The paramedics I know in our paramedic-RN bridge program, have been practicing as paramedics for 5-15 years and want to get off the trucks. Most have families with young kids, so moving to another town for PA/MD school is out of the question. Here, we have this bridge, BSN, and FNP school in the same town, so they can get to midlevel (NP) without having to move 150 miles away (closest MD or PA school). So, it is not necessarily a case of being mediocre, but of finances and moving families.