I can't speak for EMTs as I'ver never been one and I don't know the difference between what EMT-Bs and EMTs are or what all that entails. I do know that a EMT is not even a tenth of a paramedic. Medics and prehospital care is a whole other world, a whole other specialty, and totally not part of this discussion. If you want to be paramedic, be a paramedic. If you want to be a doctor, don't waste the EMS instructors' times by thinking that being a paramedic will help you get into medical school. I know this wasn't the OP's question but I do know there are lurkers and other people reading this, frustrated by the whole premed process, and hoping for a foot in the door. Look, please don't think that you can do that by faking the paramedic process. It's disrespectful to those professionals.
What I can speak about is being a scribe. Please forgive any following spelling errors.
It's geography, hospital, legal, and physician-dependent, so not every body will have the same experience, but I've been fortunate enough to be part of an awesome scribe program. Nova and Footballfan have both touched on a lot of why it's a great concept, but from my own personal experience in one specific ED, I just want to elaborate on one take away: you learn what being an emergency physician is like and have the opportunity to get a better glimpse of what other specialties entail. Basically, while you don't lay hands, you learn to think like a doctor.
For example, as a scribe, the elements of a HPI are ingrained in my mind (quality, severity, location, timing, duration, context, modifying factors, and associated symptoms/signs). We document everything from history to ROS to physical exam to labs to rads to consults. When pts come into the ED, we can usually predict how their course will go given their chief complaint. Walk in 67 yo male comes in with substernal chest pain, radiating to the L neck and jaw, is diaphoretic and nauseous with a recent hx of dyspnea on exertion is getting EKG, troponin, CXR, maybe a CK-MB index, placed on cardiac monitor, oximetry, 2L O2, and other point of care labs. He'll probably get a nitro spray as well. Plan to rule out acute MI or other ACS. If they have to go to the cath lab, a scribe knows that s/he have to document the anticoags, Plavix, beta-blockers, asa, etc. There's obviously more to this, but I just wanted to show you an example. I also know why that same dude with a slightly different HPI might get a GI cocktail instead.
If you show enough initiative, you start to learn what the labs mean. Total bilirubin of 26? That's probably why the pt's glowing like a yellow highlight pen. That alcoholic hunched over with epigastric pain? Lipase 250. L temple tenderness? ESR of 80 confirms temporal arteritis. Heck, I'm starting to read CXRs and CTs. Hey doc, you know that pt with through and through CP we planned to start on a heparin drip? Well, isn't the mediastinum kinda wide on CXR? I love pulling up a CT of a chronic abd pain pt with h/o repeat prescription narcotic meds issues who is complaining of worst abd pain of life and recognizing the scan as showing the pt is FOS. Literally. If you're only a premed but a scribe, you would know what I'm talking about. I also understand the medical decision making. A 79 yo patient with only vague RLL atelectasis by film but has a WBC of 17,000, yellowish productive cough, and is febrile will likely be started on Avelox and admitted even though the CXR was not conclusive for pneumonia like infiltrate. Heck, I've even written a few preliminary MDMs for the physicians. Do I know what SOAP is? Heck yeah! And so do the scribes
And if you're fortunate enough to work in a large hospital with multiple EDPs, you get to observe different practice habits, picking out what you like and hope to do in the future, as well as appreciating what you do not want to do as a doctor. The docs I work with invite us into the doctor's lounge for food and coffee. They write our recc letters. They discuss various pathophysiology with us. We also get to interact with various specialists from neuro to onc to cards to hospitalists to rads. Some of the rads even trust us to relay stat CT findings to the docs without even waiting to tell them personally. Basically, I know how to act as a professional in the hospital.
Sure there are times I wish I had EMT training. I don't know what all the splints are. I'm not called on to help move a patient off the board. I don't do chest compressions. But a ED doc doesn't do chest compressions either. While the EMT gets to be part of the excitement during a code, sweating, and pushing away, I'm only charting the code. But guess what the ED doc is doing? Well, s/he's not drawing blood - that's the lab tech. S/He's not putting in IVs - that's the nurse. If the pt crumps, s/he's not doing compressions - that's the EMT (or the Lucas). S/he is sure as heck not putting in the Foley. No, the doc's running the code and if necessary, doing RSI or putting in a central line. And by documenting everything, you start to see the big picture. Did they push the succs and etomidate for RSI? ****, she's crumping: atropine, epi, and bicarb (not necessarily in that order)! I'm scared of status asthmaticus. I know what a GI bleed smells like. And I think only girls can smell DKA.
I'm not at a trauma center so those who are can elaborate more on it if they want.
I also know about billing BS and that to get paid level V, the chart needs at least 4 elements of the HPI, 10 systems in the ROS, 2 PSHx, 8 or more systems on the PExam.
And as a scribe, I can have as much close interaction with the pts as I want. Getting water, blankets, talking and chatting, teasing pt's children, commiserating. I can do all that and remember the compassion that is in my heart. I can even tackle pysch pt's if I want. But I don't have to wipe any butts. Nor do I have to grab commodes or bed pans. Why? Because I have another pt to see with the doctor.
I also love the humility. Everyday, I recognize that there is way too much to learn and I'm absolutely terrified to start medical school. But I excited as hell, too. And because I have this job, I have so much respect for the other professionals that work with the docs. The nurses, NPs, PAs, Medics, techs, and EMTs all play vital roles, without whom the hospital would not work. Don't ever forget that. And if I ever do want to know what all those splints are, I ask the EMT because I respect their knowledge base and what they do, and because I'm not better than them.
But honestly, I don't know if being a scribe is better on a resume than being an EMT. I have been fortunate to be admitted to a US allo medical school for fall 2008 and the physician (not EM) who interviewed me loved the idea. But I've heard that certain interviewers downplay the program although a friend who interviewed with an ED doctor had a blast talking about it. I know that some of the specialists in our hospital think highly of the program, the ED docs love having us around and love to teach us, and the rotating medical students and residents in our ED think we're gonna be so ahead of the curve, especially in year 2. The nurses teach us tricks on getting in good with other nurses (something of value when we're annoying medical students). And because they've told me, I know that all the premed EMTs (not the future paramedics) in our ED wish they had our jobs. Finally, one of the director of admissions in our states has come out and specifically recommended to applicants that they apply to any of the area scribe programs.
But I think that any clinical experience will be highly valued by admissions. Scribe, EMT, nursing aid, phlebotomist, volunteer, shadowing. Anything clinical with pt contact, so that we applicants know it's not all about trying to attain sainthood, will look good with admissions. And all and any of it, will be absolutely useless if the grades and MCAT scores suck. So scribe or EMT doesn't really matter. And of course, remember that what I write is specific to my own personal experience and different scribes may have had worse times. I just think that if you have the choice between being a scribe or EMT, go become a scribe.
So good luck to the OP and others who have read this. Whatever, you do, just do it well. I'm sure it will pay off in the end.
And if any EMT wants to show this posting to their ED docs and say that I'm FOS, go right ahead. I've said, extensively, my peace.
