Trial By Fire-- Medical students doing EMT school

[JPINFV]

No need, just send them to DC or Detroit.

On another note, don't GIS "rimshot." It's not pretty.

 

[Aerin-Sol]

Are EMTs licensed or certified?

It would be good if this school required students to become EMT-B certified & work a few shifts *before* attending the school, because as the dean says, it's better than "passive shadowing of doctors." I was avidly pre-med for awhile and read far too many stories of MDs who don't have real patient interactions until they're too far into their education to turn back. It's ridiculous that you can go to medical school without having been exposed to the negative parts of medicine.

But... once you're actually in medical school, it seems quite silly to make MD students do ambulance ridetime instead of hospital clinicals, especially when the dean admits EMTs can only do "limited medical interventions." Make them work as CNAs if you want to force human interaction on them.

Past Physician Declarations of Necessities, what does the -average- EMT know about Medicade and Medicare?

I know a lot about how much Medicare/Medicaid abuse goes on, and I thought that's what the poster was referring to.

 

[SanDiegoEmt7]

Third, how is training someone to be a physician, then limiting what they can do with that knowledge to the level of an EMT supposed to be educational. "Yes, all of those things about reactive oxygen species and the like we taught you in biochem? Yea, ignore that, give a NRB to everyone since that's the standard you're going to be held to as an EMT. Yea, we just taught you about decompressing chests for tension pneumos, but you can't do that either because you can't operate as a physician while on the ambulance." How is that educational again

As a paramedic one can decompress a chest, does this mean that seeing a tension pneumo as an EMT (while in paramedic school) is a wasted experience?

But it is a little backwards to send med students into the field, regardless if they can gain insight/experiences, if thats not what they are going to do in their career.

 

[JPINFV]

Are EMTs licensed or certified?

Regardless of the specific noun used, the way the law works is more towards the definition of a "license." Alternatively, you wouldn't need the card from the government to work as an EMT.

I know a lot about how much Medicare/Medicaid abuse goes on, and I thought that's what the poster was referring to.

However, does it matter? Does a bank teller need to know the ins and outs of check fraud before being hired as a bank teller?

 

[johnrsemt]

He is right; Medics can needle decompress a chest: how many medics out there have done it, or seen it done? How many basics could diagnose it if they had one

 

[jjesusfreak01]

He is right; Medics can needle decompress a chest: how many medics out there have done it, or seen it done? How many basics could diagnose it if they had one

Diminished breath sounds on one side with difficulty breathing and possibly diminished saturation, leading to hypotension, cyanosis, and severe respiratory distress when it moves to tension pneumothorax. Should be suspected in tall thin males and individuals with blunt or penetrating trauma to the thoracic cavity. Do I win a prize?

 

[MrBrown]

Somebody with a 100 hour course is more capable than a Physician?

Well then by all means, let us get rid of all the PRIME and BASICS Doctors and start putting EMTs on the helicopter .... seeing as how they are more capable than the helicopter Doctors

 

[Shishkabob]

Somebody with a 100 hour course is more capable than a Physician?

Well then by all means, let us get rid of all the PRIME and BASICS Doctors and start putting EMTs on the helicopter .... seeing as how they are more capable than the helicopter Doctors

Someone who does something fairly often is less capable than someone who has probably never done something?


How does that logic pan out?

 

[MrBrown]

It pans out that Brown could teach somebody to put together a scoop stretcher or put a hard collar on somebody in five minutes.

Can some 100 hour course person differentiate between appendicitis and a missed septic abortion? Can some person with a 100 hour course differentiate between when it is appropriate and not appropriate to give somebody oxygen or leave them at home? No.

So therefore, some person with a 100 hour course is nowhere near as capable as a physician.

And there is still really no point in putting medical students on an ambulance, why? because more than likely the two walking Galls or 511 catalouge models are going to be standing there going "come on hurry up lets get him on the spine board and race him lights and sirens to the hospital already that Golden Hour is almost up!"

 

[Shishkabob]

Can some 100 hour course person differentiate between appendicitis and a missed septic abortion? Can some person with a 100 hour course differentiate between when it is appropriate and not appropriate to give somebody oxygen or leave them at home? No.

So, you jumped to a conclusion not anywhere based in what was spoken in the article... and that pans out the logic?



The article never stated that an EMT knew more / was better than doctors in medical type things... just that EMTs have some experiences that medical students could benefit from (IE, running a team with minimal help, minimal backup, minimal resources, and minimal equipment, and problem solving from that). The article specifically states that when they write "as any honest doctor who has stopped at an accident scene will tell you"


With the caveat of it being done right...

 

[MrBrown]

If your medical students are that deficient and lacking in teamwork and people skills that they need to be given a 100 hour course and put on an ambulance to try and fix the problem ... then all Brown can say is that your system of medical education is pretty flawed and needs serious work.

Brown is not sure about how the US works but we have a five year undergraduate medical degree, where students are put into community and clinical experience with real live patients and expected to you know, talk and function with others, from the first year of medical education.

But then again, we do not have to pass a "standardised test" which the Americans seem to love ... hmm :unsure:

 

[Shishkabob]

So... they will learn absolutely nothing at all doing 2 years of ambulance rides? Is that what you're stating?

 

[MrBrown]

So... they will learn absolutely nothing at all doing 2 years of ambulance rides? Is that what you're stating?

Medical education has existed for thousands of years long before the formation of the Ambulance Service.

Yet somehow, it has reached a point whereby the students undertaking said medical education are so deficient and lacking in teamwork and interpersonal skills that this problem must be solved by putting medical students on an ambulance. There must not be anything that medicine has collectively learned in the thousands of years it has existed which would enable it to solve whatever problem exists intrinsically so it must only be solved by putting medical students on an ambulance.

Fix whatever problem exists with the system of medical education rather than put them on an ambulance.

If the idea of putting medical students on an ambulance for two years is such a good one, gosh how come nowhere else in the world does it?

Could it be just another poor attempt at symptom based management rather than fixing the underlying problem?

 

[Shishkabob]

So... they can learn absolutely nothing, period, at all, with their time spent on an ambulance...???


Apparently quite a few places disagree with you, beginning with this medical school, along with local hospitals near me that send new nurses to spend time time on ambulances, to other places that have physicians do ride-outs as well.



The only thing they are doing different is certifying them as an EMT... I make you a promise that wont make their IQ or medical reasoning go down or be detrimental to their future as a physician.

 

[MrBrown]

Brown would argue a medical student in community and clinical placements from Year 1 to Year 5 is going to learn a hell of a lot more that is relevant and contemporary to the practice of medicine than spending time on an ambulance.

Yes, medical and nursing students have to do one or two 12 hour shifts with the Ambulance Service here but it's not expected of them to actually do anything; it is simply to gain an appreciation of the role of Ambulance and Ambulance Officers.

Brown got "teamwork" and "interpersonal" skills from being a cook at KFC, so should we send everybody to KFC during their House Surgeon year?

Do your medical students get ANY clinical placements during their first two years?

 

[JPINFV]

So... they will learn absolutely nothing at all doing 2 years of ambulance rides? Is that what you're stating?

How often are they on the ambulance during those 2 years? It's not going to be 3 24s a week plus medical school.

How many of the things taught should be taught during years 3 and 4 when the students actually, you know, start to act like physicians.

 

[MrBrown]

Do you only get clinical placements during year 3 and 4?

 

[JPINFV]

Do you only get clinical placements during year 3 and 4?

It depends on the school. 3rd and 4th year are when we are in the hospital full time, however some schools have limited clinical experiences during 1st and 2nd year and essentially all schools run volunteer health fairs (health screenings, youth sports physicals, etc), have options to volunteer in free or low cost primary care clinics, or do shadowing (which, when it comes to medical students shadowing, is very similar to rotations, just without the continuity).

 

[MrBrown]

It depends on the school. 3rd and 4th year are when we are in the hospital full time, however some schools have limited clinical experiences during 1st and 2nd year and essentially all schools run volunteer health fairs (health screenings, youth sports physicals, etc), have options to volunteer in free or low cost primary care clinics, or do shadowing (which, when it comes to medical students shadowing, is very similar to rotations, just without the continuity).

Wow, this is so different! We get clinical experience in all five years of the MBChB and its not "shadowing" or "volunteer" we are actually expected to apply our knowledge and you know, small steps but it is structured formal clinical exposure and practical based learning to complement the problem based learning done in class.

All of health professional degrees have clinical and practical components from year 1 including Paramedic and Nursing.

Perhaps this explains the aforementioned problem and a change in learning methodology would be better than putting people on an ambulance?

 

[Aerin-Sol]

Wow, this is so different! We get clinical experience in all five years of the MBChB and its not "shadowing" or "volunteer" we are actually expected to apply our knowledge and you know, small steps but it is structured formal clinical exposure and practical based learning to complement the problem based learning done in class.

What JPINV described is the "traditional" model: 2 year of didactic + 2 years of clinicals. There are a variety of new models being developed that are more like what you described. I know Indiana Univrsity has much more clinical integration throughout the program.