With much ballyhoo and publicity, we’ve heard a ton about increasing educational requirements for EMS. The National Registry now requires a paramedic candidate to have graduated from an accredited paramedic program. What does accreditation mean? Speaking cynically, it means that an education program has gone through a process where it has created a big ol’ (Yep, “big ol'” is a Texas colloquialism, so deal with it…) policies and procedures process that may or may not have anything to do with academics and/or successfully creating baby paramedics.
And at least some of the EMS world is clamoring for a degree requirement for paramedics. They’re convinced that a degree for paramedicine will enhance both pay and professionalism. They point to nursing as an example where this has happened. Perhaps. Maybe. Respiratory therapy now has degree programs and, if I remember correctly, its pay hasn’t skyrocketed like nursing. Correct me if I’m wrong.
What concerns me about the EMS education trend is this. We are continuing to look at an EMS degree as a technical thing. More hours in the hospital. More hours in the classroom learning what paramedics already know how to do.
What EMS hasn’t done is grow a future generation of EMS leaders and thinkers. We need paramedics who know public health, public policy, management, the political and regulatory processes, and dare I say it, the legal realm. EMS is a business, whether it’s publicly run or a private enterprise. Johnny and Roy may know how to intubate, but if Johnny and Roy can’t make a budget, deal with HR, and deal with Capitol Hill, Johnny and Roy are going to remain the bastard stepchildren of healthcare.
If we’re going to have a debate about a paramedicine degree, let’s be sure that we know what a paramedicine degree should contain. And let’s start growing a cadre and a core of EMS subject matter experts in all of the fields that touch EMS — not just experts in EMS.
Oregon has required an associates degree since 1999. We do not get better pay because of it and it makes it much harder for medics to come from other states and become an Oregon Paramedic…
More reality and practical training. Some training in a hospital is great but for a vast majority it is standing around and not learning much about prehospital care. We need some real EMS TRAINJNG academies with realistic patient and MVC simulators. Some real life video examples and serious field training. What passes for training is what has always been done-manikin on the floor-material and procedures that are miserably outdated.
As a paramedic program director, I took a rural hospital paramedic program and got it accredited. As is true with all accreditation programs, there are aspects that a less necessary than others. However, by going through that process, it has made our program a better, more fair program overall. On your other issue, I don’t necessarily support requiring a degree. However, EMS is full of misfits who would have a problem working in most other professions. EMS instructors must teach providers how to critically think, work through problems effectively and be professional. We also must teach people from the EMT level that EMS is more than 9-1-1 calls and lights and sirens. If EMS is going to evolve and “grow up” we must become part of the healthcare industry. Otherwise the pay that we all want will never come.
Salaries increase when you limit the number of people available to work at a given job.
When you raise educational requirements, you keep some people out of the particular job market.
That is what a degree requirement helps happen.
I helped to write the Oregon degree requirement. It was greatly watered down by political influence, so it is still easy to become a paramedic in Oregon. Not as easy as in other places, but still easy. So salaries haven’t risen much. But paramedic salaries in Oregon (at least the populous parts) are very good, compared to much of the country.
The spring issue of the NAEMSE newsletter addressed these same issues by comparing the career and educational paths of paramedics and nurses. If you are not a member I can email you a copy; it is well worth reading. To summarize, nurses must get degrees from accredited programs, and have lots of opportunities to return to higher education to pursue diverse career paths. Not so much for paramedics, and the best ones leave after a short time.
You write about additional classroom hours teaching paramedics things that they already know how to do. I disagree. The advanced airway disasters in literature suggests that we should spend more time in that area. Paramedics in the US also have shorter training programs than Canada, the UK, and Australia and much longer internships. There’s also the supply and demand aspect that Skip mentioned. Paramedics in those countries are also further along in the money and respect arena than we are here.
I share your pain about some of the CoAMSP requirements, but what is the alternative? What other profession allows you to become certified without completing an accredited program? Can you take the bar exam without graduating from an accredited law school? If the process needs to be tweaked, so be it, but not requiring accreditation would be a step backwards.
Because “technically correct” is the best kind of correct, I’d point out that you don’t need to attend law school at all in order to take the bar exam, at least in a few US States:
http://en.wikipedia.org/wiki/Reading_law
As I wrote in a reply to a comment on my blog just today, the nurse – paramedic analogy falls down for a few reasons.
I’ll summarize here, but you can still read my post.
1) There are no volunteer nurses, at least not in quantities enough to compete with paid paramedics.
2) The fire department does not provide nursing services between the ever decreasing number of actual fires.
3) Nurses are in most parts of the country highly unionized. Even where they aren’t competitive salary pressure helps to maintain higher wages.
4) People don’t go to nursing school “just to have the knowledge”.