Yeah, there really isn't any reciprocity here, although I have seen one of the guys in my Firefighter Recruit class who was an out of state Paramedic, they worked some admin magic to fast track a bridge course to get him his HI State license. But that's obviously a clear exception.
It's a good organization, 3-4 12 hour shifts a week (yeah all their shifts are either noon to midnight and midnight to noon), Type III Mod ambulances (mostly F550 cabs, a few newer E series van cabs), no posting, each unit has it's own station (and where the ambulance and fire share a station, EMS has it's own separate wing so you don't have to rub elbows with the firefighters all day if you don't like lol), they have full undisputed medical authority on scene (Fire, we're only BLS) (Fire responds to maybe half of EMS' calls so its def NOT a fire based system here...) Medics do have RSI, can BLS patients to their EMT partners (who can also start IVs and give certain meds (under supervision). I've seen a Medic hop in the driver seat calling instructions to their EMT to start a line and give Zofran. And of course, Oahu is freaking gorgeous.
Single biggest downside is that they're busier than sin. 10 transports in 12 hours is normal. Some units in town average 1 call every hour. There's only 19 units on 24/7 for the whole island, 2 more that are only staffed noon to midnight.
Uniforms are White shirts. Ugh.
I know a lot of you don't like the Ferno Pro Flexx cots that fold into a chair (I do... we can get the cot into the house and up to the patient, much less lifting and carrying vs when you gotta leave the giant Stryker outside everytime... but I digress, the Ferno is all they got, no power cots or lifts. Well unless you count us in the yellow pants, EMS is a big believer in "Dont lift with your back, lift with your fireman" lol).
And it is pretty expensive out here, gas is like $3.30/gallon, my rent is $1500/mo for 600sq ft, and is like the cheapest I can find, median house price is like $700K, a family of 4 can expect to pay almost $200/mo in electricity
But if you love the beach, surf/diving, hate winter, want to work for a professional Third Service in a non Fire based system where you can call the shots, it really is a pretty darn good place to be.