Clinical Experience and EMT Dilemma

It sounds like what you're doing definitely counts as clinical experience. You're interacting with patients in a hospital setting--that's pretty much the definition of clinical experience. Now, I was an EMT-B and that was what made me really want to do medicine, so I'm a little biased. I would recommend getting your EMT cert and working/volunteering just because it's so much freakin FUN. But if you don't want to commit the time and energy to doing that, you've still got clinical experience.

As for the amount of time you should do it, there's no set amount that is considered the "minimum". If you've had clinical work or volunteering a few hours a week for a year or two, that would probably suffice. More importantly, do YOU feel you've gotten enough clinical exposure to feel comfortable explaining why you want to be a doctor? And that you've experienced the upsides and downsides to medicine?

I guess you are new here so you don't know the LizzyM definition of clinical experience.

EMT-B is a license to use a stretcher and drive fast. Frankly, not as good a clinical experience as getting around in a hospital environment and talking to patients, IMHO.

If you can manage 2 hrs/wk for 1 yr, you are about average. Weekly for 2 yrs or more before you apply and you are well above avg.

LizzyM said:

I guess you are new here so you don't know the LizzyM definition of clinical experience.

EMT-B is a license to use a stretcher and drive fast. Frankly, not as good a clinical experience as getting around in a hospital environment and talking to patients, IMHO.

If you can manage 2 hrs/wk for 1 yr, you are about average. Weekly for 2 yrs or more before you apply and you are well above avg.

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This makes me sad I've done college EMS for 2 years, and we don't transport or have stretchers. I do get puked on regularly though

LizzyM said:

EMT-B is a license to use a stretcher and drive fast. Frankly, not as good a clinical experience as getting around in a hospital environment and talking to patients, IMHO.

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I think this really depends on where you're working. For some companies, this is completely true - your job as an EMT is pretty much just transporting dialysis patients and nursing home patients who have fallen down. Generally these people don't really want to talk to you, and it's not the most meaningful clinical experience.

Some volunteer services, though, are fantastic. If your ambulance is the primary response for any emergencies in your town/college, you will see a huge variety of calls, get exposed to a lot of diseases/injuries, get to talk to a wide variety of patients, and learn a TON of leadership/decision making skills. Of course, I'm pretty biased, since being a volunteer EMT is what first convinced me to consider medicine as a career

If you're on the fence about getting your EMT-B cert, take a look at the ambulance where you'd be volunteering/working for pay. If it looks like you'll be making nursing home shuttle runs, the hospital may be a better clinical experience. If your ambulance is actually a dedicated 911 vehicle where you'll get a lot of responsibility, I think it could be an incredible experience for you.

LizzyM said:

EMT-B is a license to use a stretcher and drive fast. Frankly, not as good a clinical experience as getting around in a hospital environment and talking to patients, IMHO.

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+1. I was also an EMT for a while, and in my experience you have a LOT of down time between runs (assuming you are in a corps or fire department). Additionally, the scope of cases that you are allowed to work with as a basic is very limited (and rightfully so) even compared to an intermediate or paramedic. As a basic you are not allowed to perform anything invasive (IVs included) and invariably yield to an EMT-I or P for 'interesting' cases (though you can still watch). If I were you I'd stick to the hospital gig.

aSagacious said:

+1. I was also an EMT for a while, and in my experience you have a LOT of down time between runs (assuming you are in a corps or fire department). Additionally, the scope of cases that you are allowed to work with as a basic is very limited (and rightfully so) even compared to an intermediate or paramedic. As a basic you are not allowed to perform anything invasive (IVs included) and invariably yield to an EMT-I or P for 'interesting' cases (though you can still watch). If I were you I'd stick to the hospital gig.

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But at least you get to touch patients. And then you can move up to an ER tech Job and really do something cool

LizzyM said:

I guess you are new here so you don't know the LizzyM definition of clinical experience.

EMT-B is a license to use a stretcher and drive fast. Frankly, not as good a clinical experience as getting around in a hospital environment and talking to patients, IMHO.

If you can manage 2 hrs/wk for 1 yr, you are about average. Weekly for 2 yrs or more before you apply and you are well above avg.

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I disagree wholeheartedly with this statement. I have been on multiple cardiac arrests, trasnported postictal patients, splinted, backboarded, and collared patients as an EMT and the list goes on. Who says you can't talk to patients when you're running patient assessment? Furthermore, do you really think as an EMT I sat silently while I transported patients who were healthy (i.e., during BS calls)?

OP: Hospital volunteering is a WASTE OF TIME. You can't do ANYTHING besides crap that they should be paying former prison convicts to do. Unfortunately, Adcoms require this so they can check it off of their "required" list of activities. You probably won't get much out of it.

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fashionrebel said:

So I am currently a little confused. I want to get some clinical experience this school year (I'm a rising sophomore), but I need a little help!

I currently have a job 'Patient Navigating' at a hospital associated with my campus. Basically this means I spend a few hours each week going through patient rooms and asking them if they are comfortable/need anything. I also discharge patients at the end of their stays. While the work is easy and generally enjoyable, I do feel as if "Patient Navigating" won't look very legitimate to an adcom and I'm concerned it won't be considered "clinical experience" (whatever that actually means).


I was originally debating getting an EMT-B certification, so I would at least feel more usefu,l but more and more people are telling me that EMT's don't do all that much and that the work doesn't even count as clinical experience!

So my question is: Do I stick with Patient Navigating? Or do I get my EMT certification? Or do I try something totally different? If so, what?

On a related note, how much clinical experience is necessary for a strong application? I mean including shadowing/volunteering in a hospital, etc?

I would love some advice!

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Hey

So I am actually a student and an EMT. It honestly helps a lot to get your EMT cert. You meet a lot of docs from doing runs and can get a great variety of patient contact cases. My first day I got a motor vehicle accident with a semi truck! just me and a medic racing down the high way trying to make sure this guys leg wasn't gonna be amputated! pretty fun stuff but on the flip side, did get a patient who couldn't walk and litterally peed all over herself. (it was even dripping from her hair!!)

and if you don't think you have the time, you can usually volunteer with EMS. I suggest going to the 911 EMS group in your country. I don't know about other places but we have our government run EMS and a transport EMS group. Obvi, you are gonna be doing jack squat with transport and act as a taxi driver. Also, a lot of group will allow you to work only during the summer or just a couple times a month. If you tell them that you are a pre-med student, usually they will highly exultant you lol

hope that helps

You need more clinical experience,good luck!

Look into your own counties scope of practice for EMT's. They're different from county to county. Here in LA, all 911 calls are pretty much through fire. You also can't use a few of the things that are taught for the NREMT certification because the county has the final say on the scope of practice.

If you live in an area where EMT's get to respond to 911 calls then I think it will be worth it to get a license.

fashionrebel said:

So the impression I'm getting is that EMT may or may not be a good experience (depending on where I work)

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Correct.

fashionrebel said:

...adcoms don't care whether I EMT or volunteer as long as I check off the 'clinical experience' one way or another. Am I right?

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I don't think any of us would go so far as to say that 'all clinical experiences are created equal.'

I've been and EMT for 4+ years now and I wholeheartedly recommend it! I started off volunteering to respond to 911 calls for a local fire department. After a few months I got a job as a tech in the ER and now work in the OR as a tech. Accepting that nothing that comes from a 160 hour course is going to make you an expert and transform you into a healing machine, I've found the training has given me a great starting point to learn about medicine.
Regardless of your area and its scope of practice policies, as an EMT you get the very informative experience of involved in the actual medical care of patients not just observing. You will get practice with basic patient assessment (even if you don't have the training to diagnose), patient interviews and, if you work in the field, you get practice making decisions under pressure.
If you can swing it I would definitely recommend trying to get a job at your hospital in the ER. While you're still limited to basic tasks, you'll see a lot, develop your training and perhaps get a little more satisfaction that volunteering as you care for "your own" patients. At my hospital I've gotten to work with patients with anything from psychological issues to severe trauma or other life threatening conditions. I've been trained to do phlebotomy as my state is one with that only requires your hospital train you and ensure your competence. In the OR I've been trained to scrub into surgeries and have been able to sit in on a bunch of interesting cases during any downtime.
While of course experiences may vary, and you may be a trained monkey compared to physicians, isn't being a trained monkey better than being a monkey with no training?
As to the people in EMS being zombies I would definitely disagree. Just like anything else there are people who are *******s and bad at their jobs and people who are full of helpful knowledge and really awe inspiring to be around and learn from. The advice I've gotten from the many good EMT's I've interacted with and learned from far and away compensates for the unsavory people you're bound to find.
My one caveat would be don't bother if you don't plan on using it. I know plenty of my peers at my school who have gotten their EMT thinking it would look good on their applications and then never used their certifications. It sounds like if you're already investing time in volunteering this won't be an issue but for some reason some people think it's the certification that makes your resume "pop" but really its all about what you do with that certification.

If you have the time to get the certification and the determination to continue on and use it then do it!

I really don't understand why all the negativity for EMTs on this forum. I've volunteered as an EMT-B for two years now, and we are the primary responders for our campus, integrated with the city's emergency department so that if any 911 calls get routed through Fire, we get dispatched if it's within our service area. We're staffed completely by students 24/7, each crew consisting of a crew chief, second, and third rider. You move up the ranks, learning as a student third, teching as a second by handling most of the patient care and responsibility in the back of the truck, and by the time you make chief, you're responsible for each call, making a lot of critical decisions and communicating with healthcare professionals, police, and other officials. I volunteered for a year at a local hospital and barely got my hands wet when it came to clinical experience, but two months into being a certified EMT, I had already responded to a drug overdose, laceration, sports injury, drunk call that required backboarding and ASL onboard, just to name a few...

Why the reputation of calling us speed-loving taxi drivers? Talk to any respectable EMT and you know that's what really gets on our nerves. And to really satisfy my curiosity, why do adcoms believe that as well, especially since we are primary responders and have direct contact with patients just as much as the nurses who see them as soon as they come into the ED? I know it's not the same as being in an actual hospital setting, and I totally respect that. But in terms of learning bedside manners, how to talk to patients, getting patient history, etc., my EMT experience was invaluable. I highly doubt I could have had that experience by merely volunteering or shadowing.

Silverwing said:

Why the reputation of calling us speed-loving taxi drivers? Talk to any respectable EMT and you know that's what really gets on our nerves. And to really satisfy my curiosity, why do adcoms believe that as well, especially since we are primary responders and have direct contact with patients just as much as the nurses who see them as soon as they come into the ED?

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What do you actually DO when you 'arrive first to the scene'? You can't prescribe drugs (no, oral glucose and activated charcoal don't count), you can't start IVs (not even a blood glucose reading), you can't reset fractures, you can't administer an AED (that's reserved for ACLS), etc, etc. You are merely there to stabilize vitals long enough to safely transport the patients to the ER, where they are actually treated... hence the stereotype.

B...B...But aSag, I get to touch the patient! Isn't that good enough?

I'm so glad on rotations I get to do everything you said, sans admin IV and AED

I guess that's what I don't understand. Why do you need to be able to do those things in order to be considered "useful", "a proper pre-med candidate"? Without basic life support (and yes, our service can take glucose readings, which was highly useful in teaching me how to distinguish a diabetic who hasn't eaten all day from a psych patient), some patients won't even last till the hospital where you can actually DO something. Keeping airway open, giving oxygen, stopping bleeding should be considered the first steps of basic patient care, shouldn't it? Without those, IVs, drugs, fractured bones won't count for anything.

And why are AEDs reserved for ACLS? We carry an AED with us as part of our first-in bag, not to mention AEDs are scattered all around campus so that lay people who have been trained in our CPR classes can also use them by following the verbal instructions.

aSagacious said:

What do you actually DO when you 'arrive first to the scene'? You can't prescribe drugs (no, oral glucose and activated charcoal don't count), you can't start IVs (not even a blood glucose reading), you can't reset fractures, you can't administer an AED (that's reserved for ACLS), etc, etc. You are merely there to stabilize vitals long enough to safely transport the patients to the ER, where they are actually treated... hence the stereotype.

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well, in fairness, a student volunteer in a hospital isn't going to be doing many of these things either.

Volunteering in a hospital is the most worthless, waste of time thing I can think of doing. I want to kill myself every time I step into the hospital to do "make a difference". Oh, I get to file the papers! Wonderful! Sort through the old medication so the night crew can take a nap? Bueno!

Silverwing said:

I guess that's what I don't understand. Why do you need to be able to do those things in order to be considered "useful", "a proper pre-med candidate"?

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Eh, I suppose it's a matter of preference. I'd much rather sit passively in the corner of a room during a procedure or behind the scenes work (MRI analysis, histology/biopsy interpretation, etc) than do repetitive (and frankly rather brainless) chores for the sake of acting in a 'hands-on' manner. But again, it's a matter of preference. To be clear, I do not do these things to be 'useful' or 'a proper pre-med candidate' but instead to LEARN about the wide variety of work settings and roles available to a physician. I'm also not saying VOLUNTEERING is better than working as an EMT. I was fortunate enough to obtain an internship (which, IMO, is not terribly difficult to come by). Of course you work your way up the ranks to earn trust within the department by starting with more mundane chores.

pfaction said:

Volunteering in a hospital is the most worthless, waste of time thing I can think of doing. I want to kill myself every time I step into the hospital to do "make a difference". Oh, I get to file the papers! Wonderful! Sort through the old medication so the night crew can take a nap? Bueno!

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^ agreed. and yet it continues to be a pseudo-prerequisite. at least as an EMT, you get to experience the pressure of having someone else's health actually depend in some degree upon your actions

I like to think of volunteering in a hospital as a check on the "did you get MRSA today? No? Well, it looks like you're okay spending a shift here, congratulations" box. Also, how to properly wash your hands box.

aSagacious said:

Eh, I suppose it's a matter of preference. I'd much rather sit passively in the corner of a room during a procedure or behind the scenes work (MRI analysis, histology/biopsy interpretation, etc) than do repetitive (and frankly rather brainless) chores for the sake of acting in a 'hands-on' manner. But again, it's a matter of preference. To be clear, I do not do these things to be 'useful' or 'a proper pre-med candidate' but instead to LEARN about the wide variety of work settings and roles available to a physician.

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That I totally get and respect, and I wish adcoms who viewed EMTs negatively made the same distinction as you. I happen to learn better from hands on experience, and watching people do things make me itch to do them myself. Shadowing doctors was great, taught me a lot by observing how they interacted with patients, volunteering and talking to patients was great too, but it was the getting my hands dirty - actually bagging someone, reading the glucose count, bandaging, etc - that was exciting and made me think I could take on medicine as a career. And I'd hate to see people get discouraged from being an EMT out of fear that it won't count as clinical experience.

Well, you'll rack up volunteer hours at the same time, so 2-for-1 shot to get your leg up to other pre-med standards.

That's why we're doing this in the end, right? Because we're pre-meds?

aSagacious said:

What do you actually DO when you 'arrive first to the scene'? You can't prescribe drugs (no, oral glucose and activated charcoal don't count), you can't start IVs (not even a blood glucose reading), you can't reset fractures, you can't administer an AED (that's reserved for ACLS), etc, etc. You are merely there to stabilize vitals long enough to safely transport the patients to the ER, where they are actually treated... hence the stereotype.

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So what are you saying, that you have to get your EMT-P or RN to get useful clinical experience? That's crap. There are different protocols everywhere, but just so you know, EMT-Bs in my state can start IVs, do blood glucose readings, and administer AEDs (automated defibrillators..though to be fair any ***** can use one of those). And even if we couldn't, EMTs still get way more patient interaction than a hospital volunteer paper-pusher. Sure, I got plenty of BS calls where someone stubbed their toe or threw up. But I got legit calls too. My BLS unit once ran a code entirely ourselves because ALS didn't show up until after we got the patient to the ED. There are pros and cons to every clinical experience--I work as a CNA now and working on the hospital floor is very different from EMS. But both have been hugely valuable experiences.

TheMightySmiter said:

So what are you saying, that you have to get your EMT-P or RN to get useful clinical experience? That's crap.

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See my last post above for elaboration/clarification.

aSagacious said:

What do you actually DO when you 'arrive first to the scene'? You can't prescribe drugs (no, oral glucose and activated charcoal don't count), you can't start IVs (not even a blood glucose reading), you can't reset fractures, you can't administer an AED (that's reserved for ACLS), etc, etc. You are merely there to stabilize vitals long enough to safely transport the patients to the ER, where they are actually treated... hence the stereotype.

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Where do you practice?!?!?!?!

I can use AEDs, Glucose readings (I do these so often I can use any major monitor with my eyes closed) Can currently give 6 drugs, and in my state that is jumping up big time to include IVs, more drugs, and many advanced airways in the next few years). And while we cant set fractures we can splint them, and in the case of a traction splint, can elimate a large amount of pain.

I love being an EMT, I only wish I could join a real service They are a dime a dozen in MA and finding a job is a nightmare. At least I have College EMS and disaster relief to give me something to do College EMS is hilarious if you have a good smell and vomit tolerence. Ohhhhhhh the stories I have!

LizzyM said:

I guess you are new here so you don't know the LizzyM definition of clinical experience.

EMT-B is a license to use a stretcher and drive fast. Frankly, not as good a clinical experience as getting around in a hospital environment and talking to patients, IMHO.

If you can manage 2 hrs/wk for 1 yr, you are about average. Weekly for 2 yrs or more before you apply and you are well above avg.

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Sure, being an EMT isn't like what you see on rescue 911, but I think your statement reflects most adcoms lack of understanding regarding an EMT's job. If fact, after working in a hospital for 4 years, I can say that 99% of my co-workers (doctors and nurses besides in the ER) don't know what an EMT does.

As an EMT, protocol requires a basic medical history and physical exam of every patient. This includes signs & symptoms, allergies, medications, pertinent past medical history, last oral intake, and events leading to the present illness or injury. The experience of doing this with a dozen patients every day is great, and not something a volunteer, or most employees below an RN level, will get to do in a hospital. It is a great experience because you learn to interview and communicate effectively with patients and hospital staff. In addition you see a variety of healthcare facilities, medical conditions, treatments, and the effect these things have on a patients quality of life.

While I recognize the benefit of working inside a hospital, since this is the setting doctors work in, I think your statement is unnecessarily dismissive.

senorsquishie said:

Where do you practice?!?!?!?!

I can use AEDs, Glucose readings (I do these so often I can use any major monitor with my eyes closed) Can currently give 6 drugs, and in my state that is jumping up big time to include IVs, more drugs, and many advanced airways in the next few years). And while we cant set fractures we can splint them, and in the case of a traction splint, can elimate a large amount of pain.

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Ok, point well taken, the level of responsibility varies by state. However I think you are missing my main point.

Does repeated administration of an NPA/OPA/bag-valve improve your knowledge of medicine? How about a few hundred blood pressure readings? What about a tourniquet/gauze administration? Do you see where I'm heading with this? At best you can argue that you become proficient in skills that might come in handy down the road (though highly unlikely, aside from the blood pressure readings). I'd much rather observe doctor verbalize his thought process as he diagnoses a patient or something to that effect.

I think this release from the AAMC articulates my point well. Here are a few brief excerpts:

"Acquiring exposure to a variety of health-related clinical settings is a vital part of premedical and medical student preparation. Many students are now taking advantage of opportunities to gain clinical experiences abroad, where regulations governing the procedures that students can perform on patients are often less stringent and well defined than in the United States and Canada. Additionally, existing local regulations may not be uniformly or fully enforced. While many students have had beneficial experiences through involvement in patient care activities abroad, and services have been provided to people in need, the potential for harm and abuse in these situations cannot be ignored."

"The primary purpose of a student clinical experience is observation, not hands-on treatment. You are there to learn, not to treat."

"Always keep the welfare of the patient foremost in your mind, not the perceived opportunity for proving yourself. Ask yourself how you would feel if you were in the place of a patient and a person with limited skills and preparation was about to perform a procedure on you. If this thought makes you feel uncomfortable, it is probably not an appropriate task for you to be doing. Recognizing patient autonomy is one of the core values of medical ethics; it is particularly important to honor in communities with limited resources, where all patients must be given the choice whether or not to have trainees involved in their care."

While using abroad clinical experiences is a more extreme example, it illustrates the AAMC's (and my) position that it is more important to learn from your clinical experiences than to exercise the few hands-on skills you have to offer.

aSagacious said:

Ok, point well taken, the level of responsibility varies by state. However I think you are missing my main point.

Does repeated administration of an NPA/OPA/bag-valve improve your knowledge of medicine? How about a few hundred blood pressure readings? What about a tourniquet/gauze administration? Do you see where I'm heading with this? At best you can argue that you become proficient in skills that might come in handy down the road (though highly unlikely, aside from the blood pressure readings). I'd much rather observe doctor verbalize his thought process as he diagnoses a patient or something to that effect.

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I see your point to a degree, and I hate to admit it but I use my experiences as a spring board. For example, I got a call to someone with MS. When I got home I was curious about the mechanisms of MS and what could have done differently. Not to be a gunner, but out of genuine interest. I have heard a lot of med students say though that their comfort with pt exams helped them a bit. They could jump right in where other students where handling their pts with "kid gloves". BPs and stuff I agree is useless because Med school practically covers the relevent EMT skills in a day

As an EMT-B during training I performed cpr in the field, ventilated, helped take down patient history, got vitals, ventilated, deal with angry family, etc. I dont know what the admission's committee thinks of it but the clinical experience I got just from the training was invaluable and fun.

My training wasn't just glorified transport. Then again I did my training with the Fire Department. Maybe the situation is different state-to-state.

Yeah, and med school goes through Pharmacy in about a semester (one of the pharmacology professors taught in a med school and was stunned)...

Volunteer in inpatient physical therapy and try to do the work of a tech or an aide. very clinical... at least my job is

ucfknight407 said:

As an EMT-B during training I performed cpr in the field, ventilated, helped take down patient history, got vitals, ventilated, deal with angry family, etc. I dont know what the admission's committee thinks of it but the clinical experience I got just from the training was invaluable and fun.

My training wasn't just glorified transport. Then again I did my training with the Fire Department. Maybe the situation is different state-to-state.

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I think they don't look at it negatively it's just common now. You can do EMT-B in a short period and everyone seems to be using it as a go-to for clinical experience.. It's not just about clinical experience, it's about not being cookie cutter. I know that Orlando and South Florida is crazy for Emergency Med..

BoxAtDaRedLight said:

I think they don't look at it negatively it's just common now. You can do EMT-B in a short period and everyone seems to be using it as a go-to for clinical experience.. It's not just about clinical experience, it's about not being cookie cutter. I know that Orlando and South Florida is crazy for Emergency Med..

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It is lol but dont you think they should stop worrying about what's cookie cutter and whether or not its valuable. Sometimes i think there is too much focus on what's different instead of what's better. I know the EMT experience was an eye opener for some.

ucfknight407 said:

It is lol but dont you think they should stop worrying about what's cookie cutter and whether or not its valuable. Sometimes i think there is too much focus on what's different instead of what's better. I know the EMT experience was an eye opener for some.

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And I see many people who spend the time to get EMT-B training and can't find (or don't have the time for) a job or volunteer gig using the skills.

An applicant working full-time as an EMT-B was the person who told me that he could put a bandage on it and drive fast.

And, my own experience of ambulance rides has not included much in the way of history, allergies, medications, etc as I had suffered relatively minor traumas <8 minute ride from the emergency dept. There are also those routine transports between nursing home and family gatherings, radiation oncology, etc.

aSagacious said:

What do you actually DO when you 'arrive first to the scene'? You can't prescribe drugs (no, oral glucose and activated charcoal don't count), you can't start IVs (not even a blood glucose reading), you can't reset fractures, you can't administer an AED (that's reserved for ACLS), etc, etc. You are merely there to stabilize vitals long enough to safely transport the patients to the ER, where they are actually treated... hence the stereotype.

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What do you DO when you volunteer at the hospital? No, bringing food, water, and blankets to patients don't count. Oh, and I can shock a patient with an AED, you must be referring to using a life pack. Is albuterol considered a medicine? How about epinephrine? Because EMTs can administer both.

So first you posit that the reason that being an EMT is useless is because you don't do anything, and now you're saying that doing things (i.e., treating patients) is not what the AAMC wants to see as a clinical experience? As an EMT you interact with hospital staff and physicians on a less superficial level than just "observing". Making blanket statements about the "uselessness" of being an EMT is ignorant. If you can't get a valuable experience from being an EMT, that's one thing, but don't make these ridiculous statements and discourage people from entering a field that they may get a great deal of satisfaction and joy from.

LizzyM said:

And I see many people who spend the time to get EMT-B training and can't find (or don't have the time for) a job or volunteer gig using the skills.

An applicant working full-time as an EMT-B was the person who told me that he could put a bandage on it and drive fast.

And, my own experience of ambulance rides has not included much in the way of history, allergies, medications, etc as I had suffered relatively minor traumas <8 minute ride from the emergency dept. There are also those routine transports between nursing home and family gatherings, radiation oncology, etc.

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Doesn't sound like you have had very good EMTs. In the first 5 mins, there should be a history and assessment any life threats

senorsquishie said:

Doesn't sound like you have had very good EMTs. In the first 5 mins, there should be a history and assessment any life threats

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I was lying in the snow a 7 minute drive from the hospital. (It could have been a shorter drive but the EMT thought I'd prefer a slow and less bumpy ride & he was right.) I was awake, alert and had no complaints other than the fact that my foot was positioned in an unatural angle in relation to my leg after a slip & fall. No one was in the mood for a lot of chatter.

LizzyM said:

I was lying in the snow a 7 minute drive from the hospital. (It could have been a shorter drive but the EMT thought I'd prefer a slow and less bumpy ride & he was right.) I was awake, alert and had no complaints other than the fact that my foot was positioned in an unatural angle in relation to my leg after a slip & fall. No one was in the mood for a lot of chatter.

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I'm not entirely sure what your point is. Your particular situation (luckily) did not necessitate further intervention in the prehospital scene besides (hopefully) hard splinting. Would you have preferred a femur fracture that required the use of a Sager splint to straighten out your femur and restore circulation to your leg?

You're right that many applicants with the license don't do much with it. However, your situation experience as a patient does not define the scope of experiences that an EMT may have.

FIREitUP said:

I'm not entirely sure what your point is. Your particular situation (luckily) did not necessitate further intervention in the prehospital scene besides (hopefully) hard splinting. Would you have preferred a femur fracture that required the use of a Sager splint to straighten out your femur and restore circulation to your leg?

You're right that many applicants with the license don't do much with it. However, your situation experience as a patient does not define the scope of experiences that an EMT may have.

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I guess what I'm saying is that in many urban areas, there is very little that needs to be done by EMTs besides trundling the patient to the hosptial as quickly as possible.

There was no splint of any kind applied (this was a big city ambulance crew staffed by professional fire department personnel ). I was loaded onto a stretcher and driven to the hospital. I had to be knocked out to put the leg back into a normal position and get a temporary cast until the swelling went down & I could have surgery to fasten everything back together. If I'd been a very rural area where the ride to the hospital is over an hour, there might have been more that would have been done in the field.

I'll just say that in my experience (mostly with applicants who have LizzyM scores of >72), only one in five EMT-Bs have actually worked/volunteered in that role. I think that the time is often better spent on research & preparing for the MCAT if your goal is a top school, with 100 hours of clinical experience acquired through volunteering/shadowing.

LizzyM said:

And I see many people who spend the time to get EMT-B training and can't find (or don't have the time for) a job or volunteer gig using the skills.

An applicant working full-time as an EMT-B was the person who told me that he could put a bandage on it and drive fast.

And, my own experience of ambulance rides has not included much in the way of history, allergies, medications, etc as I had suffered relatively minor traumas <8 minute ride from the emergency dept. There are also those routine transports between nursing home and family gatherings, radiation oncology, etc.

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First, every transport should include all the things I listed before, so you can give a proper turn over report to the RN at the ER. Second, since you were transported to the hospital for a trauma injury they probably focused on the mechanism of injury, vital signs, interventions and treatments.

All of the "routine" transports are actually the best learning experiences. That is when you can really review a patients medical history and see how difference medical conditions present in actual patients. This is the best time to hear what CHF sounds like when auscultating, see what someones feet look like after diabetic neuropathy sets in, to see the effects of chemo after a cancer diagnosis, and to listen to people tell you about their medical conditions. The interfacility transports are a great learning opportunity just because the patient usually has a H&P with them from the doctor. I used to read them as much as possible, and read what treatments they prescribed.

Being an EMT isn't useful for the limited skills you learn, it's more about your exposure to patients and your interaction with them.

Having not been there, I can say for sure, but I am puzzled as to why they did not splint the injury I think your ride to the hospital would have been a lot more comfortable.

LizzyM said:

I guess what I'm saying is that in many urban areas, there is very little that needs to be done by EMTs besides trundling the patient to the hosptial as quickly as possible.

There was no splint of any kind applied (this was a big city ambulance crew staffed by professional fire department personnel ). I was loaded onto a stretcher and driven to the hospital. I had to be knocked out to put the leg back into a normal position and get a temporary cast until the swelling went down & I could have surgery to fasten everything back together. If I'd been a very rural area where the ride to the hospital is over an hour, there might have been more that would have been done in the field.

I'll just say that in my experience (mostly with applicants who have LizzyM scores of >72), only one in five EMT-Bs have actually worked/volunteered in that role. I think that the time is often better spent on research & preparing for the MCAT if your goal is a top school, with 100 hours of clinical experience acquired through volunteering/shadowing.

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Protocol dictates you don't try to set a broken limb, if the patient is experiencing intent pain from your attempt to intervene, unless circulation is compromised. They weren't being lazy, just following protocol.

rHinO1 said:

Protocol dictates you don't try to set a broken limb, if the patient is experiencing intent pain from your attempt to intervene, unless circulation is compromised. They weren't being lazy, just following protocol.

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Very true but some sort of splint is indicated even if it is just a pillow and a TON of medical tape. Perferable a good old hard splint.

I'm kind of sad reading some of the things that people said here, but I can somewhat understand. Just being an EMT really doesn't mean anything. It's all about what you make of your certification.

Honestly, getting my EMT certification was one of the best decisions that I've ever made. It really opened doors for me and gave me invaluable clinical experience. However, I never worked for an ambulance company or with fire. I have always been an ED tech. I would say there is a huge difference in the capacity of the two (Pre-hospital work and in an ED). But I will say that working in either role will give you some good experience. Learning how to talk to patients and really being able to feel comfortable in different situations is important. Yes, pre-hospital work can kind of be the slums. Lots of interfacility transports and easy BLS stuff. You may get to work a code or a see a bad trauma, but you really are limited to what you are able to do. However, at least you have gained some experience. I would say the highest yield being interpersonal skills, not medical skills/knowledge.

If you plan on getting your EMT, I would say just make sure you do something meaningful with it. Lots of pre-meds think getting their EMT will look so good on their application for medical school--but we all know this isn't the case. Do things because you like doing them, not because what other people, including adcoms will think of it. I chose activities that I was genuinely interested in. I got my EMT certification because I loved the idea of being able to work in an emergency department; working with patients, nurses, doctors, and really being part of the medical team. So, I got my EMT, seeked opportunities for employment, and got hired. I have worked in the ED as a tech for the past three years. This has led to many opportunities to know physicians well (getting good letters of recommendation as I have worked with them for a while), great research opportunities, awesome volunteer opportunities, etc. I could go on--but I think you get my point.

FIREitUP said:

So first you posit that the reason that being an EMT is useless is because you don't do anything, and now you're saying that doing things (i.e., treating patients) is not what the AAMC wants to see as a clinical experience?

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You are mixing two separate statements out of context. The first claim was in response to a question asking 'why the taxi driver stereotype.' The others were with regards to the amount learned from various clinical settings.

I have now been told by 8 (you would be the ninth) person claiming 'I can do X, Y, Z in the field so I am learning medicine.' I congratulate you on your wide variety of responsibilities but that still does not invalidate my main point. You are still performing relatively thoughtless tasks and not learning much in the way of medicine. (And please don't try to tell me that an inhaler or epipen are 'prescribing drugs,' now you're just grasping at straws). Additionally, no you do not interact with hospital staff or physicians 'beyond a superficial level.' You drop the patient off at the ER, deliver your report, and go on your merry little way.