No such thing as a stupid question? Challenge accepted!

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

rn2busyontinder2startiv

New Member
7+ Year Member
Joined
Sep 7, 2016
Messages
3
Reaction score
0
Ok, so I'm an MA student and a full time employed worker bee. I had an EMS background in another life but things were different back then. I'm strongly considering becoming a PA and moving away from the big city lights and to somewhere there is almost nothing but tumbleweeds. Due to the nature of my current work and lifestyle I unfortunately don't have the time nor the lumbar strength to do hours and hours of research for anything that isn't assigned to me by an instructor or an employer. My question is simple in a sense, however the old "why don't you just google it?" nonsense isn't what I'm looking for. If I was still on casual terms with any EMS docs I would obviously ask. I know the nature of EMS changes frequently especially state to state. I have lived in many states in the last decade so I have no real baseline to judge what maybe typical here or there...Any input thats not mean spirited would be appreciated because I'm genuinely interested in the topic.

Anyhow...What does it take to be a Doc in your local EMS system? What state are you in and must you be an MD or a DO with extra residency/training? Who can do what? Medical Director? Intake/Triage vs surgery? Tell me what it takes to be an EMS Doc where you live. Tell me as a layperson what being an EMS Doc means. I doubt I will ever work in an ER but I was enamored by a British show called Trauma Docs in the states and the state of EMS in the UK was mind-blowing to me. I want to know about our current American systems though. What separates the ER/ED Docs from the rest? What are the main orgs I should look into for more info? Thanks for any info! Cheers to all you ED folks!

Members don't see this ad.
 
It's pretty universal. You have to be what the people there want. You always have to be a physician (I hope to god there aren't NDs and DCs out there being medical directors, but frankly it wouldn't surprise me).
After that, it's just like anything else. The big cities where there's competition usually want you to have done an EMS fellowship, or have worked in EMS for some time back when there wasn't a fellowship. The small towns and volley squads just need the letters after your name and a full unrestricted license.
That's pretty much it.
 
It's pretty universal. You have to be what the people there want. You always have to be a physician (I hope to god there aren't NDs and DCs out there being medical directors, but frankly it wouldn't surprise me).
After that, it's just like anything else. The big cities where there's competition usually want you to have done an EMS fellowship, or have worked in EMS for some time back when there wasn't a fellowship. The small towns and volley squads just need the letters after your name and a full unrestricted license.
That's pretty much it.

Hey, appreciate the answer, I'm a little bummed by the amount of replies without any responses. I wish there were some Docs who could put a straight answer to a simple question. It shouldn't be a mystical topic that must be researched for the everyday man to figure out who they're seeing when they go to the ER. Anybody else have anything helpful...? Thanks ninja. Appreciated.
 
Members don't see this ad :)
Well, in the US at least, being an EMS doc means you are the offline medical director for an agency. You write up the protocols, and they follow your orders and practice under your license. You're not riding on the bus.
In Europe, it means you're on a motorcycle, car, ambulance, or aircraft and actually going on scene. There are very few HEMS units in the US that use physicians, and even those generally are for interfacility transfer instead of scene runs.
 
Ok, so I'm an MA student and a full time employed worker bee. I had an EMS background in another life but things were different back then. I'm strongly considering becoming a PA and moving away from the big city lights and to somewhere there is almost nothing but tumbleweeds. Due to the nature of my current work and lifestyle I unfortunately don't have the time nor the lumbar strength to do hours and hours of research for anything that isn't assigned to me by an instructor or an employer. My question is simple in a sense, however the old "why don't you just google it?" nonsense isn't what I'm looking for. If I was still on casual terms with any EMS docs I would obviously ask. I know the nature of EMS changes frequently especially state to state. I have lived in many states in the last decade so I have no real baseline to judge what maybe typical here or there...Any input thats not mean spirited would be appreciated because I'm genuinely interested in the topic.

Anyhow...What does it take to be a Doc in your local EMS system? What state are you in and must you be an MD or a DO with extra residency/training? Who can do what? Medical Director? Intake/Triage vs surgery? Tell me what it takes to be an EMS Doc where you live. Tell me as a layperson what being an EMS Doc means. I doubt I will ever work in an ER but I was enamored by a British show called Trauma Docs in the states and the state of EMS in the UK was mind-blowing to me. I want to know about our current American systems though. What separates the ER/ED Docs from the rest? What are the main orgs I should look into for more info? Thanks for any info! Cheers to all you ED folks!


I think part of the reason you are not getting a lot of replies is that you may be a little bit confused about the terms, and people just don't want to take the time to clear it up. Honestly, based on what you wrote, I am not sure what you mean. I think there are several somewhat related physician roles that need to be cleared up:

Emergency Medicine Physician: This is who we mean when we say ER doc, EP (emergency physician), EM doc, ED doc. This is the doctor who sees you when you come to the ER, whatever the complaint, whether it's something medical (heart attack, stroke, sepsis) or surgical (trauma, etc). Most of the time this requires either a 3 or a 4 year residency (there are 2 types of programs, opinions differ on which is better or whether there is a difference). In more rural areas this role can be filled by someone who did a residency in Family Medicine and an EM fellowship, or sometimes even Family or Internal Medicine residencies without fellowships. If you want to see just kids, you can do a residency in pediatrics followed by a pediatric EM fellowship.

EMS Medical Director: This is the doctor who serves as medical control for ambulance services, does training, creates protocols, etc. The best route to this is through EM residency followed by a 1 year EMS fellowship, but in some places you can get this job without the fellowship.

Ambulance Doctor: in some countries there are docs riding around on ambulances, doing things to patients in the field. This isn't really done in the US on a regular basis. Sometimes something like this will be done as part of a residency or fellowship elective, or as a minor/rare part of an EMS Medical Director gig, but basically this is non existent in the US.

Trauma Surgeon: works at a trauma center, mostly deals with traumas that comes to the ER. Operates on the ones that need operating, keeps treating them after on the floor or in the ICU. Sometimes this is combined with other surgical duties, such as doing other emergent (but not traumatic) surgeries. The most common route to this is 5-7 years of general surgery residency followed by a trauma surgery fellowship, but there are people who fill this role with no fellowship or a critical care fellowship following general surgery.

Hope this helps.
 
  • Like
Reactions: 1 user
As a small counterpoint to what people are saying, it is entirely possible to pull shifts on the ambulance as a medical director of an EMS service. While it's not usually "part of the job" per se, all the medical directors I had back when I was in EMS would ride on the trucks occasionally. Usually this was on their own time though, it wasn't a paid shift, though I knew at least one who had a job as chief of an ambulance service as well as a normal job working in an ED.

Basically the reality is that with the way healthcare reimbursement is set up, no ambulance service has the money to actually pay a physician a fair wage to work on the ambulance as a job, so docs who do this tend to just be volunteering their time. I'm sure in some academic settings with an EMS fellowship you might be able to wrangle your way into spending more time in the field/in a helicopter as opposed to the ED but that would be a relatively unique way to practice.
 
Top