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Refresh? LOL! If you've never taken those, you won't be refreshing anything. You'll be pouring a foundation for the house you've already built. Obviously far from an ideal solution, but better late than never. No, experience is not the best way. Education is. Without a foundation, you have nothing to build upon. Go back to school, starting next semester.

So, I took the NREMT-P written test yesterday, and found out this morning that I passed (pass/fail results posted on the website). Now, let me preface what I am about to say with the following disclaimer: I completely understand for individuals going through Paramedic school (or EMT school, for that matter) that the final written test can be nerve-wracking. 15 months ago, when I took the New York State written, I was confident I could pass, but was still scared about it, because it was the "moment of truth" so to say. My thoughts on the matter. I went in, with almost no pressure at all. My wife and I would like to move, which is why I am obtaining my Registry certification. However, as I'm already a State certified Paramedic, and NYS doesn't require the NR, I really had no big "pressure" to pass. That probably helped. I did find the test somewhat harder than the NYS written, but not much. It was shorter, however. The CBT cut me off after 80 questions. I finished in about 25 minutes. Now, I COMPLETELY agree with Dwayne, Dust, Lone Star, et. al. on the topic of increased educational standards in EMS. That being said, is the NR (or state written that I took just over a year ago), really the minimum standard that needs to be passed? I, for one, don't really think it truly assesses what Paramedics need to know - it doesn't even begin to assess that, IMHO. Now, I would hope that most Paramedic schools would teach far above and beyond what is required to pass the NR, but the sad fact is, they don't. Many of the Patch mills out there teach to pass the test, and that's it. I am reasonably certain that my basic partner could pass the written test without ever having set foot in a Paramedic classroom (admittedly, he's one of the best BLS technicians I've met, but I digress). I remember after taking the state written exam, my nervousness about passing was over. To be honest, I almost felt insulted by the content on the exam. I truly think it's scary to think that there are medics out there that are ONLY taught the MINIMUM to pass this test. That, coupled with a lack of an adequate QA program in many agencies... it's scary to think about how many patients we could be seriously harming through a lack of knowledge, through just being a "skills monkey." I seriously hope that certifying bodies such as the NR and various state Offices of EMS wake up and "smell the coffee" and raise the bar. They don't even have to make the classes harder! Based on what is supposed to be taught in the curriculum, the tests could be much more in depth. We talk about raising educational standards, but it makes me wonder whether the "standards," such as they are; are even being fully explored in class, or whether many programs are simply "teaching the test" and teaching the bare minimum that will allow their students to pass the NR. And by some reported first-attempt pass rates, it makes me wonder whether the they are even teaching that much! Excuse my ramblings, but after being through both the state and NR written tests, I really am kind of scared at exactly what the competence level of some of the people that could be showing up at my door step if I ever had my own medical emergency. Your thoughts and inputs are appreciated.

But the thing is that you made your intentions clear as wanting to go on to bigger and better things than a lil ole vollie squad they are running. My spidey sense says that no matter what you tell the guy now after you've already said your aspirations which go way beyond that of this volunteer service has effectively killed any such interest from Chief "kill your ambition" Charley. My advice is to make one more attempt to offer your services and then move on. In the end, it will be their loss but I for one would not want to be involved in a organization that would want to pidgenhole me into the situation that it seems like they tried to do to you. I'll bet that you could find at least a couple of other vollie agencies that would be happy to have you as well as be happy to let you spread your wings and fly.

If you've not had the full semester college level courses Bio 201/Bio202 then there is absolutely no question that this is the direction that you should take. None whatsoever. You may need some prerequisites before you'll be allowed to take those as well...get them. You are going to see that you are not really doing any true clinical medicine until you taken those....Trust me...you'll see. Dwayne

With your desire to continue on to Medic I can't imagine that you'd even want to be part of such a system. It will likely do you little good and has the possibility of doing you harm. Motivation as a stumbling block to being able to participate. Yeah....see ya. But, very few will take your desire to be a flight medic seriously when you are still at the infant level of EMS. You have many years before you'll even be considered for a flight position, and most will quit or fail long before then. And in what capacity would you have been allowed to teach EMS there? EMS teachers with no EMS experience? That's pathologic. Where does your desire to be a volly stem from? Maybe it's best to just work on your paid gig instead? Dwayne

Maybe they wanted you to be an automaton and give them pie in the sky assurances that you would be there forever. Sounds like they don't want to spend money on you all in the end result of you leaving. The guy who told you that you had to choose obviously wants someone who will put their life on hold and give all their time to the volunteer service and not look for any way to better themself. Are you sure you want to be associated with a service that wants to hold you back and put restrictions on your professional growth?

What is your educational background? What areas are you weak in?

For the record, and thanks to those who came to my defense: I am not against higher education, but we know two things as fact: There is a good chance this person will not even attend or complete EMTB school, as we all know the drop-out rate for any EMS class. Secondly, even if she passes with the highest score possible, she will probably not find a job anytime soon. So to me, to spend money to take extra classes for a career you are not even in yet, is a waste of money, unless her back-up plan is another healthcare related field. But if she chose to be a Nurse for instance instead, there is a good chance her Nursing school would not recognize the AP course, so she would have to take it again. Once she becomes an EMTB and knows that she loves the career then I think she should take every class possible.

As a test writer for the NREMT, let me attempt to explain some things. First, NREMT is simply a testing agency... not a certifying agency or licensing agency per state, although many choose to utilize the NREMT as the test to offer. Unfortunately, EMS is so fragmented and so out of touch with professional and educational standards it is ridiculous! The sole basis for any certifying and professional tests is to assure that they meet the minimal and safe practices as a beginner practitioner. This is NOT based upon a 5 year experienced Paramedic, or one with a high academic science degree. Unfortunately, NREMT can only test what is based upon the current NHTSA curriculum , AHA ACLS/BLS standards, PHTLS and that's it ! Nothing else... no State protocols (as each state and areas vary) no specific manufacture book (i.e. Mosby, AOOS, etcas the ONLY reference material is as I mentioned (NHTSA, AHA, PHTLS) for test questions. So one should look at the source if that is where the material is coming from.. i.e. Don't blame the testing agency, if the curriculum is faulty! So, the new curriculum is out and guess what? Major anger and head bleeds from those that want to resist and fail to understand professional standards. NREMT has been at the forefront encouraging increasing educational standards and better evaluation tools from true academic and scientific research (as true professional testing agencies have to do) and they have met resistance along the way from professional, state EMS groups due to their demands of requiring educational institutions to be accredited to have students test. (Really, why would should a healthcare education be held accountable?.. satire) So the problem is much more than what is on the surface. As well, majority of the personal in EMS do not understand professional standards, testing procedures (blind studies, question writing and values) that are required by academic and professional standards (why most states opt to NREMT due to costs). Simply, don't blame the messenger ... change the system R/r 911

I love the way some people are up this MEdic West and AMR crowd for meeting their contractual obligations? I mean, wheres the sense in that? Perhaps you should be turning your outrage against the city for having what you may find to be substandard targets? Or better yet, get the bucket fairies out of ambulance and use thatmoney to pay for more services and a superior contract? You cant have it both ways.

Damn, man (?). I gave you a +1 for your opening post, but then had to take it back when I read the above post. So you're saying that people shouldn't bother to learn their job until they are hired? It don't work that way. When you see someone with MD after their name. you can pretty safely assume that they have already attained the educational foundation necessary to begin competently "practising" to perfect their craft and charge for it. Our patients should be able to safely assume the same thing about us, when we show up to care for them during the worst hour of their life, shouldn't they? Yeah, I realise that might cramp the plans of a lot of 3-week wonders, who think that qualifies them as a big hero, who gets to play with the siren and eat half-price at Dairy Queen. Oh well.

FSM came down and collected me already. I'm posting this from the great plate of spaghetti in the sky. (side note: free wifi up here)