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

We have to wake up and do whats good for us. What is the worst that can happen - we get better educated and qualified individuals (who know what the lymphatic system is) working on the ground and in the air as prehospital clinicians? No, the worst that can happen is we continue the status quo, and we continue our ubiquitous griping and grabassing while we sit on our phones and computers typing here on EMTlife in our downtime instead of plugging away at some college classes.

Your mileage may vary, as always. (Also, there's nothing wrong with grabassing on EMTlife on occasion)
You keep saying We have to wake up do what's good for us.....
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But the costs are burdened on the next generation, not the current one. We (the existing generation) are telling the new guys they need to get educated, but we don't need to get educated. So which is it? do educational standards need to be raised, because if that's the case, than everyone should need an AAS in EMS, and I would support that 100%, especially if everyone in the industry wanted it (and even if the FD didn't, well, if it gets them out of the ALS first response and that funding gets reallocated to put more paramedics on the ambulance even better), or are we good with just our NRP cert, but those new guys are too dumb and need to get more educated?

The are some much needed benefits to the degree (well, the education obtained during the degree process anyway), but it's naive to say there are no drawbacks, especially to the individual who has a family, or is the breadwinner, and now needs to take off 2 years of their life to go to school, and have 0 income, vs taking a certificate program while working FT, getting a job in EMS as a medic, and continuing to support their family while they completed the EMS bridge program. Also, that degree is great, but experience + degree is even better.

I'll go one step further: how many EMS agencies are pushing for their personnel to obtain EMS degrees? how many are paying for their staff to attend those classes? is every EMS agency reimbursing the cost for all the fees and textbooks at the local CC? How many EMS agencies have hired a person who is an NRP and told them they have 5 years to get their AAS in EMS, and if they don't, they are terminated? So while many individuals are advocating for it, are their agencies actually investing in the push, or just taking advantage of it if it happens?

If we need a degree, why stop at a AAS? why not require a BS? or an MS? heck, we could make it a PhD, so we could really get some EMS research done!!! ok, hyperbole aside, the level of education should correlate to the job. And yes, there should be different educational requirements for ambulance paramedics, ambulance supervisors, flight paramedics, EMS educators, EMS director, FTOs, EMS administrative officers, etc, all of which should have increasing level of educational requirements before you are even considered for the position.

Remember, I am only talking about the requirements for the entry level ambulance position; everything else should require progressively more formal education, and more experience.
 
Every time this topic comes up, as it does several times a year, I have to remind myself we're not talking about whether to get a degree, but whether degrees should be required industry-wide.

How would that happen? We can't even mandate safe lifting or mental health among our members. I don't see degree requirements going beyond the agency level.

That's not to say degrees aren't useful. And there's a big difference between saying lots of good paramedics don't have degrees (true) and there's no good reason for paramedics to have degrees (false). But those are issues for another thread.
 
I skimmed due to time crunch, however I did see raising bar creating a shortage....hmmmm, sounds like old familiar tactic. A shortage would lead to low supply, high demand, which means better wages or negotiating ability for those who did seek the degree. And the only way a service can get paid for ALS calls is if they provide ALS service....now wages are tied into reimbursement. Sweet!

Also, a shortage is ok, because as most of you are aware, many studies have shown fewer medics on scene is more ideal overall.
 
I skimmed due to time crunch, however I did see raising bar creating a shortage....hmmmm, sounds like old familiar tactic. A shortage would lead to low supply, high demand, which means better wages or negotiating ability for those who did seek the degree.
only if 1) a degree was a requirements to hold a paramedic certificate and 2) if you look at the thread to see who is fully staffed, you will find there is already a shortage in many areas, yet wages haven't gone up.... but yes, that is the theory about how supply and demand works... My suspicious is with all the OT lovers and people willing to work 60 and 80 hour weeks on a regular basis, as well as work for multiple services, we are out own worst enemy when it comes to that
And the only way a service can get paid for ALS calls is if they provide ALS service....now wages are tied into reimbursement. Sweet!
If the only way you can paid for ALS services is having a provider with a paramedic degree treat the patient, I would agree with you. But that isn't what is being proposed by various parties.
Also, a shortage is ok, because as most of you are aware, many studies have shown fewer medics on scene is more ideal overall.
So do we have too many paramedics, or not enough? Can't have it both ways.....
 
You wrote a lot, so I will hit what I thought were the high notes.

I wasn’t comparing wages, I was comparing educational mandates and the progression of the most similar professions in medicine. AKA the RT, RN, PA, NP, and physicians. Educational foundations and building blocks that progress onto each other, you know the old adage - Rome wasn’t built in a day. The RNs are phasing out the ADN and transitioning to all BSN while giving current ADNs time to get their BSN. The PAs are transitioning to MS but still allow practice for anyone grandfathered in at a lower degree level, including certificate holders, AS, BS - With no plans to force any existing provider to get an MS, while all incoming will be forced to complete an MS program.

Two different routes but generally the same result. The argument is made that having a degree vs a certificate does not make a good provider better or a MS provider better than a BS provider better, yet whether we like it or not that is how medical education is trending.

I’m not advocating basket weaving BS. In my experience, formal education is not a requirement for any level of paramedic, and generally speaking time in service is the only parameter utilized for a majority of EMS supervisors, FTO’s, educators, and CCT/FP-C (although additional specific technical training is required for CCT/FP-C),

I’m advocating an AAS in EMS from an accredited community college (which obviously includes the DOT paramedic curriculum/internship) being THE BASE requirement for a NREMT Paramedic card.

Yes, it starts for entry level medics, the new guys, where current NREMT P card holders are grandfathered in. Obviously there will be a timeline for them to get their AAS as well. Judging by how long EMS takes to do anything I’d say it would probably take within 2-4 cycles before being mandatory for all those recertifying has to have it. (That’s off the cuff, I’d like to see 2 at most but that’s just me; four years seems like plenty of time to get that done IMO).

Rome wasn’t built in a day. This initiative will take time.

There are so many things I’d like to say, but these posts are just getting too long.

BUT. One more thing... AKFlightmedic hit the nail that is supply and demand. The wages WILL increase. And volunteer PM should not be a thing, but I digress.
AND- stop comparing us to social workers. That’s not even the same playing field. Might as well argue that a lot of teachers have MS degrees and make crap wages. I’m not arguing wages with my comparison to RN, RT, PA, etc. I’m arguing educational requirements and foundation for CLINICAL medical providers and professionals.

Edit: damn, okay one more thing. Re: cost.
The cost of an AS/AAS paramedic program is often several thousand dollars less than a private paramedic program. At least on the western half of the US.
 
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no research at all? what about https://www.emsworld.com/article/10323777/prehospital-use-cpap which is from 2005, or Kosowsky J, Stephanides S, et al. Prehospital use of continuous positive airway pressure (CPAP) for presumed pulmonary edema: A preliminary case series. Prehosp Emerg Care 5:190–196, which was published in 2001? Looks like there is plenty of research, if you chose to look for it.your entitled to your opinion, just as I am to mine.

...
I stand corrected. You are correct I did not look for the research as, at that time, all I went off was the memo released by KCM1.
 
You wrote a lot, so I will hit what I thought were the high notes.
I know... I try to be thorough and complete
Yes, it starts for entry level medics, the new guys, where current NREMT P card holders are grandfathered in. Obviously there will be a timeline for them to get their AAS as well. Judging by how long EMS takes to do anything I’d say it would probably take within 2-4 cycles before being mandatory for all those recertifying has to have it. (That’s off the cuff, I’d like to see 2 at most but that’s just me; four years seems like plenty of time to get that done IMO).
You just did what I call "assuming facts not in evidence." I have seen 0 calls for any timeline mandating that existing providers get AAS in EMS. you say it's obvious; you're making an assumption, one that makes logical sense to me, but I could just as easily see the old guard fighting it. But including that AAS in a 2 cycle period would go a long way to showing that the entire industry supports this change, and is willing to put forth the effort to raise the bar, vs simply forcing this on the next generation.
BUT. One more thing... AKFlightmedic hit the nail that is supply and demand. The wages WILL increase. And volunteer PM should not be a thing, but I digress.
volunteer PM aside, considering we are currently in a paramedic shortage, with everyone having open spots, have wages risen yet? in theory that should happen, but there are still plenty of agencies who are paying crappy wages.
AND- stop comparing us to social workers. That’s not even the same playing field. Might as well argue that a lot of teachers have MS degrees and make crap wages. I’m not arguing wages with my comparison to RN, RT, PA, etc. I’m arguing educational requirements and foundation for CLINICAL medical providers and professionals.
Well, teachers are not hospital employees, but you missed what I was trying to say: with increased education doesn't always correlate to higher wages. even restricting to clinical medical providers and professionals, you can probably make that argument for in hospital providers; do you think private company paramedics will do the same? what about fire based, where 80% of their budget goes to the suppression side? When the pool of available money doesn't increase, where will the funding come from?

QUOTE="SandpitMedic, post: 679225, member: 20958"]The cost of an AS/AAS paramedic program is often several thousand dollars less than a private paramedic program. At least on the western half of the US[/QUOTE]Seriously? can you provide some examples?

The reason I ask is around me, most of the paramedic programs are ran by the CC system, through their paramedic program through their continuing education department. Privates don't exist (except for when an agency runs their own paramedic class). And from my conversations with some directors, they tell me moving from the con ed side to the cirruculum side makes the college more money because they charge more.
 
They don’t have private medic schools where you are? That’s fantastic. Throughout the west there are numerous private EMS educators. I would like to see private EMS education for PM go away and see the paramedic level only offered at the CC level. (To be overly optimistic, I’d like to see private EMS ALS services go away too nationwide and be replaced by govt or hospital based services, but that’ll never happen).

We must remember that if we view this from a self centered perspective we won’t understand each other. Things are different in different parts of the country. By pushing for an EMS AAS degree as the basic entry level requirement, you are pushing for the domino effect that will be better for the entire industry. If it was NREMT mandated then states would have to comply or rewrite their legislation to drop the NREMT. They most likely won’t drop it (didn’t drop the nursing, PA, RT, and medical boards) which means it would have an effect on most states and therefore more of the industry. Yes, it is an assumption because none of us have a crystal ball.

I did a little research and found there are only a handful of states that do not recognize the NREMT-P (now NR-P) level. Somewhere on the order of 3-5 states as the data is inconsistent in a few states. That means somewhere on the order of 90-94% of EMS has some NREMT-P requirement for initial paramedic certification. Already in Oregon, if you became a paramedic after 1999, an AAS degree is required for certification. Texas also has an AAS degree requirement of some sort for paramedic licensure.

All of the benefits have been opined and espoused too many times to repeat.

With the current shortage I have seen some pretty hefty bonuses offered in the private world upwards of $10,000... again maybe different in your neck of the woods.
 
Usually at the college level it is a credit based system in which you pay per credit.

I’ll tell you my timeline and costs.

In 2008 I went to a community college (CC) and took my EMT Basic course for about $300.

In 2012 I was searching for a paramedic school and the private school (NCTI) was charging $10,000 just for the didactic year(not including an internship/books/additional fees) and $13000 all told in Riverside, CA. I did some shopping for a one year medic cert course. In Las Vegas the same NCTI school (under a different name at the time) was only $6000 all inclusive of books, equipment and internship, and thus I moved to Las Vegas. However, if I would have done the 2 year Paramedic AAS option it would have only been about $3000 at the time. (Side note, I only paid $3000 up front anyway for my PM school, and halfway through I got hired by an agency that covered the rest and gave me a paid internship in exchange for a 2 year contract- lucky).

In today’s numbers with tuition costs soaring, the most recent NCTI folks in Vegas are either sponsored by AMR or they can pay the $13000 for the paramedic course. Meanwhile at the CC, you can get an AAS in Paramedicine for about $7000.

That’s roughly half the price for a degree program. Also, at the CC level you can use GI bills, get financing/FAFSA, or get a sponsoring agency to pay for you. With a private school they are harder to finance and most don’t qualify for the GI bill to cover costs of tuition.
 
I took my EMT-B while on active duty in the Army and when I got out, I used my GI bill to pay for my initial paramedic program (a 10 month certificate) that I finished in 1997, and I've been involved in pretty much this same discussion almost constantly since then.

In the interim, I earned a AS-science with the intention of going to school to become a PA (which I never did), an AAS-EMS in 2000, AS-Nursing in 2002, BSN in 2008, and MS-Nurse Anesthesiology in 2015. My first EMS job was in a busy urban 911 service, and I quickly transitioned to working FT in HEMS and part-time in various 911, ALS intercept (QRV), and ground CCT roles while also working in level 1 trauma center ED's and high acuity ICU's. I took CCEMTP while it was still a fairly new program (1999, I think?) and was one of the first few dozen CFP's (in 2000?) -now called FP-C) for whatever that matters (this was back in the day when the only study resource was ICU nursing textbooks). I taught large portions of the CCEMTP as adjunct faculty for several years and have been a clinical coordinator and clinical instructor for student nurse anesthesiologists, medical students, residents of various flavors, and paramedics since 2016. I have not practiced in field EMS since 2013, but when I did, I worked with as many excellent clinicians who had little formal education as ones who had bachelors degrees and higher.

None of that is laid out as an attempt to brag, or to position my opinions as more valuable than anyone else's. I mention it all merely to illustrate the background that underlies my thoughts, which are outlined below:

  • Every paramedic should have a strong, working understanding of the basics of A&P and pharmacology, as well as the ability to reason logically and communicate effectively via both the written and spoken word. All this in addition, of course, to mastering the fundamental skills of paramedicine.

  • Paramedics are not mini-ED physicians or intensivists. They are also not PA's or NP's or ICU nurses or anesthesia providers. Too much focus on trying to make them appear as such has been harmful, IMO.

  • "Education for the sake of education / more education is always worth it" is a blatant lie. There are far too many people working for $15/hr and struggling to pay off huge student loan debts for anyone to believe that more education is always worth the cost, either in terms of dollars or the time that it requires. You only live once, and your time and money should be spent conservatively.

  • Supply and demand is always probably the most important factor in determining wages, but it isn't the only thing that matters. In the healthcare industry, there are many things (aside form the value of the work performed by the frontline providers) that influence the payroll budget of any given agency. The fact that a majority of paramedics now have degrees has no bearing on reimbursement, or on the cost of fleet maintenance, for instance. Obtaining a degree doesn't automatically make you more valuable to your employer.

  • There have been several references in this thread to the push for a BSN for nurses. The reality is that there is no increased reimbursement for hospitals that have 80% BSN's. There is also no evidence that a nurse with a BSN provides better clinical care than one with a ASN. People often quote "facts" such as this, but those ideas are promoted primarily by the ANCC, which is effectively a trade origination for nursing educational programs and has no ability to back its claims up with any credible research, or even with any decent reasoning. A BSN can be a useful credential for the nurse that holds it, but there's very little (if any) evidence that education beyond a basic nursing program benefits patients or systems.

  • I think EMS education needs to evolve, but I also agree with @DrParasite that sweeping changes should be based on some sort of solid rationale (not necessarily a large, multi-center, double-blind study). The proposed increases in minimum education are a big, expensive deal.

  • I may have more to say later, but I'm done for now.
 
I took my EMT-B while on active duty in the Army and when I got out, I used my GI bill to pay for my initial paramedic program (a 10 month certificate) that I finished in 1997, and I've been involved in pretty much this same discussion almost constantly since then.

In the interim, I earned a AS-science with the intention of going to school to become a PA (which I never did), an AAS-EMS in 2000, AS-Nursing in 2002, BSN in 2008, and MS-Nurse Anesthesiology in 2015. My first EMS job was in a busy urban 911 service, and I quickly transitioned to working FT in HEMS and part-time in various 911, ALS intercept (QRV), and ground CCT roles while also working in level 1 trauma center ED's and high acuity ICU's. I took CCEMTP while it was still a fairly new program (1999, I think?) and was one of the first few dozen CFP's (in 2000?) -now called FP-C) for whatever that matters (this was back in the day when the only study resource was ICU nursing textbooks). I taught large portions of the CCEMTP as adjunct faculty for several years and have been a clinical coordinator and clinical instructor for student nurse anesthesiologists, medical students, residents of various flavors, and paramedics since 2016. I have not practiced in field EMS since 2013, but when I did, I worked with as many excellent clinicians who had little formal education as ones who had bachelors degrees and higher.

None of that is laid out as an attempt to brag, or to position my opinions as more valuable than anyone else's. I mention it all merely to illustrate the background that underlies my thoughts, which are outlined below:

  • Every paramedic should have a strong, working understanding of the basics of A&P and pharmacology, as well as the ability to reason logically and communicate effectively via both the written and spoken word. All this in addition, of course, to mastering the fundamental skills of paramedicine.

  • Paramedics are not mini-ED physicians or intensivists. They are also not PA's or NP's or ICU nurses or anesthesia providers. Too much focus on trying to make them appear as such has been harmful, IMO.

  • "Education for the sake of education / more education is always worth it" is a blatant lie. There are far too many people working for $15/hr and struggling to pay off huge student loan debts for anyone to believe that more education is always worth the cost, either in terms of dollars or the time that it requires. You only live once, and your time and money should be spent conservatively.

  • Supply and demand is always probably the most important factor in determining wages, but it isn't the only thing that matters. In the healthcare industry, there are many things (aside form the value of the work performed by the frontline providers) that influence the payroll budget of any given agency. The fact that a majority of paramedics now have degrees has no bearing on reimbursement, or on the cost of fleet maintenance, for instance. Obtaining a degree doesn't automatically make you more valuable to your employer.

  • There have been several references in this thread to the push for a BSN for nurses. The reality is that there is no increased reimbursement for hospitals that have 80% BSN's. There is also no evidence that a nurse with a BSN provides better clinical care than one with a ASN. People often quote "facts" such as this, but those ideas are promoted primarily by the ANCC, which is effectively a trade origination for nursing educational programs and has no ability to back its claims up with any credible research, or even with any decent reasoning. A BSN can be a useful credential for the nurse that holds it, but there's very little (if any) evidence that education beyond a basic nursing program benefits patients or systems.

  • I think EMS education needs to evolve, but I also agree with @DrParasite that sweeping changes should be based on some sort of solid rationale (not necessarily a large, multi-center, double-blind study). The proposed increases in minimum education are a big, expensive deal.

  • I may have more to say later, but I'm done for now.
Interesting perspective, although, I’m unclear whether you’re for a degree or not? You seem to lay out both sides of that coin. I presume at the end there, you seemed to ultimately support it with some kind of study first...

I would say that the majority of paramedics nationwide do not hold an AAS in EMS. I would also say that an EMS AAS would not sink someone into a huge debt at a price point of $5k-$10k.

Also, I’ve not seen anyone say that paramedics are equivalent to mini-ER physicians or intensivists. I think the reference was made to illustrate the educational paths the most similar medical professions to EMS have taken as they have grown.

My path is a very, very similar one to yours, however you’ve got some years on me. Likewise, when I take my position on being pro-degree it stems from my own educational and professional experience. As I stated earlier, what’s the worst that can happen from mandating an AAS to be a paramedic? Better educated EMS providers who are better suited for their own future with a degree and some college credits, and better suited to master the skills and understanding of paramedicine.
 
I’m going to bump this up a notch. Wages are not the only reason to mandate degrees and evolve EMS education.

One reason, to be blunt, is if it prevented some people from becoming a paramedic. In my opinion and experience, barriers to entry eliminate some (not all) people who shouldn’t be paramedics in the first place. Whether due to emotional immaturity, lack of common sense, failure to strive, or just being flat out too lazy to accomplish the requirements it will prevent some undesirables to reach such a level.

EMS should not be the catch-all career for those who want to play with lights and sirens or couldn’t pass a civil service exam or background check. You all know the salty lazy muckity mucks I’m talking about, you see them in the ER bay and around the ready room with their feet on the ****ing table. As it stands, anyone can just go to paramedic school and get a P card, and with staff shortages, the private schools just pump them through. They get retests on exams and it practically takes an act of Congress to fail someone on an internship these days. Then they just get recycled. If anything the educational standards are falling.

To be respected as professionals and to evolve as a profession we cannot allow a process like that to continue.
 
  • Every paramedic should have a strong, working understanding of the basics of A&P and pharmacology, as well as the ability to reason logically and communicate effectively via both the written and spoken word. All this in addition, of course, to mastering the fundamental skills of paramedicine. Couldn't agree more! I've seen so many medics break down a 12-lead EKG to a "gnat's a$$" but not have a grasp on A&P, and pharmacology.
  • There have been several references in this thread to the push for a BSN for nurses. The reality is that there is no increased reimbursement for hospitals that have 80% BSN's. There is also no evidence that a nurse with a BSN provides better clinical care than one with a ASN. People often quote "facts" such as this, but those ideas are promoted primarily by the ANCC, which is effectively a trade origination for nursing educational programs and has no ability to back its claims up with any credible research, or even with any decent reasoning. A BSN can be a useful credential for the nurse that holds it, but there's very little (if any) evidence that education beyond a basic nursing program benefits patients or systems. As for 80% BSNs, that speaks to hospitals achieving or maintaining Magnet status. As Remi said, having BSNs doesn't affect reimbursement. Remi is also correct about BSNs do NOT provide better clinical care than ASN/ADN nurses. Some nurse (Aikens) did a study, which is often quoted, stating than patient outcomes were better with BSNs. I read the study and it was specific to a surgical floor with some iffy correlation and no causation. Don't believe everything you read!

  • OTE]
I personally agree with many of the posts that the EMS community needs to get degrees. Since there are so many analogies to the hospital community (RN, RT, PA, etc.), I would say this, get together and work on what degree is needed. This is a hard question and it can be resolved through NAEMT, NREMT, NAEMSP, etc. With all of the b*tching and moaning about various companies, pay, etc., you'd think that people would pull their collective heads out of the sand and stop saying "I don't need a degree to be a good medic". A degree doesn't make a good medic, but a degree gives you position and enhanced credibility in the overall medical profession. Just think about two words: community paramedicine.
 
Interesting perspective, although, I’m unclear whether you’re for a degree or not? You seem to lay out both sides of that coin. I presume at the end there, you seemed to ultimately support it with some kind of study first...

I do support moving to a AAS degree for paramedics, with the program centered around one or two semesters of A&P and a semester of pharmacology, as well as a basic clinical statistics / research course and writing courses. I don't think this is much of a leap, since most paramedic courses are already at least two semesters. There's no reason to do any sort of study first - the ones that the pro-BSN crowd talks about are useless - other than perhaps trying to estimate the economic and related impacts on the whole emergency services field.

While I think this is probably a good idea and I don't really see any downsides either, I also don't think I see any real advantage or necessity for the profession. I guess that's where I diverge from the rest of the "pro degree" caucus; I think it would probably be generally positive, but I just don't see it really having much impact overall on the industry level. So I'm a bit agnostic about it. Partly because I'm a little cynical about the value of higher education in general.

For individuals…..heck yes. Every damn one of us should seriously consider whether earning a degree would have value to us. For anyone who plans on making a career in EMS and possibly eventually move on to something else in healthcare, I'd say it's definitely worth it.

But for the profession as a whole? Again, I think the idea probably has more positives than negatives, but I'm not personally convinced that it really needs to be done.

I feel the same exact way about a BSN requirement for RN's.


One reason, to be blunt, is if it prevented some people from becoming a paramedic. In my opinion and experience, barriers to entry eliminate some (not all) people who shouldn’t be paramedics in the first place. Whether due to emotional immaturity, lack of common sense, failure to strive, or just being flat out too lazy to accomplish the requirements it will prevent some undesirables to reach such a level.

To be respected as professionals and to evolve as a profession we cannot allow a process like that to continue.

I agree. A requirement for a AAS degree almost certainly would weed out some of the less motivated candidates. It also might put some upward pressure on compensation, at least in some areas. And it might help improve the perception that the rest of healthcare industry has of paramedics. But I also think adding two semesters to what is already required might not be enough of a barrier to have too much of an effect in these areas.
 
If I'm correct, an AAS doesn't allow for progression to a BS degree, correct? So, entry-level degree should be an AS.
 
Conversion of the current EMT-P programs to an AS seems like a logical starting point. The added classes are things that would actually be useful (as stated many times before, A&P, pharm, some basic chem, math, etc).

Municipal service could be the place to really see the increased entry requirements in play. It's easier to change civil service regulations for a more desirable job than convince private companies they need to cut out their pool of applicants. In NY, most of the PD and FD jobs require 60 college credits anyway, which would be perfectly aligned with AS.
 
A lot of replies here from people who USE to work in EMS, got degree's and changed career fields. Nursing and PA school are defiantly the classics. I have lost so many good co-workers and partners over the years, especially to PA school. What I find interesting is many of you still clearly care about EMS or at the very least are still interested in it and staying active on this forum and likely other sources, maybe via literature and networking, or volunteering or even working part-time in EMS. I think this kind of builds on the discussion at hand. You likely left for a reason, whatever that reason was... your new career, which requires a degree, is probably better in terms of pay, working conditions, professionalism, ect ect. I'm coming up on my late 30's, I have a masters degree (completed on campus) from a QA world ranked top 50 university, but here I am, still hanging around in EMS qualifying for low-income assistance with housing and working full-time. I don't think it should have to be this way and in my personal opinion, one of the ways forward for the entire profession is getting our paramedics degrees, treating and not transporting, along with restructuring some of the financial and reimbursement issues with our industry.
 
If I'm correct, an AAS doesn't allow for progression to a BS degree, correct? So, entry-level degree should be an AS.
An associate's degree (AA, AS, AAS, ASN, etc.) is typically about 60 or so credits and takes four semesters (traditionally two years), which is half of what a bachelors degree (BA, BS, BSN) requires, which is 120 or so credits typically taken over 8 semesters and 4 years.

An AA or AS is usually intended for transfer to a bachelor's program. As such, you take all the same major and general education and elective courses that you would take during the first two years of a bachelor's program, so that when you transfer to the 4 year program, you are in pretty much the same place that you would be had you started out in the bachelors program to begin with.

An AAS degree, on the other hand, is usually intended to prepare you for a specific field that doesn't require additional college education. So you take fewer electives and gen eds and more "applied" courses that are intended to prepare you to go right to work in the field you are studying.

Look at two year engineering degrees, for instance. The AS in electrical engineering is a transfer degree where you take all the math and science and humanities and what not that the bachelors degree requires during the first two years, and there's not much you can do with it if you end up not transferring. The AAS in electrical engineering technology requires fewer math and science courses and fewer electives, since you aren't going to transfer into a 4 year program. Instead, you spend that time learning hands-on technical skills so that you can go right to work as an electrical engineering technician as soon as you graduate. Similar degree names, same length of time, very different results.

For paramedicine, the AS degree won't won't work because you have to spend so much time taking the paramedic-specific courses that you simply don't have time to take all the general education courses that a AS would require.

All that said, much of a AAS will still transfer. My AAS-Paramedicine included I think 40 credits in "paramedic theory" and "field practicum", and the rest of the credits were the gen eds. When I started my BSN program, they took all my gen eds and also gave me like 30 elective credits for the paramedic courses. So it wasn't a seamless transfer the way a AS—>BS transfer is intended to be, but I still got a lot of credit for my paramedic education.

There's probably no way to create a two-year degree that includes all the normal paramedic program education and clinical, as well as all the courses that would be required to transfer as a junior into a 4-year program. Just not enough hours in the day.
 
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My AAS in EMS also transferred most of my gen ed and elective credits towards my PA degree, as well as satisfied some of the prerequisites to apply for PA programs.

There’s no downside from my lens.
 
If I'm correct, an AAS doesn't allow for progression to a BS degree, correct? So, entry-level degree should be an AS.
OK, What Remi said was correct, but I can make it even simpler: for every degree you complete, you need to complete it's requirements.

so if you get an AS, AA, ASN, whatever, you need to complete the requirements for THAT degree. Now, if you want to earn your BS, you need to complete the requirements for the BS. Maybe the classes from your associates will qualify; maybe not. So if I get an ASN, or an AAS, AS in Nursing, and decide to get my BS in engineering, some classes from my associates may qualify for my bachelors, but I will still need to complete all the classes for the program that my bachelors will be in.

I'm currently completing my MBA; my adviser was able to take some of my undergrad classes (5xx level classes) and apply them to the MBA program, so I didn't have to retake those classes. But it's all program and degree specific.
 
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