I'm in upstate New York. NY isn't a Registry state, but I'm getting mine because my wife and I plan on relocating, most likely to Virginia, so we're closer to her mother, and we like the area, etc.
Now, I completely agree that more education should be required! That being said, even with EMS education as it stands today, the test could have been a lot more thorough! As I said in my OP, I seriously think a trained monkey could have passed it. Another poster stated that they can test on the DOT curriculum, current ACLS and current PHTLS standards. Most of that wasn't in there! If it was, there were an average of less than 3 questions per subject, and even those seemed similar to one another. Now, it probably doesn't need to be 1000 questions, but I seriously question the validity of a test that can even come to predict competency over a broad range of subjects with a grand total of 80 questions, and no more than about two per subject.
I suppose I wouldn't object to the difficulty level of the test if I knew that all areas of the country were closely supervised by medical directors, with strict standards and QA processes. It is, after all, easier and more thorough to manage competency at the local level, IMO. Unfortunately, there's too many systems that are "a patch and a pulse." You have the patch, and a pulse, you go on the road, with all your toys, and little to no oversight in how you use them, until you screw up big time. Or perhaps until you screw up big time multiple times. And by then it's too late for your patients that you screwed up on. (I understand, everybody screws up. But most of us recognize when we do, and report it, and correct the deficiency. The above comments are directed to those services/areas where the level is set so low providers may not realize they even did mess up.)
If more people fail, so what? (IMHO) That makes the schools actually teach the curriculum! Of course, the curriculum standards need to be increased too, but I'm honestly of the opinion that schools could be seriously shortchanging their students, even given the current standards, and still have a high pass rate. The curriculum standards will NEVER change until what's already being "taught" is ADEQUATELY taught!