Pre-meds in EMS

[daedalus]

Hey! Don't get my topic closed!

Now, most premeds do take A&P I thought. Or else the MCATs would become very difficult very quickly!

Also, daedalus, I was referring to advanced skills that basics can do here. Those I mentioned were just some of them. When we run medic-basic, the basic is usually the one that intubates, and the medic starts ACLS and the manual defib. Since we run medic-medic-basic here, usually one medic will do the acls and defib while the other does the tube, but when the Med3 guy is around, they'll often let him do the tube.

Hm, that is interesting. I would never let a basic intubate on my rig even if it was allowed here in California. Medical students are not taught how to intubate a patient, and I am going to guess that most residents will not intubate unless they are EM, pulm or Anesthesia.

UCLA and USC both recommend against taking courses that overlap with what is taught in their schools of medicine, and one of them go out of their way to advise against taking A&P.

Anyways, all I am saying is that a premed or medical student should not think they can challenge a paramedic partner.

 

[JPINFV]

Anyways, all I am saying is that a premed or medical student should not think they can challenge a paramedic partner.

I wouldn't necessarily go that far. There's a time, place, and method to challenge a medic and unless it is something that will negatively affect the patient (and most things won't in EMS), it definitely should not be brought up in front of the patient. If anyone does want to challenge a higher provider following a call, it's best to start that conversation off along the lines of, "Hey, given X, Y, and Z, I was wondering why you decided to treat with 1." This gives you the out of pleading ignorance and learning from it that you wouldn't have in a more confrontational starting point.

 

[ericg533]

Hey! Don't get my topic closed!

Now, most premeds do take A&P I thought. Or else the MCATs would become very difficult very quickly!

Also, daedalus, I was referring to advanced skills that basics can do here. Those I mentioned were just some of them. When we run medic-basic, the basic is usually the one that intubates, and the medic starts ACLS and the manual defib. Since we run medic-medic-basic here, usually one medic will do the acls and defib while the other does the tube, but when the Med3 guy is around, they'll often let him do the tube.

There isn't any human anatomy on the MCAT. It's chem, bio, some math/physics, "reading comprehension", and, I believe, two essays.

 

[ericg533]

Anyways, all I am saying is that a premed or medical student should not think they can challenge a paramedic partner.

You need to get off your high horse. Anyone can and should question anybody (when the situation is appropriate) regarding patient care. We are all in it to learn and to get better, and to sometimes save lives. Sometimes higher levels can learn from lower levels.

 

[daedalus]

You need to get off your high horse. Anyone can and should question anybody (when the situation is appropriate) regarding patient care. We are all in it to learn and to get better, and to sometimes save lives. Sometimes higher levels can learn from lower levels.

You are not understanding what I am saying and your also leading this thread down the same path that got it closed the first time. If you wish to ask about or suggest something regarding what your higher level partner did, do it after the call. But do not do it because you are Student Doctor EMT or Premed EMT. Statements like get off your high horse should be replaced with civil discussion.

 

[WuLabsWuTecH]

There isn't any human anatomy on the MCAT. It's chem, bio, some math/physics, "reading comprehension", and, I believe, two essays.

Physics and General Chemistry make up Physical Sciences Section (PS)
Verbal is verbal Reasoning (V)
Writing is 2 essays (W)
and Bio Sci (BS) section is Organic chemistry, biochemistry, cytology, and also physiology. Anatomy is not really required except for a basic understanding of the layout.

 

[ericg533]

You are not understanding what I am saying and your also leading this thread down the same path that got it closed the first time. If you wish to ask about or suggest something regarding what your higher level partner did, do it after the call. But do not do it because you are Student Doctor EMT or Premed EMT. Statements like get off your high horse should be replaced with civil discussion.

What you said was..

a premed or medical student should not think they can challenge a paramedic partner.

And now you are saying the oppisate. That lower levels can question higher levels. Interesting. I agree with you now.

 

[daedalus]

What you said was..



And now you are saying the oppisate. That lower levels can question higher levels. Interesting. I agree with you now.

No, I did not contradict myself. I continue to hold to my opinion that a premed or medical student should not question their paramedic partner. What Idid go on to say later is that an EMT or EMT-I can and should ask about things after the call. You do not wear the hat of a medical student at work as an EMT. You wear the hat of an EMT.

 

[daedalus]

Physics and General Chemistry make up Physical Sciences Section (PS)
Verbal is verbal Reasoning (V)
Writing is 2 essays (W)
and Bio Sci (BS) section is Organic chemistry, biochemistry, cytology, and also physiology. Anatomy is not really required except for a basic understanding of the layout.

I believe that biology courses should contain the needed physiology. I could be wrong. I have already taken college A&P for paramedic school and thus shouldn't have a problem when I go to take the MCAT.

 

[JPINFV]

There isn't any human anatomy on the MCAT. It's chem, bio, some math/physics, "reading comprehension", and, I believe, two essays.

Have you taken the MCAT? The AAMC loves a few systems, especially the renal section. While 3 or 4 of the 5 questions in the renal passage may be answered by the passage, understanding the A and P of the renal system will help score a point or two and will definitely make the section go faster.

 

[WuLabsWuTecH]

Have you taken the MCAT? The AAMC loves a few systems, especially the renal section. While 3 or 4 of the 5 questions in the renal passage may be answered by the passage, understanding the A and P of the renal system will help score a point or two and will definitely make the section go faster.

Totally agreed. There is some physiology you need. Cardiac is another one that they test often.

 

[JPINFV]

Oh, and to add something in case someone's going "a point or two doesn't matter," it very much does. While the Bio and Physical Sciences sections are 70 some-odd questions (if I recall correctly), each section is ultimately score on a 15 point standardized scale. At the high end (12-15 points out of 15), the difference between a 12 and 13 is litterally a couple of questions.

 

[usafmedic45]

+1 Does everyone want to be on a helicopter?

No.

I am beginning to see how hard it is going to be to get my shot at it.

It's only going to get tougher when the number of services start to decline when increased operating standards come into effect within the next few years. The only advantage is that fewer spots will open because the person who previously occupied it is now occupying a six foot deep hole in a cemetery.

You do not know more than a medic. You are learning very general pathology and biochemistry.

Thank you. I was about to call him on that one.

If your MS-III friend tries to overstep his bounds, he can be fired and lose his cert.

...and quite possibly get expelled from medical school. We had a EMT-I/MSIII that worked for us at the service I was a supervisor at. She overstepped her bounds and our medical director passed it along to the state who in turn passed it along to her medical school. She was working waiting tables trying to pay off the $100K+ debt she'd accrued the last time I ran into her. The reminds me of another good point for premeds, major in something useful as an undergrad in case you don't get into medical school. That degree in peace studies might sound like a great way to keep your GPA up but it isn't going to pay the bills if you don't get into medical school.

I wouldn't necessarilly sell the basic science courses short and a lot of premeds take anatomy and physiology even though it's not required.

As someone who has been through all of them while working on his degree (by the way, I'm aiming for graduate school, not medical school), I think they are generally less than helpful in EMS. Most of them are pitched at such a slow and low level that you really don't learn that much that is clinically applicable. There is a reason why medical school admissions officers (including a few friends of mine) regularly have to remind premeds that taking undergrad A+P or biochem is not going to make medical school any "easier" by providing prior knowledge.

They will however, be able to write an exceedingly long history and physical and than ask the paramedic (attending) what to do next.

that exceedingly long history and physical (provided that it is done rapidly) may detect something that needs rapid transport or a paramedic that a regular basic wouldn't catch.

Chances are it won't though because most med students miss a lot of the subtle things you are implying that they are more likely to pick up on. Experience is what allows people to do what you're describing and medical students generally are seriously lacking in that department.

When we run medic-basic, the basic is usually the one that intubates

When the heck did that become a BLS skill in Missouri?

Anyways, all I am saying is that a premed or medical student should not think they can challenge a paramedic partner.

It depends. I always welcome someone who can give a different perspective. They might see something I don't and I'm a huge believer in CRM (crew resource management). However, that does not mean to imply that I will do what they say simply because they speak up. Usually the ones who are simply speaking up to stoke their own egos- the ones who may known something but not well enough to apply it clinically- are silenced pretty quickly as it becomes rapidly apparent that they have their heads up a certain orifice that you don't need an anatomy class to identify or name.

 

[JPINFV]

As someone who has been through all of them while working on his degree (by the way, I'm aiming for graduate school, not medical school), I think they are generally less than helpful in EMS. Most of them are pitched at such a slow and low level that you really don't learn that much that is clinically applicable. There is a reason why medical school admissions officers (including a few friends of mine) regularly have to remind premeds that taking undergrad A+P or biochem is not going to make medical school any "easier" by providing prior knowledge.

As someone who has been through both undergrad level and medical school level (via special masters program) anatomy and physiology, yes, undergrad A&P does not compare to medical school level A&P. We aren't talking about using undergrad to make medical school easier though in this thread. We're talking about applying undergrad courses to the practice of prehospital medicine. Are you seriously going to say that prehospital providers don't need an A&P course, or just that the 5 day AMR (NCTI) A&P for paramedics is a better course?

Sure, college education isn't all that important if you're just going to transport all of the patients to the closest receiving hospital and follow a cook book. On the other hand actually knowing what an electrolyte is and why they're important (something not generally covered in EMT-B class) kinda of makes those "abnormal lab" calls from SNFs a lot more interesting.

Now it could be that the upper level anatomy, physiology, and neurobiology courses (clarification: all three are separate courses) are taught slightly differently than the community college lower division courses.

Chances are it won't though because most med students miss a lot of the subtle things you are implying that they are more likely to pick up on. Experience is what allows people to do what you're describing and medical students generally are seriously lacking in that department.

How about we try comparing apples to apples here? Let's compare a basic with a college education does versus a basic with just EMT-B training on a critical patient that isn't screaming "I'm circling the drain." I'd bet that the basic with the college education is going to catch more than the basic without a college education. Otherwise it's like saying that paramedics don't need an education because they're going to miss things a med students going to miss. Apples to apples, not apples to peaches.

 

[daedalus]

I like to think that when I speak about paramedics, I am talking about paramedics that opted to take the college level A&P and took their education seriously, paramedics who do not think like technicians but rather practitioners, not mill medics with a 5 day A&P. An EMT is a lot different from a paramedic like the one I described.

So, an EMT with no college education may not appreciate the role of electrolytes in the body, and may find the fact they need to wake up at 2 AM to bring the abnormal lab patient from the SNF to the ER as a bullpoop call. Your absolutely right JP.

However, do I apply basic chem or bio in my prehospital care? No, with a notable exception of the kreb cycle and cellular metabolism. I like to keep these things in mind when I am looking at capnograpghy, since the CO2 I am measuring is a direct result of cellular metabolism.

JP, did you complete one of those special masters programs for waitlisted med school applicants? I have been looking into those. How much of the first year med school stuff did you get to sit through?

 

[JPINFV]

JP, did you complete one of those special masters programs for waitlisted med school applicants? I have been looking into those. How much of the first year med school stuff did you get to sit through?

Yep. The program at Tufts (Master of Biomedical Sciences) includes the same (as in same course, same professors, same exams) molecular biology, immunology, biochemistry, histology, and physiology courses. Anatomy and nutrition is extremely similar and taught by medical school faculty. Our pathology course was supposedly somewhere between introductory pathophys and the system specific pathology courses.

 

[JPINFV]

However, do I apply basic chem or bio in my prehospital care? No, with a notable exception of the kreb cycle and cellular metabolism. I like to keep these things in mind when I am looking at capnograpghy, since the CO2 I am measuring is a direct result of cellular metabolism.

Chemistry: osmosis, diffusion, concentrations, enzyme dynamics are all important for understanding different organ functions (especially endocrine, neuro, and renal) as well as pharmacology.

Basic bio: cell functions, very general A&P, basic immunology. Yes, being able to memorize and regurgitate families of various animals is completely useless and will generally be quickly purged from memory (and yes, I hated that intro course).


A lot of this isn't going to be some grand epiphany where the light bulb clicks on, and you scream, "By George, I've got it!" Instead it's going to be operating in the background and used to add color to your patient assessments and history.

 

[daedalus]

Chemistry: osmosis, diffusion, concentrations, enzyme dynamics are all important for understanding different organ functions (especially endocrine, neuro, and renal) as well as pharmacology.

Basic bio: cell functions, very general A&P, basic immunology. Yes, being able to memorize and regurgitate families of various animals is completely useless and will generally be quickly purged from memory (and yes, I hated that intro course).


A lot of this isn't going to be some grand epiphany where the light bulb clicks on, and you scream, "By George, I've got it!" Instead it's going to be operating in the background and used to add color to your patient assessments and history.

I stand corrected and guilty as charged. When I was in the pharmacology portion of my program, I did go back through a few chapters in my undergrad inorganic chem book to brush up on colloids, suspensions, solutions, and ionic disassociation.

Remember that I do advocate for a paramedic to take chemistry and biology in college prior to starting paramedic school.

 

[Meursault]

I'm sort-of-maybe going to apply to med school in the future, but I'm in EMS because I like prehospital medicine. I've seen a depressing parade of undergrad students volunteering in EMS just to have something for their app, and they almost universally did not care about the profession, or the patient, or, for that matter, delivering decent medical care.
I don't think that my experience in EMS will be terribly relevant if I ever become a physician, unless I'm in EM.

JP, thanks for the info on the Tufts program. Might have to look into that.

 

[JPINFV]

Here's the website for the MBS program. http://www.tufts.edu/med/education/mbs/