UK Paramedic heading to CA

[ShockableAsystole]

Hello there, I have been lurking for a while now trying to get as much information as possible but I am left with a few questions. I am a UK HPC Paramedic and will be moving to Southern California toward the end of the year. The qualifications side of things seems to be relatively sorted with CA-EMS being very helpful.

Am I going to struggle to find a job? There is the obvious split between fire and private, I don't mind working for Fire as long as I'm still involved in EMS. Would I have to pay to go to a fire academy or do FD's recruit EMT-Ps and train you up? Do you earn more in a FD? Is it harder to find a job within FD?

Some threads seem to indicate that most places will not have you doing 911 work... how many transfer calls can there be? What does you day consist of without 911 work? In the UK we have our 999 work and then very occasionally we'll do a hospital transfer, I can't imagine a company dedicated solely to that.

I do have lots of other questions, mostly random, trying to picture my day to day work out there so it's not a shock when I come over. Many thanks for any responses.

 

[terrible one]

Where in SoCal are you moving?

Yes, you may struggle to find a job depending on where you are headed.
Yes, it is extremely difficult to get a job in CA with a fire department.
Yes, fire pays almost 3x more than privates.
Depending what FD you apply to will determine if you need an academy as a Pre-Req to apply. Even then you will most likely go through their academy.
Yes, privates can run a full day of IFTs. Even some emergency dedicated units will run more transfer calls then emergency runs.

EMS is far different in the US v. the UK, with CA being the worst state to work within EMS. If you don't have to move here I wouldn't. And if you do research the area and apply before moving. If you can find another state to live in I'd recommend that.
CA EMS for most privates involves pay just above the poverty line while being undervalued and under appreciated. Sorry to be the bearer of bad news, if you feel lucky you can play the FD lotto, but you will be competing against 1000s for that one spot.
Good luck.

 

[ShockableAsystole]

Thanks for your reply. I'm moving to CA for family reasons, it seems it wont be for the work! I appreciate the honesty!

It does seem strange, all the education that goes into becoming a Paramedic, along with the various other qualifications and certifications, along with the responsibility... where is the motivation for Paras in CA if it's as bad as you say?

As a HPC Para, EMT-P, a fire qualification, and an unrelated Bachelors degree... Am I likely to at least get an interview? (I realise this is a vague question, sorry). Would working for a Private alongside volunteering for the FD (presumably this is one way to get fire qualifications) be a good way of eventually working for the FD?

One problem I foresee is most privates are only BLS, are there many ALS privates out there. I see only AMR out of SD. I'm going to be living around Laguna Niguel/San Clemente area.

 

[terrible one]

The US standards to become a paramedic are lower than the UK, which is what most privates use to justify low pay and demeaning work. In CA there is no reciprocity for a 'fire qualification' if you want your FF1 or any other fire certs in CA you must volunteer and/or go through the appropriate courses.

Most private paramedics in CA apply to fire departments, nursing school, PA school, or some other career. Very few work their entire career as a paramedic. As far as getting an interview you need to review the departments testing process. The fire culture in CA is much different than the UK (I'm assuming). Look up what departments you are interested in and go talk to them. Each department is different.

In San Diego County (where you mentioned) most of the Northern cities are all transporting departments. AMR and R/M are the two private transporting companies in the county. Look up their EOAs to see what cities they transport in.

 

[Imacho]

In OC all the ambulances are BLS with OCFA providing ALS. The primary provider being Doctors Ambulance. As far as your certs... You may be overqualified for a medic spot, but without fire experience it will be difficult without a network connection. Hope It works out for you.

 

[AnthonyM83]

What part of California are you moving to? There are large differences in how EMS is run in different parts of the state.

In some places I've been told it's an average of 6 years to get hired as a firefighters, plus academy time, plus probation time, then some other times, then finally you get put on the ambulance or paramedic squad. In some areas the fire departments aren't even hiring for a few years so it doesn't matter what your qualifications are. So, it wouldn't make sense to go into another profession just work as a paramedic.

Then in other areas, you might just apply, get yourself on a waiting list, eventually get an interview, and start working as the 911 provider. What many people do in the meantime is work at a company that uses paramedics for interfacility transports (they don't have a 911 contract). Or work as a basic technician in an emergency department.

What county/city are you looking at?

 

[ShockableAsystole]

I am looking for work anywhere between northern San Diego and southern OC though willing to travel up to an hour. I can only assume its similar to here in that a registered Paramedic can't legally work as a Basic/Advanced (tech or ECA here) so I'm guessing all EMT-B jobs are off the cards.

Going from emergency work to IFT doesn't sound too exciting but I'll do what I have to do. OCFA is the fire authority presumably (not able to access their site from outside the US!), do they hire 911 work out to any privates? Can't see me being overqualified for a medic, our paramedics are extremely similar to EMT-P's, we have one or two less drugs but a lot more autonomy. About equal.

Are there just not many EMT-P's working in So-CA outside of a FD then?

I suppose my only real options without going back to school are to work for someone like AMR doing IFT until a FD takes a look at me. :unsure: Who covers San Diego's 911? Any ALS opportunities down there?

 

[Imacho]

AMR and rural metro both cover 911 response in SD County.

 

[DPM]

Once you have your National Registry / California Paramedic card you should be able to challenge the EMT-B... either way, I think you'll be able to work as an EMT-B if you really wanted to.

Rural Metro and AMR are going to be your best bet job wise. Some of the Fire Departments down there will have an ALS capability but might not transport... which is a concept that I didn't quite understand at first.

There's a few of us from the UK on here, if you've got any questions then feel free to DM me.

 

[m0nster986]

Moving down here for family reasons is one thing, but to find a career in EMS is another. Otherwise stay far away from EMS in Cali.

 

[ShockableAsystole]

Working as an EMT-B would most likely be very frustrating though.

Whats the pay like with AMR and Rural Metro? Looks like Rural and AMR both are recruiting for Paramedics.

Another question, on their requirements, they list "Paramedic Accreditation from the San Diego County EMS Agency", how does one go about getting that?

 

[DPM]

Working as an EMT-B would most likely be very frustrating though.

Whats the pay like with AMR and Rural Metro? Looks like Rural and AMR both are recruiting for Paramedics.

Another question, on their requirements, they list "Paramedic Accreditation from the San Diego County EMS Agency", how does one go about getting that?

Once you have your National Registration you take proof of that and a few other things down to your county EMS office. They take a look at all your stuff and give you your State / County Paramedic card. It's not hard or anything, takes an hour or so.

 

[terrible one]

Whats the pay like with AMR and Rural Metro? Looks like Rural and AMR both are recruiting for Paramedics.

$11-13/ish an hour starting. FYI they always say they are hiring, but that doesn't actually mean they are

 

[ShockableAsystole]

Yikes.

Sorry for the endless questions but some day to day questions... In the UK, were, er, run into the ground. We do 12 hour shifts and any longer than that would kill you as most days are spent going from one job to the next. I notice most places do 24hr shifts so I can only imagine the work is slightly different.

Typically, how many jobs do people do on a shift working for a company like AMR or RM? Ie is there down time? Do you sleep on nights?

Does billing get in the way of patient care? For example, going out to someone in pain with a # arm, do you discuss how much things are going to cost before cannulating and giving morphine? For the more serious patients, surely emergency care and billing people are incompatible?

 

[DPM]

Where do you work back home? Most privates do 12 hour shifts, with Fire tending to do the 24s, and I've not seen anything as busy as the LAS gets... but it depends on where you are. I also found that a larger proportion of calls here didn't require an ambulance at all, so on busy days you might only have 2-3 real ALS calls.

 

[ShockableAsystole]

Ah sorry, missed the part about you being from the UK. Im with WMAS so probably not as bad as LAS to be fair. I'm on the outskirts so tend to stay busier with my fair share of proper jobs but most of what we see doesn't need an ambulance.

If they're only 12hrs then that's fair enough, 24 just seemed crazy.

 

[DPM]

As far as I know, 24 hour shifts will be more like 'fire' shifts. Instead of posting at a car park somewhere you'll be working out of your station where you'll be able to get your head down / have a piss when you're not on a call. I've not done that here though but I'm sure someone will be along soon that will be able to shed some more light on this.

 

[RocketMedic]

Billing really doesn't affect care, but your documentation does. In many systems, billing is handled by third parties or prepaid by taxes or subscription.

 

[subliminal1284]

I am looking for work anywhere between northern San Diego and southern OC though willing to travel up to an hour. I can only assume its similar to here in that a registered Paramedic can't legally work as a Basic/Advanced (tech or ECA here) so I'm guessing all EMT-B jobs are off the cards.

Im not sure how it is in CA but here in WI if youre a paramedic you can work at any level below paramedic, basic, advanced EMT, intermediate etc.

 

[AnthonyM83]

If you get your paramedic license in California, there's no need to challenge the EMT (Basic). It's automatically part of your scope. There are dozens and dozens and dozens of people in the SoCal working as EMTs even though they have Paramedic licenses. The hardest challenge I see for you getting all your documents and syllabi from your paramedic program in the UK transferred over to get your P-license. Definitely call up the state EMS Authority to ask for details.

Then, most counties around here require an additional accreditation. You just take a day class on local scope of practice and take a test. It's to teach you local variances in protocols (and sometimes double check your skills).

If you're working in OC, you'll be working for a private ambulance company as an EMT. They'll basically be just transporting units, which FD Paramedics hop onto if patient needs ALS.

If I were you specifically, I'd start hunting for any EMT job at first (ER, IFTs, or 911) while you get your medic stuff sorted out and apply to FDs if that's your route.