Dont get caught up in the degree hype

[Wheel]

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.

I don't think anyone here would advocate for less field time. I don't think it's too much to ask for a paramedic to have a better understanding of physiology, and I think paramedics should have more/longer rotations in a variety of specialties (similar to nursing). If this came to pass, along with a requirement for an associates degree and an option for a bachelors, ems could successfully lobby for reimbursements similar to nursing and RT. You might see an increase in community paramedic pilot programs and higher pay because of this. Why would it be such a problem for ems to come to equal footing with the rest of the allied health fields?

 

[Sandog]

Here's the thing about the foundational sciences. Can I recall every step of the Krebs cycle from memory? Nope. Can I sit down and push electrons around or answer synthesis problems? Nope.

Do I still remember the underlying concepts from both? Yes. ...and those underlying concepts are what helps me interpret the medical world and new medical literature. Just because people lose the specifics of a course because they no longer use them doesn't mean that the broader understanding is lost.

I don't know. I had molecular biology class and all I can remember is that you got this little protein molecule enzyme thingy that goes to a little cell and say's "Hey bud, let's party" and the cell opens its little cell door and other little molecules run in and out the door.

On the chemistry side, if you ask me about acid/base titration, I am like, "Is that when the clear liquid turns pink?" :wacko:

 

[JPINFV]

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.

Get the heck out of the pre-allo/osteo section. Heck, I rarely venture far out of the clinical rotations and EM forum now. Trolling in those places are virtually non-existent.

 

[JPINFV]

I don't know. I had molecular biology class and all I can remember is that you got this little protein molecule enzyme thingy that goes to a little cell and say's "Hey bud, let's party" and the cell opens its little cell door and other little molecules run in and out the door.

So you have the basis of understanding how drug agonists/antagonists works besides, "Beta blockers lower the heart rate."

On the chemistry side, if you ask me about acid/base titration, I am like, "Is that when the clear liquid turns pink?" :wacko:

You know what an acid is right? You know what denaturing is, right? So, you have a fairly good idea why acid/alkalosis is bad, right?

You understand chemical equilibrium? So you understand if you push a reaction by increasing/removing a reactant pushes an equilibrium to the right or left? Pretty much the basis for renal physiology and acid/base homeostasis.

 

[JPINFV]

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.

Residency is useless without the basis of medical school. If the only thing needed was residency then we wouldn't have medical school... we'd have residency.

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?

If EMS wants to act like a technician, then they shouldn't be surprised when they're treated like a technician.

 

[Sandog]

I was sorta joking JPV, I am all for school and think it is a good thing and anyone who says different is only fooling themselves. There are many professions like engineering, Chemical science, biological science to name a few that you can not even get into without a degree, there are exceptions once in awhile, but not often.

But I got to tell ya, I think my brain is full, as soon as I take a new class, all the stuff I learned before just goes poof...

 

[ExpatMedic0]

I don't know, maybe the OP is right. Maybe I should drop out of university, and just work for AMR and ask they place me with an FTO for an extended period of time. Preferably one with no higher education who can teach me the art of medicine he/she has learned by saving lives at 60 miles per hour, watching emergency, and by having the tried and true "that's the way we have always done it"
Obviously there is no future in higher education, degree earners do not make any more money or have any better career aspects. Clearly a profession does not need degree's to advance or conduct its own scholarly professional research, advocate, create policy's, ect. We have nurses and doctors that can do that for us and shape the hero vocation we are also so blessed to be a part of. Although apparently, we should actually be using PA's and NP's instead of doctors, but you get the point.

 

[Sandog]

Would that be sarcasm or patronizing, or a combination of both?

Sarcazing. :blink:

 

[MrJones]

...Why would it be such a problem for ems to come to equal footing with the rest of the allied health fields?

Eastern Kentucky University, which offers an Associates and three different Bachelors Degree programs in paramedicine through it's Emergency Medical Care (EMC) Department, has a College of Health Sciences and a College of Justice and Safety. The EMC Department is located in the latter College.

That's why it would be such a problem.

 

[Brandon O]

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?

No?

Does it matter if I know WHY giving a 0.9 percent NS bolus will make his sodium level WORSE?

Yes?

 

[WTEngel]

I don't know, maybe the OP is right. Maybe I should drop out of university, and just work for AMR and ask they place me with an FTO for an extended period of time. Preferably one with no higher education who can teach me the art of medicine he/she has learned by saving lives at 60 miles per hour, watching emergency, and by having the tried and true "that's the way we have always done it"
Obviously there is no future in higher education, degree earners do not make any more money or have any better career aspects. Clearly a profession does not need degree's to advance or conduct its own scholarly professional research, advocate, create policy's, ect. We have nurses and doctors that can do that for us and shape the hero vocation we are also so blessed to be a part of. Although apparently, we should actually be using PA's and NP's instead of doctors, but you get the point.

In all fairness, you probably were never gonna be that great anyway... lol

I'm probably headed for the same fate. No sense in completing my higher ed. Now that I figured how much it really cost, anyone who spends 100k to get themselves to the point where they can earn 250-300k a year, and <gasp> actually make decisions, is clearly making a bad choice.

And the point the OP is making about mid levels spending slightly less on school and making nearly half of what a physician makes is totally correct.

Extrapolate that out over a 25 year career and I'm only losing literally millions of dollars by making the choice to not go to school.

Thank you OP for making sense out of the most bass ackwards idea I've ever seen.

 

[ExpatMedic0]

In all fairness, you probably were never gonna be that great anyway... lol

:sad:

 

[TransportJockey]

Eastern Kentucky University, which offers an Associates and three different Bachelors Degree programs in paramedicine through it's Emergency Medical Care (EMC) Department, has a College of Health Sciences and a College of Justice and Safety. The EMC Department is located in the latter College.

That's why it would be such a problem.

But then you have programs like the UNM School of Medicine, EMS Academy. It's a branch of the department of emergency medicine. It offers a BS in paramedicine.

 

[MrJones]

But then you have programs like the UNM School of Medicine, EMS Academy. It's a branch of the department of emergency medicine. It offers a BS in paramedicine.

That's as it should be. And when most, if not all, state flagship medical schools offer a paramedicine program I'll believe that we're on the path to equal footing with the rest of the allied health fields.

 

[platon20]

That's as it should be. And when most, if not all, state flagship medical schools offer a paramedicine program I'll believe that we're on the path to equal footing with the rest of the allied health fields.

Screw that. Why settle for allied health when you can tell people that you graduated from medical school?

Think that's ridiculous? Well thats exactly what the PA grads do at schools where the PA program is organized under the school of medicine.

 

[Handsome Robb]

Screw that. Why settle for allied health when you can tell people that you graduated from medical school?

Think that's ridiculous? Well thats exactly what the PA grads do at schools where the PA program is organized under the school of medicine.

Blanket statement much?

 

[WTEngel]

Screw that. Why settle for allied health when you can tell people that you graduated from medical school?

Think that's ridiculous? Well thats exactly what the PA grads do at schools where the PA program is organized under the school of medicine.

Yeah, they didn't graduate from medical school, and they don't tell people that. Any PA that does is a liar, and most every PA I've met is proud to have graduated from PA school, and not med school.

 

[MrJones]

Screw that. Why settle for allied health when you can tell people that you graduated from medical school?

Think that's ridiculous? Well thats exactly what the PA grads do at schools where the PA program is organized under the school of medicine.

That's not what I think is ridiculous....

 

[mycrofft]

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.
We've established that cost is variable as is resultant quality. But as a rule your better education will cost more than a certificate or diploma mill will.

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.
I'm speaking with nurses, paramedics etc in mind, especially those of us on the forum. And a citation of that study would be a telling argument.

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.
And what is a midlevel? As before, give us some URL's to these studies.
There are many many ERs in rural areas that have ONLY midlevels with no doc on site at all.
That is why patients aren't sent there from the Mayo clinic for superior care. Those folks are doing heroic work sometimes and may exhibit a great working grasp of what is occurring in their neighborhood. Sometimes they don't. Rural and frontier EMS, and medical service in general, are underserved especially since the little county hospitals all started shutting down in the Seventies and Eighties.
Blowing an extra 50k on "education" to do the same stuff that a midlevel can do at half the cost is ridiculous.
See above.

Have you never lost a patient because you just didn't have what you needed at the time? Raising the level of education and preparation across the board, while not possible due to political economic and sociological reasons, is still something to aim for. Controlling the costs of training is another matter.

 

[JPINFV]

Yeah, they didn't graduate from medical school, and they don't tell people that. Any PA that does is a liar, and most every PA I've met is proud to have graduated from PA school, and not med school.

My masters degree is from Tufts University School of Medicine. There's a reason, however, that I never identify the School of Medicine part when people ask where I went.