Will medical school make me a better EMT?

Discussion in 'Pre-Hospital [ EMS ]' started by han14tra, Dec 25, 2008.

  1. han14tra

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    I've been an EMT since I was 16, and I really don't feel qualified to do what I do. I work for a volunteer service over breaks from college, and so I don't get a lot of experience. Yet, since I work in a small town I'm often the sole provider of care. Will medical school make me a better EMT? Will I gain experience setting up IVs like I do for medics, reading and taking EKGs, backboarding, etc?
     
  2. michaelrack

    michaelrack All In at the wrong time
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    In your 3rd year of med school, you will gain experience putting in IV's.

    In med school, you will gain experience reading but probably not performing EKG's.

    Not much experience backboarding
     
  3. howelljolly

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    Thats a bit of an unusual question... usually its the other way around

    I would ditto what Dr Rack said.

    As long as you make the effort to extract useful skills from medical school to apply to EMS, then yes... you will become better. But like everything in med school. It's what you make of it. You could also extract bad habits, or learn things that, for example, might make you overthink things, and slow you down, or second guess a protocol.

    Though I wonder... you'll be 8 years out of EMT school when you're doing these things in med school. Wouldnt you have gained experience anyway buy that time?
     
  4. FrickenhugeMD

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    It will at least make you a more competent health care provider.

    Not sure why being a better EMT is more important to you if you goal is to be a physician, these jobs are at entirely different levels of the health care "food chain". If you are concerned about EMT skills, why not forgo the 8 years of medical education and become a full blown paramedic?

    Either way, by the time you even get to 3rd year when you learn these skills you wont have much time to go back and help out except for the holidays and the occasional month off. You will feel more comfortable around patients and doing most of what you describe though.
     
  5. han14tra

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    I still want to volunteer in EMS when I'm in medical school and even when I'm a doctor (family medicine). I just want to make sure I'm learning stuff in medical school that will refine my skills so that I can handle a trauma pt better. EMS con-ed is a joke. You watch a few videos and take a test.

    Also, another question just came to mind. I'm considering doing a FM residency but perhaps a EM residency on top of that. I only want the EM so that I can do volunteer EMS (possibly being a medical command physician) and teach a few medic classes. Is there an easier way to reach these goals other than an EM residency?
     
  6. MedicFL

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    Once you become a doctor you may not be able to ride on an ambulance anymore.. Each state varies on this but the majority I know of will no longer allow you to work on a rig as a EMT or Medic you must do so as a doc, and then that brings up the medical control issue and the agencies insurance and your own insurance for that matter.. It sound like to me that you went to a crappy EMT school, if you are not able to feel confident in your skills as an EMT after 8 years on the job I am not sure what to say to you... If sounds like to me that you haven't put the effort in to seek out additional trainings to better yourself.. Those two residencies are totally different, you don't need EM to teach medic classes, most medic classes are taught by medics. Also at least in FL to be a medical director you dont have to be in EM to do so... It sounds like you have a bunch of research that needs to be done before you start planning out your life goals..
     
  7. howelljolly

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    In that case, yes... as long as you make the effort, keep reading EMT textbooks to keep things in perspective you'll learn things that will make you a better EMT. The reason I stress this is because you may have to resist the urge to stay and play, and remember to decide to load and go.

    To volunteer on EMS or teach medic classes, you do not have to be an EM physician. However, as far as online medical control, you'll probably have to be the attending physician in the ER from which the paramedics are based out of.

    There are currently one or two EM fellowships for FP residents. However, these are shutting down, as they do not lead to Board elegibility in EM... while EM residencies are opening up. So by the time you do your residency, you'll proabably have to choose one or the other.
     
  8. DeadCactus

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    Have to be 18 to be an EMT...
     
  9. howelljolly

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    you have to be 16 to take the class. 18 to practice
     
  10. DeadCactus

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    Touche.
     
  11. psychbender

    psychbender Cynical Member
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    18 to practice as an Attendant In Charge. You can still use the skills as an assistant (many volunteer agencies have Junior squads).

    I'll echo what howelljolly mentioned: sooner or later, the increased knowledge you will obtain through medical school will cause you to vapor-lock, as you overthink your protocols and start considering the "what ifs?". However, you will also have a greater understanding of the underlying disease processes in your patients, and therefore may feel more comfortable with the truly sick ones than you would otherwise.

    The EMS CE in your area sounds terrible. Are you just watching EMSAT videos? You should see if your state offers an annual EMS conference or symposium with classes on various topics. You might also see how much CE you can get for classes such as ACLS, PALS, or ITLS/PHTLS.

    With regards to being a physician and EMS education and medical direction, it is not necessary to be an EM physician. Check your state's regulations, some will say an EM physician, or any physician that keeps active ACLS and PALS, and meets the approval of the other Medical Directors in the state. I plan on staying involved in EMS education, and I'm going into Anesthesiology.
     
  12. han14tra

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    Thanks for all the input so far. In PA, you can be a crew chief when you are 16. On my first call out, I was the only one in the back of the ambulance for a BLS call. I'm just sick of paramedics telling me to set up IVs and the monitor when my EMT class did not teach me how to do that.

    Also, I had no patient exposure during the EMT class. I was basically thrown in the back of the rig the first day after a graduated, and expected to somehow put everything I learned together.
     
  13. Forthegood

    Forthegood ProcrastinationAficionado
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    ^This is why I chose NOT to live in a small town.

    A new version of see one, do one, teach one....:laugh:
     
  14. emedpa

    emedpa GlobalDoc
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    Have emt-basic programs changed so much since I did mine in the 80's?
    didn't you have a day or 2 on als-assist level skills?( IV/monitor/aed/etc)?
    didn't you have to spend a few shifts in the hospital and a few shifts on a rig?

    on a separate note I worked as a medic while in pa school in pennsylvania.
    ems there was REALLY SCARY......way too many volunteers who had absolutely no clue who went through their emt training just to get a blue light for their car.....talk about ricky rescue
     
  15. COMedic2Doc

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    I'm beginning to wonder the same thing, and I just became certified in 2000 as an EMT. Granted there wasn't a ton of time spent on ALS-level assist, but still it seems to have changed. I do find interesting the discussion on being able to attend at the age of 16, as most states I'm familiar with expect you to be 18 for state certification. Also, whenever I've worked for a new agency or worked with a new Paramedic as an EMT they generally tried to make sure I understood things like setting up for an intubation, the monitor, handing them particular drugs, etc, and so I've done the same as a Medic for my partners.

    On the Medical Director note, or Physicians working in the field. I know here PAs are allowed to work as a Paramedic for example, and not be held to the same level they are in the ER for their protection and that of the Medical Director. I want to say it's the same for Physicians here, but I can't remember for sure.

    EMT for a blue light? Yep, sounds like some I've met as well both paid and volunteers. It's truly scary when you think about it, especially when they tend to be the ones that don't come for CE even when it is offered.
     
  16. emedpa

    emedpa GlobalDoc
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    I know pa's who still work as medics but they have kept their medic certs and work under that certification when in the field. some states allow pa's to challenge the medic cert.
    pa's can also be base station medical control (which I have done at 2 prior jobs) which is a fun role as a former medic.
     
  17. COMedic2Doc

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    Yeah, a friend of mine (PA, former Fire EMS Chief for a Metro Department) and I are starting at a volunteer agency after the New Year and he's kept his NREMT-P up just to have it and misses the field. So since we're both currently out of the field, we're goin up to run some calls, etc.
     
  18. MedicFL

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    I went through in 2002-2003 my EMT and Medic I did EMT at 16 my junior year of high school and my Medic I started at 17 my senior year finished right at 18 and took my medic exam..
     
  19. MedicFL

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    WHat state can a pa be a base station medical control? In FL in order to step outside protocol you must have the ok of your medical director and or another doctor who happens to be on scene that is willing to accept patient care..
     
  20. EMmedic

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    After your next call with paramedics, I think you should just ask them if they can show you how to set up the monitor/IV etc. Explain that you never learned that and aren't sure what to do when they ask you to help. I'm sure they will be fine with teaching that to you and will probably appreciate it. As a medic, I definitely appreciate the BLS crews that ask questions and try to learn more from every call.
     
  21. docB

    docB Chronically painful
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    When I did my EMT training back in 1991 :eek: we were taught IV set up (spiking the bag and flushing the tube) and monitors (smoke over fire, white on the right) in my class.
     
  22. Captain Fantastic

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    +1, although my cert was a bit post 1991. ;)

    Unfortuately, the NREMT exam doesn't include any competencies for acting as an EMT on an ALS crew. Spiking bags, setting out the catheters/blood tubes, putting the patient on the monitor, etc., are all EMT duties regardless of what you learned/didn't learn in class.

    In fact, most medics will (should) pimp the crap out of you the first few shifts you work with them to gauge where you are/what you know and to show you how they like the back of the bus to run during their shifts. Some medics like Mac blades others like Miller, and being on-scene is not the time to learn how to set-up the laryngoscope for your medic!
     
  23. psychbender

    psychbender Cynical Member
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    None of that is taught in the Basic classes out in my neck of the woods, but the agency that I run with has made it a requirement that all new members be checked off on those skills before coming off probation (along with other skills like cot handling).
     
  24. emedpa

    emedpa GlobalDoc
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    Not as stringent on the west coast where any er doc, pa, or rn (who has taken the micn course) can give direction to medics in the field.
     
  25. NPEMTIV

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    It made me a worse one. I now find myself trying to approach situations as a student physician and not an EMT anymore. Much of what I want to look at are out of the scope of care for my licensure. I also don't like dealing with some medics now. If I were a medic it'd probably be a bit different since my scope would be higher and I'd be the guy making more of the calls. Anyhow, I only work maybe 10 shifts a year so its really no big deal.
     
  26. NPEMTIV

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    :thumbup: This is the same as in Tennessee. You can't "moonlight" as a medical director anymore.
     
  27. NPEMTIV

    NPEMTIV Accidentally Accepted
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    This is exactly what I was talking about above! Well it's what I meant to say above, only put much better. I still work a few shifts as mentioned above for some extra cash, but its a completely different experience now and I find I'm ready to move on. (I don't plan on renewing my license any longer)
     
  28. howelljolly

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    On my first run as an EMT-B, one of the medics who backed me up was one of my class instructors. So, after my first run I knew how to set up the monitor. As I set them up for the medics without being asked, they started showing me other things... how to spike and run the bag... how to set up the nebulizer... and I'd ask questions.

    Its like med school. Show that you know some things, and show interest in what you dont know. Medics and Residents will be more than happy to show you things.
     

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