Happy New Years everyone!
It was great to find SDN (by accident)… but finding OPM has been awesome! Reading MPP’s story was very inspirational, particularly since I did visit Mayo this summer, had dinner with a Mayo family member and toured the mansion…
Since there are so many kind people on this site, I thought this might be a thread of interest to a few people–>
I have been in EMS for 8 years now starting in a small (~700) Montana town… moved to a larger town (~3,000) and commuted to paramedic school (250 miles round trip daily). The acute nature of the rural patient population sent me to Critical Care Paramedic school. I also worked part-time for an EMS agency that was 280 miles one-way from home pulling fairly regular 72-hour shifts there.
All the while I worked in the rural hospital hand in hand with MDs, DOs, PAs, and a great nursing staff. My medical director began teaching me how to suture, I attended all deliveries to provide the neonatal care, and spent many hours in the OR as an observer and assistant. It was almost like being in clerkship although I did not have med school behind me.
Near the end of my tenure there one physician asked me to cover the ED for him so he would not be called in unless it was ‘bad’, I was flattered but refused. It was clear to everyone except me that I had been bitten by the medicine bug!
I eventually ended up in the SF Bay Area working in a busy trauma center and back into administrative EMS. I really miss clinical care… and am now even more removed from it than ever.
So here I am, in the process of registering for my remaining prereq’s (all but electives) at Boise State University. My college career started 11 years ago in an agricultural AAS program, one which did not retain my interest and thus did not retain me.
I have one of those ‘good jobs’ that could last till my retirement… with two kids living with my ex and 1.99 living with me (I’m remarried and she will be going into labor at any moment) so my decision weighs heavy. I would appreciate hearing from others, particularly anyone else who has been exposed to medicine in similar settings.
Be safe!
medicnick
Not sure what it is you’re asking.
Hi Crooz (that was fast!)
I realize that I’m not asking a specific question… it was intended as part introduction and part conversation starter. My interest continues to be in advocating for rural healthcare including EMS.
Hearing from others with similar experiences would be a bonding moment 
but learning how they worked their way out of the rural area and into pre-med/med-school is of great interest to me. It is difficult to leave a rural area when you are in EMS (many reasons… posters may want to mention some) and are a non-trad so there may be relatively few who end up in med school.
Hi Nick -
My background has a few similarities to yours. I became a volunteer EMT in my rural small town (not nearly as rural of an area as yours, though) and quickly decided to take the EMT-I training. I also started working part-time for a neighboring county that had a full-time EMS system and became a volunteer for the fire department. I wanted to obtain my paramedic certification, but unfortunately, the local programs were not being scheduled with my full-time teaching job in mind. After a couple of years of not being able to start paramedic school and going through the application/interview process for a city fire department (the only way I could afford to quit teaching and be a fulltime medic), I started looking into other options.
With the support of my fiance, I quit teaching and returned to school full time to take my pre-reqs. I worked part-time for a private ambulance service (a totally different world from volunteer land) while taking the pre-reqs and applying.
I still haven’t totally left the rural life. I live about 45 minutes from my medical school in a county that is more rural than the one I left. I have a strong interest in EM and EMS medical direction/management. My tentative plans (unless I happen to fall in love with another specialty during clinical rotations) are to apply for an EM residency, hopefully match in a program with a strong community/EMS component and eventually return to rural EM. I have seen first hand (and I’m sure you have too) what a difference it can make in a rural/small community ED having board certified EM physicians in terms of quality of care not only in the ED, but also in terms of the quality of care provided by EMS providers if they are supervised by quality medical direction. I hope to be actively involved in EMS and pre-hospital education.
So - there’s my introduction. I think there are a few other former/current EMTs/Medics wandering around here.
Good luck in your pre-reqs!
Amy
Nick,
Welcome. I myself am in a similar situation. I started in EMS almost 10 yrs ago, riding as a 3rd, for a busy EMS station outside of NYC. Well my love of EMS took me to EMT-P school, then my CCEMT-P, and I worked for the past 5 yrs as a CC paramedic for a critical care transport service (ground and rotor) at Univ of MD, Shock Trauma, Until recently. I, just as you, was been bitten by the med school bug. So I applied for a flight job outside of NYC, sold my home and moved back in with my parents.
Now I don’t have any kids, and am not married, so I can’t say that I’m in the exact same boat. But, as a guy who took a 40K a year pay cut, just so I could have a better schedule to go to class, I’m sure you can figure out how to make it work! And these guys here are the best ones to help you through it!
Any questions, hit me up, and be safe out there!
Hi Seth and Amy
When you started in EMS did you realize that you had a strong interest in medicine?
Many of the EMSrs that I have taught, worked with, or met do not know a lot about medicine other than any personal experiences or what they learn on the job.
It is interesting to read some of the posts (particularly on SDN) where people talk about EMS as a ‘tool’ to help them get into school. My interest in EMS was and is different… and have identified myself with EMS as an EMS provider for some time. I have friends who have even tatooed this identity on their bodies…
Some physicians I know have maintained a strong interest in EMS, many of whom (coincedentally?) are DO’s. Perhaps that is related to a former life on the street/in the box/in the bus… and the apparent affinity that DO schools have for non-traditional students. That is not to say that MD’s do not share an interest because many do but there may be fewer who started out in paramedicine. Just a casual non-scientific observation…
Another observation… many who have chosen EMS as a career (or is it the other way around?) do not appreciate having people use EMS as a stepping stone to another career. Have you experienced this? How did your EMS friends (or employers) take it when you came out of the closet about med school?
Finally, I also wonder if there is potential for some portion of the EMS curriculum to include an orientation to MD/DO career paths and the prereq’s to these… any thoughts? Would this benefit the relationships between EMS providers and their Medical Directors-if nothing else?
Be safe.
Nick
Hi Nick -
No, when I started out in EMS, I had no idea at all that I was interested in medicine. EMS was something that had kind of intriqued me for a long time, but for various reasons, I never pursued it. EMS as a career never really occurred to me after high school for a couple of reasons. EMS was still in its infancy when I graduated from HS ('88) and EMS in my area was all volunteer. As far as my parents were concerned, I WAS going to go to a four year college and back then I’m not even sure that anybody in our area had started up AA degree programs in EMS. The only full-time route to EMS was as a FF for a city, and fire not only didn’t interest me, but wasn’t really open to women (at least, not without some difficulty) and I wasn’t interested in challenging the status quo at that point.
I think your experience with EMTs not knowing a lot about medicine is fairly common. People form their notions about EMS based largely on TV or on what they see of EMS in the areas where they live. But - it is not only EMT’s/medics who don’t know much about medicine. I often meet nurses and other skilled hospital personal who have virtually no idea about what it takes to become a physician unless they work in a teaching hospital or bothered to ask a physician somewhere along the way.
As for SDN, yes, I cringe every time I read a post in the pre-allo forum about whether or not getting an EMT cert will look “good” when applying to medical school. If EMS and/or EM is truly something that someone has an interest in, I have no problem with them taking the class and volunteering/working as an EMT. As far as I can tell, though, adcoms are not impressed with having an EMT/medic cert unless you have actually done something with it. They take a distinctly different view of those who started in EMS and then realized that they had a quest for knowledge and skills that couldn’t be satisfied in EMS.
I have no actual stats on how many Emergency Physicians came from an EMS background - the number is probably still relatively small compared to the total number of EPs just because of the number of people who identify themselves as EMTs prior to med school is fairly small. However, of those with a strong EMS identity prior to med school it does seem that a large percentage of those people end up pursuing EM as a specialty. As for the MD/DO thing - I’m at an MD school, so I haven’t really noticed that. The few physicians I knew before I started med school who had an EMT/medic background were MDs, though. Of course, there also aren’t a lot of DOs in general (one DO school vs 6 MD schools in the state). A lot of the medical directors I have run across do have an EMS background, but there are a fair amount of those who don’t.
While I agree with your assessment that many career EMTs/medics don’t appreciate people using EMS as a “stepping stone”, I don’t think that I have experienced any resentment from (former) co-workers about furthering my level of education. There is a vast difference between someone who is using EMS as a resume/experience padder to apply to nursing/PA/med school and someone who truly loves EMS and decides that they want to do more with their life. Around here, unless you are on a full-time fire/EMS civil service, a career as an EMT/medic is a dead end job. Pay is not great, there is little potential for advancement, and it’s physically demanding work. I know a lot of people who have made the decision to pursue nursing or PA degrees because of those reasons. It’s not that they don’t love EMS - many of them continue working part-time or volunteering after getting other degrees - but because of the reasons above.
The biggest frustration for EMS providers in watching their non-stepping stone co-workers leave the field is that these are often your best and brightest EMTs/medics. So, although I experienced some jealousy (in that co-workers wished they were capable of or had the guts to take the leap), I can’t say I experienced any resentment. I think it all depends on your relationship with your co-workers and how you present your desire to do something different.
As for an orientation in EMS coursework to the MD/DO pathway - I’m not sure that in and of itself would help much. I would argue that ALL healthcare workers should have at least a cursory introduction to how much training/college/etc. is required for most medical career paths and a little bit about the differences in scope of practice (i.e. - EMT vs Medic, NA vs LPN vs RN or PA vs NP vs MD). In my opinion, what would lead to a better relationship between medical directors and their EMTs/medics would be a stronger commitment to education/training on the part of EMS. Although some services have rigorous training, standards and CE, the bare minimum standard for becoming an EMT in most places is not all that challenging. As long as the training standards remain as they are, I don’t think you will see much of an increase in respect towards EMTs from those with more education. (As a side note - EMTs/medics in an area with rigorous training/standards/QA etc were treated with MUCH more respect by hospital personnel than those in an area where the standards to become and EMT consisted largely of “do you have a pulse?”)
Amy
Great points.
Good luck with your education and career!
Nick