Ahh Siff, I thought you would never ask.....
Judith, these are my personal opinions only, and remember, you get what you pay for....
I work for both a rural service and a city service; I am also an instructor and have supervised EMT practicum placements, and have followed the careers of a number of my students.... and I see a number of fresh EMTs straight out of school who have been hired as casuals for the city service I work for... I see a number of areas where these newbies need a lot of work... (1) on a tough call, they find it far too easy to hand the call completely over to the medic, and not do any thinking or assessing on their own. (2) they find it easy to be "the driver" and not take any responsibilty for how the call went, other than getting the medic to scene, and getting the medic and patient to the hospital (3) they haven't developed patient communication skills - their only patient experience was on their EMT practicum, which really does not give them a well rounded exposure to patients - they don't know how to talk to elderly patients to keep them calm, or an agitated patient to get the information they need. (4) working for an ALS service, they do not spend enough time developing their basic skills (basic assessment, vital signs, history taking) (5) overall, they get used to the security blanket of having ALS always available, and unless they are actively moving towards being a medic, they end up backsliding on the skills they do have.
Now... on to rural services. Of course there are drawbacks here.. you may be working with volunteers, who may or may not have their skills up to date either. Yes, it may be inconvenient for you, as you may have to commute, but, on the other hand, some services do provide housing for those staff who come in from out of town, for no cost or a very small cost. You may not get a high call volume. You may be working a BLS service, where ALS may be more than an hour away. However, there are positives to this as well. You will get to attend often, if not most of the time, which will improve your skills, and your confidence. Having to deal with patients for more than 10 minutes will allow you to see if your interventions work or don't work, and force you to review your assessment and interventions to see what you could be doing to better help your patient. It forces you to be a thinker, and not use ALS as your security blanket. Many times, doctors in smaller centres are very happy to answer any questions you may have, and allow you to assist in procedures that you wouldn't have the opportunity to assist with in a larger centre. You will get the opportunity to follow up on patients more, and see long term effects.
A word of warning... do not be the EMT who thinks that just because you have that tiny piece of paper that ACP sent you (for all the money you spent, that little card isn't even laminated) you should be able to walk into the job of your dreams instantly. It rarely happens. If you show that you are willing to work, and willing to learn, and are willing to make some sacrifices for your career, doors will open. Some of my students worked 2 and 3 casual positions at a time, at various rural centres, to get the skills and experience they needed before they moved on to larger centres. Some of my students went to larger centres right away, and given the two, I would hire the first ones in a heartbeat, and not the second, as I know the first ones have a wider range of experience and knowledge. The students who show the commitment to getting the experience and working on their skills will do better in the long run.
Judith, I am not trying to scare you... I am trying to get you to look at a bigger picture, and the possibility that short term pain (I get the feeling you don't want to be anywhere but Calgary) may lead you to long term gain.
Again, best wishes in your endeavors.