine is the same, no matter where you practice it! I would love to get rid of every medic, that thinks they need street smarts. Yes, you do learn to improvise in this job, but it is nothing that can not be learned, while working.
> 
> If a person wants more experience, they can work as an EMT, while going through medic school. That is all the experience needed.
> 
> Remember, You choose where you work. If you go to work for a system, as a new medic, who throw you to the wolves. You chose to work there. Find a system that fits your needs and has a great preceptor program. Any system that just wants warm bodies on the truck, it a crap system to start with. Do you want to be associated with a system like that? The reputation will follow you for a long time!



Some are either unwilling, or unable to relocate to find a system with a great preceptor program. That "crap system" may be the only game in town.


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## 46Young (Jun 2, 2009)

"Medicine is the same, no matter where you practice it! I would love to get rid of every medic, that thinks they need street smarts. Yes, you do learn to improvise in this job, but it is nothing that can not be learned, while working." So, would you be comfortable with a brand new medic with practically no prior BLS experience treating your mother?


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## reaper (Jun 2, 2009)

46Young said:


> Some are either unwilling, or unable to relocate to find a system with a great preceptor program. That "crap system" may be the only game in town.



Then they are stuck with it, by choice!


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## reaper (Jun 2, 2009)

46Young said:


> "Medicine is the same, no matter where you practice it! I would love to get rid of every medic, that thinks they need street smarts. Yes, you do learn to improvise in this job, but it is nothing that can not be learned, while working." So, would you be comfortable with a brand new medic with practically no prior BLS experience treating your mother?



I will take the new medic over the seasoned EMT, treating my mother.


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## 46Young (Jun 2, 2009)

reaper said:


> Then they are stuck with it, by choice!



By choice, if their spouse is unwilling to move, or if they have a mortgage to pay?


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## 46Young (Jun 2, 2009)

reaper said:


> I will take the new medic over the seasoned EMT, treating my mother.



The new medic has many more tools available to potentially harm your mother. A new medic is much more apt to misdiagnose, or miss something, and treat/fail to treat with dire consequences. Why, exactly, would you want to get rid of every medic that thinks they need street smarts? Why would that be undesireable?


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## VentMedic (Jun 2, 2009)

46Young said:


> The new medic has many more tools available to potentially harm your mother. A new medic is much more apt to misdiagnose, or miss something, and treat/fail to treat with dire consequences. Why, exactly, would you want to get rid of every medic that thinks they need street smarts? Why would that be undesireable?


 
The thing is the medic who only depends on street smarts doesn't have the education behind them to know how much harm they are doing. Also, the street smart medic who doesn't have time for all that book learning will go through a PDQ medic mill just to get on the street and avoid all that education stuff. 

The educated Paramedic we are referring to has spent time learning and applying their knowledge in clinicals and not just running amok on the street looking for shortcuts. 

So yes, the medic mill products who rely only on street smarts that have little education to back up what they are doing should be eliminated.  I also don't even see how an EMT fits into the equation.


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## SeeNoMore (Jun 3, 2009)

Im glad this question was asked. I just finished my EMT-B and had the time of my life in school. I've worked for years in menial jobs since I dropped out of high school and it was great to think I would be able to pursue a career that was important and also a professional job. 

I have been trying to decide whether to go straight to Paramedic school or attempt to get 911 experience under my belt. It seems like there are strong arguments for either decision. 

I have an oppertunity to volunteer with a 911 squad which seems really interesting but the downside is the call volume is not much more than 1000 a year. 

The other problem is that I am almost 25 and this seems very old for EMS which surprised me. If I wait I could be almost 27 before I became a Paramedic! I worry that I will not find work at that age with so many other medics having been working since their early 20s. 

I honestly don't know what the right decision is.


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## daedalus (Jun 3, 2009)

SeeNoMore said:


> Im glad this question was asked. I just finished my EMT-B and had the time of my life in school. I've worked for years in menial jobs since I dropped out of high school and it was great to think I would be able to pursue a career that was important and also a professional job.
> 
> I have been trying to decide whether to go straight to Paramedic school or attempt to get 911 experience under my belt. It seems like there are strong arguments for either decision.
> 
> ...


There is no strong argument for getting time on a truck. Its dogma and tradition that cause people to tell you "dude, you gotta have 911 experience before medic school, otherwise you will fail".

I really do not see where handing things to a medic on a 911 unit will help you when you are trying to study the immune response in detail for your first pathophysiology test. I do not see how getting to drive code will help you assimilate the massive amount of pharmacology you will have to learn. Spiking bags at work also is no good when it comes to learning the krebs cycle. In fact, I am the one with the least amount of 911 work in my medic class and have the highest grade.

By the way, if your medic school does/did not teach you the above, you are not in an accredited program. Get your money back and join 21st century paramedic education.


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## SeeNoMore (Jun 3, 2009)

I guess I was trying to say there are arguments for the benefits of both, if not the absolute necessity. I have no doubt what you are saying is true, and that someone who works hard can do very well in Medic school and make a great Paramedic. By the same token, in can not hurt to have at least some experience in Ambulance operations and BLS before school either. 

Ill probably end up spending a year on a truck. It just feels like a long time to wait and like I said, I got into this late. Thanks for the advice though, and good luck in school.


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## TransportJockey (Jun 3, 2009)

The only reason I had any time on a truck is because I was working while taking all my pre-reqs. I was trying to get into medic ASAP. And I actually haven't worked on a truck, except for internship, since beginning of the cohort


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## 46Young (Jun 3, 2009)

VentMedic said:


> The thing is the medic who only depends on street smarts doesn't have the education behind them to know how much harm they are doing. Also, the street smart medic who doesn't have time for all that book learning will go through a PDQ medic mill just to get on the street and avoid all that education stuff.
> 
> The educated Paramedic we are referring to has spent time learning and applying their knowledge in clinicals and not just running amok on the street looking for shortcuts.
> 
> So yes, the medic mill products who rely only on street smarts that have little education to back up what they are doing should be eliminated.  I also don't even see how an EMT fits into the equation.



I was referring to medic gaining street smarts as a basic, on a dedicated BLS rig, and then going through a quality medic program. A medic mill product is no better than an EMT-I, educationally speaking. I agree with the need for a stronger educational foundation and a structured internship program. There are things that can only be learned on the street, with no safety net.


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## 46Young (Jun 3, 2009)

daedalus said:


> There is no strong argument for getting time on a truck. Its dogma and tradition that cause people to tell you "dude, you gotta have 911 experience before medic school, otherwise you will fail".
> 
> I really do not see where handing things to a medic on a 911 unit will help you when you are trying to study the immune response in detail for your first pathophysiology test. I do not see how getting to drive code will help you assimilate the massive amount of pharmacology you will have to learn. Spiking bags at work also is no good when it comes to learning the krebs cycle. In fact, I am the one with the least amount of 911 work in my medic class and have the highest grade.
> 
> By the way, if your medic school does/did not teach you the above, you are not in an accredited program. Get your money back and join 21st century paramedic education.


Having a high grade is vitally important, but is only one side of the job. I've seen new medics with a solid educational background choke under pressure when on their own. If you've always had a preceptor as a safety net, it will be difficult function on your own, never having done so before. If you're too shaken up and nervous to get the BLS done, how can you provide effective ALS? I've repeatedly seen nervous mistakes such as starting an IV, monitor, 12, NTG, and forgetting O2. Fumbling with spinal immobilization, or splinting, dangerously extending onscene time. Starting a line on a trauma pt before doing a full ITLS survey. Forgetting about lung sounds until much later in the incident. Not attempting repositioning of the hypotensive pt prior to pharmocological intervention(with respect to respiratory status). Not knowing how to remove the pt in extremis from a residence with narrow stairs, tight corners, and various other obstacles. If you don't have a trauma weave, you can make stirrups out of cravats to prevent the pt from sliding down the backboard. Forgetting to continue CPR on each landing of the multi story building. Not watching the BLS to ensure proper CPR, being preoccupied with recalling protocols. Worrying about a room air O2 sat while the pt is sucking wind. Forgetting to properly dispose of sharps during a hectic situation. These are all repeatedly observed mistakes by new medics that didn't do well under pressure, at least not well enough to properly implement BLS prior to advanced interventions. You'll find out when you are actually finished with class, and are required to function on your own as a paramedic, not a student as you are currently.I know medics who couldn't backboard a pt, or perform effective Cx compressions, never having had to do so, as they were doing only ALS stuff, and using BLS for CPR. Not everyone has the resources to relocate or travel to attend a medic program that is superior to the one in their region. As such, one needs to make up for shortcomings elsewhere, on their own.


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## terrible one (Jun 3, 2009)

daedalus said:


> By the way, if your medic school does/did not teach you the above, you are not in an accredited program. Get your money back and join 21st century paramedic education.



a guy in my class had the 4th highest grade and failed his internship because he had no experience. it goes both ways. all you are doing is reading the material and not practicing it in stressful situations when you need it. the book cant teach you everything in every single situation.


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## VentMedic (Jun 3, 2009)

terrible one said:


> a guy in my class had the 4th highest grade and failed his internship because he had no experience. it goes both ways. all you are doing is reading the material and not practicing it in stressful situations when you need it. the book cant teach you everything in every single situation.


 
What are clinicals for?

Just like the EMT-B, if it takes you very long to realize your arse is in a dangerous place, you probably don't belong in EMS.  Does it really take you 3 years to know that gun shots in your direction is bad?

Stressful?

The ones who usually get stressed out the most are those who have had the comfort of being an EMT-B too long where they know the Paramedic has the ultimate responsibility. Then, when they are put into that seat, they fall apart because they have become so accustomed to having someone else in the lead while they believe they are saving the Paramedic.    

Again, it is usually those who have little education that continue to argue against it.


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## triemal04 (Jun 3, 2009)

Why is it that so many times the same threads come up with the same responses again and againandagainandagain?

Simply saying that "you will learn everything that you know in your paramedic course" is not entirely accurate, as is using the CNA before RN argument.  It's not entirely false by any means, but there is a little more to it that often times is left out.



> The amount of time that is required for clinical (in hospital) and the internship (field) varies widely, as does what the student/intern is allowed to do. In some states the amount of time an internship lasts is as little as 200 hours with 40 ALS pt contacts...think about it, that's less than a month of full time work. Do you really think that will help truly prepare someone to work in the field on their own? Of course, that isn't necessarily a problem; some agencies expect this, and are willing to spend the time, effort, and money in getting their new hires up to speed before letting them loose on their own...strange, but it's usually these agencies that don't have a problem with people leaving... Others expect people to come in fully prepared and throw them to the wolves right off the bat...not necessarily a problem if your internship consisted of well over 1000 hours, but if it was short...could be a problem. This is where prior EMT experience could help. (and by EMT experience I mean working in a 911 system paired with a paramedic...though that doesn't always work out)
> 
> If you come into the internship already being comfortable in talking with pt's, police, nurses, doc's, family, bystanders, nut jobs, and everyone else we encounter, it makes things much easier; not having to learn how to gain a rapport with people gives you more time to focus on how to be a paramedic. The same goes for the basic skills; backboarding, splinting and the like. While it doesn't take much time to master those, it still takes time away from being able to learn other things, and, depending on where you go, you may not have the luxury of a lot of time.
> 
> ...



Again:  having experience as an EMT in a 911-based system can be a good thing and beneficial before going on to paramedic school.  It also can be detrimental unfortunately.  There is no strict answer that will work for each person...look at how long your field internship will last, the call volume for the agency it will be with, all the things said above and in 46young's post; yes, you will learn all that (hopefully) during the internship, but, how well you learn them and everything else that you are supposed to be learning will depend on multiple factors, with the length of that internship being a large factor; if it's short you may have problem down the road when you start working as a paramedic.  Hell, just look at some of the posts on this forum for proof of that.  (with that said I'm not advocating mandating prior experience as an EMT, rather revamping the entire education structure)

Oh...and arguing that RN's aren't required to be CNA's...if the above didn't make it clear them even blunter:  RN's have much, MUCH more time spent on clinicals than paramedic students (which isn't a bad thing)...so the comparison is pretty lousy.


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## JPINFV (Jun 3, 2009)

So then, basically the argument isn't for working as an EMT-B first, it's about making clinicals longer.


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## triemal04 (Jun 3, 2009)

JPINFV said:


> So then, basically the argument isn't for working as an EMT-B first, it's about making clinicals longer.


Unfortunately I can only think of how to say yes in about 3 different languages, but if I could come up with more...

That's one of the biggest problems with changing how we teach new paramedics; yes, the classroom portion absolutely needs to be longer, but so does the field internship.  Think about it, why do doctors, RN's, PA's, and I'm guessing RT's all spend thousand(s) of hours or YEARS after the classroom part is over learning how to apply what they learned in a real-world setting?  Because it can take that long to really learn what you are doing.  If you end up somewhere that has a short internship (and there are plenty of accredited college programs that are otherwise very well regarded that still have short ones) having a little prior knowledge and experience may be beneficial.  Or it may not.

It might be a cop out, but there really isn't a perfect answer for this.  It really will depend on the individual, where they go to school and where they would be getting their EMT experience to determine if it's a good or bad thing.


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## VentMedic (Jun 3, 2009)

I've been using the quantity of 3 years in my posts because that is approximately how long it may take to get a two degree.  

Ideally one would get the EMT-B and not wait a year to start with the science prerequisites.  I can not see working for a year if you do not have enough A&P to even know what your are assessing.  And, a live patient gives you a great "lab" to study by.   Too many EMT-Bs believe they must wait to take any additional classes.   Some RT departments won't hire for any entry level position such as O2 jockey or equipment tech unless they are already enrolled in the RT program AFTER they have already completed their prerequisites.  Nursing programs may also be like this.  Once all the prerequisites are complete and the first official semester of nursing school is done, the student may apply for a CNA cert and get on with a hospital which may then pay the rest of their way. 

Other healthcare professions often are required to get their prerequisites completed before even apply to their program of choice.  Then, they start their classes for their future profession.  This also frees up time to add more clinicals.  Some RT and RN student will do not less then 24 -36 hours of clinicals per week besides classroom.  This is full time patient contact with several patients  and only a couple of scheduled breaks. 

In summary, any time you spend as an EMT-B without being enrolled in some type of class that will promote your learning is wasted.


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## terrible one (Jun 3, 2009)

VentMedic said:


> The ones who usually get stressed out the most are those who have had the comfort of being an EMT-B too long where they know the Paramedic has the ultimate responsibility. Then, when they are put into that seat, they fall apart because they have become so accustomed to having someone else in the lead while they believe they are saving the Paramedic.
> 
> Again, it is usually those who have little education that continue to argue against it.



dont agree at all.


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## VentMedic (Jun 3, 2009)

terrible one said:


> dont agree at all.


 
Well since there is not that much difference between an EMT and a Paramedic in many areas of California, I can understand your comment.


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## terrible one (Jun 3, 2009)

edit nevermind


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## VentMedic (Jun 3, 2009)

terrible one said:


> only 1000 hours more education.
> you may be content with 20 year old paramedics with no experience working on your loved ones but not me.


 
Again, your state scope of practice is not very impressive. As well, in many counties, EMT-Bs and not Paramedics work the CCTs.  But, of course, the MICN is required on most of them because of the lack of sufficient protocols for the Paramedic.

I also hope you are not bragging about 1000 hours.  That truly is not much although it is about 200 hours more than some states but CA also hasn't put a stop to the ALS engine sleep overs in that hour count.  

How I hate speaking terms of just hours of training when EMS is over 40 years old!


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## terrible one (Jun 3, 2009)

not bragging just stating its about 5x more in depth than emt


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## 46Young (Jun 3, 2009)

Triemal said it better than I ever could. I'll go with those posts.


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## Ridryder911 (Jun 4, 2009)

The old .."must have BLS" or "BLS first over ALS".. is nothing more than propaganda T-shirt and patch vendors love to sell to uneducated providers. 

Just how much experience does one have to have to learn to load a cot, apply oxygen therapy and take vital signs? Geeez... if it takes a person a year to learn those basic skills and apply them, maybe those are not the type of people we need in medicine! 

C'mon basic skills are just that... basic! Repetitive practice makes one able to provide competency. Those of us that are in education realizes that upon the chain of level of hierarchy; EMT skills are not difficult and are just very simplistic. That is not an anecdotal statement but from researched studies. 

Experience is great, is it essential no. Whom would I rather have? Someone that knows what they are doing both clinically and that can apply it. 

Experience is great but way over rated. 

R/r 911


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## atropine (Jun 4, 2009)

yes definately go to medic school


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## Noctis Lucis Caelum (Jun 4, 2009)

atropine said:


> yes definately go to medic school



class starting june 16th ^_^


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## rjddvm (Jun 15, 2009)

So let us know how your first day goes, please!  

Resurrecting the thread with a question too:  my paramedic class admission interview is next week.  About a 30-minute interview.  Any tips on what questions I might expect?  

Thanks for any advice!


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## Noctis Lucis Caelum (Jun 16, 2009)

rjddvm said:


> So let us know how your first day goes, please!
> 
> Resurrecting the thread with a question too:  my paramedic class admission interview is next week.  About a 30-minute interview.  Any tips on what questions I might expect?
> 
> Thanks for any advice!



Maybe an obvious one would be "why do you want to become a paramedic?"


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## TransportJockey (Jun 16, 2009)

rjddvm said:


> So let us know how your first day goes, please!
> 
> Resurrecting the thread with a question too:  my paramedic class admission interview is next week.  About a 30-minute interview.  Any tips on what questions I might expect?
> 
> Thanks for any advice!



I wish I could help but my program only does interviews on the students who don't do the pre-reqs through the program. Our cohort instructors teach all the pre reqs so they are well familiar with every student in the medic program


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## VentMedic (Jun 16, 2009)

jtpaintball70 said:


> I wish I could help but my program only does interviews on the students who don't do the *pre-reqs* through the program. Our cohort instructors teach all the *pre reqs* so they are well familiar with every student in the medic program


 
Define pre-reqs.  Is this a tech school program, a college degree program or a cert program at a college?


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## TransportJockey (Jun 16, 2009)

VentMedic said:


> Define pre-reqs.  Is this a tech school program, a college degree program or a cert program at a college?



I guess I do need to define. I meant EMS dept pre-reqs of Pharm, Adv Trauma, and drug cal. Other pre-reqs are A&P (they unfortunately accept 1&2 and non-major's A&P), basic math, english, and chem.

We are right this second a college cert program, but the AAS plan was approved for starting next semester so I will be going for that.

I read it before I left and it looked ok. Read it on a class break and realized I needed to change it a little... but this board doesn't allow editing of posts after a certain time limit


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