Why EMS degree could be the standard come 2025

Kavsuvb

Forum Lieutenant
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Saw this article and what do ya think. According to the 2009 National Emergency Medical Service Educational Standards, they want to make Paramedic an Associate degree Requirement and those who specialize in Community Paramedic, Flight Medic and Critical care paramedic, get a Bachelor's degree. One quote from the article states " If we do not change, then we can look to another 50 years of low paying careers with little mobility as other healthcare professionals perform the out-of-hospital clinical tasks we are best suited for."
 

Peak

ED/Prehospital Registered Nurse
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Realistically consider what level of skill needs to be on a transfer bus or fire engine, that is going to be the minimum in the US.

For better or worse EMS is to a large degree married to the fire service (and there are some benefits). Those that aren't are mostly for profit companies doing close to the minimum to maximize their returns. True third services are rare.

You also have to consider the cost (fiscal, time investment, and so on) versus benefit for the majority of services, especially in rural and low volume areas. Can you realistically support a minimum of associates or bachelors level training in rural America that sees a few calls a month? Can you even keep up training in these areas? Or do you mutual from a farther out service (or contract and provide nothing) delaying transport and definitive care?

In the ideal world every ambulance would only be called to emergencies and staffed by physicians, nurses, RTs, and paramedics with level one trauma and referral medical experience, but that just isn't reality. Where the compromise ends depends on a lot of factors, but isn't going to be the same across a single state let alone the US.
 

Achilles

Forum Moron
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Won't happen if the fire unions have their say.
FD is hurting enough as it is on members, unless cities are going to pay the extra salary, why get an as in something that's not needed for the job
 

Lo2w

Forum Captain
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FD is hurting enough as it is on members, unless cities are going to pay the extra salary, why get an as in something that's not needed for the job
I'm not disagreeing with staffing issues but the attitude that pre-hospital medical staff don't need any more education or a higher degree of education is ridiculous. As was stated earlier, the makeup and support for EMS varies so widely across the US it's hard to imagine how you could realistically change the standards.
 

Kavsuvb

Forum Lieutenant
101
9
18

Attachments

SandpitMedic

Shock&Awe
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The repeater is back I see.

NRP should require AAS or AS... then states can choose to stick with NREMT standards or be left in 1969. That solves the issue of the low volume/volunteer rural states and areas if that is the greatest concern. My greatest concern is widening the scope of education (and practice by virtue), doing away with “a pulse and a patch,” and advancing the career.

Additionally, such questionable EMS areas have adequate police and fire coverage. They can figure out how to provide EMS to their communities, and citizens can encourage and vote for change if they want ALS staffed access to EMS. For those that do not have such services, people choose to live that lifestyle knowingly.

I think we have many threads on this topic.
 

FiremanMike

EMS Coordinator
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Before we blindly say "education is the answer to everything" I think it's time we redefine what our educational pathways are and what we envision our role in the street to be.

I just checked our local Community College EMS degree program and it's primarily the paramedic certification class plus A&P and a handful of general education classes. Having just finished up gross anatomy (it was not a pre-req for medic school back when I went), I can say that it's overkill for most paramedics. So this leaves us with a block of gen ed classes which offer little to the day to day practice in America. If we're going to get serious about this, we need to develop an EMS curriculum that actually contribute to the day to day practice of paramedics in the area.

Next I think we need to take a hard look at actual expectations of paramedics in this country. Like it or not, in modern EMS most of the calls are non critical in nature and our public expects to be taken to the ER without much debate. This does not require a degree, and I would agree with what you're naturally thinking "it doesn't require a paramedic either" and I'd agree, but for many areas of the country this is yet another major system overhaul.

I'm not opposed to a complete overhaul of the system, going back to a true tiered system, and even adding advanced practice providers into the mix. Don't forget, though, that in this push we'd likely lose a lot of actual paramedic positions across the nation. While paramedics would likely make more, there would be less, and I think you could argue that overall EMS salary average would actually drop.

Finally, to the jab at the IAFF as being the stonewall to EMS. Is it at all possible that it has more to do with a cost/benefit analysis, given the current practice environment, as opposed to just a hatred towards EMS? Departments in my area can't get enough applicants as it is and are regularly exhausting lists without filling all positions. It already takes approximately 2-3 years to complete FF-2, EMT-B, and then Paramedic. Imagine adding 1-2 more years of college level coursework on top of that. So what about hiring somoene and then sending them to school.. Who pays for their classes? Who pays for their time off? I've yet to see a college program that was unit-day friendly (online classes notwithstanding, but online classes aren't for everyone).

TL:DR - this issue is FAR more complicated than just "require more education to advance the profession".
 

mgr22

Forum Deputy Chief
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A college education isn't just about matching students to professions; it's also about giving students broad-based knowledge that may help them in ways not known in advance -- e.g., opportunities for advancement, unanticipated career changes, self-employment, etc. It's difficult to do a cost-benefit analysis of such possibilities when the benefits are so varied and speculative. It's also unrealistic, I think, to expect an industry-wide consensus on this matter.

Each of us gets to decide how to value knowledge. If you don't think it's worth pursuing a degree, you probably shouldn't.
 

Summit

Critical Crazy
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@FiremanMike OH NO! THERE MIGHT BE LESS PARAMEDIC POSITIONS IF WE BOOST EDUCATION!

Yes. You are right. Because you don't need every FF to be a Paramedic.

You are right, you don't need 6+ paramedics going to every non-emergent urban BLS call.

You are right, you can't justify more education when that ridiculousness is the FF response model used to justify the mill levy or whatever the FF funding is.

BUT that is just the way IAFF wants it.
 

FiremanMike

EMS Coordinator
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The decrease in overall paramedic positions was a fraction of my post, but let’s focus only on that teriary point and find a way to turn it into a bash of the FD.
 
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FiremanMike

EMS Coordinator
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Here's an idea, lets turn this thread into a discussion about what education could do to change the overall delivery of EMS in this country..
Lets talk about what a good bachelors program in EMS might look like..
Lets talk about how to implement these changes in a manner that's realistic in terms of affordability and schedule (an issue that would plague private and third service EMS just as much as FD based EMS)
Lets remove the fire-medic chip from our shoulder..
Just this once?
 

SandpitMedic

Shock&Awe
1,852
909
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Having just finished up gross anatomy... I can say that it's overkill for most paramedics. So this leaves us with a block of gen ed classes which offer little to the day to day practice in America.
I could not disagree with these statements more.

Here's an idea, lets turn this thread into a discussion about what education could do to change the overall delivery of EMS in this country..
Lets talk about what a good bachelors program in EMS might look like..
We were talking about that what an EMS degree might look like, and then you said you think it’s all a waste and overkill. So you contradict yourself.
What’s it going to be? Also, an AS or AAS is not a bachelors degree, and if we want to evolve we have to take all those classes that leave us with “little.” That’s how higher education works in America; we have to play the game.
 

FiremanMike

EMS Coordinator
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I could not disagree with these statements more.
I'm open to hearing why?

As I have said before on this forum - I have a bachelors degree with honors, currently working on pre-requisites for NP school. While my schooling has helped me immensely in my administrative and teaching roles, I feel they offer little for the day to day activities of a paramedic. I have stated this repeatedly while also asking repeatedly in these threads for SOMEONE to define how it changes anything about taking care of an ill person at 3am. I'm actually open to hearing why! Converse, my brother, stop trying to poke holes!

You can choose to expound on that, or you can "not disagree with these statements more" without qualifying your position, other than the fact that you disagree.

We were talking about that what an EMS degree might look like, and then you said you think it’s all a waste and overkill. So you contradict yourself.
What’s it going to be? Also, an AS or AAS is not a bachelors degree, and if we want to evolve we have to take all those classes that leave us with “little.” That’s how higher education works in America; we have to play the game.
I'm really scratching my head at why you're being both aggressive in your stance towards me while at the same time you seem to be making an effort to only responding to snippets of my posts. I only contradicted myself because you're either refusing or unable to read and digest my entire post before firing off at the keyboard.

What I said was, EMS degrees in their current iteration don't seem valuable to me (and in fact, I was referencing the Community College AAS program, as mentioned). What I also said is "lets start talking about what a useful EMS degree would look like". Sorry if I skipped a step and went straight to bachelors. If you'd like, we can start with what a higher yield AAS degree would look like and then move on to bachelors?
 

Tigger

Dodges Pucks
Community Leader
6,969
2,048
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I just checked our local Community College EMS degree program and it's primarily the paramedic certification class plus A&P and a handful of general education classes. Having just finished up gross anatomy (it was not a pre-req for medic school back when I went), I can say that it's overkill for most paramedics. So this leaves us with a block of gen ed classes which offer little to the day to day practice in America. If we're going to get serious about this, we need to develop an EMS curriculum that actually contribute to the day to day practice of paramedics in the area.
To me those gen ed credits give students the ability to develop study habits, the ability to do a little research, and think critically. All of these are important to pretty much every profession, the same goes for paramedics. Could you get by without, I suppose? Will you see a difference in street level medicine? Maybe? It seems like many paramedics lack the critical thinking skills to appropriately treat patients without formulaic guidelines. Will a switch away from such a model improve care? I don't think we know, and I don't think we even know how to measure improvement at this point?

And frankly, if we practice medicine and are a (smallish) part of healthcare, should we not have similar education programs to the rest of the industry? Every other degreed provider has gen-ed classes, are we different? I am not going to say that those courses make them better providers as a matter of fact. But if we want a seat at the adult's table, it might be worth looking the part.

As for the A&P part, it would be nice if lower level clinically-oriented anatomy courses existed. I do not wish to get rid of A&P requirements but I agree that the practicality could be improved.
 

Tigger

Dodges Pucks
Community Leader
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I could not disagree with these statements more.


We were talking about that what an EMS degree might look like, and then you said you think it’s all a waste and overkill. So you contradict yourself.
What’s it going to be? Also, an AS or AAS is not a bachelors degree, and if we want to evolve we have to take all those classes that leave us with “little.” That’s how higher education works in America; we have to play the game.
This goes for everyone, I am not specifically picking on you:
Instead of pointing out contradictions and making statements, lets have an actual discussion instead of a debate? Let's try to talk like I dunno, people.
 

FiremanMike

EMS Coordinator
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164
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To me those gen ed credits give students the ability to develop study habits, the ability to do a little research, and think critically. All of these are important to pretty much every profession, the same goes for paramedics. Could you get by without, I suppose? Will you see a difference in street level medicine? Maybe? It seems like many paramedics lack the critical thinking skills to appropriately treat patients without formulaic guidelines. Will a switch away from such a model improve care? I don't think we know, and I don't think we even know how to measure improvement at this point?

And frankly, if we practice medicine and are a (smallish) part of healthcare, should we not have similar education programs to the rest of the industry? Every other degreed provider has gen-ed classes, are we different? I am not going to say that those courses make them better providers as a matter of fact. But if we want a seat at the adult's table, it might be worth looking the part.
Yeah, I suppose I can agree about that benefit of gen-ed classes. My issue is that of the programs like the one at my local community college is pretty much just the core paramedic certification class, a&p, and then a handful of gen-eds (5ish, maybe?). So in that case, I'd argue that the AAS really isn't that beneficial. Maybe if it was intermixed with more courses on actual medical research, public education, something.. I dunno, I just feel it should be more impactful if we're going to move in that direction.

As for the A&P part, it would be nice if lower level clinically-oriented anatomy courses existed. I do not wish to get rid of A&P requirements but I agree that the practicality could be improved.
Lol you ain't kidding. I had a discussion with my contact person with the advanced standing medic to RN (still not committed to this, but it will make NP school cleaner, albeit longer). The college offers both an integrated A&P 1 and 2 course which are designed for healthcare folks, as well as a traditional gross anatomy semester 1, physiology semester 2. I asked my contact person if I could take the integrated class instead, and she didn't even know it was being taught there (relatively small school, mind you). When she looked into it, she got back to me and said "No, the RN program only accepts the traditional gross anatomy, physiology series.."
 

VentMonkey

k’uhul ajaw
Premium Member
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I don’t think having and EMS degree has anything to do with what type of service you work for (fire-based, private, public, aeromedical, etc.). At least, not yet; it’s currently a personal choice.

Mandating will take some time and effort. There was a good podcast discussion on this a month or so ago—the 2025 timeline. IIRC, Dave Olvera spoke on it, as he and his cohorts are all in favor and lobbying for it.

I don’t oppose the mandate. I will say, as a current non-degreed “specialty” paramedic (i.e., flight paramedic), it would certainly pique my interest to have a 2, or 4 year degree aimed at topics and applicable to my specific arena of paramedicine.

I agree that it’s hard to fathom how for the “day-to-day medic” the degree currently makes sense. But I can also see how the basic fundamentals that a degree affords can help many who lack intrinsic critical thinking skills.
 

FiremanMike

EMS Coordinator
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I don’t think having and EMS degree has anything to do with what type of service you work for (fire-based, private, public, aeromedical, etc.). At least, not yet; it’s currently a personal choice.

Mandating will take some time and effort. There was a good podcast discussion on this a month or so ago—the 2025 timeline. IIRC, Dave Olvera spoke on it, as he and his cohorts are all in favor and lobbying for it.
I’d love to hear that podcast! Do you remember where it was?
 

VentMonkey

k’uhul ajaw
Premium Member
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I’d love to hear that podcast! Do you remember where it was?
Most likely in one of the three FBE podcasts. It’s essentially an overview of what’s often discussed here rallying for the mandate.

If I find it, I’ll post it.
 
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