To Degree or Not to Degree. That is The Question.

mgr22 said:
I get it: You don't think EMS providers need degrees.
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You obviously don't get it, because I said no such thing; you are are putting words in my mouth, words that are incorrect.

What I said was EMS providers do not need degrees to obtain entry level positions to work on an ambulance (or fire truck) as a field provider. And there is no evidence to say contrary, and because there is no mandate for current providers to obtain degrees, I question how much the degree is really needed. If an EMS provider wants to do more than be an entry level provider, they absolutely should further their education. Because experience + additional education beyond the entry level standard = person likely to be promoted.

If you want to get your PhD for the gratifying experience, go for it. I'm sure it will be very gratifying.

If you want to get your PhD, and all you do is ride around on the ambulance as a paramedic, than you are one super educated provider, but your going to be treated the same as a paramedic who completed a certificate course. Spending the extra money and time in class that you won't get back because the degree isn't required, and the time you were not working.... sure graduating is gratifying, but was it worth it?
 
Me: "I get it: You don't think EMS providers need degrees."

DrParasite: "You obviously don't get it, because I said no such thing; you are are putting words in my mouth, words that are incorrect."

Ok, so you DO think EMS providers need degrees?
 
I've been watching this and thinking. My personal opinion is that the entry requirements into a paramedic program are too low. And to bring them up a paramedic should be an AA degree. We need a real anatomy and physiology series, we need a communications class, an ethics class would not be bad, statistics would be great because ems is getting more and more into research and the basic field provider NEEDS to be able to understand those if they want to be competent providers. Just those classes alone on top of English 101 and 201(or maybe a technical writing class instead of 201), math, psychology, and your token elective or two, and you have an AA degree.

Now to explain myself. My a&p for my paramedic program helped to explain diseases just enough as my classmates did pass and understand the materials. But I felt like it was easy as I had done a full a&p series with lab. Statistics is as explained above. Psychology, we deal with a lot of psych patients so having a basic understanding of psychology and how it works I think would help. A communications class would be good as we do a lot of communicating, reports to nurses, public events, talking to medical dirrctors to modify protocols. Ethics can be good but also know depending on the teachers viewpoint it is very subjective (in my opinion).

I just feel the more education would bring us up as as providers with a better foundation to learn paramedicine, which I believe will improve competency.

I also will note the BSN push is because hospitals get a higher reimbursement rate if they say they have x% of their nursing staff with BSN's. So maybe we could force an increase in education by tying reimbursement from Medicare to having associates degree paramedics.
 
The psychology BS program I was in included a required stats class, a required junior-level research methods class, and a required writing-intensive senior capstone class. If we want paramedics doing research in and advancing our field, we should train them to do it.

My paramedic program requires a full A&P series with lab, a communications course, a psych course, an English class, and a few electives on top of the paramedic core courses. I don't understand how people can claim that paramedics should be allied health professionals but have any less education than that.
 
Eir said:
I don't understand how people can claim that paramedics should be allied health professionals but have any less education than that.
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Because paramedics didn't need it for decades prior, and they did the job pretty damn well? And current paramedics who don't have that education are still allowed to be paramedics?

Unless you're saying every paramedic who doesn't have that education is grossly incompetent, and it was just by dumb luck that their aren't bodies lining up on the sidewalks of people they have killed because they were operating without such a basic fundamental education.....
 
mgr22 said:
Ok, so you DO think EMS providers need degrees?
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That's a simple question, with a complicated answer, primarily because the definition of EMS providers can vary.

Should anyone who wants to be a "community paramedic" has at least an associates in EMS? absolutely. If you are going to be a critical care paramedics, should you have a degree in EMS? absolutely. And if you are going to be an EMS supervisor, you should definitely has an associates degree in EMS, with a bachelors in some type of management.... not just years as a field provider for that agency.

If you are a paramedic on a first responding engine, should you have a degree? well, considering I am against ALS engines on general principle, I would say maybe; while it would make it harder to be a paramedic on an engine (which I think is needed), I ask the same question: what has changed over the past 20 years that makes the existing education no longer sufficient for that particular role? Where is the evidence that it is needed, that it will help created better paramedics, or that it will do anything other than make the degree cost more, while not giving a positive return on investment?

If you are going to be an ambulance paramedic, should a degree be mandatory? no, because the job hasn't changed much in the past 20 years.

How much voodoo have we done in the past, that the smart people said was in the best interests of the patient, and everyone else agreed? backboards, everyone gets a NRB at 15 LPM, giving oxygen to a COPD patient who is having respiratory distress will make them stop breathing, lights and sirens for all calls save lives, because response times matter, giving ACLS drugs down the tube will save a life if you can't get a line, etc. As we switch to evidence based medicine, and are realizing that a lot of the voodoo isn't really help, we want to see evidence before we do something that it is beneficial. Shouldn't we hold our proposed educational minimums to the same standards?

Now, if you want to make the National Registry exams harder, where they have a 60% failure rate, and when reviewing the data, you find that out of the 40% who did pass, 80% were from degree programs, while only 20 % were certificate only, and of the 60% that failed, 80% were from the certificate only, and 20% were from the degree, than I would absolutely say that it's time to get rid of the certificate only programs, because it's obvious that the current non-degree requirements are no longer meeting the new testing standards.

Do I think all paramedics should have at least an associates in EMS? Well, maybe. If the entire industry say that degrees are good, and says that in 6 years, if a paramedic does not have a degree in EMS, their certification is revoked,than I will support it. I think it's wrong for all these experienced paramedics to say that we need to have degrees in EMS for all new paramedics, when they don't have degrees in EMS. It's a combination of do what I say, not what I do, and I already got mine, so I'm good, but all you new guys needs to jump through a bunch of hoops to get yours. If you are going to raise standards, those standards should apply to EVERYONE, not just new people.

Do I think a generic associates should be a valid substitute? absolutely not. Do I think a bachelors degree in an unrelated field should be a valid substitute? absolutely not. Does the EMT need a degree? nah, and they are still EMS providers.
 
Most of the programs I'm familiar with required a full year A&P course, and college level algebra (or tested equivalent). Granted, that was a few decades ago. Amusingly, there was no degree track most places then. Unless as a paramedic you took a 2 year program in EMS management, in which case the NREMT-P was worth 18 whole credits.

What we need more than revamping paramedics to degrees, is revamping colleges and degrees. With the exception of a few technical programs (18D comes to mind), the pre-reqs, actual paramedic program, should be merged into a neat 2 year program. When I was browsing before, two paramedic "associates" degrees were 3 years in length, well in excess of the "equivalent" allied health 2 year associate tracks.

But colleges are in business to sell seats, not to effectively educate. That said, the very best medics I've ever seen or worked with were technical and not degreed ones.

On an irrelevant side note, my Psychology 101 class was taught by a non-PhD person. I loved, loved, loved the biology of psychology portion. I had just completed Neurobiology 401, and had that professor actually accompany me to the hippy tree-hugger's class after she yelled at me for explaining how very very wrong she was on a few parts. Then he explained how wrong she was that lecture. Good times.
 
The degree "thing" is a never-ending conundrum. Nurses and paramedics have this debate all of the time. Since I'm both, here's what I think: For medics, if there was a medic-specific degree (AS, AA) that would lead to a Bachelor's, that would be great. AAS degrees can't be used for a Bachelor's I believe? Other than that, I would say no.
In nursing, BSNs are a minimum entry requirement requirement at a majority of hospitals, my hospital being an exception. They hire new grad RNs with an ASN and no further requirement for a BSN. And if a hospital wants to apply for Magnet status, a minimum of 80% of RNs must have their BSNs.
Having said that, nurses with ASNs can have a career as a floor nurse. But if they ever want to become "more" than a floor nurse, they need that BSN or MSN. To be an nursing school instructor, the majority of schools require an MSN. Which has led to a large percentage of wanna-be nursing students getting denied entry into school due to a lack of instructors. A great Catch-22. I've got my BSN and do not plan to go any further.
There's no right answer.
 
In Canada there is increasing pressure to make the Advanced Care paramedic program require a bachelor's. The ACP schooling already takes three years and there are bachelors programs in place to top up to a degree post diploma (No associate's degrees of any kind in canada). some examples of these...

https://www.mhc.ab.ca/programsandcourses/academic programs/programs of study/paramedic

http://www.upei.ca/programsandcourses/paramedicine

https://www.utsc.utoronto.ca/jtprogs/

I did some of my clinical time in the states, and wish that the degree ( AAS or AS ) was mandatory for new Paramedics. It would go a long way to making the profession more respected. Medicine is very academically driving and we should never shy away from something that would give ourselves more clout.
 
I’m curious..

What is the practice environment for those of you who are vehemently in the “all medics should have degrees” camp?

In my neck of the woods, everyone and their sister is a paramedic, and the majority of the work they do is BLS transport. I am in the “medics in leadership and instructor positions need to be working on degrees, but street medics do not” camp, and that is likely influenced by my practice environment..
 
FiremanMike said:
I’m curious..

What is the practice environment for those of you who are vehemently in the “all medics should have degrees” camp?

In my neck of the woods, everyone and their sister is a paramedic, and the majority of the work they do is BLS transport. I am in the “medics in leadership and instructor positions need to be working on degrees, but street medics do not” camp, and that is likely influenced by my practice environment..
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As you know, many people excitedly get into EMS and are quickly disappointed with the mundane work, relatively low pay, limited career options, and a perceived lack of respect from the rest of the healthcare industry. I think what happens is that then, when they begin to consider what might be done to improve things, they come to think that for some reason all that will change if more education is required.
 
FiremanMike said:
I’m curious..

What is the practice environment for those of you who are vehemently in the “all medics should have degrees” camp?

In my neck of the woods, everyone and their sister is a paramedic, and the majority of the work they do is BLS transport. I am in the “medics in leadership and instructor positions need to be working on degrees, but street medics do not” camp, and that is likely influenced by my practice environment..
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Good post. I think you are stating what is probably the only good reason, for now, where a degree would be necessary-leadership. EMS can't be compared to hospitals because there's no similarity. Everyone in hospitals have degrees for the most part, excluding CNAs, etc. Our physical therapists, occupational therapists, have Master Degrees! Nurses at a minimum have an Associate's. This is due to license requirements, not so with EMTs or medics. This debate will continue on, as we all know. If a degree does become mandatory for medics, it should be an Associate's with progression to a Bachelor's possible.
 
MackTheKnife said:
The degree "thing" is a never-ending conundrum. Nurses and paramedics have this debate all of the time. Since I'm both, here's what I think: For medics, if there was a medic-specific degree (AS, AA) that would lead to a Bachelor's, that would be great. AAS degrees can't be used for a Bachelor's I believe?
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If there is a credit transfer agreement from the college conferring the degree it should not matter. Even if you never got a degree, many institutions will let you transfer at least some credits earned at another institution.
FiremanMike said:
I’m curious..

What is the practice environment for those of you who are vehemently in the “all medics should have degrees” camp?

In my neck of the woods, everyone and their sister is a paramedic, and the majority of the work they do is BLS transport. I am in the “medics in leadership and instructor positions need to be working on degrees, but street medics do not” camp, and that is likely influenced by my practice environment..
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We have far from a paramedic shortage here, but there aren't five paramedics on every call here either. It's common to have two paramedics on a call, rare to see many more. While the paramedics might be present every call, there isn't such a glut that half of them are stuck doing "mundane" things. Usually one will lead the call and the other will provide the skills the EMT-IVs can't. Given the frequency in which an individual leads a call here, I think some adding a degree requirement to get some more exposure to critical thinking would go a long way here.
 
Most of the debates I've seen about degrees for paramedics have focused on EMS-related curricula. I urge those of you considering the pros and cons of higher education to be flexible about your major. I've seen many management openings in EMS that required AS or BS degrees without specifying the field. Also, if you had to leave EMS at some point due to injury, finances, or burnout -- a more common occurrence than you might think -- an EMS-specific degree probably wouldn't give you an edge.

There aren't usually any guarantees of higher net earnings with degrees, but there are possibilities -- good, long-term possibilities. If you have the flexibility to spend lots of discretionary money on either a degree or something else, consider the former.
 
FiremanMike said:
In my neck of the woods, everyone and their sister is a paramedic, and the majority of the work they do is BLS transport.
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It's been a while since I looked at the numbers when I was in NJ, but IIRC, ~80% of the EMS calls handled by my agency were handled by BLS only (ALS was either never dispatched (most common), cancelled by BLS crew on scene prior to arrival (second most common), or triaged to the BLS crew after an ALS assessment (smallest occurrence). ALS was a separate regional entity, with BLS 911 being municipally organized, with no FD role in EMS at all.

Now that I'm in NC, every ambulance in the region has a paramedic on it, and the FD first responders are BLS only (City of Durham FD is ILS, and there are some volunteer departments and one career department that doesn't go on EMS calls at all). My rough guess is 50% of the calls could be handled by BLS only. If you include those calls where only VOMIT is done, that number jumps to 75%.

I've worked in urban areas, suburban, and now quasi rural, all for non-FD based EMS systems. never saw the need for a paramedic degree, and worked with some great providers. But is someone shows actual evidence as to why it is needed to be an entry level provider, I will gladly reevaluate my position.
FiremanMike said:
I am in the “medics in leadership and instructor positions need to be working on degrees, but street medics do not” camp, and that is likely influenced by my practice environment.
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Respectfully disagree. I do think that paramedics should get degrees to progress in their career, however the entry level street medic doesn't need one (hasn't needed one in the past 20 years, and there is no evidence that it is needed currently).

If you just want to be a street medic, on the ambulance, no degree is needed. but if you want to progress at all (special operations, FTO, supervisor, community paramedic, training division, administrative roles, QA, doing anything other than simply being an ambulance rider), you should be mandated to get a degree. or even better, you can get the job with just the cert, with the understanding that the EMS degree must be completed within 4 years (after you have some real-world experience, so you can expand your clinical knowledge).
 
DrParasite said:
It's been a while since I looked at the numbers when I was in NJ, but IIRC, ~80% of the EMS calls handled by my agency were handled by BLS only (ALS was either never dispatched (most common), cancelled by BLS crew on scene prior to arrival (second most common), or triaged to the BLS crew after an ALS assessment (smallest occurrence). ALS was a separate regional entity, with BLS 911 being municipally organized, with no FD role in EMS at all.

Now that I'm in NC, every ambulance in the region has a paramedic on it, and the FD first responders are BLS only (City of Durham FD is ILS, and there are some volunteer departments and one career department that doesn't go on EMS calls at all). My rough guess is 50% of the calls could be handled by BLS only. If you include those calls where only VOMIT is done, that number jumps to 75%.

I've worked in urban areas, suburban, and now quasi rural, all for non-FD based EMS systems. never saw the need for a paramedic degree, and worked with some great providers. But is someone shows actual evidence as to why it is needed to be an entry level provider, I will gladly reevaluate my position.
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I think you make a good point about the general huge overuse of ALS in situations where it is not beneficial (in my personal opinion, due to the pathetic standards of BLS education), but I think that's a separate issue from the degree argument.
 
DrParasite said:
Respectfully disagree. I do think that paramedics should get degrees to progress in their career, however the entry level street medic doesn't need one (hasn't needed one in the past 20 years, and there is no evidence that it is needed currently).
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We actually agree on that point, sorry sometimes I get a bit wordy and my responses can be unclear because of it..
 
ExpatMedic0 said:
Any type of advocacy for paramedics not having at least an AA/AAS cracks me up.... Fire department and old people love the idea though! ;-)
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The same fire departments that require at least an AS/AA to be in any kind of leadership position...
 
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