Why EMS degree could be the standard come 2025

[DrParasite]

NAEMT, IBSC, IAFCCP, and other professional organizations as well as you and I have to lobby for the NREMT to implement an EMS AAS requirement for new and continued certification. It will be much easier to get industry leaders and the single national credentialing body (in a sense) to do something rather than an untold number of employers. That’s the best strategy in my opinion.

until you realize that the IAFF, IAFC, and every other hose handling department and hose supporting union would lobby against it. Also don't forget, the fire service is the largest provider of EMS in the US (at least according to the National EMS Assessment).

Don't get me wrong, I'm not saying it shouldn't happen, and it would be the most efficient way to implement this change for all new hires, however there are a few HUGE hurdles to overcome (namely the fire service and all of their public supporters and lobbyists). it's easier to start locally, where you have more pull, vs starting nationally and fighting those groups that don't want there to be any degree requirements, because it's not a primary responsibility of their organization.

 

[Summit]

In nursing the change came when professional organizations pushed degrees, students sought degrees, enough of the hiring pool had degrees, that ultimately the employers gave preferential clinical placement spots to students in degree programs, and then preferentially hired degreed RNs, and ultimately started requiring degrees with expectations for non-degreed RNs to get degrees. This cycle is repating in the motion towards BSN as entry level, and it is the de facto standard in many markets.

That model may not work for EMS because of the reasons that DrParasite points out: Fire Services are the primary employer of medics and the primary opposition to degrees as a medic standard. The opposition is entirely about model: is EMS public safety vs healthcare?

 

[FiremanMike]

Interesting side note, as I continue workign towards RN/NP, any college class I take that is patient care related is approved by my state as 3 hours per week per credit hour towards continuing education. My 10 week accelerated microbiology class (4 semester hours) counts as 120 hours of continuing ed..

I'm going to try to get 1,000 hours towards this cycle

 

[FiremanMike]

until you realize that the IAFF, IAFC, and every other hose handling department and hose supporting union would lobby against it. Also don't forget, the fire service is the largest provider of EMS in the US (at least according to the National EMS Assessment).

Don't get me wrong, I'm not saying it shouldn't happen, and it would be the most efficient way to implement this change for all new hires, however there are a few HUGE hurdles to overcome (namely the fire service and all of their public supporters and lobbyists). it's easier to start locally, where you have more pull, vs starting nationally and fighting those groups that don't want there to be any degree requirements, because it's not a primary responsibility of their organization.

It comes back to the IAFF a lot.. Serious question - can anyone provide any documented evidence of the IAFF fighting education requirements? I'm not saying they aren't, but I haven't seen it around here.. Heck, in this area, there are several departments that require degrees in order to promote, there are also departments across the nation that require college credit to even apply. I don't think this would be a thing if the IAFF were so aggressively anti-education as it is portrayed here..

In my state, it is historically the volunteer fire chiefs who fight education changes "this is going to cost me a fortune" or "I'll lose all my manpower", as opposed to the IAFF..

 

[Lo2w]

It comes back to the IAFF a lot.. Serious question - can anyone provide any documented evidence of the IAFF fighting education requirements? I'm not saying they aren't, but I haven't seen it around here.. Heck, in this area, there are several departments that require degrees in order to promote, there are also departments across the nation that require college credit to even apply. I don't think this would be a thing if the IAFF were so aggressively anti-education as it is portrayed here..

In my state, it is historically the volunteer fire chiefs who fight education changes "this is going to cost me a fortune" or "I'll lose all my manpower", as opposed to the IAFF..

IAFC, IAFF, NFPA, NVFC oppose required degrees for medics

In a joint statement, four national organizations state the reasons they oppose requiring college degrees for entry-level paramedics

www.firerescue1.com

 

[PotatoMedic]

Their recent position papers I think are the clearest example of them fighting degrees for people in EMS. I find the hypocrisy funny when they're actively promoting degrees in firefighting. But degrees in fire science panders to their base so it makes sense.

 

[Summit]

Their recent position papers I think are the clearest example of them fighting degrees for people in EMS. I find the hypocrisy funny when they're actively promoting degrees in firefighting. But degrees in fire science panders to their base so it makes sense.

I think it is because many/most of them think of EMS as something they took over as a secondary purpose and as a financial stream. Fire first, EMS second. Pushing EMS degrees takes away from the Fire first focus.

 

[SandpitMedic]

Well. It will be an uphill battle. However, the EMS organizations and specifically the NREMT are not beholden to the fire unions.

To a question posed asking why the NREMT should do it... Virtually every state requires NREMT registration and “certification” for state certification (at least initially). It is the only metric utilized to demonstrate proficiency in paramedic competencies and skills in the majority of markets.

The fire unions can be vehemently against it all they want. If they can sway their state legislators to do away with NREMT requirements for certs and rebuild a new system and metric... more power to them. But it’s going to cost them.

 

[mgr22]

To a question posed asking why the NREMT should do it... Virtually every state requires NREMT registration and “certification” for state certification (at least initially). It is the only metric utilized to demonstrate proficiency in paramedic competencies and skills in the majority of markets.

It's true national registry is required for initial certification in most states. I wonder how that would change if a degree were added to the prerequisites. I think there'd have to be some sort of waiver process to prevent a dramatic reduction in the labor pool.

I really hope you're right and I'm wrong about this whole degree thing, but there are so many special interests, and EMS seems very far from a consensus. For now, I think soft-selling the value of knowledge is a better use of resources than forcing people to get more education.

 

[Carlos Danger]

When I was in the corporate world, I don't remember degrees being required by anyone except employers. There was no national deadline for, say, managers or planners or marketers to have degrees. And most technical fields didn't have organizations mandating degrees for their members.

Employers set standards based on supply and demand. For example, when there were enough degreed engineers to ensure every engineer-like position could be filled by college graduates, employers made it so. It was up to prospective employees to satisfy prospective employers' prerequisites.

I don't think EMS will be any different. Right now there are more paramedic jobs than degreed paramedics (I assume), so degrees aren't required by most agencies. Perhaps that will change someday. Meanwhile, it's up to individuals to judge the value of higher education without guarantees of placement or payback.

Good point, and I would always rather see required education levels be dictated by the market rather than bureaucratic fiat.

However, in engineering and most other corporate world professions that I can think of off the top of my head, no sort of licensure is required, leaving required qualifications to be determined solely by the employer.

Healthcare is very different in that we need permission from our governmental overlords to practice our profession, and one of the requirements to even apply for that permission (license) is typically completion of an educational program that the educational industry (and other interested groups) has convinced the state government is necessary in order to keep competition at bay ensure competence.

It may be surprising to many in this discussion to learn that, for all the growth in opportunity and influence that the nursing field has seen over the past decades, most states have only somewhat recently gotten around to requiring degrees of any kind of RN's. Quite a few states still don't require a degree to apply for RN licensure, and many that do, haven't for very long.

The best way to advance education in EMS is just to walk the walk. Earn a related degree - preferably an EMS specific one. Encourage others to do the same. Encourage employers to incentivize higher education. And stay involved in EMS. It took nursing a long time to reach a point where a degree was the standard, and it will take EMS a long time. It may take EMS even longer, and EMS may never look just like nursing in terms of the educational model. Paramedicine in the US might never look like it does in Australia.

I also think we oversell the importance and benefit of college degrees. Initial education for paramedics definitely needs improvement, and I think an associates degree program as the entry-level course makes sense. But if every paramedic in the US earned a degree next year, not much would change. Pay would not skyrocket. Scope of practice wouldn't change. New roles would not instantly be invented. And the proverbial "seat at the table" is largely a myth.

If every paramedic earned a degree next year, not a lot would change immediately, but it would be good for the profession in many ways. More importantly, it would be good for the individuals in the profession.

 

[FiremanMike]

I also think we oversell the importance and benefit of college degrees. Initial education for paramedics definitely needs improvement, and I think an associates degree program as the entry-level course makes sense. But if every paramedic in the US earned a degree next year, not much would change. Pay would not skyrocket. Scope of practice wouldn't change. New roles would not instantly be invented. And the proverbial "seat at the table" is largely a myth.

I do believe that A&P is a pre-req to get into medic school now (it wasn't when I went). At this point, with the paramedic class being longer than it was when I went, you almost have an AAS just between EMT-B, A&P, and the paramedic class alone..

 

[FiremanMike]

IAFC, IAFF, NFPA, NVFC oppose required degrees for medics

In a joint statement, four national organizations state the reasons they oppose requiring college degrees for entry-level paramedics

www.firerescue1.com

I wasn't aware that occurred, thanks for posting it.

With that said, is what they concluded really any different than what folks have been saying in this thread?

 

[FiremanMike]

Anecdotally - most of the departments in my area offer pretty liberal tuition reimbursement. Speaking personally, my chief has been pretty flexible about my college schedule..

 

[DrParasite]

It comes back to the IAFF a lot.. Serious question - can anyone provide any documented evidence of the IAFF fighting education requirements? I'm not saying they aren't, but I haven't seen it around here.. Heck, in this area, there are several departments that require degrees in order to promote, there are also departments across the nation that require college credit to even apply. I don't think this would be a thing if the IAFF were so aggressively anti-education as it is portrayed here..

the IAFF and most FDs are finally coming around to the idea that their leaders should have degrees..... for decades it's just been time on the department and OJT... you can't deny that...

However, the topic that you are describing is the mandate of a degree to get promoted, not to get hired as an entry level position. those are two different times in a person's career, with the only thing they have in common is a degree is required. The fire service as a whole is (finally) recognizing that their leaders needs bachelors degrees and masters in PA or BA to run a large organization, but there are still plenty that are only asking for experience and a HS diploma. But if you need to be a paramedic, they are fighting that push to mandate associates degrees, because it 1) they are fire departments, and paramedicine is just an ancillary service that they provide and 2) many in the fire service (not you specifically) would give up EMS and their paramedic certs tomorrow if they could, because they have no desire to do EMS for the rest of their career.

In my state, it is historically the volunteer fire chiefs who fight education changes "this is going to cost me a fortune" or "I'll lose all my manpower", as opposed to the IAFF.

that's a different topic altogether, although I will say that often fight those changes because the education before forced on them isn't always entry level stuff. But if they can't handle the new requirements, thank them for their service, have them enjoy their retirement, and bring in someone who will do it.

and if the fire service doesn't want to mandate degrees for paramedics, than it's time to thank them for their service, create a new government funded agency that is ready to walk the walk (and reallocate the funding to the new EMS department to handle EMS from the department that used to do EMS), and raise standards to a level that the public deserves.

I do believe that A&P is a pre-req to get into medic school now (it wasn't when I went).

it is, sort of. all medic programs require some form of A&P. All too often this is A&P for EMS, possibly held online, not a full 8 credit college level anatomy and physiology, with lab, where students are educated and evaluated by non-EMS instructors.

At this point, with the paramedic class being longer than it was when I went, you almost have an AAS just between EMT-B, A&P, and the paramedic class alone..

not even close. As associates degree is 60 credit hours. EMT class is 8 credits (2 days a week, for a semester, from 6pm to 10pm). A&P is 8 credits (4 for part 1, 4 for part 2, including lab). Assuming paramedic is two 4 hour days a week for 12 months, that is 24.... add another 6 for clinical time, and you are are at 46 credits... still 14 short of an associates degree, almost 25% short for a full degree (and most paramedic programs don't require college level A&P with lab).

 

[SandpitMedic]

Good ideas coming out. Many who want the same thing with different paths to get there.

 

[SandpitMedic]

An associates degree is 60 credit hours. EMT class is 8 credits...A&P is 8 credits .... plus paramedic.....still 14 short of an associates degree, almost 25% short for a full degree.

I snipped the quote for brevity, and while different colleges have slightly different degree requirements- this math adds up.
When I went back for my degree I had to get exactly 15 credits, which is five 3 credit courses of general ed. (English/math/IT/biology/psychology).

It wasn’t hard. Anyone can do it, it’s just a matter of actually doing it. You just have to find a school that will give you credit for your EMT/paramedic certs and schooling. I did it in 2016 and it cost me around ~$1200.

To the argument that it thins the labor pool- that is one of the desired effects I’d like to see.

 

[VentMonkey]

To the argument that it thins the labor pool- that is one of the desired effects I’d like to see.

I read this as more of a point than an argument.

When I went back for my degree I had to get exactly 15 credits, which is five 3 credit courses of general ed. (English/math/IT/biology/psychology).

It wasn’t hard. Anyone can do it, it’s just a matter of actually doing it. You just have to find a school what will give you credit for your paramedic certs.

You’re right, it really isn’t. I have no rebuttal here.

Also, one click of the mouse and you can find a handful of online degrees both associates and bachelors that allow licensed paramedics to utilize their card as a good amount of credit hours that counts towards the degree.

 

[SandpitMedic]

I read this as more of a point than an argument.


You’re right, it really isn’t. I have no rebuttal here.

Also, one click of the mouse and you can find a handful of online degrees both associates and bachelors that allow licensed paramedics to utilize their card as a good amount of credit hours that counts towards the degree.

Exactly. They’re out there. Get it now while it’s cheap.

To the thinning the herd thing- I meant it was brought up as though it is a problem for FDs to get on board with entry level degree requirements. I concur, but it is a manufactured problem. We all know we don’t need 6 paramedics showing up on scene.

 

[FiremanMike]

the IAFF and most FDs are finally coming around to the idea that their leaders should have degrees..... for decades it's just been time on the department and OJT... you can't deny that...

However, the topic that you are describing is the mandate of a degree to get promoted, not to get hired as an entry level position. those are two different times in a person's career, with the only thing they have in common is a degree is required. The fire service as a whole is (finally) recognizing that their leaders needs bachelors degrees and masters in PA or BA to run a large organization, but there are still plenty that are only asking for experience and a HS diploma. But if you need to be a paramedic, they are fighting that push to mandate associates degrees, because it 1) they are fire departments, and paramedicine is just an ancillary service that they provide and 2) many in the fire service (not you specifically) would give up EMS and their paramedic certs tomorrow if they could, because they have no desire to do EMS for the rest of their career.

Yeah, I don't really have much of an argument with this..

it is, sort of. all medic programs require some form of A&P. All too often this is A&P for EMS, possibly held online, not a full 8 credit college level anatomy and physiology, with lab, where students are educated and evaluated by non-EMS instructors.not even close. As associates degree is 60 credit hours. EMT class is 8 credits (2 days a week, for a semester, from 6pm to 10pm). A&P is 8 credits (4 for part 1, 4 for part 2, including lab). Assuming paramedic is two 4 hour days a week for 12 months, that is 24.... add another 6 for clinical time, and you are are at 46 credits... still 14 short of an associates degree, almost 25% short for a full degree (and most paramedic programs don't require college level A&P with lab).

I mean, 14 credits is 3-4 classes. 1 semester full time or 2 part time..

 

[DrParasite]

It wasn’t hard. Anyone can do it, it’s just a matter of actually doing it. You just have to find a school that will give you credit for your EMT/paramedic certs and schooling. I did it in 2016 and it cost me around ~$1200.

That's my point exactly. It's not hard to do, unless you don't want to do it. the college level A&P courses are probably the toughest and most time consuming part, but the reality is, if the current providers don't know it, than it's good that they learn it, and if the current providers know it, than it would be a breeze for them.

Just picking on NC, here are the requirements from Carroll CC, with the NRP ones being taken care of by having an NRP cert

Emergency Medical Science (EMS) Bridging – Coastal Carolina Community College

www.coastalcarolina.edu

Paramedic, National Registry Paramedic AAS

www.carrollcc.edu

Emergency Medical Science Bridge Program

The Emergency Medical Science Bridge Program is designed to allow currently certified non-degree paramedics to earn an Associate in Applied Science (A.A.S.) degree in Emergency Medical Science.

www.abtech.edu

It's not ridiculously hard, the schools are working with existing people (and I'm sure some places could even find an online program), but you need to be willing to put forth the effort to get it done. And the other courses are all there to make you a better provider and ensure that you meet the new paramedics standards. So if we are going to require this of the next generation, shouldn't the existing generation also step up and raise the standards, and show the new guys how it should be done?