Choosing a Paramedic Program

An education isn’t how much you have committed to memory, or even how much you know. It’s being able to differentiate between what you know and what you don’t. — Anatole France (French novelist)

Becoming a paramedic is one of the most challenging, yet rewarding, decisions a person can make. Unfortunately, many students don’t take time to explore different options in EMS education. Paramedic programs differ as much as people’s preferences for pizza toppings. Choosing a program is the first and, at times, most important step in becoming a paramedic. Many people choose programs based on word of mouth, relationships with previous graduates, reputation and location. Although these are important, other aspects should be investigated. This article reviews questions you should ask before making one of the most important decisions of your EMS career.

What are the program’s entry requirements?

Some programs require a certain number of years of prehospital experience as an EMT-Basic or EMT-Intermediate, while others require letters of recommendation from physicians, employers or friends. Many programs require some form of exam that may involve a practical and/or written test. In addition to exams, programs may also require an interview with their staff. The interview allows the staff to obtain a better understanding of its prospective students, which theoretically allows them to select stronger candidates for a limited number of openings. Anatomy and physiology education are required by most programs. If you have already taken those courses, speak with the program director about transferability, as some programs may require that it be taken concurrently with their program. Others may incorporate this course into their program. Most prospective paramedic students should begin to research various institutions 6–12 months prior to beginning the program to ensure they find a program that fits them and to allow for any prerequisites to be met.

How can I find more information about paramedic programs, and what types of programs are available?

Contact the regional or state agency that oversees EMS education in your area. Find out how many programs exist and where they are located. The program in your backyard, although convenient, may not necessarily be the best one for you. In many states, paramedic programs are not restricted to community colleges. Hospitals, private companies or regional EMS agencies may offer paramedic programs as well. Find out which programs offer their courses for credit, in case you want to further your education in the future. Do they have a degree program? Is it a certificate, associate’s or baccalaureate degree program? With the continued growth and expansion of our profession, many employers may require a minimum of an associate’s degree. Many supervisory and educational positions also require an associate or baccalaureate degree. If it is a certificate program, is there an agreement in place to transfer to a two- or four-year school? Will local colleges give you credit for a program you took at a private institution

Most college-based paramedic programs require being a full-time student and involve more than just signing up for a course. Prior to registering, you may have to apply to the college, take entrance exams, meet with advisors and meet health requirements for internships. All of this takes time. Some students begin this process up to six months prior to the course starting. If you choose a college-based program, you need to consider whether or not you will pursue a certificate, an associate’s degree or a baccalaureate degree.

Many people traditionally choose the certificate option, where a certificate is granted for successful completion of the paramedic program. They also include the prerequisites or corequisites of anatomy and physiology, but there are no additional courses. This is the path taken by some younger paramedic students, or those who already have advanced degrees. A certificate program may grant you college credit, but no degree.

Having an associate’s degree in EMS may be beneficial, especially for those who choose to pursue educational or managerial roles. Those students often go on to obtain their baccalaureate and, many times, graduate degrees. All colleges require that certain standards be met for an associate’s degree. These usually involve approximately 60–70 college credits (or more than 100 quarter credits) and give students a more well-rounded education by requiring social sciences, English and possibly EMS management and operations courses.

Having a degree also gives some credibility to the profession. Many comparisons are made to the nursing profession. In the past, nursing programs were more certificate-based. Now, almost all nursing programs are Associate Degree Nursing (ADN) programs. There is even talk about making a bachelor of science in nursing (BSN) the minimum for registered nurses; however, there is as much controversy over that as over requiring an associate’s degree as the minimum for paramedics. As previously stated, although you may not feel you need a degree now, it will come in handy a few years down the road when you are looking to expand your career.

Baccalaureate degree programs involve many different aspects of EMS. These programs not only include the actual certification content and general educational requirements, but also specialized courses in EMS like healthcare ethics, EMS management, management information systems and healthcare policy, to name a few. These programs prepare students to pursue roles in education or management and provide a stepping-stone toward a graduate program.

We are seeing an increase in graduate programs throughout the country with specialties in EMS. Although many of these programs use EMS as a subspecialty of degrees like Disaster Preparedness and Allied Health Sciences, among others, it is a trend that will continue to grow over the next decade. More and more EMS educators and managers are obtaining higher degrees, which helps the profession grow and gain more respect among other healthcare professions.

How do I interview for a paramedic program?

When interviewing for a paramedic program, you will encounter both similarities and differences to a standard job interview. In both interviews, the candidate wants to be chosen for a particular position. All the general rules apply, such as showing up early, dressing professionally, bringing copies of a current resume and speaking professionally. This is where you get to show the program staff that you are serious about your education and the profession as a whole. One obvious difference is that you are applying to become a student, not an employee. You will need to convince program personnel that you are a dedicated student who wants to become a paramedic.

This is also your opportunity to interview the program personnel. Ask them about their qualifications, experiences and views of the profession. Are they in education because they no longer want to take care of patients? How much time did they spend in the field? Are they still practicing as a paramedic or other healthcare professional? Ask if you could talk to a current student or recent graduate volunteer. Speaking to current students or recent graduates will give you a different perspective on the program and allow you to see what you may be getting into. Another unique aspect of programs involves physician involvement. Does the program have an active medical director? Does the medical director lecture in class and participate in lab sessions? Is there physician involvement other than the medical director?

An important aspect that is often overlooked includes textbooks. Does the program rely on one textbook for the entire program, or does it require supplemental texts to help give students a better-rounded education or different sources for similar information? Some programs utilize as many as 18 different books throughout the program. No paramedic textbook is all-inclusive. There are many specialty books that can be used to help provide the best education possible.

What types of certifications does the program offer?

It’s important to know what kind of program you are applying for. Many programs follow the National Standard Curriculum; others follow their state’s curriculum. Although many people ask this simple question, they forget to ask if the program exceeds the curriculum. Does the program teach only what is required, or does it strive to teach what you will need to function as a paramedic in your area? If you live in a non-National Registry state, does the program offer the National Registry exam? You will never be as prepared for this exam as you will be when you finish a paramedic program. You may think you will never move out of state after completing your paramedic program; however, it may be necessary to attain a job in EMS education or management. National Registry certifications allow for direct reciprocity in most states. Also, many companies pay higher wages to nationally registered personnel. Your National Registry certification is relatively easy to maintain, as long as you attend continuing education classes. Further along in your career, certain jobs like flight paramedic may require this certification.

In addition to the curriculum, what ancillary certifications, if any, are offered? The concept of these courses being offered within a paramedic program is somewhat controversial, although they may give students varying points of view. For instance, if the main paramedic textbook covers a topic like congenital heart anomalies, an ancillary course may present similar material in a way that makes sense to the student.

The types of skills covered and the ways they are taught are also important. Does the program follow the rule of “my way or the highway,” or does it present various methods for performing the same skill?

How long is the program, and will it fit into my schedule?

Although a paramedic program is based on content rather than length, it raises certain issues. The National Standard Curriculum for paramedics states that “it is recommended that the course be planned for approximately 1,000–1,200 total hours of instruction (500–600 classroom/practical laboratory, 250–300 clinical, 250–300 field internship).” How do the programs in your area compare? If the program exceeds the standards, in what areas and by how much?

In addition to the length of the course, you’ll want to investigate the hours that classes are held. It seems basic, but even within this domain there are options. Some programs offer both daytime and nighttime hours; others offer just evenings. Although an evening program may sound enticing, there are almost always hidden conflicts. For instance, most evening programs refer specifically to didactic aspects. Clinical and field rotations may require you to attend daytime shifts. Depending on where you live, the operating room rotation, for instance, may only be available from Monday to Friday during the day. Does the program offer exclusively day or nighttime courses, or is there a mixture? How willing is the staff to work with your schedule? Most important, are you willing and able to make the concessions necessary to complete the program?

The number and variety of clinical and field sites are just as important as the number of hours spent there. If the program you are going to be affiliated with is also affiliated with a Level 1 trauma center with extensive medical specialties and a teaching facility, you can truly get an invaluable education there. If it isn’t, what are your options? If there are multiple hospitals in your area, does the program have affiliation agreements with these various facilities, or will you be tied to one facility?

Becoming a paramedic is an exhausting experience. Most students work either full- or part-time while going through a paramedic program for various reasons, primarily financial. During paramedic school, students must be prepared to sacrifice many things, especially free time. Many paramedic programs, even those affiliated with community colleges, follow a nontraditional schedule. Find out how many breaks are offered throughout the program. No matter how determined a student may be, everyone requires down-time.

How much travel is involved with the program? How much will your commute add to the overall length of the program? In some programs, students commute almost an hour each way just for classroom sessions. Does the program provide clinical and field sites closer to your home? If not, are they willing to expand their available clinical and field sites to accommodate students?

What facilities does the program have?

Does the program have dedicated classroom space? Some programs have the benefit of a dedicated classroom and/or lab space, which allows for equipment storage and having the equipment constantly available. Some programs must cart equipment in and out of classrooms. One issue here is that equipment may not be available to you when labs are not in session. Are the facilities organized? Don’t be afraid to ask for a tour of the facilities. You may need to make an appointment to do so, but it will give you a plethora of information regarding the program.

What kind of equipment will you be using?

All paramedic programs have a minimum amount of necessary equipment. In addition to the type of equipment available, how much is there? For instance, is there one advanced airway-management manikin or several, so multiple students can practice simultaneously? Is the equipment new or old? How often is it replaced? Does the equipment reflect what is used in the area by field personnel? Some programs tend to purchase equipment based on price rather than appropriateness. A sign of a quality program is one that teaches and shows students equipment that they will encounter in their area, as well as what is being used in the field. All of these issues will give you a sense of the program’s financial status. This is important to know, because if a program lacks adequate financial support for capital expenditures, other areas may also be lacking.

What support services are available to students?

Support services are often available at college-affiliated programs, including learning center services to assist students with proper test-taking skills or individual tutoring. Many paramedic students do not consider their program to be a “college course.” Students do not consider their test-taking ability or studying skills when gauging their potential success in a program. If you have been out of school for more than a few years, these services could prove extremely helpful.

Other services may include computer labs, counseling and childcare services. Many paramedic programs require written essays or using the Internet as a supplemental tool for learning or internship verification. Are these services available to you in the event that you do not have computer access? A paramedic program can be a stressful time in a student’s life, and these services can help alleviate any issues that may arise.

Is financial aid available to help offset the costs? The financial aspect of a program oftentimes is the deciding factor on whether one chooses to pursue this education. Financial aid is available from multiple sources. Traditionally, if you are attending a college-based program, you may be eligible for state or federal aid. In addition to these forms of aid, many companies have a tuition reimbursement program, which may require students to pay for the course and receive reimbursement upon successful completion. Other programs have private scholarships, and there are also many grants that you can pursue. However you choose to seek financial assistance, begin the process early and ensure that you research all details of the programs. Many programs have specific requirements and stipulations that must be met to receive or continue aid.

One support service that many people take for granted is library services. Libraries provide supplemental material for students, as well as a wealth of resources for research purposes. Many paramedic students consider library work unnecessary during their education, but information from videos, publications, research articles or Internet services can be a great help in understanding material covered in class.

Is there a national accrediting body for paramedic programs, similar to other allied health professions?

Paramedic programs can be accredited through a few different organizations. The primary accrediting body for EMS programs, the Commission on the Accreditation of EMS Programs (CoAEMSP), is part of the Commission on the Accreditation of Allied Health Educational Programs (CAAHEP). CoAEMSP accredits programs based on many factors like those listed above, as well as others, such as attrition rates, evaluation processes and others. A CoAEMSP-accredited institution must continually evaluate its program. These evaluations are provided by the faculty, staff, current students, recent graduates and employers of recent graduates. The program must acknowledge any deficiencies and not only strive for improvements, but also show a plan of action to accomplish them. A list of all accredited agencies is available ot www.coaemsp.org/.

Is the program you’re considering accredited? Has it considered accreditation? If not, why? There are many reasons why a program cannot become accredited, such as a small program that cannot afford the necessary costs associated with accreditation. States like Alabama, Arkansas, California, Colorado, Indiana, Kansas, Maryland, Minnesota, Mississippi, New Mexico, New York, Virginia and Washington currently require paramedic programs to be accredited. This number has increased over the past few years.

One of the interesting items that an accredited program must track is attrition rate. The attrition rate is the percentage of students who do not successfully complete the program. For example, an attrition rate of 25% means that 25% of the initial enrollees did not complete the program. Upon initial investigation, a high attrition rate might imply that it’s a bad program, but this isn’t always the case. If a program has a 50% attrition rate, but has a 100% passing rate on its state and/or National Registry exam, this tells you that even though they lost half of the class, the remaining half was prepared enough to pass the final certifying exam. This could mean that the program has high standards for progression and has produced a good product at the end. On the other hand, a program with a 50% attrition rate that only graduates 25% of the remaining students may not have adequate screening or evaluation processes. Most programs that track attrition rates also track the reasons for attrition.

In addition to CoAEMSP, many programs may be accredited by other bodies. For instance, community colleges are usually accredited by numerous bodies at the state or federal level, such as the Middle States Commission on Higher Education.

Now that you’re educated, how do you pay for it?

One of the benefits of going to a college-based program is the issue of financial aid. There are many state and federal aid programs that can help students achieve their education at an affordable price. Grants are another avenue to pursue. There are thousands of grants available to students. It’s just a matter of going out and looking for them. In addition to grants, many schools and organizations have scholarships or tuition-reimbursement programs available. Some employers will even pay for your paramedic program, providing you work for them for a pre-determined period of time. All of these are viable options to help offset the costs. One word of caution: Always read the fine print. Some of these programs do not include textbooks, lab fees or malpractice insurance.

Conclusion

Choosing your paramedic program will be one of the most important decisions you make in your EMS career. It will also be an experience that you will remember for a lifetime. Don’t make the decision lightly.