Working BLS for a year might seem like a bitter pill to swallow for an experienced paramedic, but when you figure its one year from your date of hire, so after the academy and field internship your looking at 6 months. In that 6 months the new hire will have time to learn the system, geography, protocols, etc...The promotion to medic is from within and is very competitive. There is a competitive written, practical and oral exam to get into an ALS internship, usually 4-8 spots with 50 plus applicants. The medic internship is heavy on didactic and clinical rotations, and takes an additional 5-6 months. So, an additional 700-1,000 hrs beyond whatever medic school you came from. Is it the only way to provide ALS? No way, but it does work. I'm sure some 20 year old medic from Houston knows better though.... :roll: