Unlike many of my colleagues here, I WAS a firefighter for 9 years, and AM a currently certified paramedic, along with board certified EM doc.
Let me see if I can find what I posted in the past...
"Well, mostly, it's not taught as much as selected for. Many EMS providers have or have had bachelor's degrees in unrelated, and poorly employable, disciplines. Then, there is hierarchical progression; in NY, for example, there are 5 EMS levels, from CFR (Certified First Responder - aimed towards police and firefighters), EMT, EMT-Intermediate, EMT-CC (critical care), and EMT-P (paramedic). Other states may not have so many levels. In NY, you just have to be EMT to take a paramedic class, although many, like me, went through intermediate first. In Western NY, the EMT-3 (CC) just isn't taught, and there are no medical director protocols for them.
So, how do you make a radical? You educate a man, then don't give him a job. I studied - literally - nearly zero for my original class in 1995-96, and, when I recerted in 14 and 17, I literally did not open the book (Nancy Caroline's "Emergency Care In The Streets"). EMS is full of overeducated, moderately to heavily underemployed people. It might be standard now that people have to have a 2 year paramedic program, but it wasn't in the past.
So, the paramedics are the top of the **** pile. And, some of them let it go to their heads. Since they can do a lot of procedures, and can "cut to the front of the line" to talk to the doc on the med call phone, they think they are better than they are; they forget that "technician" is right there in the name. Add to that personality issues/disorders, and you get the "paragod". If they are flight medics, it can be even worse."
This was in response to the question, "Do they teach arrogance in paramedic school?", in
this thread.
Of course, that paradigm is "3rd service/private company", whereas the fellow above is fire department. Without knowing, that pathway was, likely, fire academy, and then paramedic school. Both of these are technical schools, like enlisted training in the military. You learn how to to the job, and you learn it well. If you don't know any professional firefighters, then you probably don't know how well of a job that they do. They are the "real thing".
It's because of that, that I can see how it can spill over to the overconfidence thing (not saying that about
@FiremedicMike , but just in general). However, a rough parallel to this is the CRNAs that become anesthesiologists, and they say, "I didn't realize how much I didn't know".
Even if intubating is just a technical skill, it's like the rubric about surgical residency - "the first two years is learning how to operate, and then the last 3 years is learning when NOT to operate".
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