Efmb

[82nd medic]

anyone here done the EFMB recently?

first went through it in 2005 and the overall consensus among everyone there that wasnt a hospital/clinic medic was that it was a waste of time because it was 1: civilian medicine in combat scenarious, 2: violated the TC3 guidelines (according to the POGS from ft sam, tourniquet was still a last resort, etc), and 3: was well below the standards set by 68W ait (let alone the standards for medics set at unit level). i know it was the same in 2008 (those of us with CMBs didnt have to go but our cherries still had to), has anyone been since then? CLS finally evolved from bs to what actually works not too long ago, so kinda hoping this has too.

 

[ffemt8978]

anyone here done the EFMB recently?

first went through it in 2005 and the overall consensus among everyone there that wasnt a hospital/clinic medic was that it was a waste of time because it was 1: civilian medicine in combat scenarious, 2: violated the TC3 guidelines (according to the POGS from ft sam, tourniquet was still a last resort, etc), and 3: was well below the standards set by 68W ait (let alone the standards for medics set at unit level). i know it was the same in 2008 (those of us with CMBs didnt have to go but our cherries still had to), has anyone been since then? CLS finally evolved from bs to what actually works not too long ago, so kinda hoping this has too.

Hmmm...something with a pass rate of 15.3% in FY2008 is a waste of time and is below the standards set for 68W AIT? That doesn't make any sense.

For those of our members that don't know what the EFMB is, here is a wiki page for it: http://en.wikipedia.org/wiki/Expert_Field_Medical_Badge

 

[82nd medic]

Hmmm...something with a pass rate of 15.3% in FY2008 is a waste of time and is below the standards set for 68W AIT? That doesn't make any sense.

For those of our members that don't know what the EFMB is, here is a wiki page for it: http://en.wikipedia.org/wiki/Expert_Field_Medical_Badge

Have you attended it?

 

[ffemt8978]

Have you attended it?

Nope, wrong branch.

 

[82nd medic]

Nope, wrong branch.

Ok so then I take it you don't know that as far as line/field medics go most purposely fail out so they get to go home early? Especially in times of war when the CMB is what matters, not the EFMB? Or that the only medics that really take it seriously at all are hospital medics who've been spending the last X amount of years working more as a janitor/litter carrier than doing actual medical skills?

 

[ffemt8978]

Ok so then I take it you don't know that as far as line/field medics go most purposely fail out so they get to go home early? Especially in times of war when the CMB is what matters, not the EFMB? Or that the only medics that really take it seriously at all are hospital medics who've been spending the last X amount of years working more as a janitor/litter carrier than doing actual medical skills?

And you don't know that either. I've seen a lot of comments that so far, you have been unable to factually support. You seem to think that your experiences in the military are the standard for everyone in the military, and that's just not the case. So how about some facts to support your position?

 

[82nd medic]

And you don't know that either. I've seen a lot of comments that so far, you have been unable to factually support. You seem to think that your experiences in the military are the standard for everyone in the military, and that's just not the case. So how about some facts to support your position?

This is the only comment I've seen from you so far (not that ive spent hours scanning these boards or anything) and it's about a course you never even attended... Not sure it's correct to point fingers about what you can or can't support with this. I'm pretty sure that someone that's been to a course would know more about it than someone who hasn't.
I have an entire brigades worth of medics to go off of... What are you basing your assumption that medics do want to attend it?
I never said the standards I had was the only one in the military.

Google "opinion on EFMB", I'm far from the only one who thinks it's irrelevant to actual medics

 

[ffemt8978]

This is the only comment I've seen from you so far (not that ive spent hours scanning these boards or anything) and it's about a course you never even attended... Not sure it's correct to point fingers about what you can or can't support with this. I'm pretty sure that someone that's been to a course would know more about it than someone who hasn't.
I have an entire brigades worth of medics to go off of... What are you basing your assumption that medics do want to attend it?
I never said the standards I had was the only one in the military.

Google "opinion on EFMB", I'm far from the only one who thinks it's irrelevant to actual medics

I'm not the one making unsupported, blanket statements about a program. I asked a question, which you've conveniently decided to side step answering by questioning whether or not I've attended the program.

 

[82nd medic]

In fact to quote from the military.com boards:

"I think the way they do EFMB is a load or crap, the way they grade it and what they grade you on is bogus. Some of the best medics I have ever had the pleasure of working with have not made it, and some of the worst have...

They have a set way they want you to do things, when when I went through; it wasn't the wrong way, but it wasn't the way we do things now. And if you deviate from they way they want it, like do things the way you where trained in AIT you will fail. Most of the people I have seen get their EFMB where not medics, had no prior medical training, or just didn't remember their training.."

Like I said before: it tests your ability to memorize, not your actual medical ability. It's like if they had a course for firefighters and in it they said to douse a fire with gasoline... Would you have any real desire to pass or would you rather get out early and go back to actually doing your job?

 

[82nd medic]

I'm not the one making unsupported, blanket statements about a program. I asked a question, which you've conveniently decided to side step answering by questioning whether or not I've attended the program.

And your question was?

 

[ffemt8978]

Hmmm...something with a pass rate of 15.3% in FY2008 is a waste of time and is below the standards set for 68W AIT? That doesn't make any sense.

For those of our members that don't know what the EFMB is, here is a wiki page for it: http://en.wikipedia.org/wiki/Expert_Field_Medical_Badge

And your question was?

I'm just having a hard time believing that a course that difficult is below the standards of a program for people straight out of boot camp, referring to AIT.

 

[82nd medic]

I'm just having a hard time believing that a course that difficult is below the standards of a program for people straight out of boot camp, referring to AIT.

talking from personal experience, the trauma lanes they put you through in AIT were harder than the ones they put you in during the EFMB.

read up on any collective group of opinions on it, and i garuntee you'll come across atleast 1 person pointing out that those fresh out of AIT have an easier time passing than those who are experienced medics.
the actual injuries they give you arent hard: from what i remember one guy with an amputation, one whos unconcious and blocked airway, one with a head injury, and one with a closed fracture. you do a quick triage then get to work...including holding pressure on the amputation for several minutes.

the reason why i say its below standard is because (atleast as of 2008) it wasnt using the TC3 standard that all medics go by. it was using the standard of treatment that the military moved away from (the civilian standard of ABC with turniquets as a last resort after you've already wasted time trying other things) because its well documented that the treatment order of MARCH saves more lives.

 

[82nd medic]

its not that the course is really all that difficult for what SHOULD be its target candidates (line/field medics). the written test is easy, the land nav course can be completed in 1/3 of the time they give, and the other skills are basics. keep in mind that theres pretty much 2 types of medics attending though (line/field and hospital).
line/field medics strive towards the CMB and you cant wear both on your uniform... not that that really matters because the CMB is from actually saving lives and the EFMB isnt. FROM MY EXPERIENCE, no field/line medic really wants to be there. i doubt its limited to just the overall consensus of a brigade's worth of medics, we didnt recieve some "this course is BS" speech before we went though i could be wrong.
to hospital medics its really the only medical badge they can get, but hospital medics arent keeping up on those basic "combat unit" skills and a lot of them fail out at the 12 mile road march... marching is easy when you're doing it weekly, its a pain when its something you rarely if ever do though.

 

[82nd medic]

anyway this has gotten a bit off topic, perhaps it would help if i refrased:

Has anyone attended the EFMB course recently? i'm interested to know if its changed its standards to that of the current TC3 guidelines? (hope that clears up what i meant by "sub standard")

 

[Veneficus]

If I might just make an outsider's observation?

I have never been a medic in the military, but this thread looks a lot like what experienced basics say when they get to paramedic class.

In both the institutions I have taught medic class in, this population represents the largest group of fail outs and struggling to pass as long as records at either institution were kept.

The tag line of "it's not all this book learnin' that matters in the field" is exactly the same excuse they always use when put on academic probation.

It would seem from the comments here that the field medics attending the course may have a precourse bias against it which then manifests itself as a consensus opinion. Those who think otherwise are somehow not part of the group and therefore lesser.

From the educational standpoint, that type of attitude usually inhibits learning, which prevents students from taking into account what is presented and then applying that theory in some way to their specific area of practice even if it is not directly translatable.

In the civillian world, there is lots of diversity in the types of positions paramedics may find themselves in. But they are all still responsible to the basic curriculum irrespective on the environment they go to work in.

I acknowledge that the program may have been set up prior to the country being in multiple wars, designed for people who had not yet seen combat. The military is exceptionally slow at change, considering it usually prepares for the next war on the experience from the last.

But where I am from, a fail is still a fail, and the only explanation is that the participant didn't do what it takes to pass.

I have also witnessed this exclusive class attitude between civillian field paramedics and hospital ED techs who are also medics. Interestingly enough, without the other one, both are useless. The patient needs to survive to the hospital, but once there somebody needs to carry out the tasks that are no less a part of patient care and saving lives.

Thank you for the indulgence.

 

[mycrofft]

Half seriously...

Maybe this also reflects the lowering recruitment standards we keep hearing about?

 

[82nd medic]

If I might just make an outsider's observation?

I have never been a medic in the military, but this thread looks a lot like what experienced basics say when they get to paramedic class.

In both the institutions I have taught medic class in, this population represents the largest group of fail outs and struggling to pass as long as records at either institution were kept.

The tag line of "it's not all this book learnin' that matters in the field" is exactly the same excuse they always use when put on academic probation.

It would seem from the comments here that the field medics attending the course may have a precourse bias against it which then manifests itself as a consensus opinion. Those who think otherwise are somehow not part of the group and therefore lesser.

From the educational standpoint, that type of attitude usually inhibits learning, which prevents students from taking into account what is presented and then applying that theory in some way to their specific area of practice even if it is not directly translatable.

In the civillian world, there is lots of diversity in the types of positions paramedics may find themselves in. But they are all still responsible to the basic curriculum irrespective on the environment they go to work in.

I acknowledge that the program may have been set up prior to the country being in multiple wars, designed for people who had not yet seen combat. The military is exceptionally slow at change, considering it usually prepares for the next war on the experience from the last.

But where I am from, a fail is still a fail, and the only explanation is that the participant didn't do what it takes to pass.

I have also witnessed this exclusive class attitude between civillian field paramedics and hospital ED techs who are also medics. Interestingly enough, without the other one, both are useless. The patient needs to survive to the hospital, but once there somebody needs to carry out the tasks that are no less a part of patient care and saving lives.

Thank you for the indulgence.

I get what your saying but it's different than what you're describing. It's not the difference between "field right" vs "book right" it's a difference of "book right" and "outdated for almost a decade". The "book right" for the army is TC3 which is pretty specific about treatment guidelines. As of 2008, the EFMB was not operating on the TC3 guidelines. To put it into civilian terms, it's like if you attended any medical program and they told you that maggots were the preferred method of fighting all visible infections. It may have been right at 1 point in time, but it's well documented that it's not right today.

the overall consensus about the course comes from that, that it's not what you do according to not just your senior medic's experience but also what you don't do according to the book.

 

[82nd medic]

Maybe this also reflects the lowering recruitment standards we keep hearing about?

Not really. The body fat %s of recruits out of basic are a good example of that, this is from the years of 2005 and 2008, and badges don't really have anything to do with recruitment standards.
Also considering that 75% of Americans are not eligeable for military service I thin the "lower standards" thing is a bit over dramatized

 

[Veneficus]

I get what your saying but it's different than what you're describing. It's not the difference between "field right" vs "book right" it's a difference of "book right" and "outdated for almost a decade". The "book right" for the army is TC3 which is pretty specific about treatment guidelines.

I understand. The same thing happens in civillian medicine, especially in trauma guidlines.

But we have to sit through the classes and we do. We say the magic words they want to hear, do what they want to see. We get our card with a new expiration date on it, then go drinking and talk about what BS it is and what we would really do. But most of the preceptors are extremely knowledgable people and always have something worth hearing. We all still pass.

As of 2008, the EFMB was not operating on the TC3 guidelines. To put it into civilian terms, it's like if you attended any medical program and they told you that maggots were the preferred method of fighting all visible infections. It may have been right at 1 point in time, but it's well documented that it's not right today..

A bit of an exaggeration I think.

I am quite familiar with trauma guidlines all over the world, and the latest ones, which are usually done by consensus, are still easily 10 years behind with only a few changes. So I am not really sure how out of date it could be?

the overall consensus about the course comes from that, that it's not what you do according to not just your senior medic's experience but also what you don't do according to the book.

If I could humbly point out?

All of the senior surgeons and intensivists I know are quick to point out that there is no one right answer.

The textbooks I use now basically say "here is all we know, best of luck in your decisions."

In those same textbooks, they talk about the history of various treatments including the failed and impractical ones, because seeing where you come from helps you get where you are going.

Some of the topics I am researching have not even become recognized as possible, and are far from mainstream.

The higher you go in medicine, the less definitive answers there are. Even from the most experienced.

There is no such thing as education that is a waste of time. But there is education that is wasted on people who cannot or do not use it.

 

[82nd medic]

I understand. The same thing happens in civillian medicine, especially in trauma guidlines.

But we have to sit through the classes and we do. We say the magic words they want to hear, do what they want to see. We get our card with a new expiration date on it, then go drinking and talk about what BS it is and what we would really do. But most of the preceptors are extremely knowledgable people and always have something worth hearing. We all still pass.




A bit of an exaggeration I think.

I am quite familiar with trauma guidlines all over the world, and the latest ones, which are usually done by consensus, are still easily 10 years behind with only a few changes. So I am not really sure how out of date it could be?



If I could humbly point out?

All of the senior surgeons and intensivists I know are quick to point out that there is no one right answer.

The textbooks I use now basically say "here is all we know, best of luck in your decisions."

In those same textbooks, they talk about the history of various treatments including the failed and impractical ones, because seeing where you come from helps you get where you are going.

Some of the topics I am researching have not even become recognized as possible, and are far from mainstream.

The higher you go in medicine, the less definitive answers there are. Even from the most experienced.

There is no such thing as education that is a waste of time. But there is education that is wasted on people who cannot or do not use it.

If this was a certification or qualification of required to do your job or increase your scope of practice I'd agree whole heartedly. But it's not, all it does is get you a badge which is replaced by the CMB the second you treat a casualty in combat. It has no bearing at all on your job. Even if it taught you something new I would agree but it's just a test of the skills that medics were taught from the 90s or earlier.
Look up "tactical combat casualty care", it has a good list of why the current protocols are in place.
Yes it is a bit of an over exaggeration but it gets the point across. Maggots would help clean a staph infection, and holding someones arm for 5 minutes would slow blood loss from a distal location on the arm, but it's so outdated and there's so much documentation suggesting other treatment, that's it's pointlessly innefective if any other means (antibiotics with landing and packing or in tc3s case getting a tourniquet on the limb). The difference is that in combat if you're holding someones arm you can't shoot back, and that can get more people hurt. So yes, there is no absolute right, but this is as close as absolutely right gets.