ER Tech or EMT?

[DeadCactus]

Hey all,

I'm about to finish my EMT-B Certification. I took the class as a way of introducing myself to medecine and seeing if Med School was a path I wanted to seriously consider.

Now as the class is moving into the last steps, I've become pretty certain that this is the direction I want to go in. I plan to start volunteering somewhere in the medical field next semester and hope by doing so I will remove the last shreds of doubt that Medicine is what I want to pursue.

Anyway, that was a longwinded intro. My question is: Would I be better off trying to volunteer with a 911 service on an ambulance or as an ER Tech in a hospital?

Being an ER Tech has the advantage of being in a hospital and working with MDs. It seems like a good chance to see what Doctors actually do on a day-to-day basis. Added to this is that regularly working with MDs puts me a in a good position to ask to shadow them and possibly even for a letter of recomendation later on down the road. The downside, and maybe I just have a bad impression of being an ER Tech, but it seems like it is a bit detached from the actual treatment and is closer to running errands.

Working an an EMT seems like a more interesting route to simply because I would actually get to perform some treatments. It would let me actually make an assessment and provide some level of treatment. The downside is that it is detached from the hospital setting and probably has a lot more downtime than working in an ER.

Thank you for any advice, opinions, or comments everyone.

Edit: Spelling

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[supernareg]

i'm an ER tech.

to become an ER tech, you usually need some time of ambulance emt... mine was 6 months before i got hired.

the experience u get in the hospital, is FAR greater than the 911 area, BELIEVE ME.

and u dont run errands, you still get to participate in all the procedures, assist doc's with suturing, LP's, etc, clean / dress wounds.

you see MORE stuff at the ER than you do 911. no doubt.

 

[pretenda]

an ER tech will always be doing something...EMT's work schedule is similar to a fireman's...They can sit around for hours without a single call but when that call comes it can be quite intense...

 

[Agent Splat]

You probably would be busier as an ED Tech. But you'll also be told what to do for everything.

As an EMT-B, depending on your service (if you have paramedics around, etc), you may have more autonomy, which can be scary, but it quickly builds experience. When I first started as an EMT-B I worked in an area that had no paramedics, so it was all "up to us." You quickly start to learn to problem solve and such. You might get more hands on use of your skills and I have a feeling you'd be more involved in patient care.

Of course, I'm coming from the point of view, as I mentioned, of an EMT that works in smaller city areas where the only "supervision" we have is if we want to push a med.

 

[Agent Splat]

an ER tech will always be doing something...EMT's work schedule is similar to a fireman's...They can sit around for hours without a single call but when that call comes it can be quite intense...

agreed...plus that makes good homework/movie/Xbox time.

 

[gotmeds?]

I have to disagree with the majority here. Nothing beats good 911 experience. I worked 911 for about 5 years -- a year as an EMT, and four as a paramedic, and it was the best job I ever had. I couldn't even dream up some of the weird things I saw at work. More importantly, you have a lot more autonomy and you are actually providing medical care rather than watching someone else do it. It's the difference between being able to talk about what you saw in the ER vs. what you did in the ambulance.

With that said, in most places the EMT-B's role is pretty limited. Unless you work in a system where you have a paramedic partner or where EMTs are the only prehospital providers, you will end up doing mostly transfers from hospitals and nursing homes. Between those two choices, I'd probably pick the ER. Or better yet, go to paramedic school like me and be an old man by the time you apply to med school.

 

[SoccerGuy09]

i think you'd be better off as an er tech. it might be tough to get a job, though, without much experience, but you never know. er techs can do a lot of cool stuff, too, like iv's, splints, foleys, ekgs, and more. they get to see a TON of people with a wide variety of ailments, as they are usually the people who take vitals right away before nurses come in and are the ones taking care of patient "needs". plus, you're always busy, unlike emts, which someone had mentioned earlier. the downside would be that you'd have to do all of the scutwork like changing linens, cleaning up puke, poop, urine, and whatever messes the patients may make. i guess there's always a down side to everything. plus, you were right, you would be able to hang out with the mds and see what's up. emergency medicine is the ugly face of healthcare, as people are the most on edge, especially after sitting in the waiting room for hours. there are also your everyday drug addicts and alcoholics who cause some problems, but all in all, it's really exciting! good luck with your decision.

 

[notdeadyet]

With that said, in most places the EMT-B's role is pretty limited.

I second this. For every person on SDN that talks up the "sirens in the night" form of EMT work, there are three EMTs who spend the majority of their day shuttling little old ladies from one hospital to the next.

 

[45408]

I second this. For every person on SDN that talks up the "sirens in the night" form of EMT work, there are three EMTs who spend the majority of their day shuttling little old ladies from one hospital to the next.

That's why you research your employer first. In Milwaukee, there's two companies that do 90% of the grandma shuttle work, and some occasional 911 work, and there's two companies that do 911 calls at least 3/4 of the time. I worked for the latter, and enjoyed myself immensely. No, I wasn't raising the dead or wading around in blood, but it was fun and interesting.

Like others said, it usually requires 6-24 months of EMT experience to get an ER tech job, and most of them said so up front.

 

[Pose]

ED tech here.

Wouldn't replace the experience. Great hours -- highly busy. Great friends with ED staff, and great enthusiasm from the ED physicians about my goals. Always seeing/doing something new. Oh, and good pay/benefits for a college student.

We take ambulances and follow standard protocols before the nurse and doctor come in (vitals, monitor, EKG, O2, foley, irrigation/suture setup, labs, csm-xray-splint...cutting off nasty clothing from 90 year old incontinent women, getting vomited on...Changing 3 month old foleys in obese patients...).

We're also part of the PCI/Stroke/Code/Trauma team...Which is more or less composed of the exact same people (EP, respiratory, IV therapy, x-ray, CT, surgical resident, and 2-3 nurses). And for every non-trauma or code, there's something fantastic we can watch and ask about, and sometimes even help.

Now, if I didn't want to go to medical school, and become an EP -- I'd work towards my medic. We, as techs, never sit down due to the vast number of EKGs, or labs, or lonely elderly people complaining of CP or SOB. Our entire job is doing things nurses don't feel like doing.

 

[Rachael07]

Become an EMT--you have an opportunity to make a difference in someones day. I've been an EMT for 3 years, on two different ambulance core(both volunteer), and every interview I've been on, the adcoms have asked me about my experiences.
Being an EMT allows you to incorporate volunteer hours, clinical experience, and teamwork all in one activity. Being an EMT allows you to show adcoms that you are committed, compassionate and able to work both as a leader, and part of a team.
You have to think on your feet and be able to think outside of the box.

I say go for EMT, but then again, I am biased.

 

[Vvandenn]

I agree. Becoming an EMT was the best decision I've made so far; I absolutely love it.

 

[DeadCactus]

Just for a little more detail:

The EMT service I am looking and trying to join at has the Paramedic/EMT-B partnered on each ambulance set up.

The hospital I'm looking at trying for is the local Trauma Center (Level 2, I think, maybe Level 1.)

 

[Pemberley]

I already have the impression that EMT pay stinks for living on (unless you're a college student happy to live on ramen and bud light.)

Approximately how well are ER techs paid, and what qualifications do they require?

ED tech here.

Wouldn't replace the experience. Great hours -- highly busy. Great friends with ED staff, and great enthusiasm from the ED physicians about my goals. Always seeing/doing something new. Oh, and good pay/benefits for a college student.

We take ambulances and follow standard protocols before the nurse and doctor come in (vitals, monitor, EKG, O2, foley, irrigation/suture setup, labs, csm-xray-splint...cutting off nasty clothing from 90 year old incontinent women, getting vomited on...Changing 3 month old foleys in obese patients...).

We're also part of the PCI/Stroke/Code/Trauma team...Which is more or less composed of the exact same people (EP, respiratory, IV therapy, x-ray, CT, surgical resident, and 2-3 nurses). And for every non-trauma or code, there's something fantastic we can watch and ask about, and sometimes even help.

Now, if I didn't want to go to medical school, and become an EP -- I'd work towards my medic. We, as techs, never sit down due to the vast number of EKGs, or labs, or lonely elderly people complaining of CP or SOB. Our entire job is doing things nurses don't feel like doing.

 

[Pose]

I make $11.50 an hour, with shift differential. I had no experience with my EMT cert. Many of the techs in our ED (with experience) started at $12.50.

I also have full health insurance (BCBS -- amazing coverage), dental insurance, life insurance (4x salary...eh), long term disability, and tuition reimbursement ($1,500-2,000/semester for a 3.5-4.0GPA for full-timers, $800-1,400/semester for 3.5-4.0 for part-timers).

The techs at our ED must be at least BLS (EMT-basic), though there is a nice preference for Intermediates, obviously. The two or so that aren't certified have loads of experience as a CNA or equivalent on the floors or nursing homes.

 

[LifetimeDoc]

I would first think about the reasons you want to be an EMT or an ER-Tech before diving into one of them. Everyone in this forum wants to be a physician, right? Are you wanting to be an EMT or ER-Tech so that you can get clinical experience?

The whole point of clinical experience is to observe and experience the patient-doctor interaction, and to see what patients are like in the clinical setting. The back of an ambulance or waiting in the hallway for an ER bed isn't the clinical setting, and doesn't give you the experience of what it's like to be a doctor. Sure it's fun, you are practicing healthcare, getting to do all sorts of cool medical stuff. But you are missing the point...that you need to see what doctors do, not what an EMT does in the field.

As an ER-Tech, you are directly involved with clinical care that only doctors and nurses get to do. If you want direct clinical experience, either be a nurse or a tech. BTW, volunteering in an ER allows you to observe doctors working with patients in the clinical setting as well...you just don't get to do anything medical other than watch, and you don't get paid.

 

[spicedmanna]

The whole point of clinical experience is to observe and experience the patient-doctor interaction, and to see what patients are like in the clinical setting. The back of an ambulance or waiting in the hallway for an ER bed isn't the clinical setting, and doesn't give you the experience of what it's like to be a doctor. Sure it's fun, you are practicing "healthcare", getting to do all sorts of cool medical stuff. But you are missing the point...that you need to see what doctors do, not what an EMT does in the field.

As an ER-Tech, you are directly involved with clinical care that only doctors and nurses get to do. If you want direct clinical experience, either be a nurse or a tech. It's like shadowing many doctors all the time whle you get paid. BTW, volunteering in an ER allows you to observe doctors working with patients in the clinical setting as well...you just don't get to do anything medical other than watch, and you don't get paid.

I must respectfully disagree with you here. It's true that observing the dr-pt relationship in a hospital is important, but actually being the primary care provider on scene and relating directly to the pt in a therapeutic capacity (which is essentially the dr-pt relationship, only out in the field), is an incredible and equally valuable experience, in my humble opinion. The last I checked, this was considered definitive clinical experience. I don't know if you have any experience as an EMT-B or P, but prehospital care experience is undoubtedly clinical if you are running calls as part of a 9-1-1 service, or rescue squad. There is no better experience than when you are the direct care provider for a pt, in the hospital or prehosptial environment. You are not just observing therapeutic interaction, you are intiating that interaction. If you want to know the day-in-a-life of a physician, just shadow one for a few weeks (and I mean full shifts, not just for a few hours).

The role of an EMT is often misunderstood; EMT's are not just ambulance drivers in many states. As an EMT, you are part of EMS, and you are practicing medicine under the license of a medical director in a limited capacity (via standing or online orders), most often within an uncontrolled environment; there's no doubt about that. You are 100% responsible for the care of your pt in the field, within the context of a reasonable standard, until you can get them to a hospital, or appropriate heathcare center, where definite care can be initiated. When you arrive on the scene, you and your partner perform either a trauma or medical assessment, obtain relevant history, check a full set of vitals, give BLS or BTLS care if it is indicated, assign pt priority, and perform ongoing assessments during transport. You are interacting with the pt in a manner similar to a medical doctor; you listen to, reassure, assess, and treat the pt. In many cases, you and your partner are completely in charge of the scene. In a true BLS call, Doctors probably wouldn't do too many different things than you would, if they were out in the field under the same set of circumstances. This is, of course, not true with ALS calls.

Look, I'm not saying it is better to be an EMT than an ER-Tech. I'm sure both are equally awesome clinical experiences to have. It's really a matter of what you like personally; a matter of taste and also of what your state allows. There is some level of adrenaline rush involved in getting out there on a call at 3am, pedestrian struck, and being able to stabilize them enough to receive definitive care at a trauma center. Some people love that. On the other hand, if you like working in a controlled environment, do more technical work on a pt (ER-Techs sometimes do 12-leads, take blood, and do IV's and foleys) as part of a larger hospital care team, then be an ER-Tech. Some people love that. One relevant difference I can see between the two is that as an ER-Tech, you might have an opportunity to become exposed to the all-important diagnostic process, which you can't readily receive in the field as an EMT. I obtained that sort of experience by following an attending and his residents through every step of the diagnostic process, from database scrubbing, pt interview, to definitive care. Also, I should note that where I am from, EMT's don't usually get to be ER-Techs; most hospitals require CNA or paramedic training to be an ER-Tech.

OP, most likely you will have to be an EMT for a little while before becoming an ER-Tech, so trust your gut to either continue as an EMT, or try rotating at a hospital, if you want to check out being an ER-Tech. If you aren't certain about a career as a physician, then do shadow some doctors at your local hospital at the same time you are doing your EMT volunteering. Sometimes, because they know you are an EMT, they will let you get involved in checking vitals, or performing a physical assessment. I heard that my local hospital will allow that. Also, it doesn't hurt to volunteer at the ER or medicine ward, because that will give you plenty of exposure to what doctors do. FWIW, not that this is the primary consideration, but if you are a volunteer EMT, you are killing two birds with one stone in terms of what medical schools like to see; you are a volunteer in a health care setting, which shows that you are of the giving sort, and you are obtaining direct clinical experience.

 

[LifetimeDoc]

Not trying to disrespect EMTs, but being an EMT is not like being a doctor. They don't do the same things doctors do, they do what EMTs do. Sure it's all medical procedures or assessments, but you are getting a different perspective than what the doctor sees. If you enjoy the adrenalin rush of going out to the scene, and stabilizing a patient before they get to the ER/Trauma Center, then you want to be an EMT and not a physician. Medical schools will wonder why you spent all this time going after an EMT certification rather than focusing on your academics or doing everything you can to become a physician. I have heard from countless adcoms and deans that they want to see if you understand what a physician does on a daily basis.

A physician doesn't get to do all of the cool stuff on the scene, they are in the clinic juggling patients, waiting on labs, talking with patients and caregivers/parents/spouses/family, etc.. Being a physician isn't all high adrenalin stuff you may get as an EMT, but can be sometimes boring and mundane at times as well as exciting in other ways. I just feel that being an ER-Tech would give you a better handle on what a physician actually does from minute to minute since you are in the clinic with physicians and not out in the field.

 

[DeadCactus]

Well, I just sent an e-mail to the volunteer coordinator of the hospital and one to the director of the EMS unit to see if they even have any place for me. Heh, I might not even have any choice.

Thanks for all the oppinions so far everyone and I welcome any additional ones.

One additional concideration, however, I have quite a few years left before I will be applying to Med School; it would therefore not be impossible for me to get some volunteer time as both an ER Tech and an EMT. In light of this, would you all concider one or the other to be a better starting point?

 

[spicedmanna]

Not trying to disrespect EMTs, but being an EMT is not like being a doctor. They don't do the same things doctors do, they do what EMTs do. Sure it's all medical procedures or assessments, but you are getting a different perspective than what the doctor sees. If you enjoy the adrenalin rush of going out to the scene, and stabilizing a patient before they get to the ER/Trauma Center, then you want to be an EMT and not a physician. Medical schools will wonder why you spent all this time going after an EMT certification rather than focusing on your academics or doing everything you can to become a physician. I have heard from countless adcoms and deans that they want to see if you understand what a physician does on a daily basis.

A physician doesn't get to do all of the cool stuff on the scene, they are in the clinic juggling patients, waiting on labs, talking with patients and caregivers/parents/spouses/family, etc.. Being a physician isn't all high adrenalin stuff you may get as an EMT, but can be sometimes boring and mundane at times as well as exciting in other ways. I just feel that being an ER-Tech would give you a better handle on what a physician actually does from minute to minute since you are in the clinic with physicians and not out in the field.

Sorry, I didn't mean to become defensive. I understand where you are coming from, after some afterthought. As I was finishing my post, I realized that as an EMT you don't get readily exposed to the diagnostic process that doctors perform. You don't get to see all the database scrubbing (looking up prior diagnostic tests, labs and studies), the hard-core researching process, what's involved in coming up with the differential diagnosis, ordering the necessary studies, crunching the numbers, interviewing the pt for relevent Hx, and giving definitive treatment. Much of what an IM doctor does is project management and a lot of boring paper work to ensure the continuity of care and treatment. In my opinion the diagnostic/research process is truly awesome; that's one of the reasons why I want to be a doctor. I like solving puzzles related to the dysfunction of the human system. Furthermore, I get to treat pt's/people, too. That's a winning combination in my book.

Yes, I agree, EMT's are not doctors; they have limited scope of practice and don't diagnose. Also, there is little to no continuity of care. You practically only see your pt once. On the other hand, they do practice medicine in a limited capacity, so it's cool from that end, to be able to have that kind of direct impact and relationship with your pt. I guess it's a way for me to sneak that in, pre-medicine. But if there is another way to obtain that kind of direct relationship with a pt, short of nursing or PA school, I'd do it, too. As I mentioned before, however, my state doesn't allow EMT's to become ER-Techs without further training and certification. Bummer.

As for what adcomms like, I can't directly speak to that. But I will say that my IM attending friend was part of an adcomm a few years back and he made sure to tell me that actually practicing as an EMT looked very favorable in his committee's eyes for the reasons I outlined in my prior post. But, you are right, medical schools do want you to understand what a doctor does.

 

[spicedmanna]

One additional concideration, however, I have quite a few years left before I will be applying to Med School; it would therefore not be impossible for me to get some volunteer time as both an ER Tech and an EMT. In light of this, would you all concider one or the other to be a better starting point?

If you want to do both, there are some logistics to consider, much of which depends on your state. EMS is largely state run, and therefore each state has their own rules. In my state, I am required to affiliate with a fire station or state rescue squad in order to receive my certification and run 9-1-1 calls. I need to do this within 1 year of taking my certification test. I don't know what the rules in your area are, but I would check them out and what it takes to attain and maintain an EMT certification. I know in my area, I don't get to be a lead EMT until I go through an extensive probationary period where I do only ride-alongs, then I can become an aid for a while, and then finally ride as a lead EMT. It's a dedicated process. Just something to consider. It might be easier to become a volunteer at a local hospital, but that means you might risk lapsing your EMT certification and knowledge, although I'm sure it'll come in handy when you are working in the wards. If you could do a little of both at the same time that might be good, if it is easy and feasible. I re-examined your original post, and since you are really wanting to experience what medicine is like, and wanting to know if it's something you'd like to do, I'd go for the ER position before the EMT, if you have that choice and it feels right to you, simply because it'll likely give you greater exposure to the profession in question, in order for you to make a good choice.

 

[gotmeds?]

Not trying to disrespect EMTs, but being an EMT is not like being a doctor. They don't do the same things doctors do, they do what EMTs do. Sure it's all medical procedures or assessments, but you are getting a different perspective than what the doctor sees. If you enjoy the adrenalin rush of going out to the scene, and stabilizing a patient before they get to the ER/Trauma Center, then you want to be an EMT and not a physician. Medical schools will wonder why you spent all this time going after an EMT certification rather than focusing on your academics or doing everything you can to become a physician. I have heard from countless adcoms and deans that they want to see if you understand what a physician does on a daily basis.

It takes all of 130 hours to get an EMT cert. You can do it in a month. Just as EMTs don't know much about what doctors do, doctors generally don't know much about what EMTs do. To start with, EMTs and paramedics are not intechangeable. Paramedic training takes around 1300 hours (usually 1 or 2 years) and the scope of practice includes a lot of procedures that only doctors are generally allowed to do in the hospital. EMTs don't do any invasive procedures or give any meds. Technically, paramedics are not allowed to diagnose, but whenever I've stuck a 10 gauge needle into someone's chest, I was pretty sure that I was treating a tension pneumo rather than trying out some crazy new experimental treatment for psoriasis.

Anyway, after all that, I have to basically agree with you. EMTs and paramedics are not doctors. There are some similarities, but a lot more differences. If you want to see what a doctor does, ER Tech is a better job. Of course, so is shadowing, being a CNA, or anything else you can do in a hospital where you can follow doctors around. I was recommending working on ambulance because it's the type of experience that you can't get anywhere else. If I had decided to be an ER Tech instead of a paramedic, I wouldn't be applying to med school right now.

 

[45408]

Not trying to disrespect EMTs, but being an EMT is not like being a doctor. They don't do the same things doctors do, they do what EMTs do. Sure it's all medical procedures or assessments, but you are getting a different perspective than what the doctor sees. If you enjoy the adrenalin rush of going out to the scene, and stabilizing a patient before they get to the ER/Trauma Center, then you want to be an EMT and not a physician. Medical schools will wonder why you spent all this time going after an EMT certification rather than focusing on your academics or doing everything you can to become a physician. I have heard from countless adcoms and deans that they want to see if you understand what a physician does on a daily basis.

Schools like seeing that YOU did something, and since you can't be a doctor yet, they're generally more than happy to see CNAs, EMTs, hospital volunteers, etc. I was an EMT for the experience, and to pay the bills. I needed a job anyways. I made at least eight grand while getting my clinical experience. As for seeing what doctors do, I shadowed three surgeons, an anesthesiologist, and an ER attending. Nobody questioned my clinical experience.

 

[Pose]

Needing a job does make you cheerish the experience even more. Before I got my job as a tech, I was looking at a part-time job at Barnes and Noble for $6.75 an hour and no benefits.

 

[45408]

Well, let's keep it on the real I made $8/hr as an EMT, but I did get to "EMS" - "earn money sleeping" some of the time

 

[notdeadyet]

Well, let's keep it on the real I made $8/hr as an EMT, but I did get to "EMS" - "earn money sleeping" some of the time

Amen to that. I made $7.50 as an EMT, though it was years ago.

Note that the pay for ER Tech's is usually a good bit higher. When I was working, it was roughly double what EMTs made.

But keep in mind that working as an ER Tech, you lose your study time you find as an EMT.