Education, and other dirty words

Have you been following the recent articles on EMS1.com regarding degrees for paramedics? Dr. David Ross wrote A college degree requirement for paramedics: Is it just B.S.? based around an episode of EMS Garage where the panel discussed degree requirements for paramedics. Dr. Ross believes that there is not sufficient career opportunities, and little benefit to the patient, to having a paramedic with a degree. He is not against higher education, but he sees little return for the time, effort and money.

Art Hsieh, in a rebuttal, posted an article Why a degree is a must for today’s paramedic . I agree with Mr. Hsieh’s point, by the time you graduate from a paramedic program, you have earned 35 to 44 credit hours over two years. Many Associate’s Degree program require 62 to 66 credit hours. The only missing courses are the general education courses. English, math, sociology or psychology.

Why not make the extra effort, get an Associate Degree? You are already 2/3 of the way to a degree. You think general education courses are a waste of your time? English will improve your writing skills (you know a few EMS people who can use some help writing their patient care reports). Math will help you calculate drug dosages. Psych and/or Soc will help you understand the situation, the mental state of the patient and their family. I would also add a Pathophysiology class to the requirements, you will have a much better understanding of disease processes after taking this class.

Australian Paramedics must earn a bachelor’s degree. Canadian Paramedics must earn an associate’s degree. Paramedics in the United Kingdom use to follow a similar system that the U.S. has, working through the ranks (similar to a trade), but now requires a degree to become a new paramedic.

History Lesson

Emergency Medical Services were first pioneered in the United States. In 1966, the Committee on Trauma and Committee on Shock of the National Academy of Sciences, published Accidental Death and Disability” The Neglected Disease of Modern Society known as The White Paper in EMS.

The Highway Safety Act of 1966, included federal funding for training emergency care providers, ones recommended by the white paper.

In 1973, USC Title 42 The Public Safety Act (Chapter 6A, Subchapter X, Part A) , known as The Emergency Medical Services Systems Act was signed in to law. This was a large federally funded effort to create EMS systems in the U.S.

The Omnibus Budget Reconciliation Act of 1981, effectively ended federal funding of the Emergency Medical Services System. This allowed the states to have greater control over the funding of EMS systems in their jurisdiction.

EMS continued to grow, but funding declined sharply and EMS agencies had to rely on billing for service as the sole means of income. This is the beginning of the stagnation in EMS. Yes, advances in medical treatment eventually trickle down to EMS providers, but we are still doing the same thing we were doing in the 1970s. Injured or ill, we show up, and transport to a hospital for definitive treatment.

Have we really advanced our profession? Where do we go from here? We will start with the Emergency Medical Services Agenda for the Future, published in 1996 by the National Highway Traffic Administration. You have some extracurricular reading to do (there are a lot of hyperlinks in this post. Please take some time to visit the sites and read the information). I’ll address the future of EMS in an upcoming blog post.

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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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5 Responses to Education, and other dirty words

  1. ambulancejunkie says:

    I would go an extra step here Monkey by saying let us not limit the remaining credits to generalized english, sociology, psycology and math. How about a college embracing a true paramedic curriculum and teach on well being of a medic which involves crisis management skills & “burn out” prevention tactics. teach a semester on cross examination and ems law. Or a class of psychology with emphasis on psych emergencies we see in the field.

  2. ambulancejunkie says:

    I would go an extra step here Monkey by saying let us not limit the remaining credits to generalized english, sociology, psycology and math. How about a college embracing a true paramedic curriculum? Teach on well being of a medic involving crisis management skills & “burn out” prevention tactics. teach a on cross examination and ems law. Or a class of psychology with emphasis on psych emergencies we see in the field.

    • Joel says:

      I am thinking of developing a course program and list what classes I think would be most beneficial for the paramedic in a while.

  3. Jeramedic says:

    This is basically in comment to this and your previous post on EMS as a profession. First: I agree with Mr. Kirkwood that we are not a profession. (at least in proper definable terms) But I believe that we need to proceed with steps necessary to become a profession. And I think I speak for many when I say that although I may not have the credentialing to be considered a professional, I certainly feel like I am one. Next is a delivery model and funding. Go nearly anywhere in the world and seek medical care, and will go to a structure with a doctor inside it. call 911 from the next county over, and EMS could come in a ambulance or a fire engine. It could be BLS or ALS. It could be public, private, hospital based, volunteer, paid call or any combination of the above. The UK, thanks in part to it’s healthcare system has the closest iv’e seen to a national delivery model. That also could start a funding debate, which is very closely tied, but not for this comment. As for degrees, it’s all related. Delivery models, funding, degrees, professional recognition, one can not succeed with out the others. I agree with Dr. Ross’s argument. If a cert is whats required, and there is not increase in respect, responsibility, or pay for the degree holder, why bother? But I also agree with, Art that we as providers need degrees. Both for ourselves, and to advance the “profession”. There are programs out there that offer AS and even BS degrees in Paramedice. Not “Allied Health” and a Paramedic cert. But Paramedicine. It’s going to happen. And will take some balls. But one day an agency with funding, structure, and progressive protocols will require professional degrees from its paramedics. King county, WA could be very near that point. But we have a responsibility in this as well. We have to be the pioneers and go seek higher education so that standards rise from within, instead of waiting for the system to chance around us.

    The future of EMS will need “EMS people”. Who? Well to put it bluntly; It takes a lot of time, money, sacrifice and dedication. While taking on enormous dangers and liability. To be given the privilege to drive drunk people around in a van. If you are still on board, welcome. We have a seat at the table for you.

    • Joel says:

      Jeramedic, you are correct. The system will not change around us, we need to change the system. I understand Dr. Ross’s argument, why bother with more education if it is not required. I believe that the current EMT can be a certification level, the same as it is now. I would like to see a little more education in the EMT curriculum.

      I would like to see more Paramedics seeking degrees, in EMS (or Paramedicine) rather than finding a way out of EMS (like the majority of medics who go on to RN degrees). Funding will always be an issue. Look back at the EMS agenda for the future. Even in 1996 they recommended that EMS moves away from billing for transport only as the sole means of funding an EMS system. 18 years after that paper, we are still funding our EMS systems with billing only.

      EMS has stagnated, and we have been since 1981, when they cut federal funding from EMS, but that’s a topic for another blog post.

      I am not as familiar as I would like to be with King County EMS, but everyone says great things about them. They have one model that is working well. We need more people that can create models for their service, take features from all over the world that will work. EMS is suppose to be created for each individual community it serves. We need more people to create, and innovate. You are the change we need. I am the change we need. Now lets find ways to make it happen.

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