Just finished my AVOC training yesterday. We finished in one day instead of 2. I had never driven an ambulance or any large vehicle (bigger than a jeep) before. Using those mirrors is a lot harder than it looks. I am amazed people were allowed to drive an ambulance in the past without this training. I am sure you can pick it up as you go, but those first few calls without experience could be dangerous. As of january 1, 2007 all ambulance operators regardless if they are driving must have AVOC training here in Maine.