Should EMT even be a prerequisite to paramedic?

[NYMedic828]

I'm sure this will get into some heated debate about BLS before ALS but it's been talked about a few times in my short time as a member here but I just wanted to get a general idea of what people think overall.

Is there real a reason for EMT to be a prerequisite to become a paramedic?

Personally, after completing my paramedic program I felt that EMT was just a waste of 150 hours of my life. It helped me in no way to perform better in my paramedic program and if anything it just lent to having a few bad habits to throw in the trash along the way. On top of that, most paramedic programs start from the ground up regardless and teach you that everything you have been doing as an EMT, is wrong and must be done a different way. I would much rather have been able to skip EMT, and just take a 150 hour longer paramedic program with a real A&P portion in the curriculum.

It isn't a requirement for an RN to be a PCA. It isn't a requirement for a doctor to be an RN or PA. Why should EMT be required to be a paramedic?

Mind you, I do acknowledge the fact that EMT programs are also money makers, and the dollar sign will always remain king. I am not advocating that EMT should not be an option should it appeal to you more as a "hobbyist" provider. Not everyone can afford a paramedic program and EMT does have its place (lets save that for other threads).

The poll is not public so please vote honestly. Keep in mind the purpose of this thread is not to turn into a "should the EMT level even exist?"

 

[usalsfyre]

No, it's a holdover from vocational "apprentice, journeyman, master" thinking. If you can't turn out a decent medic without "EMT experience" you should seriously evaluate what you're teaching people.

 

[eprex]

I'm the last person to ask since I'm only in the EMT course now, but I would say 'no'.

Make the paramedic course all inclusive (as I believe it already is) and increase the number of rotations and supervised hours in the field. Plenty of people go on to be a doctor without being an EMT, PA, or nurse first. They just go through incredibly rigorous schooling, rotations, and a long residency.

The whole 'but you need experience first' is a moot point if you have a significant amount of supervised calls before you're completely autonomous. Just stick the new people with the seasoned people.

 

[NYMedic828]

I'm the last person to ask since I'm only in the EMT course now, but I would say 'no'.

Make the paramedic course all inclusive (as I believe it already is) and increase the number of rotations and supervised hours in the field. Plenty of people go on to be a doctor without being an EMT, PA, or nurse first. They just go through incredibly rigorous schooling, rotations, and a long residency.

The whole 'but you need experience first' is a moot point if you have a significant amount of supervised calls before you're completely autonomous. Just stick the new people with the seasoned people.

I actually sat down with a young guy in my volly house who wanted to work for FDNY EMS and ultimately FDNY fire. I worked it out to be about a $20-30,000 loss he is taking (or not gaining) by applying as an EMT and not taking medic first on his own.

 

[med51fl]

I would re-vamp the paramedic program and add more diverse clinical rotations along with a real A&P program. I would also spend a lot more time teaching patient assesment and taking patient histories.

So my answer is not require EMT first, but change the existing paramedic program (i.e. OTHER).

 

[WuLabsWuTecH]

I said no, but that's because of the state of things right now in my area. I would say yes, but with the caveat that the paramedic programs have to be revamped.

Our department paid for a few basics to get their P-cards having basically no experience at all just because we needed the medics. The more experienced Basics don't have their P cards for various reasons and the "Free P-card" deal didn't change any of their minds to go get their medic. So the younger guys and gals went to get theirs even though many of them were out of basic school for less than 3 months and had fewer than 100 hours served at the station.

We are getting our first batch of medics from that program now, and the results are very disappointing. of the 5 we sent, 3 are afraid to do anything if there is not another medic with them, and 2 of them have the opposite problem and think they are God and do EVERYTHING under the sun whether it's indicated or not.

Of the 2 para-gods we have, they refuse to listen to more experienced basics who have been in EMS longer than they have been alive, and I wouldn't be surprised to see us let both of these medics go at the end of their contract.
Of the other 3, they are not as bad, but they just don't have the experience, and so now they are medics but still need to build up that time that they would have anyways as a basic to get to the same experience level.

So, with the caveat of for now, I think that medics should still have a prerequisite of not only an EMT card but also some experience before they take their medic course.

 

[NomadicMedic]

I believe the entire paramedic program curriculum should be expanded to include more general ed, but that's a separate topic. However, the idea of "some experience" while in the program is a good one. I don't believe that you should have to work as an EMT as a prerequisite, but I believe students should work as an EMT during the program. Much the way doctors have to perform the scut work during their internship. A four-year all inclusive program sounds like a solution, with the only entrance requirements being those that would apply to any other four-year degree.

 

[hogwiley]

Personally, after completing my paramedic program I felt that EMT was just a waste of 150 hours of my life. It helped me in no way to perform better in my paramedic program and if anything it just lent to having a few bad habits to throw in the trash along the way. On top of that, most paramedic programs start from the ground up regardless and teach you that everything you have been doing as an EMT, is wrong and must be done a different way.

Well why are EMT students taught to do things wrong? Why not teach them right from the beginning, instead of assuming every EMT student is an idiot who cant be trusted to think for themselves and instead have to be just taught to go by memorization. I personally dont care what is done with EMT Basic, ill let people with more education and experience make that call. I dont see a problem with having an entry level license, just increase the standards a bit.

I think an essentials of A&P class should be a pre requisite to any EMT class, so things dont have to be dumbed down so much. Oddly its the insistence on memorization and the fact no prior medical education is required that makes EMT school hard for some people. I know people who said they thought EMT Basic school was actually harder than Paramedic school for this reason.

Many EMT students start the class knowing NOTHING. We had students that actually were learning CPR for the first time when we did our BLS class at the start of the course.

 

[DesertMedic66]

I think EMT should be. Everyone always complains about "Medic Mills" and the job market being over-saturated. Having EMT as a prerequisite class will limit the number of people going into medic school.

Teaching for the EMT class I see all the students that start the program and honestly 1/4 of the students that start the EMT class should not take seats away from others who truly want them.

I love the way my future medic school accepts students. They have to be a current EMT. They have to have 1000+ hours of being an EMT. They have to pass an EMT final test and an A&P class. Then they have verbal scenarios that they have to preform well in.

Heck even our EMT class has a prerequisite reading class.

 

[NYMedic828]

Well why are EMT students taught to do things wrong? Why not teach them right from the beginning, instead of assuming every EMT student is an idiot who cant be trusted to think for themselves and instead have to be just taught to go by memorization. I personally dont care what is done with EMT Basic, ill let people with more education and experience make that call. I dont see a problem with having an entry level license, just increase the standards a bit.

I think an essentials of A&P class should be a pre requisite to any EMT class, so things dont have to be dumbed down so much. Oddly its the insistence on memorization and the fact no prior medical education is required that makes EMT school hard for some people. I know people who said they thought EMT Basic school was actually harder than Paramedic school for this reason.

Many EMT students start the class knowing NOTHING. We had students that actually were learning CPR for the first time when we did our BLS class at the start of the course.

Because to teach things properly, would far exceed the allotted timeframe of an EMT program.

An actual A&P class would also eat into a solid half or more of the EMT curriculum timeframe.

 

[med51fl]

"I think EMT should be. Everyone always complains about "Medic Mills" and the job market being over-saturated. Having EMT as a prerequisite class will limit the number of people going into medic school."
I wish this was true, but it is not. Here in Florida you must take 1st Responder, then EMT, then Paramedic. Despite these prerequirements, there is an over-abundance of "paramedics" being turned out by the medic mills. Most are private schools and will work out payment plans, etc. to help pay for it. The instructors working there will "make sure" you can pass the State test (regardless of what you really know). There is a huge glut of poorly trained paramedics in Florida even with the EMT requirement.

 

[Veneficus]

Many EMT students start the class knowing NOTHING. We had students that actually were learning CPR for the first time when we did our BLS class at the start of the course.

Sounds like most medical students I have met.

 

[mycrofft]

Revamp EMT to be transferable units towards Paramedic and sure. In my experience, LVN (License Vocational Nurses) who went into nursing college had a slightly easier time and did better work because they were up to speed on many pragmatics of working with sick, injured and cranky people.

 

[eprex]

Many EMT students start the class knowing NOTHING. We had students that actually were learning CPR for the first time when we did our BLS class at the start of the course.

Ugh, why would they? Other than the assumption or evidence that most people in an EMT course already had experience in EMS.

I certainly didn't know CPR when I entered the class, short of during some primitive attempt at compressions and giving breaths every so often. Basically TV CPR.

 

[eprex]

The way I see it is that incompetent, lazy people are incompetent and lazy. It doesn't matter if you've been an EMT for X amount of time, if you care only enough to squeak by, then you won't be a good paramedic either.

 

[Achilles]

Ugh, why would they? Other than the assumption or evidence that most people in an EMT course already had experience in EMS.

I certainly didn't know CPR when I entered the class, short of during some primitive attempt at compressions and giving breaths every so often. Basically TV CPR.

Well in michigan you learn CPR oin Health/ fitness class. And you still have to learn it even if you already have your card, unless you have a really awesome teacher that lets you leave class early because its 7th hour and you own a business and you have to go work

 

[intellectualfish]

I think having folks complete some level of EMT license before medic school is beneficial to everyone involved. The most important function that requiring EMT serves is allowing people to "try out" EMS before getting all the way through medic school and figuring out that this is not the job for them. Each level of certification you put before providers is another filter that serves to keep incompetent/unqualified people from pissing the pool we call paramedicine. Also, it's nice to have experience with the whole testing/licensing process before the end of your medic program.

 

[Aprz]

In AU and NZ, don't they start working as a Paramedic after 18 weeks of schooling? That's about how long it takes to become an EMT where I live. After those 18 weeks are up, they continue to go to school. I don't think those first weeks focus on BLS only, I don't think they even consider BLS and ALS separate. That's how I think it should be. That should give them a good idea on whether they like EMS or not. To me, being an EMT feels completely different from being a paramedic. I think they should have a little taste of both, and a taste of the field early on (with supervision).

 

[JDallas]

BLS needs to be a prerequisite to ALS.

If you become a paramedic without being an EMT-B first, you won't be as familiar with the skills of your EMT-B partner. Paramedics definately need to know what their partners can or cannot do.

 

[hogwiley]

Because to teach things properly, would far exceed the allotted timeframe of an EMT program.

An actual A&P class would also eat into a solid half or more of the EMT curriculum timeframe.

Actually an A&P class would probably eat up MORE time than EMT school, but you wouldnt need to increase the length of EMT class, only require previous training before you began, and maybe change the course material somewhat to take into consideration this previous education.

Some sort of A&P class should be a prerequisite to starting EMT school. If you havent passed A&P with a C or better, you cant go to EMT school, period, problem solved. This means theyll be a lot less people starting EMT school, but the field is already overcrowded to begin with, so no big loss there. It would probably mean that all EMT and Paramedic schools would have to be at accredited institutions, which would also be an improvement.

This would also eliminate some of the people who just go to EMT and Paramedic school because they want to be firefighters.