EMS fellowships?

[NotChoCheez!]

Sorry, I'm a young and stupid med student. I've searched this forum. I've looked on various EM residencies web sites. But I still don't really understand what you can do with an EMS fellowship. Sure you can be a medical director for EMS, but what exactly do they do (a day in the life of...)? Is it something that you can actually find a job in, or is there one per city and you have to wait for someone to retire to find a job?

It looks really interesting, but if it were employable too then it would be twice as good!

Pardon my ignorance. (Whew! Hope all those disclaimers I put in this post keep people from flaming me! 😀 )

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[Jambi]

You said you searched so you might have seen this Loma Linda

 

[southerndoc]

Most major cities hire full-time medical directors for their EMS systems (i.e., Atlanta, Los Angeles, NYC, etc.). These individuals oversee training programs, continuing education, and more importantly, perform QA of runs/patient encounters. For example, New Haven Count, CT, is served by more than 15 EMS agencies. All of them are part of the Sponsor Hospital Program, which is made up by Yale and St. Raph's Hospitals. All EMS systems operate under protocols jointly designed by the two. The medical directors (we have 3 EMS physician faculty and 1 fellow; St. Raph's has 2 physician faculty) review most cases, but not all. Any complaint is investigated by the physicians. The physicians must also ride with individuals before they are "cleared" for medical control (funny, med control actually means standing orders in this case).

Basically it gears you up for an academic position or a full-time position. It's not required to be a medical director (it probably never will be required), and may not be useful if you have prior EMS experience at the paramedic level. If you were a basic EMT before, then I think it would offer a lot of benefit. If you were a paramedic and planned a career in the community and wanted to be a part-time EMS medical director, then I would say it's a waste of your time.

The SAEM maintains a full listing of all EMS fellowships. You can go to www.saem.org and click on EM Fellowships on the left side of the page.

 

[Jeff698]

Southerdoc gave you a good overview of what they do. I got into medical school (and now an EM residency...yeah!) specifically to be an EMS medical director. I've been a paramedic for 16 years now and have a masters in EMS. For me, the EMS fellowship isn't necessary but would be an opportunity to do some research that I want to do but might not be able to do otherwise because of time. There may be some large systems that would require the fellowship but I'm not really a big city boy so that wouldn't be enough reason for me.

Take care,
Jeff

 

[NotChoCheez!]

Excellent. Thanks for the info. I think what I might do is aim for a program with a fellowship and/or good EMS exposure, and decide from there. I wouldn't want to do EMS full-time (at least not so much that I couldn't also pull some shifts in an ED), but if I knew there were some opportunity to get involved I would definitely look into a fellowship.

 

[docB]

There are a few pros and cons to an EMS fellowship that haven't been mentioned:
Con- You can't board in EMS so lots of stuck up docs don't recognize it as an actual distinct field.
Pro- You don't have to take an exam at the end of it.
Pro- Some programs offer an MPH with the fellowship.
Con- An MPH brings the same questions, ie "What do you do with that?"
Con- Fellow money for 1-2 years.
Pro- Gives you time to really scope out your practice options and decide where you want to practice. You'll likely moonlight a lot and be able to decide what you like in a job. EM has a huge rate of turnover in the first years after graduation.
Pro- What fun. To be back on the rig. Get a pt, do the fun stuff, then dump them on the ER. Man, take me back!

 

[Sessamoid]

Where I used to work, the online medical control docs got paid to carry the radio around on shifts. Typically, they'd carry them on days they were working in the ER anyway. They didn't get many calls, since since most of the medics in the area were pretty good and had well-established protocols. Good extra money for not very much work at all.

 

[NotChoCheez!]

I've sort of got a bug to do something administration-like. Can one be a part-time EMS administrator, or is that a 40+ hr/wk job?

I know what you're talking about DocB. The perception of "if you can't be certified, it's not worth it" is pretty strong, especially in academic medicine. What ever happened to doing something because it genuinely interests you? Of course, I'd have to come up with a pretty good story to tell my wife as to why this fellowship will be worth the years of lost potential income!

 

[Jeff698]

I've sort of got a bug to do something administration-like. Can one be a part-time EMS administrator, or is that a 40+ hr/wk job?

The vast majority of EMS medical directors are part-time (and, sadly, volunteer). The concept of a full-time MD outside of the really large systems is pretty new. I'm not sure there are actually any real numbers on this (relatively easy study though...hmmm) so any answer is likely to be more or less conjecture (although I'm pretty damn sure MY conjecture is accurate).

The other issue is that the EMS medical director is rarely the EMS administrator. That is usally a paramedic with administration experience and, if everyone is lucky, training.

Take care,
Jeff