EMT training as part of medical school

[Doczilla]

I'd say yes. The only physicians who get any kind of training or understanding of EMS during residency are in emergency medicine. Any physician, however, may find themselves in a disaster or other emergency in the prehospital arena, or may find themselves the first to render aid outside of a typical patient care setting. Some knowledge of basic EMT skills would be helpful. It might also cut down on some of the bitching that doctors do about prehospital care who have no idea what it's really like.

Our ER residents ride the ambulance once a month through intern year. Second year they continue their field experience but are more involved in QA, education, and meetings with the regional physicians advisory board and standing orders committees. We also put them through a medical control base station course and an extrication course. Third year, they are required to lecture EMS for con Ed, and have 8 hours of didactic training and multiple planning projects for ems. All available residents teach for te CAP Lab, and many teach for the wilderness medicine expo and hospital seminars for ems. We also provide coverage for the Dayton Air Show and X Fest. About 1/5 are on SWAT teams, and several more are associate medical directors for ems agencies.

'zilla

[ERDoc]

I'd say yes. The only physicians who get any kind of training or understanding of EMS during residency are in emergency medicine. Any physician, however, may find themselves in a disaster or other emergency in the prehospital arena, or may find themselves the first to render aid outside of a typical patient care setting. Some knowledge of basic EMT skills would be helpful. It might also cut down on some of the bitching that doctors do about prehospital care who have no idea what it's really like.

Our ER residents ride the ambulance once a month through intern year. Second year they continue their field experience but are more involved in QA, education, and meetings with the regional physicians advisory board and standing orders committees. We also put them through a medical control base station course and an extrication course. Third year, they are required to lecture EMS for con Ed, and have 8 hours of didactic training and multiple planning projects for ems. All available residents teach for te CAP Lab, and many teach for the wilderness medicine expo and hospital seminars for ems. We also provide coverage for the Dayton Air Show and X Fest. About 1/5 are on SWAT teams, and several more are associate medical directors for ems agencies.

'zilla

Hey 'zilla, I think one of your former residents is at my shop.

[brentoli]

At $20,000 they are probably making more than most EMT's in the area.

[Eydawn]

I say this program is worth a shot. Any "alternative" approach that encourages learning to engage with your patient is beneficial; my guess is those folks who want to go be podiatrists aren't that interested in an EMS-centric program anyway, and will opt for the more traditional programs. Bet these future grads will be *bitchin* ER docs and medical directors!

Is it the best idea ever? Nah. Is it unique enough that it could prove to be valuable? Definitely. I have friends that are babydocs of various stages and flavors... and the UNIVERSAL problem that I see is the inability to view things from the patient's perspective. It's all about being right, and figuring out the puzzle for these guys and gals... because that's what it takes to get through medical school.

I had one babydoc acquaintance (who disabled posting to his Facebook wall soon after our little tiff...) who said that he would have to cede care of anyone stupid enough not to realize that high sodium intake means increased blood pressure. I jabbed him here and there about the role of physician as educator and the duty to take care of even the dumbkopfs, even when they resist your teaching or are noncompliant with important therapies. He didn't like that very much, because I rained on his little bitchy-parade. He said it was his right as a future physician to choose who to treat and who to turf to others. We haven't spoken much since (but he was kind of a prick in undergrad anyway, so... no giant loss there.) I sincerely hope he's learned some compassion along the way...

Point being, with that story, is that EMS kind of forces you to think outside of the box if you're a provider who's at all interested in the bigger picture. Once you move past the "hero" stage, once you realize just how much you don't know, and once you start educating yourself and putting the sociological pieces together with the pathophysiology (not to mention a smattering of psychology here or there), your mental medical world opens up to a vast degree.

A medical school program that has instructors willing to take the risk of flying in the face of "accepted" teaching holds a lot of promise... execution, however, means everything and it will be interesting to see how long this program lasts. If these babydocs are paired with jaded old nasty paramedics who don't give a damn about improving practice or empathetic care, then it's probably going to be a bust.

Wendy

CO EMT-B

[Vorenus]

Here, med students have to do a first-aid-course (16hrs) - which I consider as kind of a joke + a ridealong on the emergency vehicle responding to 911 calls. But as far as I know, they only need about 20 hrs - which is as much as two day shifts with us.

[Kiwiology]

Fix whatever is wrong with your medical education that causes these students to have no teamwork or interpersonal skills rather than send them off to an ambulance, thats not going to help any.

Another symptom based approach, silly America

Our medical students treat patients and start doing actual clinical practical stuff from year one of the medical degree

[DFIB]

This thread makes me miss the days when the local Dr. could fix everything. They had to be prepared for whatever came through their doors. If they didn’t have a solution they pretty well made one up. So with this in mind a good dose of pre-hospital care knowledge would possibly be advantageous to make anyone, including Drs. producing more well rounded professionals and better citizens. Don’t get me wrong, specialization gives us great benefits and greater medical bills because so many professionals do not seek diversity in their training. Well rounded may not bring them more money but in the end isn’t service what we are all about? Physicians may never need pre-hospital emergency skills but if they ever do need them. I am sure they will be glad they took the time to prepare. It shouldn’t be the backbone of a medical program but would surely add value if included in pre-med education.

[fiznat]

I'm currently starting my MS1 right now and I couldn't imagine throwing in an EMT curriculum on top of everything else. There's just too much. The EMT cert would be looked at like it was a chore and the experience would be wasted I think. I'm glad I had my EMS experience before school, but I really don't think it would be worth anything at this point.

[Doczilla]

This thread makes me miss the days when the local Dr. could fix everything. They had to be prepared for whatever came through their doors. If they didn’t have a solution they pretty well made one up. So with this in mind a good dose of pre-hospital care knowledge would possibly be advantageous to make anyone, including Drs. producing more well rounded professionals and better citizens. Don’t get me wrong, specialization gives us great benefits and greater medical bills because so many professionals do not seek diversity in their training. Well rounded may not bring them more money but in the end isn’t service what we are all about? Physicians may never need pre-hospital emergency skills but if they ever do need them. I am sure they will be glad they took the time to prepare. It shouldn’t be the backbone of a medical program but would surely add value if included in pre-med education.

In those days, medicine was far less complex than it is today. Only a fraction of the medicines we have now, few surgeries, far less technical complexity of the kind of medicine we practice these days. And much higher expectations on the part of our patients and their families. But outcomes are better, people are living longer, and staying in the hospital less.

I'm currently starting my MS1 right now and I couldn't imagine throwing in an EMT curriculum on top of everything else. There's just too much. The EMT cert would be looked at like it was a chore and the experience would be wasted I think. I'm glad I had my EMS experience before school, but I really don't think it would be worth anything at this point.

So much of the MS1 and MS2 years are a complete waste of time. I have never once in clinical practice wondered about the CD40 ligand, or Krebs cycle intermediaries, or cholesterol manufacturing pathways, or looked through a microscope at a tumor to see if it was cancer. An injection of some practical knowledge would be a good thing. Some med students who rotate through our department don't even know how to glove up in a sterile manner.

'zilla

[fiznat]

So much of the MS1 and MS2 years are a complete waste of time. I have never once in clinical practice wondered about the CD40 ligand, or Krebs cycle intermediaries, or cholesterol manufacturing pathways, or looked through a microscope at a tumor to see if it was cancer. An injection of some practical knowledge would be a good thing. Some med students who rotate through our department don't even know how to glove up in a sterile manner.

Everyone keeps saying that. Nevertheless, I'm charged with learning that stuff or I don't pass (just as you were). It is probably my 1st year naivete speaking here, but I like to think there is some value in learning, if only once, those foundational scientific concepts before we get to the practical stuff. I've been pushing drugs and sticking people with needles long enough as a paramedic. For now, I'm happy to put off the instruction on glove application and focus on some abstract science haha.

With that said and in keeping on topic, there is noooooo waaaaay I have time for ANYTHING else in this schedule! If EMT were going to be added, something else would have to give. What would that be?