Curious about EMT to EM

[RHeff]

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Hi all-

I'm curious if any of you in Emergency Medicine worked as an EMT or paramedic before med school. If so, did that push you toward EM? Do you feel it has impacted your work as a resident in any good (or even bad) ways?

Thanks

 

[han14tra]

Hi all-

I'm curious if any of you in Emergency Medicine worked as an EMT or paramedic before med school. If so, did that push you toward EM? Do you feel it has impacted your work as a resident in any good (or even bad) ways?

Thanks

I was an EMT. My experience actually helped me decide on EM. A few months ago, I was doing a family med rotation in my hometown where I also volunteer as an EMT. I would get all of their dispatches on my phone throughout the day. It killed me to have to see FP patients when there were major traumas or critically ill patients happening 5 min up the road. It helped me figure out which field I truly loved.

As far as impacting my work as a 4th year med student....I will say that on my EM rotation, it helped. EMTs would bring in a chest pain patient (for example), and I would understand that the medics probably already gave nitro, they got an EKG, they received O2, they got labs/IV, and they may have even received morphine. It's really important to understand what is in an EMT's or medic's protocols if you are an emergency physician. Also, understand that what they do is really hard. They aren't running a code in a resuscitation bay with 2 nurses, an IV tech, an EKG tech, and the respiratory tech. They have family members screaming in their ear, 1 EMT-basic partner, and they will likely intubate and get IV access when they are going 60mph down the road hitting all the potholes.

 

[jbar]

First off it depends on what your experience as an EMT or medic was. If you worked as a volunteer and saw a total of 30 patients in your career, probably not much impact on your future. If you worked full time for a few years and saw 2500 patients, that is a lot of clinical experience. It's difference from being a resident but it helps in that differentiation of "sick" versus "not sick." I think it gives you a bit of a leg up in the beginning of med school, you feel comfortable talking to patients, doing an exam of some sort. But your medical school experience sorta washes out any previous experience. You see so many more patients in medical school that what kind of medical student you were has a much bigger impact on what kind of resident you will be than what you did before med school.

As to field, the issue is that there aren't many chances as a pre-med to get to do surgery, or cardiology. So while EMS is similar to EM, most EMTs go to med school an branch out ito other fields (though some like me certainly stay in emergency medicine.) Most people who like EMS tend to like fields with acuity and some hands on activity. So a lot of EMTs and medics tend to be drawn to things like critical care, anesthesia, cardiology etc.

 

[docB]

It helps because you hit the ground able to walk up to a patient, interact with them and it give you some of the all important "sick vs. not sick" vibe.

Remember though that EM is different than EMS in that you see even fewer emergent cases and you are stuck with the annoying ones for hours rather than minutes. Remember all those silly "not really sick but can't or won't care for them selves" type cases. As an EMT you just transport them. As an EP you have to actually come up with something to do with them which is really difficult.

 

[Dwindlin]

I was a medic with significant experience prior to school. I found my experience very helpful. Ultimately chose anesthesia.

Edit: I am still active as a Firefighter/Medic, and plan to be for as long as I can.

 

[beanbean]

I was a volunteer EMT for many years and my experiences with EMS led me to med school and EM.

It is very helpful as docB mentioned to already have experience talking to and evaluating patients. Additionally, when EMS describes scene specifics such as a 30 min extrication your experience lends insight.

Good luck!

 

[fiznat]

I was a medic for almost 10 years before going to medical school-- currently a MS2.

EM was the reason I went back to school, but my EMS experience has given me some insight into the negative side of things as well. I am concerned that I may become frustrated and angry at the patients in the ED (as I did oftentimes on the ambulance). My clerkship experiences will help me make the decision, but I can see how my experience as a medic could push me either way...

 

[RHeff]

Great insights. Thanks everyone!

 

[jbar]

I am concerned that I may become frustrated and angry at the patients in the ED (as I did oftentimes on the ambulance).

What do you think happens to those patients when we admit them? Difficult patients in the ER become difficult patients on the surgical/psych/GYN service. You can't change the patient, you can just change your outlook on them. Easier said than done though.