Ideally, at least one of those paramedics would have experience. If the question was "inexperienced basic vs inexperienced paramedic" or "experienced paramedic v experienced basic" I'd take the paramedic hands down. There's a reason why even residents (who are fully licensed physicians) who are moonlighting generally try to have at least double coverage.
I really don't feel like typing the same, long post that I usually do for this topic, so I'll keep this brief.
Unfortunately, people tend to forget the above when this topic comes up, as well as forgetting, or being unable to accept, that EMS (and medicine in general really) has a lot more involved in it than just medical issues. This is where working as an EMT can be beneficial to some new providers. (though it may not be beneficial depending on the type of service the EMT works for; a NETS service will not be as helpful as a 911 service where they are working with a medic)
On average field internships in paramedic programs are woefully inadequate; for the amount of things we can do and are expected to treat and know, 200 hours of fieldwork (the national minimum) is ludicrous; that's less than a month of fulltime work. Not to single anyone out, but Linuss is nearing the end of his internship, and by his posts has done and experienced very little (this is just how it comes across and an example so don't get upset). Yet he'll be turned lose soon, and may be hired by a service that does little, if any initial training of their own (and there are many, many places that do that). Is that right? Will he be an experienced, fully-capable provider ready to head out on his own? Will he be capable of handling any oddball situation that comes up? Possible, but the odds are against him, and everyone else in that situation. I believe another poster here was actually dropped from their internship because they weren't proficient at the non-medical aspects of this job.
There is more to EMS (and medicine in general) than just medicine. There is more to being a good provider than just knowing something in your head. Being able to function during stressful situations, recall the needed information, apply the needed information, evaluate the results and apply more information as needed, all while under stress and in controlled to chaotic environments takes time to learn. Being able to control a scene and direct multiple personnel. Being able to communicate and interact appropriately with pt's (and this includes different cultures and sub-cultures, ages, socioeconomic groups) family (sometimes distraught and/or hostile family), bystanders, coworkers, nurses, doctors, other medical personnel, police, FF's, drunks, crazy people and everyone else we come across is not something that can be learned in a brief internship. Being able to recognize when someone is lying or holding something back. Being able to recognize when a scene is unsafe (and I don't mean the glaringly obvious times) or has the potential to become so, being able to take in everything that is happening while still maintaining your focus on the pt, being able deal effectively with the multiple, non-medical issues that we come across regularly...the list can go on and on, but for all the fact remains the same: becoming truly proficient at these things takes more than 200 hours.
There is more to medicine than just medicine.
Learning how to cope with, and perform the above is where experience as an EMT can be beneficial. If a person ends up on a NETS (non-emergency transport service; ie nursing home to MD's appointment and such) then there will still be some benefit, though much less. If a person ends up on a 911 ambulance, preferably working with a paramedic, the benefit can be much greater, and when their paramedic internship comes around they will be able to focus more on the medicine side of things, on less on the other aspects of our job.
Of course, this also depends on the school where you go and where you eventually end up working. If you have well upwards of 700 hours of field time, that's a good start, though still not enough by far. In that case experience as an EMT is less needed, though it still might help. Same goes for where you start working; if there is a good, comprehensive training program before you start working, followed by which you are paired with an experienced partner who continues to teach and evaluate you, then experience as an EMT is less needed, though it'll still have some benefit. Of course, many places do not do the above, or only a very watered down version of this...so what should the prospective paramedic student do?
Look at the program you are going to; how many clinical hours does it have, how many internship hours? Look at the services in your local (and non-local)area; what is their training program for new medics? Can you work as an EMT on a 911 ambulance? Take a look at yourself; how do you function while under stress? Do you pick things up rapidly? Are you used to abnormal situations? Have you been exposed to multiple types of cultures and situations? Have you been placed in situations where you had to rely soley on yourself? How did you do?
Not everyone needs EMT experience, and not all EMT experience will help. But there is a reason that MD's, PA's, and RN's all spend many more hours practicing their job before they are allowed to work on their own. Until EMS education is reformed and the internship is extended to 1 year in length, prior experience as an EMT is something worth considering.
Huh...guess that ran long after all.
