Could you be more specific? (I.e., departments/oppurtunities)
I'd like to be a busy 911 paramedic in a fairly large department.
What he is saying, is that in the US. DCFD EMS is known as top 10 one of the worst, they rank up there with San Antonio, LA County, LA City, etc....... Large Fire Based EMS system tend to have bad performance.
How big is big in your mind?
There are plenty of large EMS system that are busy, but practice good medicene. Lemme slap ya down with a Few.
Mecklenburg County NC, 30+ Units
Austin-Travis County EMS Tx 30+ units
Williamson County EMS Tx 16+ Units
Montgomery County EMS Tx 15+ Units
Denver Health EMS CO 12+ units
Medstar EMS Tx 40+ Units
Wake County EMS NC 25+ Units
All of these system are large, But non fire based. They all have room for advancement... ie, officer/supervisor postions. And all of these systems are busy. All have participated in studies and have advanced EMS in the US as we know it, all have excellent statistics and patient outcome.
That being said, Miami-Dade Fire Rescue and Pheonix Fire are a few of the good fire based EMS systems