Why is this so hard?

Photo by Adrian Stewart

I recently took a vacation with my wife to the Sunshine state (Florida). While we were in central Florida, we passed by the Nature Coast EMS station in Lecanto. I am always looking at job opportunities so I took a gander at their website. Being a curious medic I looked at other agencies in the region and found a few that were looking for paramedics.

We pipe dream a lot about moving to a different state (or even different countries). I feel like it should be easy for a paramedic to become licensed in any state in the union, but that is not the case. In the age of National Registry Testing and a mandated minimum educational requirements set forth by the Federal Department of Transportation it should be easier to move from state to state.

According to EMT-Rescources.com the following states do NOT offer reciprocity with NREMT-P certification

  • Alaska
  • Delaware
  • Georgia
  • Illinois
  • Maryland
  • Massachusetts
  • Oregon
  • Pennsylvania
  • South Carolina
  • South Dakota
  • Virginia
  • Utah
  • Wyoming

So I openly ask all these states and any not listed, why do you not offer reciprocity? What vital skills, didactic lessons or other reasons do you have to deny people from seeking employment in your state? With all the talk that there are not enough paramedics in this country why do you continue to limit who can work in your state?

I have an idea for the EMS 2.0 movement. Let’s take EMS out of the DOT (unless we are content being ambulance drivers). Are the police department, fire department regulated by the USDOT? How about your local hospital, do they have to follow the DOT standards relating to patient care?

National Registry for Emergency Medical Technicians is not a perfect testing system, but it does work. You may not like it, so then help them adapt and change rather than fight NREMT. Kentucky requires basic and paramedic candidates to take the NREMT tests to obtain state recognition. So does Florida (when I took EMT-B class there), but they will not provide reciprocity from other states.  Let’s make it easier for the EMS professionals to move from state to state. Each agency can adopt entry exams/skills tests if they wish (and I do think that they should).

Please send all hate mail to me.

About Joel

I am a paramedic, firefighter and I work for an organ procurement organization. All stories related to work have been altered to HIPPA standards and for the protection of those involved. The personal stories are different. Photography, flying, aviation, hiking, camping, travel, geocaching, amateur radio are a few of my hobbies.
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2 Responses to Why is this so hard?

  1. Medic999 says:

    Whenever I travel over to the states, I always find myself having the same discussions, especially when I find myself sitting next to some EMS educators:

    Why cant a paramedic be a paramedic, no matter where they work in the USA. In the UK, I am a registered Paramedic with the Health Professions Council . That means that I can apply for a paramedic job anywhere in the country without going for any retraining or further tests.

    Now, as I keep getting reminded by my US friends, my little country can fit in California, and the USA is soooo much bigger, but surely that doesnt mean that there cant be a standard entry point in education and requirements to be a Paramedic in the states, no matter where you work?

    Agreed there will be times that certain paramedics need additional skills depending on the services and geographical locations that they may work in, but that can all be additional training after the fact, no??

    Just my thoughts…..

    • rescuemonkey says:

      Mark, I agree. The United States Department of Transportation sets minimum requirements for all levels of EMS education and every state has to meet these minimums. We already have a frame work to allow EMS workers to move to different states, but at the state level they like to exert control. If the federal government (or even state government) wanted to make crossing the lines easier, they would mandate that all levels of ambulance worker have to be trained in a college or university. Standardize the education, make degree programs within the state run colleges. I think this is an obvious direction to move EMS education.

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