Dont get caught up in the degree hype

[Carlos Danger]

"The more you learn, the less you know."

Truer words have never been spoken about education. The farther I get in my formal training and the more experience I gain, the more I realize how minuscule my understanding really is. That goes for both clinical and non-clinical things.

 

[DrParasite]

One of the prerequisite courses I had to take for RN school was microbiology. Ask me what I remember about it, and I'll tell ya that I learned a lot about growing little bugs. Ask me about how it applies to Nursing, and I'll tell ya that I know it takes a few days to get bugs identified and determine their sensitivity to antibiotics. Also some bugs like different growth media, so you may have to use different collection tubes to ensure optimal growth, because some media may inhibit their growth and thus you'll have a false negative.

There are gram positive and gram negative cells, depending on how soluble their cell walls are. we used metholyn blue dye to determined how lipidsoluable the cell walls were. certain antibiotics won't work on certain illnesses, because of how strong the cell walls were

we also learned about the kreb cycle, the process from which ATP -> ADP + Energy, and we grew stuff on petry dishes, and we weren't supposed to sneeze on the petry dishes and then grow them because we could unleash a new strain of tebucothrax that will infect everyone. Also went over DNA, RNA, and that mitocondria were the power houses of the cells, and there is a smoother and rough endoplasmic curriculum. Not bad for taking micro 6+ years ago.

I once read something like 68% of college grads work in fields apparently unrelated to their degrees.

Syracuse University, Class of '03, Bachelors of Science in Information Systems & History, currently working as a dirty button pusher for a hospital based EMS system, in a job title that barely requires a high school diploma.

"Street smarts" means Experience Based Education, which is only as good as your experience. Why not learn that up front in class instead of on your patients as part of a hard knocks OJT?

what do you think residency is? yes, they get education up front, but the residency part is OJT on live patients.

Somebody ban this toolbag.

This is the exact type of person we DONT need in or around EMS.

Why? he has his right to his opinion. you might disagree with it, but his point of view is no less valid than yours is.

I happen to agree with him. getting a degree in EMS is incredibly over rated, because of how the degree process is designed, especially for an entry level position. for supervisory people, sure, but judging from my experience of ADNs vs BSNs, the BSNs aren't much better; they are just more in debt and better positions to become MSNs, should they decide to do so in 10 years.

If you have EVERY course in the paramedic degree being directly relevant to the paramedic program, and actually increases a person's knowledge, assessment and clinical interventions, then I will be at the head of the line to support a bachelors degree for every paramedic, and say every current paramedics needs to go back to school to maintain their paramedic cards (yes, if you going to make the newbies do it, because it benefits the profession and our patients, than the old guys need to do it too). But I don't see that happening anytime soon, so I will stick by my original opinion, that a degree is overrated, and a vocational course where all the content directly responsible to paramedicine is better for patient care..

 

[platon20]

If you offered me classroom education at an AFFORDABLE PRICE that is non-mandatory, then yes I would take it.

Education for its own sake is good. But colleges/universities arent providing education for its own sake, they are providing it for a profit. A profit that YOU are going to pay for in the form of MASSIVE student debt.

Think about who would be calling the shots in such a degree based "profession." It would be academics, like the people on this thread who believe that a paramedic needs to know that campylobacter only grows on chocolate agar at 37 degrees celsius or higher.

You turn the training pathway over to academic PhDs who havent been on an ambulance in 30 years and you are going to get a ton of minutiae. Dont get me wrong, does it help me to know that oxygen is the terminal electron receptor in the electron transport chain? Sure. But does it help me to know that fact in the context that I have to dump 30-100k in tuition costs to obtain minutiae like that? Nope.

 

[Brandon O]

Dont get me wrong, does it help me to know that oxygen is the terminal electron receptor in the electron transport chain? Sure. But does it help me to know that fact in the context that I have to dump 30-100k in tuition costs to obtain minutiae like that? Nope.

It would probably help filter out a certain caliber of person, at least.

 

[WTEngel]

If you're $100k in debt from finishing a BS, that's nobody's fault but your own. Yeah, college isn't cheap, but there's no need for the dramatic exaggeration. I'll be through with medical school and spend around $80k total from undergraduate through OMS-4, and no, I didn't have any scholarships.

The fact of the matter is education isn't about learning facts, which is what everyone seems to be equating it to. Memorizing a set of facts may be the way you have learned so far, but that's not education.

Education is about encouraging higher order thinking, developing the ability to think critically and evaluate a situation from multiple angles, including but not limited to an academic angle.

You're entitled to your opinion, unfortunately I think you will find that you're on the wrong side of history with this issue.

Look at every other developed country and compare the EMS system education requirements. America is behind, as it is with just about every other educational benchmark. Go ahead and cling to the idea that technical skills are the only thing worthy of spending time on. That's so very "merica!" of you.

 

[platon20]

It would probably help filter out a certain caliber of person, at least.

There are much better ways to filter people that work better and are cheaper than dumping 30k in a classroom so a PhD can lecture you on the intricacies of aquaporin water channels and their role in the regulation of SIADH

 

[WTEngel]

And BTW, that's $80k total, 4 years BS, 1 year MS, and 4 years OMS. I say again, $100k in debt is ridiculous, and anyone who falls for it is a fool.

 

[platon20]

And BTW, that's $80k total, 4 BS, 1 MS, and 4 OMS. I say again, $100k in debt is ridiculous, and anyone who falls for it is a fool.

By your location in Ft Worth, I assume you attend TCOM.

According to their website, their tuition cost per year is 18k per year and their total cost of attendance is 44k per year. That comes out to 72k and 177k for 4 years.

If your numbers are to be believed that means you only paid 8k for your entire bachelors and masters programs.

Can you cite a single 4 year college in the United States in which the cost of attendance is only 8k without scholarships? I dont think so.

Your numbers are NOT typical.

http://web.unthsc.edu/info/200679/admissions_and_outreach/1536/costs_and_financial_aid

 

[Brandon O]

There are much better ways to filter people that work better and are cheaper than dumping 30k in a classroom so a PhD can lecture you on the intricacies of aquaporin water channels and their role in the regulation of SIADH

Not really. Positions with lower standards earn less money, and hence don't attract high-quality applicants. There are exceptions, such as the sort of long-suffering overqualified folks who spend time on forums like this, but that's not the rule.

And if your goal is to perform basic, protocol-driven life support on acute emergencies, your job may not be around much longer. Most emergency medicine (in all settings) now consists of managing chronic problems in complex patients; EMS isn't far behind on that curve; and you cannot do that job without an adequate didactic foundation.

I suppose you can learn about aquaporins in an ambulance. (In fact, I used to torture my new partners with exactly that sort of thing.) Kinda awkward when you're not facing each other though. Buildings are nice.

 

[Akulahawk]

If you offered me classroom education at an AFFORDABLE PRICE that is non-mandatory, then yes I would take it.

Education for its own sake is good. But colleges/universities arent providing education for its own sake, they are providing it for a profit. A profit that YOU are going to pay for in the form of MASSIVE student debt.

Think about who would be calling the shots in such a degree based "profession." It would be academics, like the people on this thread who believe that a paramedic needs to know that campylobacter only grows on chocolate agar at 37 degrees celsius or higher.

You turn the training pathway over to academic PhDs who havent been on an ambulance in 30 years and you are going to get a ton of minutiae. Dont get me wrong, does it help me to know that oxygen is the terminal electron receptor in the electron transport chain? Sure. But does it help me to know that fact in the context that I have to dump 30-100k in tuition costs to obtain minutiae like that? Nope.

Think about this: those "academic" types are the ones you call when you need an order for something because it's not in your protocols. If we, as a group, increase our educational base, we can expect that our protocols will eventually match what we're capable of doing. While we won't likely be in the same realm as PA providers, we'll have a lot more autonomy in what we do, and possibly function more under general guidelines that we can tailor to fit a specific situation than some more rigid protocols. We can be protocol monkeys or not. Also, the more we learn, the more we'll be able to branch out into other areas of care. While we may rail against the nurses, remember that they've blazed a trail. All we have to do is copy what they've done and apply it to our own circumstances.

If you want nursing and paramedicine to be on equal footing, academics have to be brought up to a significantly higher standard.

 

[Christopher]

what do you think residency is? yes, they get education up front, but the residency part is OJT on live patients.

Residency and EMS's learning-as-you-go are like apples and ducks.

 

[EpiEMS]

There are much better ways to filter people that work better and are cheaper than dumping 30k in a classroom so a PhD can lecture you on the intricacies of aquaporin water channels and their role in the regulation of SIADH

I'd be hard-pressed to think of one. Higher entry requirements to the field are the best way to increase wages, for one.

 

[WTEngel]

You have to pay to live either way, so you can't use the 44k figure.

18k per year to OMS-4 is 72k

I spent 3k at community college and knocked out 4 semesters of undergrad.

Flat rate tuition at 4.5k per semester for any amount of hours you want allowed me to complete my next two years in only 3 semesters.

All said that's 88.5k.

I spent 13k on my MS, so no we're at 101.5k.

It isn't the 80k I originally quoted, but at only 1.5k more than your "100k" price for a BS, I think it's safe to say that you're grossly exaggerating the minimum cost. Anyone who spends that much does so because they want to, or we're not smart enough not to.

Like i said, I'm not factoring in the cost of living, you pay that whether you're in school or not, so you "total cost of attendance" rate is flawed.

The bottom line is education, while not cheap, is affordable.



People who jack around and spend 5 or 6 years on a BS tend to go into debt a bit more significantly, but that's no fault of the institution (other than failing to kick them in the butt to graduate.)

I'm not here to debate the cost of education, I'd rather debate the cost of no education. You can't really put that into dollars and cents, but over the course of a lifetime it is significant.

 

[mycrofft]

Ask any (Most) Paramedic what Amiodarone and Grapefruit juice have in common and they will give you a blank stare....


We still have a Diploma nursing program in our city, one of the last few in the country. We will get a diploma RN at our hospital every once in a while. While they are competent and can safely do their job I would definitely not consider them experts nor exceptional. There is a substantial knowledge gap and it is evident. All skills very little knowledge.

Did you mean "Certificate" program? Degrees in nursing are common, and can even extend to a doctorate. I have a whole issue with nursing students going straight to a MSN and then taking over a department, though.

 

[Handsome Robb]

how do I ignore people?

 

[WTEngel]

This is SDN caliber trolling for sure.

Low post count, pushing all the right buttons...

Worst part is I'm still falling for it. Oh well.

 

[mycrofft]

I am not totally at odds with the OP. I remember being at that mindset sometimes. But I am not anti-education and do not think more education makes you a worse field worker.

If we have a degree we tend to feel it is important. We put a lot of time into it and if you (want to) get past constantly reacting to protocols (i.e., being a technician) then higher level reasoning and knowledge come in handy for decision making, science to make change in the career field, or just knowing what is significant to find and record on a scene.

There are means to get help with medical education costs, look into government programs. There are schools and areas with higher costs of education and living, versus places with lower ones. Shop around.

I forget who answered that practical education is paramount. As a former EMT going through the angst of nursing college, I often felt that way, and felt like that afterwards when I was still learning "the real deal" on my jobs. But there is no way to get that experience crammed into four or eight years. I think much more practicum needs to be availed, and "working ambulance " while or before going to a higher level of training is one way to see a lot you will not learn in class; class will help you sort out "Wha' happened?".

 

[platon20]

I am not totally at odds with the OP. I remember being at that mindset sometimes. But I am not anti-education and do not think more education makes you a worse field worker.

If we have a degree we tend to feel it is important. We put a lot of time into it and if you (want to) get past constantly reacting to protocols (i.e., being a technician) then higher level reasoning and knowledge come in handy for decision making, science to make change in the career field, or just knowing what is significant to find and record on a scene.

I'm not anti-education either. But when "education" means pulling you out of clinical/field training and strapping tens of thousands of debt on your shoulders with NO EVIDENCE TO INDICATE THAT IT CREATES SUPERIOR PARAMEDICS then yes, I'm against it.

Your 2nd paragraph is spot-on. Med students and doctors have "bought into" their degree hype and so therefore they think they are superior to everyone else. But the research says that's NOT TRUE. In fact, they cant cite one study that shows that physicians outperform midlevels in clinical areas.

There are dozens of studies showing equivalence between midlevels in every clinical arena from primary care clinic, to ER, to ICU. There are NO studies showing that physicians are superior to midlevels.

There are many many ERs in rural areas that have ONLY midlevels with no doc on site at all.

Blowing an extra 50k on "education" to do the same stuff that a midlevel can do at half the cost is ridiculous.

 

[platon20]

Residency and EMS's learning-as-you-go are like apples and ducks.

This is correct, but the way to fix it is to make EMS training MORE like residency. Not to turn EMS into some kind of "med school lite" where we spend hours on topics that mean little in terms of clinical relevance in the field.

If I have a 50 year old dude in the field with altered mental status and a sodium level of 105, does it really matter whether I know what the proper workup is to rule out SIADH? Does it matter if I know WHY giving a 0.9 percent NS bolus will make his sodium level WORSE?

Ask any PRACTICING DOCTOR what shaped their real education and they will tell you residency is everything.

 

[Handsome Robb]

I'm not anti-education either. But when "education" means pulling you out of clinical/field training and strapping tens of thousands of debt on your shoulders with NO EVIDENCE TO INDICATE THAT IT CREATES SUPERIOR PARAMEDICS then yes, I'm against it.

Your 2nd paragraph is spot-on. Med students and doctors have "bought into" their degree hype and so therefore they think they are superior to everyone else. But the research says that's NOT TRUE. In fact, they cant cite one study that shows that physicians outperform midlevels in clinical areas.

There are dozens of studies showing equivalence between midlevels in every clinical arena from primary care clinic, to ER, to ICU. There are NO studies showing that physicians are superior to midlevels.

There are many many ERs in rural areas that have ONLY midlevels with no doc on site at all.

Again, even if its limited, those midlevel practitioners have MD oversight...so what happens if people stop going to medical school and we run out of physicians to oversee these midlevels? Hmm?

Blowing an extra 50k on "education" to do the same stuff that a midlevel can do at half the cost is ridiculous.

Have you looked at how the rest of the developed world does EMS?

Outside of a few countries we have the lowest education requirements for prehospital healthcare providers.