Dont get caught up in the degree hype

[Akulahawk]

LMAO do you HONESTLY think that the academics that control a degree pathway for EMT/paramedics are going to stop with an AAS?

I dont think an AAS is bad. Problem is that 10 years down the line it will turn from AAS into B.S. Ten years after that it will turn from B.S. into M.S. Ten years after that it will turn from M.S. into doctorate degree.

And who gains from this the most? It's not the EMTs/paramedics who will get saddled with tens of thousands in extra debt for very poor return on MEANINGFUL CLINICAL SKILLS. It will the colleges/academics who laugh all the way to the bank that they were able to dupe gullible people into getting education that provides a very poor return on investment.

We need REAL education, and that means CLINICAL TRAINING, NOT ACADEMIC B.S. DEGREES. We need vocational apprenticeship type programs where hours in an ambulance are prioritized over meaningless time in a classroom.

Ask any M.D. what they remember about organic chemistry or biochemistry and they will laugh in your face.

What we need is a really solid understanding of 3 things: Normal physiology, pharmacology and pathophysiology. When I first became a Paramedic, I had a reasonably decent understanding of 2 of those things. One of the prerequisite courses I had to take for RN school was microbiology. Ask me what I remember about it, and I'll tell ya that I learned a lot about growing little bugs. Ask me about how it applies to Nursing, and I'll tell ya that I know it takes a few days to get bugs identified and determine their sensitivity to antibiotics. Also some bugs like different growth media, so you may have to use different collection tubes to ensure optimal growth, because some media may inhibit their growth and thus you'll have a false negative.

But with all the schooling behind me, I can certainly say that I'm not a worse provider for it. If I'm coming from a facility where they've somehow managed to get a bunch of labwork done before calling me, it makes it a whole lot easier for me to determine what my treatment plan will be, knowing what's going on from that standpoint, in conjunction with my physical exam.

Don't get me wrong, we still very much need vocational time too. We absolutely must know how to actually do the job when we finish school. We should be able to graduate from school and hit the streets, being safe, capable providers with minimal orientation to the specific working environment. It also takes a new medic a good year or two to really settle into the role, but at least we can get them out the door and able to practice in a safe manner until they find their own way.

 

[the_negro_puppy]

In most of Australia a Bachelors degree is now required to be a Paramedic, with a Masters to work at the highest level (intensive care, helicopter etc)

 

[JPINFV]

In spite of those 10,000 hours of training, they are getting their lunch eaten by PAs and NPs with less than 1/4 that training.

1. How many poor doctors do you know?
2. How many unemployed doctors do you know.
3. The unsupervised/undersupervised midlevel pyramid is going to come crashing down the first time one of them gets sued for malpractice.
4. In properly supervised practices, the attending makes bank while his team sees more patients. Of course this requires a change from physician as a medical provider to physician as medical supervisor, which is not what most physicians go to school for.

 

[ExpatMedic0]

We need REAL education, and that means CLINICAL TRAINING, NOT ACADEMIC B.S. DEGREES. We need vocational apprenticeship type programs where hours in an ambulance are prioritized over meaningless time in a classroom.

I think you have some misconceptions about "real education."

Correct me if I am wrong here, but a professional degree would be considered a terminal degree in a work related job that teaches you a foundation of academic skills needed to move onto the practical aspect of the degree, which is to do the job (often including long internships or training outside a classroom for the learning of a trade) an example of this would be medicine, resulting in the terminal professional degree of an MD. Is this not "real education?"

I believe what your referring to is an academic degree on the other hand, which would be considered more scholarly in nature. Normally focusing on research and dissertation for its terminal degree path. This type of degree generally does not include long internships, nor does it teach you a specific hands on work related skill as does a professional degree. An example of a terminal degree like this would be a PhD in say, well... Philosophy for example.

As long as Paramedic remains the major it would be considered a "professional degree" and would most likely extend our current internships and clinical hours for clinical based paramedic degree programs. This is what it has done in Australia, the UK, South Africa, Canada, and every other English speaking 1st world country. Those guys do not sit in a classroom for 3-4 years, they spend a large portion of there degree time learning (if I may be so bold) the art, of paramedicine, or as you may prefer, the trade.

What minimum standards we have for the industry right now is a vocational tech trade. Practical examples of our current colleagues would include a barber(barber school actually requires more hours than paramedic school),bicycle mechanic, ect.

 

[WTEngel]

The OP in this thread just wreaks of the "your education is all fine and dandy, but street smarts is what saves patients..." mentality.

You may think you're saving patients OP, but you're likelymtomundereducated to even know the ones you're killing, or how you're killing them.

I am not saying lack of a degree leads to killing patients, but the attitude of "everything I need to know I learned in paramedic school" is short sighted and is in large part what is responsible for the failure of EMS in America to step up as a profession.

Regarding your point about physicians not remembering anything about organic chemistry, you've missed the boat entirely, most likely because you've never sat in a course like organic or biochemistry.

These courses are not designed for the student to leave remembering everything about organic, biochem, genetics, or whatever the case may be. They create a foundation, and teach you how to "learn" when there is no professor present (better known as RESEARCH) and be able to seek and find answers when there is no one to hold your hand...all essential skills for a physician, or any other healthcare PROFESSIONAL. Why EMS has not caut onto this, I can not understand.

I began as a vocationally trained paramedic, with no intention of ever getting a degree. I even made it as far as flight medicine before I went back to school. I was even regarded as a "sharp" medic in many circles. I was still too stupid to "know what I did not know." It wasn't until I went back to get my BS and my MS that things started to really fall into place.

There is an old saying, that a little bit of education is a dangerous thing. This rings very true, because the less education you have, the less aware you are of the enormous amount that you do not know. There is also a saying, "the more I learn, the less I know." This is also true, as the further you go with your education, the more aware you are of how complex the processing of caring for and healing human beings really is.

I encourage all of my colleagues and friends to complete a BS. The importance of this degree will likely not be realized until you've completed it.

 

[fma08]

There's a lot of threads on this forum about how basic EMTs need bachelors degrees, paramedics need masters degrees, etc

Going down the degree pathway is fool's gold.

Consider the case of physicians. By any standard they have by far the most formal training. Over 10,000 hours of clinical training just to be a basic primary care provider.

In spite of those 10,000 hours of training, they are getting their lunch eaten by PAs and NPs with less than 1/4 that training.

The same thing will happen to EMT/parameds if you go down the same pathway. You might have a fancy degree behind your name, but the market will undercut you with a cheaper provider who can do the same thing you can for much less educational cost.

If you go the degree route, you will inevitably give up control of the educational pathway to academic PhDs who have never practiced as a first responder. I'm talking about them forcing you to take BS classes on ethics, healthcare policy, cultural competency, and other crap that has nothing to d with your job in the ambulance.

 

[Christopher]

If you go the degree route, you will inevitably give up control of the educational pathway to academic PhDs who have never practiced as a first responder. I'm talking about them forcing you to take BS classes on ethics, healthcare policy, cultural competency, and other crap that has nothing to do with your job in the ambulance.

You apparently have no idea how a degree program works...and this is coming from a software engineer who worked without a degree for many many years.

This is a great example of why low wages are Ok for EMS.

 

[Christopher]

We need REAL education, and that means CLINICAL TRAINING, NOT ACADEMIC B.S. DEGREES. We need vocational apprenticeship type programs where hours in an ambulance are prioritized over meaningless time in a classroom.

An academic paramedic will eat your lunch every day of the week, and twice on Sunday.

"Street smarts" means Experience Based Education, which is only as good as your experience. Why not learn that up front in class instead of on your patients as part of a hard knocks OJT?

I won't disagree that we need more clinical training, and perhaps a vocational model is not a bad way of doing it. Just if you think I'm going to choose a vocational paramedic over a degree based paramedic when I'm looking to pay providers at my service. Ha ha ha, you are funny.

Technicians using a vocational approach is probably a perfect model. Top them out at the EMT clinical set, akin to ER Tech's.

Clinicians using an academic approach would supplement them and provide the coordinated and effective care missing from the vocational side.

 

[VFlutter]

Ask any M.D. what they remember about organic chemistry or biochemistry and they will laugh in your face.

Ask any (Most) Paramedic what Amiodarone and Grapefruit juice have in common and they will give you a blank stare....


We still have a Diploma nursing program in our city, one of the last few in the country. We will get a diploma RN at our hospital every once in a while. While they are competent and can safely do their job I would definitely not consider them experts nor exceptional. There is a substantial knowledge gap and it is evident. All skills very little knowledge.

 

[Handsome Robb]

Somebody ban this toolbag.

This is the exact type of person we DONT need in or around EMS.

You know PlatoOn has two "O"s btw.

 

[Christopher]

Ask any (Most) Paramedic what Amiodarone and Grapefruit juice have in common and they will give you a blank stare....

Both have the same level of evidence for the treatment of VF/VT?

 

[Handsome Robb]

Both have the same level of evidence for the treatment of VF/VT?

That's what I was going to say.

 

[JPINFV]

p450 inhibitors?

 

[JPINFV]

Ask any M.D. what they remember about organic chemistry or biochemistry and they will laugh in your face.

Here's the thing about the foundational sciences. Can I recall every step of the Krebs cycle from memory? Nope. Can I sit down and push electrons around or answer synthesis problems? Nope.

Do I still remember the underlying concepts from both? Yes. ...and those underlying concepts are what helps me interpret the medical world and new medical literature. Just because people lose the specifics of a course because they no longer use them doesn't mean that the broader understanding is lost.

 

[VFlutter]

p450 inhibitors?

MAGIC RACKS in GQ

 

[Flightguy]

My head hurts after reading this.

 

[Handsome Robb]

So...with the OPs argument we should just abolish all medical schools and have Doctors and Surgeons learn OTJ...

Since:

 

[Meursault]

In spite of those 10,000 hours of training, they are getting their lunch eaten by PAs and NPs with less than 1/4 that training.

Oh god there's a full-on incursion of SDN trolling. Someone find the leak.

 

[Handsome Robb]

Dont NPs and PAs require physician oversight? Even if thats just an MD that swings by the clinic once a month and is available for consults?

Doesn't exactly sound like NPs and PAs are eating anyone's lunch.

 

[JPINFV]

Dont NPs and PAs require physician oversight? Even if thats just an MD that swings by the clinic once a month and is available for consults?

Doesn't exactly sound like NPs and PAs are eating anyone's lunch.

1. Some places allow NPs to practice without any oversight.

2. "Oversight" has pretty much the same range as "EMS medical director." Some places the physician will review every case, some places the supervising physician is an absentee landlord.