Australia Got It Right?

[UMSTUDENT]

I was recently reading the following article in EMS Magazine during a very slow shift...

http://www.emsresponder.com/print/Emergenc...pectives/1$8404

Focus specifically on the section entitled "Esteem Power: How Respect Benefits EMS Recruitment Down Under."

The article talks about how in Australia, EMS is considered a respected health profession. At one university in particular I read the following:

"Its bachelor's-level paramedic course was the university's fourth most popular choice among prospective students in 2007."

This is amazing. How did this happen? What did the land down under do to push EMS into the hearts and minds of its population? Can anyone who works in Australia elaborate as to how this happened? What's the history of the advancement of EMS in the country?

[Timmy]

I think Australians have a laid back attitude and generally most people appreciate help.

Most of the paramedics I’ve meet are pretty easy going people who like to made a joke, there well educated and professional. The scope of practice is pretty good. You’ll find a lot of kids flicking though the university course book at the end of high school, seeing what the paramedic course entails, think it’d be a pretty cool job, apply and realize that the study is pretty full on and there a lot to know. The drop out rate for paramedics is pretty high. You’ll find a lot of jobs in Australia require a degree or higher level education.

Don’t get me wrong, we have our floors. Sometimes the working conditions paramedics have are less than desirable, long hours, response times, understaffed ect.

I really can’t explain why paramedics here a ‘respected’?

[firedoc5]

Maybe it's because Paramedics over there aren't taken for granted. And maybe it's because they saw how EMS in the states had problems areas and they "nipped it in the bud". But what do I know?

[Dustdevil]

It seems that the Bachelor's programme in EMS in the U.S. is popular too. I don't see any of them closing for lack of students. There just aren't many of them. All medic classes are popular in the U.S. But because we offer so many "I want it now" options, there is not an overwhelming demand for the Bachelors' courses That's the problem here. Too many options. That smorgasbord doesn't exist in Oz. For professional practice, they have a choice between better and best, not this standard first aid crap that is given EMTs here.

If you build it, they will come. If we start establishing BS level paramedicine courses around the country, they will fill up. I have no doubt about that. And the smart thing to do would be to give preference to students right out of high school, over those "experienced" providers who want to go back and finally get an education. Hook them on professionalism from the start. Those are the people we want to nurture.

But I too have often pondered how EMS ended up with such a stellar level of respect from the public in Oz. I don't think that level is rivalled even in countries where EMS is more professionally developed than Australia.

[CC64]

...If we start establishing BS level paramedicine courses around the country, they will fill up. I have no doubt about that. And the smart thing to do would be to give preference to students right out of high school, over those "experienced" providers who want to go back and finally get an education.

And make those kids work for it, too!

However, Dust, there should be an option for those "experienced" providers to be able to go back and get more of an education. Have maybe one or two spots each year for them. But hold them to the same standards as all the rest, if not slightly higher.

[UMSTUDENT]

It seems that the Bachelor's programme in EMS in the U.S. is popular too. I don't see any of them closing for lack of students. There just aren't many of them. All medic classes are popular in the U.S. But because we offer so many "I want it now" options, there is not an overwhelming demand for the Bachelors' courses That's the problem here. Too many options. That smorgasbord doesn't exist in Oz. For professional practice, they have a choice between better and best, not this standard first aid crap that is given EMTs here.

If you build it, they will come. If we start establishing BS level paramedicine courses around the country, they will fill up. I have no doubt about that. And the smart thing to do would be to give preference to students right out of high school, over those "experienced" providers who want to go back and finally get an education. Hook them on professionalism from the start. Those are the people we want to nurture.

But I too have often pondered how EMS ended up with such a stellar level of respect from the public in Oz. I don't think that level is rivalled even in countries where EMS is more professionally developed than Australia.

Dust, as you know I can speak first hand for one of these programs. At least here, I think there is definitely an issue between between available supply of qualified applicants and the demand for such educational programs.

Primary Reasons:

A) In the four years that I completed by undergraduate education, tuition soared at state colleges. When I started college, it was actually very affordable. I think my first year my total bill was somewhere in the region of 14k (tuition, room, and board). During my senior year the costs had risen to almost 19k. This is even in a state that has a well established tuition reimbursement program for those students who pursue associates or bachelor's level education in clinical or managerial EMS! I think most of these costs can be directly attributed to our previous governor's short four years in office. He cut higher education funding tremendously in order to achieve his BS $1 billion surplus. He just never explained where he got it.

The value of the education seems to have diminished. When I first started I was told about all the "great opportunities" there would be for me when I graduated. And to be truthful, they weren't lying. During the 80's and 90's the program did seem to produce an extremely well-rounded group of successful graduates. State directors, numerous physicians, scores of EMS managers, physician assistants, researchers, etc. For some reason though, and it may be entirely a perception, these great outcomes seemed to stop showing up. I blame a couple of reasons:

1) My school completed an institutional realignment in order to make itself one of the top research universities in the region, if not the country. Our university president, who saw opportunity to place the school on the national stage, began pushing the science education of "disenfranchised" populations as a way to get magazine headlines.

When I began my basic sciences during my freshmen and sophomore years it was practically impossible to get anyone to pay attention to a white, middle-class student trying to actually understand chemistry, biology, math, etc. Class sizes were too large for a mid-sized school (I had almost 250-300 students in my Chem lectures) and the professors, who were imports from places like Harvard, Berkeley, Stanford, etc, were focused much more on research than on actual education. I passed and did well, but it costs me my entire first two years of a college (no partying, no social development, and definitely no shenanigans!).

2) The paramedic program is extremely credit intensive. Whereas many majors require 30-40 upper division credits (300 and 400 level courses), the paramedic program consist of 67 by itself to graduate. When you add in the lower division prerequisite requirements to even be admitted to the program , you'll take 117 required credits while at the university for completion of the Bachelor of Science in Emergency Health Services. This leaves no room for a minor or exploration of other classes or enrichment.

Many students specifically enter the paramedic program with the intention of eventually matriculating to professional schools (medicine, physician assistant, nursing, etc), but you can't. Not in four years at least. While much of the prerequisite science education overlaps with the premedical students, we are still left without Organic Chemistry, Physics, and Calculus in order to complete more specific course work in Anatomy, Physiology, Statistics, and Psychology that is specific to our major. This is particularly important as you come to finish your senior year and realize you're about to enter a workforce that may be intellectually unfullfilling.

3) Local departments are almost all fire-based. Very few seem to care where you get your paramedic, so long as your have it. Education doesn't seem to be valued. You're taught socially to just keep your mouth shut. Professional development takes a back seat to professional survival.

C) Lack of direct economic support. When you're a department of barely 300 undergraduate and graduate students fighting for funding against departments like chemistry, biology, and computer science your budget takes a definite back seat to everyone else. You struggle to pay for the equipment you need, let alone provide direct scholarships or grants for tuition or research opportunities. This is especially important if you're trying to lure qualified students who may have an interest in EMS, but may shy away from the high costs of tuition and large clinical time commitments in favor of a major that may provide a larger payoff in the long run.

Don't get me wrong. I got a good education and the people there do look out for you, but its hard. The people who decide to take this route, in my opinion, make a lot of sacrifices in order to do what they think is right. I felt like I was much better prepared than much of my peers when I entered the workforce. I had hundreds of more hours of patient contact experience in an educational setting than every other person I competed with and I was taught by a cadre of different medical professionals. The good thing about acquiring the training in a true "academic" setting is that you get to see, on a much grander scale, how the things you do directly effect the patients you see.

I was taught patient assessment by a physician assistant, pharmacology by physicians and pharmacologist, behavioral and crisis intervention by a social worker, EMS management by an actual experienced EMS manager, etc. We were constantly reminded of how we differed and interacted with our peers (nurses, doctors, etc).

Is there a demand? I guess. If you want to be a clinically sophisticated, well educated paramedic. These programs, be it Maryland, Pittsburgh, Western Carolina, etc definitely offer that to you. I think the problem is that you then have to find employers who will nourish that commitment to clinically sophisticated paramedicine. Otherwise you just get bored or complacent. What good does that do?

[Dustdevil]

This is especially important if you're trying to lure qualified students who may have an interest in EMS, but may shy away from the high costs of tuition and large clinical time commitments in favor of a major that may provide a larger payoff in the long run.

I agree that this is certainly a factor. After all, smart people don't take a leap until they have done an intelligent analysis of the cost vs. benefit equation. But there is no shortage of History, English, Art, and Liberal Arts majors out there. And none of those people expect their educational investment to pay off for them monetarily. Most people choose a major based more upon their interests than what they think it pays. That's why I say, if you build it, they will come. And the more of them that come, the higher it drives our stock. And the more it devalues those with thirteen weeks of monkey training. That is what will transform our profession. It will take a generation of brave people making brave choices, but there is no doubt that it will work.

[UMSTUDENT]

I agree that this is certainly a factor. After all, smart people don't take a leap until they have done an intelligent analysis of the cost vs. benefit equation. But there is no shortage of History, English, Art, and Liberal Arts majors out there. And none of those people expect their educational investment to pay off for them monetarily. Most people choose a major based more upon their interests than what they think it pays. That's why I say, if you build it, they will come. And the more of them that come, the higher it drives our stock. And the more it devalues those with thirteen weeks of monkey training. That is what will transform our profession. It will take a generation of brave people making brave choices, but there is no doubt that it will work.

Very true. In fact I made the final decision to choose the major, because not only did EMS interest me, but because I did complete that very same cost vs. benefit analysis.

My mother had been in education much of her life and she forecasted the extreme rise in tuition along with a slumping economy. One of the most attractive things about the major was the relative guarantee of employment immediately following college. Add to this the fact that it is the only major at our school that results in a license to do...anything...a skill. To me this is one of the most attractive things about the major, because if you want to go back to school, you have a steady income to make it possible immediately following graduation. I graduated with just enough debt to make a fifth year risky and unaffordable, so it offered a quick route to relative financial stability.

I have friends who graduated with history majors or degrees in chemistry who can't find a job. They're working at malls making far less starting with no direct career path in sight. I started with a salary solidly in the middle class, health care, and a pension. This would have been all ideal had the economy not took a crap. The rising price of everything post-Katrina really put a hurt on the possibility of an affordable post-college existence. I can't even imagine what some of my friends are doing. I struggle to save, which I thought would be a sure reality. Most of them have no job, much more school debt than I, and no route out. I've met some of them who are just diving into graduate school, master's degrees without a focus, simply to defer student loans.

[Doczilla]

And they have horribly poisonous snakes and spiders that kill people without mercy. EMS training is a necessity.

'zilla

[CC64]

And they have horribly poisonous snakes and spiders that kill people without mercy. EMS training is a necessity.

'zilla

And Koalas! Gotta be careful about them marsupials...