MD to paramedic

[Monster]

Hi,

I have a quick question. Im currently a resident, ie i graduated medical school, and completed an internship. I want to take a year off from residency to spend time with family. If I wanted to work a few shifts as an EMT (to maintain clinical skills and make some extra money) what can I do to get certified? I was an EMT-B prior to medical school however my certification has since long expired. Im up to date with ACLS, PALS, NRP, and ATLS. Is there a 'quick' way to get certified having an MD? I dont mind taking an exam if need be. Sorry about asking such an odd question, any suggestions would be appreciated. Because Im still in residency, Im not eligible to get my full medical license.

thanks for your help

 

[Veneficus]

If you have taken your step 3, depending on the state they may issue you a paramedic card.

If not, I don't think there is mch you can do except take the class.

What is your residency in?

 

[Monster]

Im taking Step 3 in january. My residency is in Family Practice

 

[Veneficus]

Im taking Step 3 in january. My residency is in Family Practice

best thing to do then is call your state EMS office and ask them what the procedure is.

 

[MrBrown]

Mate you've been dipping into the ketamine haven't you?

Have you not seen what Doctors who respond on behalf of the Ambulance Service get to drive?

Mind you, how confident are you in thoracostomy and rapid sequence intubation?

 

[zmedic]

Depends on the state. In New York if you ever had an NY state EMT cert you can take a refresher challenge class (which involves you challenging the written and skills portion), going to the classes that you didn't score highly enough on the test, and taking the NY state written test. But that's to get your old cert back, not to get medic. Some states let you challenge for medic as an MD. Yeah, check with your state.

Also even if you have the certs, you should think long and hard if you are ready to work as a medic. There is a difference between running a code on the floor and in someone's house. Especially if you are family medicine. If someone told me they wanted to challenge for medic and they were a fourth year emergency medicine resident i'd probably say go for it. Everyone else, I would be a bit leery if they haven't specifically trained for medic.

 

[EMSLaw]

Also even if you have the certs, you should think long and hard if you are ready to work as a medic. There is a difference between running a code on the floor and in someone's house. Especially if you are family medicine. If someone told me they wanted to challenge for medic and they were a fourth year emergency medicine resident i'd probably say go for it. Everyone else, I would be a bit leery if they haven't specifically trained for medic.

I have to totally disagree with this. You're ignoring the fact that a doctor - any doctor - has years of full time medical education, including an ER rotation. ACLS doesn't change no matter where you do it, save that there are some more advanced interventions that can't be done outside a hospital. And ironically, I think being a relatively new MD helps the OP here. He hasn't spent 40 years practicing podiatrics or OB/GYN.

I think you overstate paramedics and denigrate doctors. Refreshing a few protocol-driven psychomotor skills shouldn't be a problem for someone who's has MD and PGY1 training.

 

[rhan101277]

I would just call your local EMS office. I am sure your education exceeds the requirements, even though it is not exactly like the paramedic program. I would try paramedic though because you can really work on some of your differential diagnosis and more advanced procedures. Also it will help keep you up to date on the medicines were are allowed to give. You will get to experience what it is like to be by yourself making decisions, no senior resident or attending to run stuff by, just protocols. Most protocols allow for sound clinical judgment though. I hope it goes well for you, it sure is a rewarding job.

 

[d3653je]

Once again Doctor Kiwi Brown with all the answers!

Mate you've been dipping into the ketamine haven't you?

Have you not seen what Doctors who respond on behalf of the Ambulance Service get to drive?

Mind you, how confident are you in thoracostomy and rapid sequence intubation?

 

[AnthonyM83]

Hey Monster,

I think that'd be a really interesting idea. The best answer really is to contact you state EMS office to explain everything clearly.

How long were you an EMT-B? I will say that I worry a few shifts of additional training might be needed to assure field competency. Not in medical procedures, rather field equipment and scene management.

Do you have full competency in using a Sager/Hare traction splint, a KED, spinal immobilization (from standing, suping, sitting), running a code with only possibly only one EMTB at your side, etc etc? Are you comfortable running (physically, not just academically) ACLS and PALS procedures on a regular basis?

Again, I think it'd be a great experience, but remember there would be a bit to review and the EMS office would need to be sure you would be fully competent in basic skills and scene management as well.

Good luck!

 

[jgmedic]

www.emsa.ca.gov has the requirements for CA, it is not too bad, the only thing I see that you don't already have is a field internship. If you could find a school to affiliate with just for rideouts it would work. I dont know what state you are in but hopefully this helps.

 

[zmedic]

I have to totally disagree with this. You're ignoring the fact that a doctor - any doctor - has years of full time medical education, including an ER rotation. ACLS doesn't change no matter where you do it, save that there are some more advanced interventions that can't be done outside a hospital. And ironically, I think being a relatively new MD helps the OP here. He hasn't spent 40 years practicing podiatrics or OB/GYN.

I think you overstate paramedics and denigrate doctors. Refreshing a few protocol-driven psychomotor skills shouldn't be a problem for someone who's has MD and PGY1 training.

Speaking as an EMT and a fourth year medical student, I can say that most non emergency physicians are no way near ready to run calls in the street. You know how much value a month in the ED is to a psych resident, which they do with an emergency attending looking over their shoulder? Most of these residents have started only a handful of IVs. Those not in anesthesia or emergency medicine do not intubate during residency. Most do not have their ACLS protocols memorized, or their drug dosages. Most have never backboarded someone or put on a C-collar. They have never slung and swathed someone. They have no training in incident command, Hazmat, scene control, ambulance operations, scene safety or extracation.

Most doctors really aren't remotely ready to be a paramedic. It's not like we get trained as medics during med school and just have to refresh, it's a whole other skill set.

 

[usalsfyre]

Yeah I was really thinking someone should point him in the direction of a rural ED, the kind that often only have mid-level coverage.

 

[bstone]

He can almost certainly function as a medical director (assuming he has an unrestricted medical license) but functioning as a paramedic would take some specialized training. Having been an EMT-B helps a lot, however.

 

[jjesusfreak01]

He can almost certainly function as a medical director (assuming he has an unrestricted medical license) but functioning as a paramedic would take some specialized training. Having been an EMT-B helps a lot, however.

My medical director has his Medic cert, works as an ER doc, and occasionally assists calls (does not run because he trusts his medics completely) in the field. I don't think I would want a medical director without prior field EMS experience.

 

[bstone]

This is why when I finish med school you all will be happy with me. Having worked in the field for many years I will know how protocols to use and how to advance things vs thinking of medics as trained monkeys.

 

[MrBrown]

I don't think I would want a medical director without prior field EMS experience.

None of our Regional Medical Advisors or the Medical Director nor any of the HEMS Doctors that Brown knows have prior experience as an Ambulance Officer .... so why do you need field experience?

 

[jjesusfreak01]

None of our Regional Medical Advisors or the Medical Director nor any of the HEMS Doctors that Brown knows have prior experience as an Ambulance Officer .... so why do you need field experience?

This is more an issue in the US, where the needs and abilities of ambulance personnel are dictated directly by the medical directors, so without any field experience, the medical directors are either uninformed or have to rely on their medics for input (of course, theres nothing wrong with that, so long as they really do listen to their medics). What I would fear is a system where the medical directors wanted to run it according to what they their own perceptions rather than those of their medics.

 

[Veneficus]

This is more an issue in the US, where the needs and abilities of ambulance personnel are dictated directly by the medical directors, so without any field experience, the medical directors are either uninformed or have to rely on their medics for input (of course, theres nothing wrong with that, so long as they really do listen to their medics). What I would fear is a system where the medical directors wanted to run it according to what they their own perceptions rather than those of their medics.

Some of the best medical directors in the US have never worked in EMS.

 

[Veneficus]

This is why when I finish med school you all will be happy with me. Having worked in the field for many years I will know how protocols to use and how to advance things vs thinking of medics as trained monkeys.

Good luck with that, some extremely smart and capable prior EMS service medical directors have been unable to make changes.

Don't forget, it is easier to replace a medical director than it is a union fire or EMS person.