Qualities in an EMS fellowship

[quicknss]

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I'm currently contemplating pursuing an EMS fellowship and am interested in getting everyone's opinion on the most important qualities to look for in EMS training? Also my region of interest in the southwest US, ideally Texas or Southern CA due family ties.

Thanks!

 

[emsfellapp]

Bump....

Any thoughts on specific programs that would be of interest? (not southwest specific)

Thanks in advance

 

[DoctorMedic]

I too and debating this (although that will be for 3 yrs from now). I think it really depends on what you want out of your fellowship and what you plan to do with it. Do you plan to big city fire/ems based for a major city then maybe you want to find a larger urban program. There are a few suburban/urban ones like Saginaw, MI (just an example) that is med direction for a county and large commercial ALS company. Some may be more flight dependent. Guess it depends on your flavor.

 

[medicsb]

I'm interested in EMS as a fellowship, but as a medic myself, I find myself looking at the type of EMS system in which a fellow would work. To me, any system that has paramedics on fire engines is automatically a crappy system and not a place where I'd want to learn to be an EMS physician. Flight is almost all hype and any program that is heavy on aeromedical is probably a big part of the problem with aeromedical services today - gross/dangerous overuse.

In my opinion, CA and most of Texas is an EMS crapshoot.

 

[EM_Rebuilder]

I'm interested in EMS as a fellowship, but as a medic myself, I find myself looking at the type of EMS system in which a fellow would work. To me, any system that has paramedics on fire engines is automatically a crappy system and not a place where I'd want to learn to be an EMS physician. Flight is almost all hype and any program that is heavy on aeromedical is probably a big part of the problem with aeromedical services today - gross/dangerous overuse.

In my opinion, CA and most of Texas is an EMS crapshoot.

Words of wisdom... 80%+ of EMS medical direction is Political and Situational Savviness... Statements like above can be detrimental to your EMS career.

The medicine is certainly different then what we do in a state of the art emergency department, but reasoning through prehospital practice is not terribly hard for someone who gives it some effort. The hard stuff is dealing with personal issues, administration, hospitals, and your community. At least that has been my experience....

I did not answer the OPs question, I think a system that gives you the most autonomy would be the best. If the fellow is dealing with the above, with the teaching staff giving oversight in the background, then it will probably give you a great experience.

For what its worth, I am not an EMT or medic and have no formal EMS training. Like many directors in the past, it sort of fell my way about a year ago. Lots of learning for me on the job, and I have met some tremendous 'mentor' types out there and find the EMS director community is always very open to helping anyone out.

 

[DrDrummer]

Caveat: MS3 here-- planning on going EM, hopefully staying here in Houston. I also work very closely with a lot of the faculty, including one in the EMS Fellowship, on research and have a brother and father who are firefighter/paramedics, one of whom just completed the CC-EMTP course offered here and run by the EMS faculty in our EM department.

Take a look at our program at UT Houston. The guy who runs it is one of the best teachers in the department, has a very diverse and interesting background, and HFD utilizes MDs in a big way. Houston has a very interesting tiered-response system of dispatch, and we send MDs out on ACLS calls when they're in the area-- as a fellow, you'll get to do some pretty cool stuff with/for HFD, along with working in a high-volume Level I trauma center with great colleagues. Obviously I'm biased, but if I was looking to do an EMS fellowship and especially if you're interested in TX, I'd consider this program.

 

[jbar]

I think some of it depends on what kind of exposure you are looking for. Some seem to be very broad, you are running around doing a lot of different elements of EMS. Tactical, flights, SAR, rescue, etc. Some are much deeper in one area like spending most of your time working with traditional paramedic/EMT services. Some people are coming into fellowship with a lot of previous exposure in a part of the field and are less interested in repeating that experience. I did 5 years of search and rescue prior to med school, spent about 9 seasons ski patrolling. While it would be fun to do fellowship somewhere with a wilderness component, It's not something that I feel I need to really work on. For someone else getting to do high angle rescue training or working with a ski patrol would be a really cool new experience.

 

[quicknss]

Words of wisdom... 80%+ of EMS medical direction is Political and Situational Savviness... Statements like above can be detrimental to your EMS career.

The medicine is certainly different then what we do in a state of the art emergency department, but reasoning through prehospital practice is not terribly hard for someone who gives it some effort. The hard stuff is dealing with personal issues, administration, hospitals, and your community. At least that has been my experience....

I did not answer the OPs question, I think a system that gives you the most autonomy would be the best. If the fellow is dealing with the above, with the teaching staff giving oversight in the background, then it will probably give you a great experience.

For what its worth, I am not an EMT or medic and have no formal EMS training. Like many directors in the past, it sort of fell my way about a year ago. Lots of learning for me on the job, and I have met some tremendous 'mentor' types out there and find the EMS director community is always very open to helping anyone out.

Thanks for the input. It seems that even after a 1 year fellowship much will be on the job training as you settle into a job in a particular community. I'm gathering that it is about learning how the system works in a general level with basic clinical skills