EMT training as part of medical school

[Kiwiology]

Kiwi, in answer to your question, we order lots of expensive tests because an educated scientific wild ass guess often simply won't do. Patients don't read the book, and terrible disease often lurks with subtle symptoms. Add to the barriers to care in this country with fewer primary care doctors, insurance that is hardly affordable even if you have a job, and a safety net of the ER which has to catch all those with no place else to go.

I was just taking the piss mate, I have great love and much respect for medicine however the point I make here with regard to this article is that something must be wrong with the system of medical education in the US if the solution to the lack of interpersonal skills and teamwork ability of your medical students is to put them on an ambulance. Surely there could be some sort of solution to come from the auspicies of medicine themselves and expose the student to much more appropriate clinical decision making and an environment more suited to their future career as a physician than an ambulance?

For example, from the outset of the MBChB here you are exposed to (and expected to be proficient) in interprofessional and interpersonal communications, clinical decision making and professional practice at an appropriate level for their knowledge. For example you do cardiovascular in Year 1 so you might be doing a discharge plan for somebody who is in CCU or in primary care doing assessments and planning for patients with hypertension or AF as examples.

See here http://www.fmhs.auckland.ac.nz/faculty/undergrad/_docs/medical_structure.pdf

We are the same with our nurses and paramedics, they have intergrated clinical and community praxis from Year 1 of the degree programs. When we are tested here you are not testing on a skill or abstract knowledge (well, that does form part of it obviously) but you are marked and scored on your ability to talk to the patient, built rapport, work with other health professionals or ambulance officers etc.

I have to ask, and I do t mean to sound like I'm belittling, but where did you get your ideas about care in the American system? A lot of it sounds, frankly, like cliff notes written by a journalist, not those of someone who had worked or lived within the system.

I have many friends who are paramedics, physicians, nurses in the US; I worked in the US for three years although not in health care, I like to consider that I am fairly well educated and well read ... but that might be blowing smoke up my bottom

Edited August 1, 2011 by kiwimedic

[NYCEMS9115]

I feel ER and Critical Care Health Provider Staff (MD, DO, PA, NP, and RN) should do some rotations on the Ambulance. Just to get a feel of how challenging it can be to do some of the "Advance Skills" in the Prehospital setting... In my previous job; we had new ER employees (MD, DO, PA, NP, and RN) do 2 ride-alongs. Most enjoyed the experience... We as Paramedics did rotations in the ER, ICU, OR, Psych, Lab, OB, & Med-Surg floors; as part of our Clinical. I do not see the problem....

[fiznat]

Ride time on an ambulance is a common requirement for physicians doing their residencies in emergency medicine...

[Richard B the EMT]

Until the Second World War, Doctors rode ambulances as the "tech", not as observers, both while interning, for training, but after completing training as well. Google "Ambulance Surgeon" for details.