Paramedic school

[mathlegend]

What is paramedic school like? What exactly do you learn, what do you need to know, how much studying is involved? Thanks.

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[howelljolly]

Um, thats a lot. do a google search on "paramedic curriculum" to get an idea of what individual programs list on their websites, or read the NHTSA documents if you have time.

Once you have an idea of the info thats available online, come back here and feel free to ask specific questions.

paramedic school is like - classes/lectures, hospital rotations in all different services from ER to anesthesia to neonatal intensive care, and rotations in the ambulance/mobleICU/critical care transport. Then theres a required internship before you graduate - maybe 3 full weeks worth of acting like a paramedic whilst one of the real medics on your team sleeps in the truck. And theres lots of exams - I think we had 5 over the course of the program which required a running average of >75%. At the end we had a written final, practical final, and oral final. Then we had the National Registry, the State exam and the City exam. I think I needed a paramedic myself after the national registry.

as to how much studying is involved - thats entirely up to you.

 

[deleted6669]

the field internship is a required # of hrs AND a required # of procedures( IV's/intubations/peds cases/codes/traumas/etc) and you need to fulfill both. my paramedic internship was 6 months of 12 hrs shifts. some of my classmates got everything done in 20-30 24 hr shifts. it all depends how busy the station you work out of is. we had something like 15-20 exams over the course of the program in addition to acls, pals, and btls exams. we also had an exit oral, written, and practical.
I did a 1 yr certificate program and never was required to take national registry because it hadn't really caught on yet back then but did take several different state exams.

 

[mathlegend]

Thanks, that was a good idea, looking up the curriculum.

Well I'm interested in attending Pitt for their BS, so this is what I found. http://www.shrs.pitt.edu/EM.aspx?id=187&nav=359 Is this a good idea?

How much information do you learn though?

What is the point of going though all those clinical rotations?

Is it hard to find a job?

Is it hard to change states? I'd be getting my certification in PA, but I would like to move back to CA sometime after.

 

[deleted6669]

Is it hard to change states? I'd be getting my certification in PA, but I would like to move back to CA sometime after.

I went california to pennsylvania which was pretty easy. had to pass a 1 day written and practical test that covered emt-b through medic. that was before national registry. most states use natl registry now so it's easy to transition between states.
when I was in pa they went to lifetime medic certification which was sweet!
my card says" expiration date: none".

 

[howelljolly]

Thanks, that was a good idea, looking up the curriculum.

Well I'm interested in attending Pitt for their BS, so this is what I found. http://www.shrs.pitt.edu/EM.aspx?id=187&nav=359 Is this a good idea?

How much information do you learn though?

What is the point of going though all those clinical rotations?

Is it hard to find a job?

Is it hard to change states? I'd be getting my certification in PA, but I would like to move back to CA sometime after.

Um, because you are the "doc" in the street?
Because patients can have anything?
Because you have to give conscious sedation in the back of your truck?
Because someone might call 911 because their vent-dependent child pulled out thier tracheostomy, and you have to get one back in?
Because you'll have patients who just had cardiac surgery, and you'll have patients who you will need to decide if you have to bring them to a hospital with a 24-hour cath lab or a thoracic surgery service?
Because you'll have patients who have their arm chopped off and intestines hanging out, and theyre still alive?
Because you'll have to take care of children who are having asthma attacks and are too tired to breathe on their own?
Because you'll have to take care of a pregnant woman who's blood pressure is sky high and shes having convulsions?
Because you'll deliver a 22-week premie and have to save her life?

 

[howelljolly]

I went california to pennsylvania which was pretty easy. had to pass a 1 day written and practical test that covered emt-b through medic. that was before national registry. most states use natl registry now so it's easy to transition between states.
when I was in pa they went to lifetime medic certification which was sweet!
my card says" expiration date: none".

Not fair!

 

[howelljolly]

Thanks, that was a good idea, looking up the curriculum.

Well I'm interested in attending Pitt for their BS, so this is what I found. http://www.shrs.pitt.edu/EM.aspx?id=187&nav=359 Is this a good idea?

How much information do you learn though?

What is the point of going though all those clinical rotations?

Is it hard to find a job?

Is it hard to change states? I'd be getting my certification in PA, but I would like to move back to CA sometime after.

Looks like that program at Pitt is 60 credits, so its not a BS (which would be about 120-130 credits). It's more likely an AS.

Finding a job - depends on when and where you are looking.

Are you an EMT? Except for true Bachelors degrees in EMS, and maybe some service based academies which send you to school and make you work for them, at the same time.... you need to be an EMT with at least 6 months of field experience before you can apply to Paramedic school.

So, if you're thinking about becoming a paramedic, look into becoming an EMT first.

 

[mathlegend]

Oh, I thought that the medic course would cover all that, I guess not!

That program at Pitt is a 4 year. The site just shows the courses for jr and sr year. First two years are spent taking mainly general ed stuff.

About jobs, I heard that jobs as a paramedic are usually better at fire stations than if they are private companies? Is that true?

I'm not an EMT yet, since I'm just 16. But I'll definitely get it my first semester in college, or the summer before college.

 

[deleted6669]

About jobs, I heard that jobs as a paramedic are usually better at fire stations than if they are private companies? Is that true?

depends what you mean by "better".
if you mean better pay and benefits than yes.
if you mean better medics then generally no.
a lot of folks who become fire medics do it to become firemen so medicine isn't their primary goal. it shows.
the largest provider of emergency services in the country now is a private company called amr, american medical response. they treat their medics pretty well when compared with other private companies. lots of room for growth there with opportunities to work your way from entry level medic to sr. medic to field supervisor or field training officer. they do a lot of disaster response as well and senior medics can get in on that. they have a reasonable salary scale and senior medics can easily make good money without overtime.

 

[howelljolly]

Oh, I thought that the medic course would cover all that, I guess not!

That program at Pitt is a 4 year. The site just shows the courses for jr and sr year. First two years are spent taking mainly general ed stuff.

About jobs, I heard that jobs as a paramedic are usually better at fire stations than if they are private companies? Is that true?

I'm not an EMT yet, since I'm just 16. But I'll definitely get it my first semester in college, or the summer before college.

Oh.

Cover all of what (EMT or most medical emergencies)?

The medic course doesn't include EMT and field experience. You have to have that before you apply to medic school.

The medic course trains you to handle ALL the scenarios I listed, and then some. You have to learn and know a lot to be a paramedic. Almost everything that can be done in the ER can also be done in an ambulance.

Unfortunately, in most places the better medic jobs are with the fire department. They have more money, and can offer their employees better benefits. I say its unfortunate because the medics end up getting the shorter end of the stick, to the firefighters. Fire Departments have absorbed EMS for financial reasons. I think Boston has the only remaining independent EMS in a major city.

Depending on where you live.....
paramedics usually work out of the FD or out of the regional hospital. They need to have constant radio communication with an emergency physician. They also need a pharmacy to supply their drugs. Large fire departments like the FDNY can hire emergency physicians to sit at their headquarters and take calls from the medics in the field all day and night. Regional hospital based medics would communicate with whoever is working in the ER at the time.
Private companies can operate medic units, but I dont know how the logistics of medical direction and getting drugs would work. I would think that they have to register with the local 911 dispatch system, and communicate with the regional hospital.

 

[mathlegend]

Yea I meant better as in pay and benefits. Where I live (SF bay area) pretty much all I see are AMR trucks. What is good money for a medic? How many years until one is considered a senior medic?

Yea cover most medical emergencies. What do you mean medics end up getting the shorter end of the stick?

 

[howelljolly]

Yea I meant better as in pay and benefits. Where I live (SF bay area) pretty much all I see are AMR trucks. What is good money for a medic? How many years until one is considered a senior medic?

Yea cover most medical emergencies. What do you mean medics end up getting the shorter end of the stick?

Yep, the medic course trains you to deal with most/all medical emergencies. And thats what the point of going through all of those clinical rotations is.

Because you can't manage those situations that I listed well, and independently, unless you've done them in a relatively controlled situation alongside an anesthesiologist, obstetrician, cardiologist, etc.

By getting the shorter end of the stick, I mean any number of issues that the fire medics have. As emedpa mentioned, you might be working with medics who hate their jobs and are only there because the fire department "made" them. In some departments its almost a punishment to be assigned to the ambulance. It costs more for the department to run the fire service, so the EMS may have older cheaper equipment. The department might make stupid arbitrary rules that make the medics sit in their ambulance out on the street rather than in the firehouse. And on and on...

 

[deleted6669]

back in the day working for the city of san francisco dept of public health as a medic was considered the bset job around. don't know if they got eaten up by the fire dept though. this was around 20 yrs ago....

 

[mathlegend]

Do fire departments hire medics? Or do you have to be ff/medic? I thought that medics normally sit in the ambulance instead of in the station.

I dunno, in SF, I see King's Ambulance, AMR, and the fire department. But yea whats a good pay for a medic?

 

[howelljolly]

Do fire departments hire medics? Or do you have to be ff/medic? I thought that medics normally sit in the ambulance instead of in the station.

I dunno, in SF, I see King's Ambulance, AMR, and the fire department. But yea whats a good pay for a medic?

It depends on the department. Some hire you to be one or the other, some require you to be both, and then put you wherever they need you.

When its 20 degrees below zero outside you might prefer to sit in the station instead of in the ambulance, between calls.

Google 'paramedic jobs' to get an idea of what the pay is like in your area. The pay varies greatly depending on location - from minimum wage to more than $30/hour. You can get paid even more if you are an instructor, or if you become a specialist (flight, critical care, pediatric, SWAT...)

 

[mathlegend]

The average doesn't seem too bad, though more would be nice.

When you do your clinicals, what do you do? Is it kind of like med student rotations?

 

[howelljolly]

The average doesn't seem too bad, though more would be nice.

When you do your clinicals, what do you do? Is it kind of like med student rotations?

yes, kinda.

It depends on where you go to school. And it depends on the rotation.

Where I went to school, there were Residents, paramedic students, medical students, and PA students. Residents were in charge of the team, and all the students were treated the same more or less. However, as a medic student we were never responsible for "following" a patient over a number of days, and we never had to write in the chart.
On most rotations you round with the team in the morning, and work with them throughout the day. If possible you'd be assigned a couple of patients to follow along with the resident for the day... just to pay special attention to, and give you a better understanding of what was going on.
In the Emergency Dept, the students would take the new patients one at a time... do a history and physical, and discuss it with the doctor, then we'd follow the patients progress until they left.

On ambulance rotations, intially you were to function as an EMT. As time went on you'd gradually be given more responsability from your medic preceptors until finally in your internship you had to function as a paramedic. Your preceptors would be there to jump in if you were screwing up (and give you a bad evaluation).

 

[mathlegend]

The clinicals sounds neat!

How many calls on average during a shift? And how long are the shifts? 8hrs? 12hrs? 24hrs?

 

[docB]

How many calls on average during a shift? And how long are the shifts? 8hrs? 12hrs? 24hrs?

Depends where you work. Heck, it depends on where you are stationed on a given day where ever you are working. I've worked shifts in sleepy departments where we could go 24 hours without a call to places that average 2 calls an hour.

 

[Paseo Del Norte]

Clinicals are typically divided between field and facility. In the field, call volume will vary greatly. In the hospital, your experience will vary greatly. Scope out the program you want to attend and have them break down the minimum number of hours and the facilities/services where you will complete these hours.

In addition, not all hospitals offer the same experience. For example, the large teaching facility in my neck of the woods is very restrictive on students. However, I worked at a small ER in an outlying facility that had a modest volume of 20-40 patients a day; however, many were Mexican train wrecks and MVC's off the interstate. The physicians at this hospital were old FP's and a couple of general surgeons with an IM doc or two sprinkled in for good measure. The environment was highly supportive of students. The medics were taken in with open arms by the physicians and were able to perform more procedures than at the larger facility. Of course, with only two nurses, we were more than happy to let the students run amuck, so to speak.

 

[howelljolly]

Depends where you work. Heck, it depends on where you are stationed on a given day where ever you are working. I've worked shifts in sleepy departments where we could go 24 hours without a call to places that average 2 calls an hour.

Yeah mathlegend, it varies drastically by where you work - in how many calls per shift, length of the shift, and turnaround time per call. So it would be impossible to gauge anything by asking that question. One place I worked, we'd have 20 jobs in 12 hours and itching for more. Another place, we'd have 4 jobs in 8 hours and be exhausted.

 

[medic25]

back in the day working for the city of san francisco dept of public health as a medic was considered the bset job around. don't know if they got eaten up by the fire dept though. this was around 20 yrs ago....

Unfortunately, the Fire Department has taken over San Francisco's EMS system, just like they have been doing all over the country. There are still some cities with well-regarded third services out there like Boston and Pittsburgh. The most recent to drop in Kansas City, MS; it was announced this fall that fire would take over their EMS system. I'm sure the standard of care will rise dramatically and patient care will be first priority, just like in other cities where FD's have taken over EMS....

 

[docB]

Yeah mathlegend, it varies drastically by where you work - in how many calls per shift, length of the shift, and turnaround time per call. So it would be impossible to gauge anything by asking that question. One place I worked, we'd have 20 jobs in 12 hours and itching for more. Another place, we'd have 4 jobs in 8 hours and be exhausted.

That's a good point. The place I mentioned with the occasional shifts with nothing for 24 hours did have a 2 hour transport time to the nearest hospital.

 

[mathlegend]

I guess I'll look into the locations when I start my paramedic courses.

Medic25, is your post sarcastic? Does that mean is worse for medics to work in Fire departments?

 

[howelljolly]

I guess I'll look into the locations when I start my paramedic courses.

Medic25, is your post sarcastic? Does that mean is worse for medics to work in Fire departments?

yes, that was sarcasm. When fire depts. run EMS, the EMS becomes their lowest priority.

Dont worry about locations and jobs and stuff. Look into becoming an EMT first. You have a long way to go.

 

[mathlegend]

Thanks for all the help guys!

 

[Paramedic8740]

It varies.

1. There are degree (curriculum) and certificate (continuing education) programs.

Curriculum programs lead to associate, and in some states bachelor degrees. continuing education only enables you to take the state/national Paramedic exam.

2. Not all programs are created equal.

Some programs will be better than others. The success of the program is usually contingent on funding, quality of instruction and supportive clinical sites.

3. Your current level of experience may have an effect your options.

Some programs will require that you have EMT or EMT-I plus field experience before you can begin your Paramedic studies. Degree programs will usually require that you have EMT only, if that.

BOTTOM LINE: If you were looking at going to the same school I went to, I could give you a better answer. But, since EMS education varies so much from state to state, even county to county in some instances I can't. Either way, you will learn enough about how the body works to be able to make a decision on what treatments are needed. The amount of studying required will depend on the person and what type of program their in.

Here is a link to my states treatment protocols. They basically serve as a guide on how to treat patients. They might give you better idea of what you'll be learning.
http://www.ncems.org/pdf/NCCEPStandardsProtocols2009.pdf

 

[DitchDoc73]

yes, that was sarcasm. When fire depts. run EMS, the EMS becomes their lowest priority.

I can not disagree more with this statement! The fact that EMS is run by a fire department has no bearing on the level of care (or priority) that is provided. I have worked for private EMS agencies whose level of care was terrible, and I now work for a fire department who has a great level of care. It all comes down to the underlying agency, not the type of agency it is. Just my 2 cents on the whole issue.

Also for those who were asking about how intense the EMT-P curriculum is, in Florida EMT-P curriculum is considered 52 semester hours (and is usually completed in one year!).

 

[howelljolly]

Also for those who were asking about how intense the EMT-P curriculum is, in Florida EMT-P curriculum is considered 52 semester hours (and is usually completed in one year!).

Yeah mine in NYC was 57 credits.

 

[Dwindlin]

I can not disagree more with this statement! The fact that EMS is run by a fire department has no bearing on the level of care (or priority) that is provided. I have worked for private EMS agencies whose level of care was terrible, and I now work for a fire department who has a great level of care. It all comes down to the underlying agency, not the type of agency it is. Just my 2 cents on the whole issue.

Also for those who were asking about how intense the EMT-P curriculum is, in Florida EMT-P curriculum is considered 52 semester hours (and is usually completed in one year!).

While you are right, there are always going to be exceptions, but it is safe to say that the majority of fire based EMS isn't on par with the majority of EMS only systems. Most people joined the Fire Department to be firefighters, not EMT's/Medics and it shows.

 

[greytmedic]

While you are right, there are always going to be exceptions, but it is safe to say that the majority of fire based EMS isn't on par with the majority of EMS only systems. Most people joined the Fire Department to be firefighters, not EMT's/Medics and it shows.

Supporting evidence, please.

 

[Dwindlin]

Supporting evidence, please.

I highly doubt there has been a study done, so anything I gave you would be anecdotal.

 

[MedicFL]

I can not disagree more with this statement! The fact that EMS is run by a fire department has no bearing on the level of care (or priority) that is provided. I have worked for private EMS agencies whose level of care was terrible, and I now work for a fire department who has a great level of care. It all comes down to the underlying agency, not the type of agency it is. Just my 2 cents on the whole issue.

Also for those who were asking about how intense the EMT-P curriculum is, in Florida EMT-P curriculum is considered 52 semester hours (and is usually completed in one year!).

The level of EMS care provided in Orange County is terrible as are the protocols, Seminole has better protocols however the level of care provided is no better. None of the FD's in the Orlando area provide anything close to "GREAT" care. I am not saying there are not some good medics in the system however they are the exception not the rule.

 

[Parapuppy]

Well I just started Paramedic school and they told us that they should have had us bring in our spouses/significant others/family so we could tell them goodbye for the next year...I've prepared to have very little to no life. Thank God my significant other is in the business and understands...

 

[greytmedic]

While you are right, there are always going to be exceptions, but it is safe to say that the majority of fire based EMS isn't on par with the majority of EMS only systems. Most people joined the Fire Department to be firefighters, not EMT's/Medics and it shows.

I highly doubt there has been a study done, so anything I gave you would be anecdotal.

So it is not exactly "safe" to say that the majority of fire based EMS isn't on par with the majority of EMS only systems, but in your "opinion" the majority of fire based EMS isn't on par with the majority of EMS only systems, based on personal anecdotal evidence only.

I say this because, like DitchDoc, I have also worked in fire based EMS that delivered top-notch care and EMS only that was well underfunded, undermanned, and delivered sketchy care at best, and then everything in between.

 

[howelljolly]

Supporting evidence, please.

OK fine. Ive edited the post so as not to be too abrasive.

That post of yours is profoundly insulting.

Each one of us has personal experience of n=1 or 2. Because youre some fancy medical student you're asking for "supporting evidence", and that's not cute. There is probably no evidence based literature out there which looks at the cultural aspects of FD based EMS.

Everyone is entitled to a personal opinion and assessment of the way things are. If you want evidence, watch the episode of The Third Watch, when Doc shoots the FD tour boss. I don't know what level of evidence that falls into... expert interviews by the writers might put it at the USPSTF classification of level III.

Also, as a scientist, you are not allowed to "demand negative proof". Its bad science.

 

[greytmedic]

OK fine. Ive edited the post so as not to be too abrasive.

That post of yours is profoundly insulting.

Each one of us has personal experience of n=1 or 2. Because youre some fancy medical student you're asking for "supporting evidence", and that's not cute. There is probably no evidence based literature out there which looks at the cultural aspects of FD based EMS.

Everyone is entitled to a personal opinion and assessment of the way things are. If you want evidence, watch the episode of The Third Watch, when Doc shoots the FD tour boss. I don't know what level of evidence that falls into... expert interviews by the writers might put it at the USPSTF classification of level III.

Also, as a scientist, you are not allowed to "demand negative proof". Its bad science.

Wow, I wasn't trying to be insulting. This is a topic that is highly debated with strong feelings on both sides, and I should have used more tact in my post. However, I was typing on my iPhone and my thumbs are too big and I don't have the patience to make long posts from my iPhone. So I apologize for any air of arrogance.

I only asked for supporting evidence to atkinsje just because I interpreted the statement sounding like he/she was stating fact. I fully agree that everyone is entitled to their own opinions based on their experience, as long as they keep an open mind that may differ from person to person, experience to experience. I have worked in several different parts of my state for different types of systems. I have personally have found that the type of system has less to do with care delivered than the professional culture of the system and funding of the department or company.

If anyone knew of some research out there that looked at patient care/outcomes from different types of system I would be more than happy to read and evaluate the research. But, as of right now I have other things to do than go hunting for that research(like screwing around on SDN ).

 

[DitchDoc73]

The level of EMS care provided in Orange County is terrible as are the protocols, Seminole has better protocols however the level of care provided is no better. None of the FD's in the Orlando area provide anything close to "GREAT" care. I am not saying there are not some good medics in the system however they are the exception not the rule.

I know you are not trying to insinuate that certain large EMS corporations (not going to name them here, as it is not necessary nor relevant to the post) provide better EMS in central florida. This is not a protocol debate (yes Orange County medical directors have chosen very conservative protocols versus Seminole County medical director who has very liberal protocols). Each are unique in their own right, and suit the departments that they serve. Having such liberal protocols in such a large system could be dangerous (lets remember that orange county medical directors cover approximately 5 times as many Paramedics and EMTs). Such a large system necessitates much more conservative protocols. Besides, protocols are not they way to judge the level of care provided by the EMTs and Paramedics of a system.

But back to the subject at hand. In my opinion, having worked for both private EMS providers and fire rescue providers in central florida (and throughout florida for that matter), the fire rescue agencies generally provide better patient care and continuity of care. Every agency has their fair share of idiots and their fair share of above average medics. And yes the level of care provided by fire departments can vary greatly, but as a whole most fire departments put an emphasis on patient care versus making a buck (like most EMS agencies).

 

[DitchDoc73]

Well I just started Paramedic school and they told us that they should have had us bring in our spouses/significant others/family so we could tell them goodbye for the next year...I've prepared to have very little to no life. Thank God my significant other is in the business and understands...

Best of luck parapuppy! Not to rain on your parade, but the divorce rate in my Paramedic class was about 40%. I hope that yours is better!

 

[DitchDoc73]

I have personally have found that the type of system has less to do with care delivered than the professional culture of the system and funding of the department or company.

Excellent point!

 

[AnaPhaLaxiS]

Oh, I thought that the medic course would cover all that, I guess not!

That program at Pitt is a 4 year. The site just shows the courses for jr and sr year. First two years are spent taking mainly general ed stuff.

About jobs, I heard that jobs as a paramedic are usually better at fire stations than if they are private companies? Is that true?

I'm not an EMT yet, since I'm just 16. But I'll definitely get it my first semester in college, or the summer before college.

it all depends on what you plan on doing. if u plan on being a ff then go for the fire dept. just realize that 80% of ur calls are going to be medical in nature.
gov.(city/county) are usually pretty good but some co's have competitive benefits as well.

Yea I meant better as in pay and benefits. Where I live (SF bay area) pretty much all I see are AMR trucks. What is good money for a medic? How many years until one is considered a senior medic?

Yea cover most medical emergencies. What do you mean medics end up getting the shorter end of the stick?

i dont know about SF, but iin some cities AMR does 911/First Responder Calls. and /or they do BLS transfers for the fire dept or they do interfacility transfers...

u might want to visit/call the school you are looking into attending and ask them all these questions. mebbe even go to a firestation or amr and ask them..they would know better than anyone here.