Why EMS degree could be the standard come 2025

[FiremanMike]

I like it. I love it. Great idea for degrees and future opportunities. Hopefully, with this kind of educational requirements though, paramedic would not be a stepping stone to other professions, but rather it’s own viable career entity with increased compensation.

I’m going to go out on a limb and assume the folks going for the 4 year degree aren’t the ones planning on staying on the line forever, so I don’t personally have a huge aversion to setting them up for other professions, but that probably pulls bias from my own situation of not wanting the fire department to be my terminal career...

The scheduling thing is an interesting take. If you are working as an EMT and want to advance to Paramedic, you already have to take time off and not work through a full time program. (At least when I went to P school that was the case, and working full time wasn’t really an option if you wanted to be successful in the program). I’m picking up that you are talking about people going back to school in a sense; however, any degree mandate implemented would likely be for newcomers. Existing paramedics would be grandfathered in as is the case with most changes in educational standards.

Yeah, you’re not wrong on any of that. I’ll again reference my own bias from struggling to complete my bachelors while on company, it took me almost 8 years to get it done (and that was after taking into account the credit for my paramedic and firefighter which I completed 10 years prior to starting back to college).. I would have jumped all over an easier way to accomplish this..

I don’t have strong feelings one way or the other about grandfathering current medics, but it’s probably the right thing to do. With that said, if we move towards more robust paramedic education, there would certainly be experienced guys like me and you and probably most of the people on this thread who would love the opportunity to pursue that, only to be frustrated by the scheduling hassle. I’d love to find a way to accommodate those folks.

 

[RocketMedic]

Nothing changes until financial changes drive change.

 

[Peak]

...It would put medics on the same footing with Associate Degree Nurses.

Keep in mind that in most areas nurses without prior experience are unlikely to get a critical care job (ED/ICU/PICU/NICU...) with only an ASN and not a BSN. In many places new ASN nurses have a hard time finding jobs outside of psych, nursing homes, and home health. There is a lot of regional variability to this, but that's the overall trend.

 

[Tigger]

I don’t have strong feelings one way or the other about grandfathering current medics, but it’s probably the right thing to do. With that said, if we move towards more robust paramedic education, there would certainly be experienced guys like me and you and probably most of the people on this thread who would love the opportunity to pursue that, only to be frustrated by the scheduling hassle. I’d love to find a way to accommodate those folks.

I think that any plan for a degree requirement that doesn't include grandfathering current providers would be met with such outrage that it could never move forward. Incremental steps, right?

 

[SandpitMedic]

I think that any plan for a degree requirement that doesn't include grandfathering current providers would be met with such outrage that it could never move forward. Incremental steps, right?

Agree, definitely would be a non-starter.

 

[Bishop2047]

I think that any plan for a degree requirement that doesn't include grandfathering current providers would be met with such outrage that it could never move forward. Incremental steps, right?

I assume we would follow nurses to some extent. Everyone is still a "Paramedic" but slowly over time those with diplomas/certs die off and are replaced with a new bread. It has been this way since days of old when nurses merely had to have a good heart or be a Nun. Unless there is additions to the scope of practice I don't really see any gap training being required either.

The old guard should welcome these changes as it legitimizes their career more and requires minimal effort.

The big question is what comes first the additional schooling or improved salaries?

 

[SandpitMedic]

I’m going to go out on a limb and assume the folks going for the 4 year degree aren’t the ones planning on staying on the line forever, so I don’t personally have a huge aversion to setting them up for other professions, but that probably pulls bias from my own situation of not wanting the fire department to be my terminal career...



Yeah, you’re not wrong on any of that. I’ll again reference my own bias from struggling to complete my bachelors while on company, it took me almost 8 years to get it done (and that was after taking into account the credit for my paramedic and firefighter which I completed 10 years prior to starting back to college).. I would have jumped all over an easier way to accomplish this..

I don’t have strong feelings one way or the other about grandfathering current medics, but it’s probably the right thing to do. With that said, if we move towards more robust paramedic education, there would certainly be experienced guys like me and you and probably most of the people on this thread who would love the opportunity to pursue that, only to be frustrated by the scheduling hassle. I’d love to find a way to accommodate those folks.

I know what you mean. I did a private medic school and went on to get my EMS associates a couple of years later a couple of classes at a time when I realized that I wanted to keep moving. It ended up helping me get through the FP-C self studying and getting a HEMS gig, and furthermore to where I am now.

As far as staying on the line with higher education... I think I would have. I love being a medic. I love the never knowing what’s coming next. I love emergency medicine. I love the camaraderie. I love being outside in the elements on the scene.

I imagine a world where single role professional paramedics have degrees, and they respond to true emergencies where EMTs and AEMT’s (ILS) tackle all of the “Non emergent” and “urgent” calls. A medical professional incorporated into the healthcare continuum as a true professional and not regarded as an ambulance driver. Single role medics that make what fire service medics make nowadays($80k-$150k depending on time in service and rank) at agencies run by municipalities and county governments with their inherent protections. Retirement, vacation, liability insurance, legal protection, and benefits that rival any other in healthcare or public service. No more street posting, no more IFTs, no more stubbed toes, no more fender benders, no more incarceritis. (It’s going to take a revamping of dispatch protocols as well)(I’m fully aware that sometimes those bogus calls turn into true emergencies, but if ALS is needed it can be summoned)
Maybe in fantasy land... I’d still be a line medic.

 

[Tigger]

Nothing changes until financial changes drive change.

The big question is what comes first the additional schooling or improved salaries?

Currently, we are reimbursed as a transportation benefit. Until we are not that anymore, I doubt any payer will have a reason to change what they pay. To provide a service worth reimbursing for (whatever you envision that might be), collectively we are going to have to have more education. So where does this leave us?

 

[SandpitMedic]

Currently, we are reimbursed as a transportation benefit. Until we are not that anymore, I doubt any payer will have a reason to change what they pay. To provide a service worth reimbursing for (whatever you envision that might be), collectively we are going to have to have more education. So where does this leave us?

While that does have merit, I would say that when companies like Envision, AirMethods, and other private companies are netting hundreds of millions to billions per year—- there is money to go around. But when you are the Walmart of medical transport you pay Walmart wages. If we could become more than Walmart employees we would force the issues of legitimacy and supply&demand.
That leaves us at upping the education first as you alluded to.

 

[Tigger]

While that does have merit, I would say that when companies like Envision, AirMethods, and other private companies are netting hundreds of millions to billions per year—- there is money to go around. But when you are the Walmart of medical transport you pay Walmart wages. If we could become more than Walmart employees we would force the issues of legitimacy and supply&demand.

These are high volume low margin companies. Their revenue might be impressive but their profits are really not for the size. Not to mention that they're owned by investment firm that you know also wants their cut of the profit.

And again, it's a transportation benefit. EMS is not deemed a provider, which means neither AMR or any other service is being paid what their services are actually worth. I can't really expect AMR to pay more when they are trying to turn a profit in an industry that is known for artifcially low reimbursement.

 

[SandpitMedic]

These are high volume low margin companies. Their revenue might be impressive but their profits are really not for the size. Not to mention that they're owned by investment firm that you know also wants their cut of the profit.

And again, it's a transportation benefit. EMS is not deemed a provider, which means neither AMR or any other service is being paid what their services are actually worth. I can't really expect AMR to pay more when they are trying to turn a profit in an industry that is known for artifcially low reimbursement.

I understand there are many dynamics, but they still net an egregious amount in profits for what they are doing, artificially subdued reimbursement or not.

Meanwhile line people make pennies- for various reasons. There is a business dynamic. I’m not a socialist or communist by any means, so I get that a business will only pay what labor is worth in a given market. BUT KKR’s shareholder earning report for Q3 2019 reports that they are worth $208 billion doll hairs. What is the average annual salary of a paramedic? $34,320 in 2018 according to the Bureau of Labor Statistics.
I get that KKR has a diverse business portfolio. In 2017, Envision posted $5B in earnings.

I’m not an economist- My point is that they are making money... that’s why they are in business. In order for us to get more doll hairs we need to make ourselves worth more.

 

[DrParasite]

In the better EMS oriented CA fire depts, degrees are mandatory to promote past Cpt and in some depts to make Cap. It doesn't have to be an EMS or Fire related degree. Higher education is a good thing, and while it may not have a direct effect on your ability to function as a medic, I really feel like it does make you a more well-rounded provider. Funny thing is, a few years ago a dept in NorCal didn't give anyone without minimum a BA a chance at the written test. First time I've ever seen that. not every Fire agency is anti-education, in fact, the better ones are all for it.

Here is the problem.... you're bringing up a point that is pretty irrelevant.

Mike's article (and the majority of this argument) is for the entry level standard; you are discussing a supervisor position, one that the better EMS agencies are also requiring degrees. But I will also say that having a degree with 0 experience doesn't mean you have a leg up to be a supervisor; and having a degree might check the HR/job description box but if the degree is in an unrelated field, or you haven't even tried to advance your education in a relevant area since you started, it's pretty much a waste when it comes to that job description.

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 agree. artificially raising the bar doesn't do much except give more money to the local community colleges.

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.

the current "A&P for paramedics" class is a joke. some offer it online; most paramedics forget everything they learn about a week after they finish the class. A&P 1 and 2 (with lab) is one of those classes that definitely should be a pre or co-requisite for any paramedic program.

I was listening to a podcast about paramedic going to medical school, and one of the comments made was that while a paramedic can do more skills (and are often more proficient in them), they don't know nearly enough of the why the stuff is being done. If we want to stop being thought of as simply skill monkey's, we need to increase our medical education so we can understand why we are doing them. having a better understanding of anatomy and physiology is one of those core building blocks.

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.

I agree. if you are going to mandate the all paramedics needs degrees, then those degrees should have to be in EMS, and the course curriculum should be focused on EMS, with minimal gen ed classes (those should be pre-reqs)

 

[EMDispatch]

I wanted to add some more food for thought, here are 3 degree outlines:

AAS in EMS

Welcome to nginx!

m.ecatalog.chesapeake.edu

BS in Emergency Health Services (paramedic concentration)

Paramedic Coursework

Download PDF: Paramedic Concentration worksheet here. Major Requirements EMT Certification (6 credits) Students without a current, acceptable EMT certification complete the following: EDHS 202 – Emergency Medical Technician I (3) EDHS 203 – Emergency Medical Technician II (3) Emergency and...

ehs.umbc.edu

And a 3 year degree from Canada:

Paramedic Care (formerly Pre-Hospital Emergency Care) (181.A0) - John Abbott College

Students who require a mise à niveau English or French course will be required to pass it before they can take their introductory course. Students will be required to pass... Continue reading

www.johnabbott.qc.ca

For my 2 cents, I appreciate the movement to a degree requirement, but the issue is much bigger.

 

[Bishop2047]

Most degree programs for Paramedics in Canada are post Diploma (We do not have Associates degrees with the term Diploma used for most 2 - 3 year programs). I was not aware of this school at all being that it is in Quebec (where the french folks live) and MAN that is a lot of classes each semester! Check out the schedule below.

Paramedic Care (formerly Pre-Hospital Emergency Care) (181.A0) - John Abbott College

Students who require a mise à niveau English or French course will be required to pass it before they can take their introductory course. Students will be required to pass... Continue reading

www.johnabbott.qc.ca

These are the more traditional style of Paramedic to BHs programs around these parts. The last showing that many of the community colleges have direct partnerships with other universities. I know this happens often in the US as well.

Bachelor of Applied Health in Paramedicine | University of Prince Edward Island

The University of Prince Edward Island offers an amazing and affordable student experience in beautiful Charlottetown, PEI. Our interesting and unique programs bring out your best, lead you to realize new and hidden talents, and be great at what you do. Find your genius at UPEI!

www.upei.ca

Not Found | MHC

www.mhc.ab.ca

Welcome to the University of Toronto Scarborough and Centennial College Joint Programs | Joint Programs

www.utsc.utoronto.ca

 

[Kavsuvb]

I was listening to a podcast about paramedic going to medical school, and one of the comments made was that while a paramedic can do more skills (and are often more proficient in them), they don't know nearly enough of the why the stuff is being done. If we want to stop being thought of as simply skill monkey's, we need to increase our medical education so we can understand why we are doing them. having a better understanding of anatomy and physiology is one of those core building blocks.
I agree. if you are going to mandate the all paramedics needs degrees, then those degrees should have to be in EMS, and the course curriculum should be focused on EMS, with minimal gen ed classes (those should be pre-reqs)

I think, if EMS wants to have a seat at the table with the Adults aka Doctors, Nurses and PA's. Then EMS has to really step up their standards in order to have a seat at the table. Otherwise, we will wind up like CNA's with no future. That would mean phasing out Certificate Paramedic programs and making Paramedic an associate degree requirement. If you want to be a Flight Medic, Critical care Paramedic and Advance practicing Community Paramedic, then it should be mandatory to get a Bachelor's degree. I think the requirements for Paramedic should mirror ADN Nursing school requirements such as A&P 1 & 2, General Chem , Microbiology, Statistics, English Comp Gen Psych, gen Sociology and even Lifespan Development. I also think the Paramedic Degree should Mirror the ADN Program.

 

[SandpitMedic]

I think, if EMS wants to have a seat at the table with the Adults aka Doctors, Nurses and PA's. Then EMS has to really step up their standards in order to have a seat at the table. Otherwise, we will wind up like CNA's with no future. That would mean phasing out Certificate Paramedic programs and making Paramedic an associate degree requirement. If you want to be a Flight Medic, Critical care Paramedic and Advance practicing Community Paramedic, then it should be mandatory to get a Bachelor's degree. I think the requirements for Paramedic should mirror ADN Nursing school requirements such as A&P 1 & 2, General Chem , Microbiology, Statistics, English Comp Gen Psych, gen Sociology and even Lifespan Development. I also think the Paramedic Degree should Mirror the ADN Program.

Say it again.

 

[DrParasite]

I think, if EMS wants to have a seat at the table with the Adults aka Doctors, Nurses and PA's. Then EMS has to really step up their standards in order to have a seat at the table. Otherwise, we will wind up like CNA's with no future.

What is this table you are referring to? I hear this a lot, but I think it's a hypothetical concept that many don't really grasp.

In many hospitals, the only way to get a seat at the "table" is to have MD after your name. Many doctors won't even listen to people who aren't doctors (i know of one attending who actually hung up on a resident from another hospital who was looking to transfer a patient to him). Not saying it's right or wrong, but all the letter after your name still don't equal MD. Nurses have clawed their way to that table (and some doctors still don't consider them peers), and have made themselves critical to the healthcare and hospital environment. But I think that has more to do with making themselves indispensable to hospital operations vs increasing the degree levels.

In some states (rhode island comes to mind), the FD unions have more EMS clout than the doctors, yet many of those FFs only have HS diplomas.

If you think having an associate's degree will suddenly make a doctor or nurse look at your differently, than you are fooling yourself. A Bachelors degree in EMS (which I think all people in specialized medic roles should be required to obtain) won't give you a seat at the table, but it will ensure you have a much deeper understanding of emergency medicine than a simple ambulance driver.

but you still might not get the respect and seat at the table that you are hoping it will bring.

And until we raise the standards for ALL providers and mandate those changes for EVERYONE, we will still be seen as ambulance drivers.

 

[NomadicMedic]

What is this table you are referring to? I hear this a lot, but I think it's a hypothetical concept that many don't really grasp.

In many hospitals, the only way to get a seat at the "table" is to have MD after your name. Many doctors won't even listen to people who aren't doctors (i know of one attending who actually hung up on a resident from another hospital who was looking to transfer a patient to him). Not saying it's right or wrong, but all the letter after your name still don't equal MD. Nurses have clawed their way to that table (and some doctors still don't consider them peers), and have made themselves critical to the healthcare and hospital environment. But I think that has more to do with making themselves indispensable to hospital operations vs increasing the degree levels.

In some states (rhode island comes to mind), the FD unions have more EMS clout than the doctors, yet many of those FFs only have HS diplomas.

If you think having an associate's degree will suddenly make a doctor or nurse look at your differently, than you are fooling yourself. A Bachelors degree in EMS (which I think all people in specialized medic roles should be required to obtain) won't give you a seat at the table, but it will ensure you have a much deeper understanding of emergency medicine than a simple ambulance driver.

but you still might not get the respect and seat at the table that you are hoping it will bring.

And until we raise the standards for ALL providers and mandate those changes for EVERYONE, we will still be seen as ambulance drivers.

It's certainly not hypothetical. There are plenty of jobs that are custom designed for a paramedic that have RN after their name. Including emergency department manager. Emergency services coordinator. EMS outreach and education manager. I can point to a dozen job descriptions on indeed right now for positions that oversee EMS operations and management and require an RN. That should be a degreed paramedic position.

That is the table we need to sit at.

 

[Summit]

RNs were always indispensable to hospital operations.
RNs are not peers to MDs, but we are considered colleagues.
RNs used increased education to increase scope, autonomy, and added more professional roles and professional aspects to previously purely vocational roles (e.g., EBP process improvement executed by bedside nurses).

The culmination was increased respect and clout which resulted in increased pay in order to draw enough supply to meet the demand generated for these more educated healthcare professionals.

Remember, in the hospital, education drives scope and then people are trained in the skill with the educational underpinning. Without education, the more educated executor of the complex or merely risky skill will not entrust delegation, because why should they?

EMS was caught in training-drives-scope without education because nobody else will do it. But EMS has hit the scope wall where anything else they might do is met with "that can be done at the hospital by someone with a degree" rather than let someone with a highschool diploma add more skills.

Follow the nursing model and the paradigm shifts.

 

[FiremanMike]

Education without depth isn't going to cut it. One simply has to look at the nonstop bashing of online NP -> DNP diploma factories to see that.