Whats up ladies and gents, new guy here. Currently at the osuokc emt program, my registry is this coming friday, flippin nervous! anyway..
anybody in oklahoma attended the emsa medic program? i understand after 6 months of employment as a emt, you can start the 1 yr program. half the time as any other community college but of course the contract afterwards. Which i think is fine. Looking for any adivice, positive or negative feedback. emsa vs community college medic school?? Is the program really fast paced and difficult? Im just trying to weigh out the pros and cons from the medics that were once in my situation. Unfortunately ive heard more negative things about it. Any oklahoman medics please feel free to help me out
Ok, here goes (you may have ridden with me, I had some OKCOSU students a few weeks ago).
EMSA is a progressively retro system to work in. There are a lot of protocols, a lot of rules and a lot of unspoken dos and don'ts. They are obsessed with measuring statistics and heavily emphasize their collection and accounting on everything you do. The protocols are fairly open, despite what people may think, and with a few glaring exceptions (ie pain management and use of ALS medications), they're comfortably progressive. QI is not terrible, but is far from excellent as well. The biggest medical complaint I had with EMSA is that I was often forced to perform interventions based on the protocol, not on medical need. Anxiety attack with possible syncope?
Technically falls into the "altered mentation" protocol and mandates 12-lead, IV access and capnography monitoring. Seizure? 12-lead and capnography in, before medication, because you never know if that seizure might really be v-fib (yes, that particular myth is common here). Trauma? It had better be on a backboard (or, in my case, adamantly refused by my patient after I asked if they wanted to be placed on a 20-degree piece of hard plastic padded only by a thin blanket- answer was "no" (and yes, I got QIed for it). Medication? You'd better have the Lifenet (IV, O2, SpO2, capnography, ECG) built before you start. Airway management wasn't terrible, but medically, EMSA is pleasantly ahead in some places and way, way regressive in others. The call diversity is pretty broad- I have literally gone from mansions to ghettos to farms to nursing homes in one night, once without leaving Edmond, OK. There is a lot of support available too, so you'll rarely be overwhelmed with patient numbers.
Operationally, EMSA is a meat grinder of a system, or perhaps a steamroller. The call volume isn't terrible on most nights, but we rotate posts constantly and falling behind on charting is a sure way to commit to a few extra hours at the end of the night. 4 12-hour rotating shifts, paramedic must tech all calls regardless of level, and the charting (Zoll Rescuenet now) is not exactly swift and efficient. As of now, the Oklahoma City EMSA schedule is a fixed, nonrotating 4x12, which means that new hires get shafted with weekend/nights for at least 8 months. Pay is low-average for paramedics, slightly above area average for EMTs. Overtime is fairly easy to get. Bonus days when they need a shift are nice, but way too many people rely on them. Benefits are mediocre and expensive Cigna. The schedule is why I left EMSA- my wife works M-F 0800-1700, I worked Th-Sun 1915-1915 with frequent overtime and the Guard tossed in and was barely making what I was planning on when I moved up here from AMR (which I still highly recommend, AMR Alamogordo rocked). As you can see, I rarely saw my wife without some permutation of sleep involved. Family life is way, way more important than any job (it's why I left the military, and it's why I left EMSA.) Plus, you're going to be staring at a computer for at least 8 hours out of the day if you want to clear the hospital in anything like a reasonable time and have coherent charts. It is a fairly unhealthy lifestyle.
Now, on to education: EMSA's paramedic program is either excellent or horrible, there's not really anything in the middle. First, let's talk about pay and job security. Your 6 months of EMT at EMSA have been tiring, but productive if you live at home or are independently wealthy, those with families have probably broken even at best or lived decently with a LOT of hours. You now get paid to go to school at your EMT wage, and can still pick up shifts as an EMT (your regular work schedule is rotating now, fairly desirable); you also get your selection of clinical spots -and- your work schedule is built on a special rotation that allows you to have very desirable shifts (M-Th 9-2100 or a rotating shift, generally). These shifts are reserved for EMSA paramedic students and work with your school schedule in mind. Once you graduate, you are contracted to EMSA for three years as a paramedic, but you'll be paid at the lowest level of paramedic pay- a little under $13.75/hour. This means you're looking at about a .40-cent pay raise from the highest EMT level, which doesn't really matter. A day-one medic makes more than a senior EMT, but it's not a lot by any means. Leaving early means you get to pay the outstanding cost of the school back to EMSA or face collections (this is rarely enforced, too expensive to recoup losses).
The education EMSA offers is not substantially better or worse than the community college offerings, but it is more distributed and probably easier to pick up due to constant exposure. The card is the same. However, EMSA EMTs are not allowed to tech patients, and most EMSA medics, myself included, are leery of 'paramedic students' teching calls to a significant extent. All in all, the EMSA paramedic students are better EMTs than their community college counterparts, but similar paramedics.
The community college paramedic courses here suck, flat-out. Although they get on the right track with education and attempted early exposure to EMS via third-rides, they do not teach students before they hit the trucks, which produces wildly variable results. It is no exaggeration to say that I had a student "there to practice assessments" at a paramedic level who had not yet been taught to read an ECG; there is another program (I think OSU) that had students doing IVs before they learned assessments as an outrider of its AEMT program. I'm a fairly new medic, and I love having students, but that made very little sense to me. Rose State and Gordon Cooper out in Shawnee supposedly have better programs, and I hear that Gordon Cooper actually has very good clinicals (I know they ride with REACT and do hospital rotations at Saints-Shawnee).
At the end of the day, your paramedic school doesn't matter. I went to a hole in the wall in El Paso that's closed now because the owner couldn't gain accreditation (EMS Online Training Plus) and learned very little that EMTLife and my parents didn't teach me or that I couldn't find out on my own. I did most of my bookwork online and did clinicals whenever I could around the Army's schedule. My knowledge base does have gaps, some of which I know, some of which I'm discovering. My school didn't teach me a whole lot, and a lot of what they did teach was outdated, but I was able to think critically and modify what needed to be changed to be a decent paramedic today. I'm currently backschooling at Rose State and working on an AAS in Paramedicine to shore up my credentials, then a bachelor's degree somewhere. In the meantime, I'm a new-hire medic at REACT who can afford to live in a nice apartment, drive a relatively nice truck and eat three whole times a day and do it under lights that turn on.
Out of the choices you have here, the EMSA program is the fastest way to get your paramedic, the most economically viable for a person who has to work a steady schedule and *possibly* a more relevant education that I would really say is more of a "training". EMSA paramedics coming from the EMSA school generally breeze through the EMSA FTO process because they know what's expected and desired from them and they know how to do everything they'll be tested on. New hires (even experienced ones) often struggle because EMSA does operate a little differently and the majority of FTOs are rather nitpicky (protip: don't draw up IM epi and benadryl and give them to an infant with a decent and screamingly obvious case of anaphylaxis without a B/P, SpO2, ECG, IV access, capnography and blood glucose- that's the issue that made me and my first FTO get in a rather heated argument and moved me to a second FTO. I could have killed that kid had my IV access not been placed prior to epi, benadryl could have made his pressure drop dangerously, and I needed to secure his airway before I worried about circulation:
Those were the stated reasons I failed that call, BTW.) Anyway, EMSA's program is the fastest and most locally job-relevant, but I would stop short of endorsing it. Long-term, it's probably the worst of the three- locally, there's a stigma at other services against EMSA Drone Thought and the school is not well-regarded in comparison to other local programs, your pay is frozen-low where other services might pay better, and relocation opportunities now come with a potentially large charge for "leaving early".
The community college programs are a bit more disorganized, but they do offer college credit for their work and you can work while you attend- a guy in the Guard is doing just that at Lifenet in Stillwater, OK. The education is the same, the operational education is inferior, the lack of commitment to EMSA is superior in that it lets you relocate easily.
EMS and EMS education is what you make of it. I am on my fifth paramedic job in three years and would only want to go back to one of those (AMR, if you ever read this, you have a loyal drone here!) My judgement on REACT is reserved until I know more about it, but I like most of it so far. You should always have an escape plan and always be ready to move in this industry, and do not be afraid to seek a better opportunity for organizational loyalty. Organizational loyalty does not pay the bills, but sometimes the best operational organizations are not the best clinical organizations and sometimes they are. You'll see what I mean.
If you have a working spouse and/or a family, I would recommend you explore alternate options before EMSA or another 12-hour SSM agency with a nonrotating schedule.
