Best State for EMS (all around).

[firecoins]

The best state for EMS is confusion.

 

[usalsfyre]

Holy crud! You can't be serious. 10 weeks!!! That is the stupidest thing I have ever heard of. No way in heck can you learn to be a medic in 10 weeks. It would take me way more than the two years required here in WA state. I was barely ready to be a basic after 140 hours.

This program caters specifically to Houston FD. My understanding of this is that the 10 weeks doesn't include clinical time, but.....yeeaaah :unsure:

Dallas has a similar program through UT Southwestern, but it takes them a whole 20 weeks to earn a new patch :wacko:

 

[Scott33]

It is not really feasible to have a balanced opinion on particular States...Counties would be more accurate. I Have heard good things about bits of Texas, bits of NC, and bits of WA for example. I am sure those states also have their arse-backward counties too.

 

[46Young]

I liked NY, particularly NYC because of how it's set up. A bunch of BLS units get assigned the BLS jobs, and the relatively fewer double medic ALS units get only high priority jobs. No (per the call type) abd pain, intox, sick job, EDP, minor injury, unknown medical, etc. Just arrests, diff breathers, cardiac condition, unconscious, and maybe the multi trauma. Cutting out a good amount of low priority nonsense makes for a steep learning curve for the medic, and you get to run multiple legit calls daily, not once a week or less like some all ALS systems.

I feel bad for medic students in all ALS systems. The majority of their pt contacts are low acuity pts. I'd hate to waste a clinical rotation seeing maybe four pts, where the first may be an MVA w/ neck and back, then a minor injury, a drunk, then the 21 y/o with flu like Sx or maybe a tummy ache after eating some bad food. How are you supposed to learn when most of your pts are V.O.M.I.T at the most? Yeah, sure, we need to do the proper assessments, diagnostics and prophylactics on each pt just in case, but you're not learning much nor are you getting to practice any skills or critical thinking until you get repetition with truly sick pt that require actual intervention.

That's what I miss about NYC. Here in VA, I might see a couple of decent calls over my three day tour, then not get any good calls for two weeks or so. Speaking from experience, I saw more good jobs in one month in the NYC 911 system than I would see in a year or more in Virginia or SC, and that's being generous.

Too bad a career in EMS isn't sustainable there. That's one of the main reasons I left. If you want good pay and working conditions, then you go with the hospitals, but they only have a 403b for retirement, and have lousy job security. If you want benefits and a pension you go FDNY EMS, but you're making welfare wages. The rest of the state pays lousy, except for the NCPD EAB.

 

[SAREMT]

I liked NY, particularly NYC because of how it's set up. A bunch of BLS units get assigned the BLS jobs, and the relatively fewer double medic ALS units get only high priority jobs. No (per the call type) abd pain, intox, sick job, EDP, minor injury, unknown medical, etc. Just arrests, diff breathers, cardiac condition, unconscious, and maybe the multi trauma. Cutting out a good amount of low priority nonsense makes for a steep learning curve for the medic, and you get to run multiple legit calls daily, not once a week or less like some all ALS systems.

I feel bad for medic students in all ALS systems. The majority of their pt contacts are low acuity pts. I'd hate to waste a clinical rotation seeing maybe four pts, where the first may be an MVA w/ neck and back, then a minor injury, a drunk, then the 21 y/o with flu like Sx or maybe a tummy ache after eating some bad food. How are you supposed to learn when most of your pts are V.O.M.I.T at the most? Yeah, sure, we need to do the proper assessments, diagnostics and prophylactics on each pt just in case, but you're not learning much nor are you getting to practice any skills or critical thinking until you get repetition with truly sick pt that require actual intervention.

That's what I miss about NYC. Here in VA, I might see a couple of decent calls over my three day tour, then not get any good calls for two weeks or so. Speaking from experience, I saw more good jobs in one month in the NYC 911 system than I would see in a year or more in Virginia or SC, and that's being generous.

Too bad a career in EMS isn't sustainable there. That's one of the main reasons I left. If you want good pay and working conditions, then you go with the hospitals, but they only have a 403b for retirement, and have lousy job security. If you want benefits and a pension you go FDNY EMS, but you're making welfare wages. The rest of the state pays lousy, except for the NCPD EAB.

I appreciate this post about NY. I've been considering FDNY EMS for some time now, and the fact that as a medic I would get to see more high acuity calls and do the job actually steers me a little closer that way.

 

[NomadicMedic]

Wow. Talk about reviving a post that is over seven years old. If you read some of the other more recent posts, you'll find the Texas ranks high on the list of one of the best places to do EMS.

Seattle is very good. Minneapolis is very good. Denver is pretty good. Delaware is very good. There's a lot of great places to work as a paramedic.

 

[DrParasite]

It really all depends on what you are looking for. If you want to see sick patients, and only sick patients (relatively speaking), you need to avoid any all ALS system.

 

[hometownmedic5]

If there was an EMS Mecca, we'd all know about it because we'd be beating each other up in the parking lot for applications.

The short answer is no system is perfect and there never will be a perfect system. Too many variable. Some systems have great overall scope, but lots of mother may I. Some have almost autonomous practitioners, but are under paid, over worked, too rural, too urban, too hot, too cold. The list could go on forever. We're all different, so what we want is different, and even if you could get a few hundred of us to agree on anything much less an entire system, with the funding and management support to make it work, that would be one place with no turn over.

I say make a list of your top five variables in order of importance. Start researching services and when you find one that meets at least your top three, do what it takes to get a job there(even if it actually means working somewhere else for a time). Re-evaluate from time to time.

 

[Bullets]

. Give me a tiered system with EMS staffed rescue. But in a system that is appropriately staffed. So like Newark but not running ourselves into the ground. Maybe Pittsburgh? But a little more suburban.

That said, i think my home agency is pretty close to what i really want to do. Its a good mix of BLS EMS and "cool" stuff. There are a couple of BLS agencies in NJ are what id like. Just add some ALS and its right there

 

[VentMonkey]

I'll reiterate what I've said before, and what others on here continue to hit on: it's subjective.

The best "state" for EMS is the providers state of mind. This can range from constantly fluid, to simple small things that solidify gratification.

For me, I'm more the latter having seen many aspects of EMS systems regardless of the physical state that they are in.

 

[agregularguy]

It's definitely a subjective thing.
I came to this website a year and a half back thinking about the same question, and this site helped to expose me to different systems. Then, a few months back I finally was in a position to do my own job search, and had certain criteria that each agency (and city) had to meet.

-Wanted a municipal third service agency- No fire based EMS and didn't want to continue with private EMS
-Had to be "progressive" in their protocols. The agency I'm starting with next month gives Zosyn and Rocephrine prehospitally, has RSI capablities, gives Heparin for ACS and has RSI capabilities after a year working there. No where near me currently can do anything like that.
-I wanted an agency that valued higher education, I worked hard to get my bachelors degrees, so I was hoping for a place that would appreciate (and compensate) the higher education
-Preference on tiered ALS/BLS system. I think we should be able to send BLS trucks to non-high priority calls, instead of all ALS systems sending medic trucks all over
-Was hoping for an agency that had a better career ladder then just FTO or field supervisor- I think that's important to retention in EMS
-As a medic, I really didn't want to be placed as an EMT again to start like Boston EMS, Austin Travis or Medic One out in Seattle.
-Not mandatory, but I really enjoy working HAZMAT. I found several agencies that had EMS work on the HAZMAT teams, and weren't fire based systems. I liked that.

I also had some criteria when looking at cities the agencies worked in.
-Wanted a medium to larger sized city
-Had to be warm (ish). I was trying to get out of the cold, miserable snowy northeast.
-Had to be within an hour/hour and a half of a major airport
-I preferably wanted to be able to live downtown/close to downtown
There's definitely more criteria, but those were the major ones.
But that's what worked for me! I realize that there's a lot of differing opinions on this website about what works best for others, what I wanted isn't necessarily what everyone else wants. It would do you well if you're doing a job search to make a list like that. Find out what you want, what you like and don't like. Then go from there!

 

[NomadicMedic]

That's the stuff. My list was similar, but different in several aspects.

1) no ssm
2) all als third service
3) fly cars
4) a realistic promotional ladder
5) excellent compensation package
6) retirement package

And education. And progressive. And not outrageous call volume. And blah, blah, blah.
No system has it all.

 

[VentMonkey]

That's the stuff. My list was similar, but different in several aspects.

1) no ssm
2) all als third service
3) fly cars
4) a realistic promotional ladder
5) excellent compensation package
6) retirement package

And education. And progressive. And not outrageous call volume. And blah, blah, blah.
No system has it all.

Yet SCEMS still tops my list from a completely selfish single-role paramedics perspective. Not taking into account I would have to uproot my family literally across the country, it really sounds like the kind of system I would revel in.

 

[RocketMedic]

That's the stuff. My list was similar, but different in several aspects.

1) no ssm
2) all als third service
3) fly cars
4) a realistic promotional ladder
5) excellent compensation package
6) retirement package

And education. And progressive. And not outrageous call volume. And blah, blah, blah.
No system has it all.

Your drug restock and the care it incentivizes makes me want to cry lol

 

[EpiEMS]

The only issue I have with Sussex is the distance from a major city...other than that, it seems darn good.

 

[VentMonkey]

The only issue I have with Sussex is the distance from a major city...other than that, it seems darn good.

I'm two hours from a major city and beaches. They at least have one of the two.

 

[StCEMT]

I don't know much about the departments, but if you want a place that pays well then St. Louis county has good places to look into. You just have to have fire certs to apply. All I know is that they have good money here. As far as protocols, education, promotion opportunity I don't have a clue.

If you don't want to do that, the neighboring county also pays really well and is EMS only. Downside is they just changed to 48's and that is not a rural system and in my opinion a bad idea having worked at some of their bases. We will see if that sticks though.

You can definitely make enough to pay the bills here though. I know a CCEMT-P position was just created with one of the county departments and I think they topped out around $84k.

That and this isn't a bad area to live in. There are good schools, cost of living isn't too bad, Cardinals games (and others stuff), plenty of cool stuff to do in the city, good state to be in if you like hunting, etc.

 

[GMCmedic]

I don't know much about the departments, but if you want a place that pays well then St. Louis county has good places to look into. You just have to have fire certs to apply. All I know is that they have good money here. As far as protocols, education, promotion opportunity I don't have a clue.

If you don't want to do that, the neighboring county also pays really well and is EMS only. Downside is they just changed to 48's and that is not a rural system and in my opinion a bad idea having worked at some of their bases. We will see if that sticks though.

You can definitely make enough to pay the bills here though. I know a CCEMT-P position was just created with one of the county departments and I think they topped out around $84k.

That and this isn't a bad area to live in. There are good schools, cost of living isn't too bad, Cardinals games (and others stuff), plenty of cool stuff to do in the city, good state to be in if you like hunting, etc.

I might look into this in a couple years. Im only 3ish hours away and Missouri has some great hunting.

Sent from my SAMSUNG-SM-G920A using Tapatalk

 

[StCEMT]

I might look into this in a couple years. Im only 3ish hours away and Missouri has some great hunting.

Sent from my SAMSUNG-SM-G920A using Tapatalk

@truetiger can tell you more than I can, PM him if you have any questions. I don't know much about the FD's internally since I never had any interest in doing anything with fire besides what is in my current job description. If you are interested in finding a good longer term place though, I'd definitely suggest giving STL county a look. There are plenty of different departments out here, but I am going to guess that the slots are fairly competitive.

 

[Bullets]

Yet SCEMS still tops my list from a completely selfish single-role paramedics perspective. Not taking into account I would have to uproot my family literally across the country, it really sounds like the kind of system I would revel in.

Ive looked at them, but i wonder if its worth the $8 pay cut to move from NJ to DE, or closer NJ, i was looking at taking the ferry