European EMS

[asrnj77]

I believe there are 14 schools in the US that grant Bachelors degrees in EMS. Below are the listed requirements for GWU, Creighton, and University of Texas, respectively. I already have a bachelors degree and I am close to a masters. However I don't see these all inclusive paramedic bachelors degree programs that are being discussed. I'm all for somebody expanding their knowledge, and they should. But saying that a paramedic with a 4 year degree is a better provider than one with a two year degree is wrong.

Program Description

The EHS Program offers a Bachelor of Science in Emergency Health Services (BS - EHS), with a concentration in EMS Management.

The BS in EHS is a total of 126 credit hours including at least 60 hours of lower division and general education, 15 hours of health science core courses, 39 hours of EHS professional studies, and 15 hours of upper division electives. The degree is designed to accommodate the busy and irregular schedules common in EMS, fire service, and other health professions. The health science core courses and the professional studies are all available on line from GW. Upper division electives are available on line, on campus, or in some cases by transfer. The student transferring 60 hours of lower division or an associate degree and 12 hours of upper division courses will have no required on campus attendance requirement.

FIELDS OF STUDY

You have several options for study. The Bachelor of Science in Emergency Medical Services (BSEMS) prepares students to be leaders and highly skilled professionals in the emergency health care field. The bachelor’s degree requires 128 semester hours of course work consisting of liberal arts core courses as well as 51 hours of paramedic course work. An Associate's degree (ASEMS) requiring 73 semester hours is also available.

In addition to the liberal arts core, students can expect to complete a rigorous paramedic curriculum that incorporates clinical and field training at the area’s trauma centers and fire and rescue departments. The bachelor’s degree is also an excellent pre-med track. Our graduates regularly go on to medical school, nursing school, and graduate programs in EMS and public health administration. Students should seek advising early, and often, in order to schedule the courses necessary to fulfill the pre-med science requirements

Texas Core Curriculum Component Areas and Requirements Credit Hours

Communication (English rhetoric/composition) – ENGL 1301, ENGL 1302, ENGL 1311, ENGL 1312, ENGL 2311, ENGL 2314, ENGL 2315, or equivalent*

Mathematics 3 hours in Algebra - MATH 1314 or higher3 hours in Statistics – MATH 1342, MATH 1442, MATH 2342, MATH 2442, or PSYC 2317, or equivalent

Natural Sciences – Courses with prefixes BIOL, CHEM, GEOL, PHYS, HORT, or other natural sciences 9

Humanities & Visual and Performing ArtsMust include: 3 hours in visual/performing arts – Courses with prefixes ARTS, DANC, MUAP, MUEN, MUSI, DRAM, or equivalent 3 hours in “other,” including literature, philosophy, modern or classical language/literature, and cultural studies** 6

Social and Behavioral SciencesMust include: 6 hours in U.S. history – either HIST 1301& HIST 1302, or HIST 1301 & HIST hours in political science – GOVT 2301 & GOVT 2302, or GOVT 2301 & GOVT 2305, or GOVT 2301 & GOVT 2306, or GOVT 2305 & GOVT 2306. 3 hours in social/behavioral science – Courses with prefixes ANTH, ECON, CRIJ, GEOG, PSYC, SOCI, SOCW 15

Texas Law requires that students receiving a degree from a Texas university must have taken a Texas Government class.

[zippyRN]

The biggest difference is in Europe, mainly Germany, France, Netherlands, etc they bring the hospital to the patient as opposed to stabilize and transport. It may work for them but their systems don't have EMT's trained at nearly the same level we do. True they got nurses and Doc's but hey, look at the Princess Di crash, can you imagine us EMS folks in the US or Canada hangin on a trauma crash scene like they did for > 45 minutes? She did'nt die till they finally decided to book with her, Anyway my point is if our country and Canada was only as big as some of these countries yea we could probably have an across the board sysytem but it aint gonna happen in my opinion. In Europe the Doc is God & all the other underlings dont do nuthin till a doc says so.Thats been my experience in Germany & some other places. They do have some very good folks and certainly we could take some ideas to use. Ok thanks for the post.

that's not the experience 'in Europe' - while it may be the experience of the franco-german system it;s not the experience of the Biritish system with Health Professional Paramedics as the main advanced provider or the Dutch /Scandinavian System with Nurse practitioners as the main advanced provider ...

[zippyRN]

asrnj77

the issues surrounding health professional education revolve around the applicability or not of the liberal arts model to all higher education courses. theUk doesn't have a liberal arts model hence the reason bachelor with honours degrees in the Uk are 3 years for none health professionals and 3 to 4 years where the several thousand hours of supervised practice are incorporated for student Health professionas

[asrnj77]

asrnj77

the issues surrounding health professional education revolve around the applicability or not of the liberal arts model to all higher education courses. theUk doesn't have a liberal arts model hence the reason bachelor with honours degrees in the Uk are 3 years for none health professionals and 3 to 4 years where the several thousand hours of supervised practice are incorporated for student Health professionas

My post was merely comparing the US model of a two-year focused Paramedic program and the supposed superior paramedic that evolves out of an American bachelors degree. I agree that paramedics would probably get more respect and maybe a little more money by requiring a baccalaureate degree. But I also believe that the current programs offered in the US are not the same as the European programs that are also being discussed. I also think that some people want more education associated with their careers because it validates them. I'm sure there are school teachers that believe all elementary school teachers should have EdD after their name. I think that would be fine and it shows that that individual teacher chose to get the maximum ammount of education they could for their career. But does that mean that an intelligent, thoughful, and insightful teacher can't exist without 7+ years of advanced education? Assuming that a paramedic in a two year program completes 60+ credits (in America), then what are the other 68 credits in? I'm sure some are more a&p but it also looks like EMS management, book keeping, employee welfare, government, literature, communications, etc. Yes they are nice to have but my bottom line is if they benefit direct patient care.

[678 Responding]

The biggest difference is in Europe, mainly Germany, France, Netherlands, etc they bring the hospital to the patient as opposed to stabilize and transport. It may work for them but their systems don't have EMT's trained at nearly the same level we do. True they got nurses and Doc's but hey, look at the Princess Di crash, can you imagine us EMS folks in the US or Canada hangin on a trauma crash scene like they did for > 45 minutes? She did'nt die till they finally decided to book with her, Anyway my point is if our country and Canada was only as big as some of these countries yea we could probably have an across the board sysytem but it aint gonna happen in my opinion. In Europe the Doc is God & all the other underlings dont do nuthin till a doc says so.Thats been my experience in Germany & some other places. They do have some very good folks and certainly we could take some ideas to use. Ok thanks for the post.

"EMT's" are mostly in the U.K., outside of there you won't find any, as most trucks are stocked with RNs.

Like Zippy said, the Franco/German EMS is pretty much DOCTOR based. They work much differently than the British Dutch/Scandinavian systems, which is mostly Paramedic and RN staff.

The Franco/German system bases it's care on bringing the ER to the patient, and do as much as possible before transporting.

The British Dutch/Scandinavian system is pretty much just like the U.S. system, stabilize and transport, although a Doctor is much more available if needed for advanced trauma life support.

I read an article in JEMS about the Italian system, which is also Franco/German based, and how they were trying to adopt more of the U.S. standards (Stabilize and Transport), mixed in with their own standards.

[Dustdevil]

I believe there are 14 schools in the US that grant Bachelors degrees in EMS. Below are the listed requirements for GWU, Creighton, and University of Texas, respectively. I already have a bachelors degree and I am close to a masters. However I don't see these all inclusive paramedic bachelors degree programs that are being discussed. I'm all for somebody expanding their knowledge, and they should. But saying that a paramedic with a 4 year degree is a better provider than one with a two year degree is wrong.

You just sort of answered your own question. The current BS programmes are not comprehensive, scientifically and medically based programmes. They are just paramedic school with a bunch of management and administrative crap thrown in. When we speak of a BS prepared medic being better, we are speaking of a programme which does not yet exist. We are talking about MEDICAL education, not just more hours for the sake of having more hours.

This is analogous to nursing education. Contrary to the whining of a bunch of ADNs, a BSN is not just an ASN with a lot of pointless managment courses thrown in. It is usually (in the better programmes) quite a few more hours of clinical education including advanced assessment, critical care, patient teaching, and specialisation electives. That is what an EMS BS should be too. We have to get away from this assinine theory that a 900 hour paramedic school teaches you all the medicine you need to know, and that further education should be nothing more than "management courses." No other medical profession thinks that way. That's why we are the laughing stock of medicine.

[678 Responding]

You just sort of answered your own question. The current BS programmes are not comprehensive, scientifically and medically based programmes. They are just paramedic school with a bunch of management and administrative crap thrown in. When we speak of a BS prepared medic being better, we are speaking of a programme which does not yet exist. We are talking about MEDICAL education, not just more hours for the sake of having more hours.

This is analogous to nursing education. Contrary to the whining of a bunch of ADNs, a BSN is not just an ASN with a lot of pointless managment courses thrown in. It is usually (in the better programmes) quite a few more hours of clinical education including advanced assessment, critical care, patient teaching, and specialisation electives. That is what an EMS BS should be too. We have to get away from this assinine theory that a 900 hour paramedic school teaches you all the medicine you need to know, and that further education should be nothing more than "management courses." No other medical profession thinks that way. That's why we are the laughing stock of medicine.

I couldn't have said it any better myself.

[UMSTUDENT]

You just sort of answered your own question. The current BS programmes are not comprehensive, scientifically and medically based programmes. They are just paramedic school with a bunch of management and administrative crap thrown in. When we speak of a BS prepared medic being better, we are speaking of a programme which does not yet exist. We are talking about MEDICAL education, not just more hours for the sake of having more hours.

This is analogous to nursing education. Contrary to the whining of a bunch of ADNs, a BSN is not just an ASN with a lot of pointless managment courses thrown in. It is usually (in the better programmes) quite a few more hours of clinical education including advanced assessment, critical care, patient teaching, and specialisation electives. That is what an EMS BS should be too. We have to get away from this assinine theory that a 900 hour paramedic school teaches you all the medicine you need to know, and that further education should be nothing more than "management courses." No other medical profession thinks that way. That's why we are the laughing stock of medicine.

Dust,

As someone who does go to one of these 4-year Bachelors programs, I can enlighten you on some of the problems facing these departments. I've spoken about my education before, but rarely elaborate on the kind of curriculum being taught us. Overall, however, I believe the education I'm receiving is superior in many ways. I'll layout some of the things that encompass it:

1. Prerequisites:

At my university, there are two available "tracks" one can decide to take. There is the "paramedic/clinical" and the "management" track.

1.Management students participate in a broad liberal arts education, with specifics on classes in accounting, statistics, public policy, and administrative law. In their senior year they participate in a fairly long internship and finish with classes in research methods and health economics. Students from the management track study, in-depth, several methods of EMS delivery and evaluate their usefulness given specific situations. This degree plan prepares students for many of the aspects of business and public health.

2. The paramedic track is a highly selective, 133 credit program, that focuses on training paramedics with advanced knowledge in both the clinical and management setting. The first two years in school are devoted to obtaining pre-requisites alone. This includes finishing the universities' general requirements while also obtaining classes in several sciences. There are two sub-tracks within the paramedic curriculum. Pre-med students take everything we do, plus they complete all the requirements needed before applying to medical school. This generally adds two semesters of Organic Chemistry and one semester of Physics, Calculus, and Genetics.

Before applying to the paramedic program in their sophomore year, all students must have completed the following:

1. Biology 100 with lab, Chem 123 and 124 with lab (substitute this with Chem 101, Chem 102 w/ lab if pre-med), and 2 semesters of Anatomy and Physiology with lab.

2. Most of the student's primary university requirements should be completed by this time. Specific to the major include: Statistics, Basic and Abnormal Psychology (2 classes), Sociology, Concepts in EMS, and an instructor's course in EMS.

In the student's sophomore year they must apply and interview for a spot in the paramedic program. This includes both an interview with current students and faculty/medical director.

Benefits of this Education Model:

1. Amazing instructors, which include: medical doctors, pharmacologist, seasoned paramedics, psychologist, etc.

2. Broad, comprehensive education. Everything gets a "why" when being taught. Everything is taught with scientific medicine in mind, especially if current controversy surrounds the skill or method.

3. Extensive clinical time. Field and hospital clinicals in a variety of different settings in many world-renowned hospitals.

4. Management classes teach the student the necessary skills needed to be an effective leader and innovator in the field.

Problems:

1.The current "standard" curriculum doesn't allow these 4-year programs to deviate from the specific skill-set. Face it, only so much can be taught before you're basically adding "hours for the sake of having more hours." We have a lot of specialist come in and guest lecture on specific skills, or physiological problems, but eventually you've thoroughly covered the topic. Sure, we get in serviced on a lot of advanced skills, but unless we fly or operate in a critical care system, how often are we truly going to be using balloon pumps? More importantly, these are skills that need to be maintained. All of us will admit that learning something like RSI in a classroom is certainly much different than doing it. So while we may be introduced and educated on these practices, it is much harder to guarantee proficiency.

2. Our profession is a mess. Part of any university's goal is to make sure that their students are successful. While we receive an amazing clinical education, the management courses are needed. No current job in the profession will allow a paramedic to make a decent living based solely upon his amazing clinical knowledge (maybe teaching). The student must be able to succeed in the "real-world" situation that is currently EMS. That means supporting a family through upper-level management positions. You don't always "wow" your boss by simply being a go-getter. You have to apply skill-sets and knowledge that he may no be familiar with. You have to increase productivity, maintain continuity of care, and deliver patient care that is better than the next guy.

3. Change isn't made by just screaming very loud. A lot of the people on this forum seem to complain about the sorry state of our profession, but exactly how many of us are truly taking the time to rise above and change it. The goals of many of these programs are simply that. Someone who has completed an undergraduate curriculum is far better prepared to flourish in the real world of business and politics. Its about showing an employer that you took the time and were intelligent enough to put up with all the BS (no pun intended) that is found in universities today. The short and long is that most universities mimic, fairly closely, the types of red-tape that someone will encounter throughout life. More importantly, succeeding in any venture requires a certain amount of complex life skills. EMS needs representation at a truly professional level; people who are going to compete with a knowledgeable physician or nurse manager. These are the people who are the dictators of our profession and we must be capable of carrying on intelligent conversation with them should we hope to rise above. More importantly, we need people are are better than them. People who are smarter, more organized, and better connected should we ever hope to gain autonomy as a true profession. These 4-year programs prepare students for this.

4. Cost of education and type of ideal student. In today's world, education is more expensive that it has ever been before. It becomes harder and harder for someone to justify receiving an "advanced" paramedic education, only to be restricted at the current level. Secondly, our program requires a significant amount of devotion similar to that found in medical school. Working a job is extremely hard to do, so its not uncommon for these students to loan out a significant amount of money, or just stress themselves out to work and go to school.

Secondly, finding an ideal student for this type of program seems to be slightly harder. They have to be extremely intelligent, physically capable, and most importantly have an absolute devotion to the profession. They really have to love it enough to want to be the very best. Anyone can go to medical or nursing school and be mediocre, but these guys have to be stellar the rest of their lives. Otherwise, what good was it?

In the long run, I think the success of graduates from these types of programs speaks for itself. Dust, I agree that it would be great to have a four year, clinically intensive, paramedic education. I think many of the educators at these institutions feel that same way. The difference is that they also have an obligation to their student to provide a useful, practical education for the amount of money. They could easily create an advanced practice curriculum and teach it to all the students, but what state is going to recognize it?

[Dustdevil]

In the long run, I think the success of graduates from these types of programs speaks for itself. Dust, I agree that it would be great to have a four year, clinically intensive, paramedic education. I think many of the educators at these institutions feel that same way. The difference is that they also have an obligation to their student to provide a useful, practical education for the amount of money. They could easily create an advanced practice curriculum and teach it to all the students, but what state is going to recognize it?

As much as I hate to say so, it seems to me that, after all that eloquent post, you're breaking it back down to the lowest common denominator again, which is skills. Advanced practise? I'm not talking about advanced practise. I am saying that a four year education is arguably the most logical starting point for today's ENTRY LEVEL Paramedic. I'm not talking about four years of learning extra "skills." I am talking about four years of learning the scientific foundation of the profession, as you suggest your programme is currently doing. Hell, a physical therapist -- who gives no medications and performs no invasive skills on anybody -- usually has a BS before even being admitted to their school! Same with an OT and an MT/MLT. All of their education is relevant, yet they aren't doing an "advanced practise."

The problem with the inadequacy of the current educational standard is that it leads people to the erroneous assumption that medics already get everything they need to know in 960 hours, so anything above that is just "advanced" fluff. Those of us who know better know that's total BS. And I don't mean the good kind of BS.