Bridge Work

We meet interesting people in this business. Sometimes they make us think.

A few months ago I treated a maître d’fromage—a restaurant’s “cheese whiz,” if I may be un peu grossier. The guy was stable, so we spoke a bit about our respective professions: He described his typical workday, I described my typical workday. He complained about his job market, I complained about our job market. He mentioned his four-year-degree prerequisite…I complained some more about our job market. If there was ever a moment when EMS’s minimalist view of education was underscored, this was it.

Higher learning is a familiar topic in mainstream EMS media. Most recently I’ve read that limited time, prohibitive costs and questionable relevance are reasons—excuses, really—for EMS providers not to attend college. The argument goes something like, “Why should I spend all that time and money studying stuff I’ll never use?” Like speaking and writing, or any of the sciences that clarify more than, say, hazmat placards? I could go on, but I have only until the end of this page. I’d rather discuss an academic alternative that is gaining popularity in our industry: bridge courses.

As I understand it, a bridge program is something that allows certified EMS personnel to advance to higher levels of medical licensure faster than uncertified candidates. For example, if I’d decided 18 years ago to work fewer than three jobs to support my family, I might have gone directly from paramedic graduation to nursing school, earned a decent wage and saved myself several months of study and many years of non-rebreather unraveling. Just because I didn’t take that shortcut doesn’t mean you shouldn’t. I mean, why risk covering material more than once?

Bridge courses, by their nature, assume you already know something about your new field of study. That’s a risky supposition—for you, not for the people running those programs. The gap between knowledge and awareness is wide; if all you have is the latter, your bridge course might become a gaping-crevasse-between-two-cliffs course. I encountered that when I tried to expedite some of the math required by my engineering school. I barely escaped with a grade of D, for Don’t try that again.

Be particularly wary of these lesser-known bridge options:

Tree surgeon to trauma surgeon—This is geared to practitioners who wish to focus on limb rearrangement—not the most mainstream of medical subspecialties. Not surprisingly, the biggest obstacle for candidates who are accustomed to life forms with seed pods has been bedside manner. For example, a landscaper enrolled in Princeton’s Surgery and Toaster-Repair curriculum was summarily dismissed for suggesting to a patient her varicose veins would be fine after “a little pruning.”

CPA to PA—I imagine there are lots of accountants who’d like to be physician assistants. Well, maybe not so many, but I hear accountants with backgrounds in creative financing are sought by offshore medical facilities specializing in deductible-free care—the $5,085 office visit, for example, or the $10,060 CBC.

PA to CPA—Yes, there are just as many opportunities for physician assistants who are inexplicably drawn to tax law. Medically trained financial advisors now offer resuscitation to retirees who discover their 401(k)s were 100% invested in Greek drachmas.

Hospitality executive to hospital executive—I work in the hospitality industry. Our 2,800-room hotel is a model of efficiency for any hospital not already featuring white-nitrile-glove service. Some customs would need just a little tweaking; for example, diversion would be repositioned as “turndown” service, and the hospital cafeteria would be renamed something cosmopolitan like Il Diabetico.

Chef to chief—There are lots of similarities between a world-class chef and a department chief. On an ambulance, I mean. Both know good cooking.

NAEMT to NREMT—I feel bad for both organizations. People constantly confuse them with each other and misunderstand their missions. Rather than fight perception, I say go with the flow. To the NREMT: Offer “honorary” certification and a patch to anyone who joins the NAEMT. To the NAEMT: Offer unregistered members 10% off their first Registry retest.

If you know someone who meets any of the above criteria and is desperate to enter the medical field, you have my permission to copy this column for them. Longhand. Sorry, I’d have to pass a columnist-to-publisher bridge course to allow more than that.

Mike Rubin, BS, NREMT-P, is a paramedic in Nashville, TN, and a member of EMS World’s editorial advisory board. Contact him at mgr22@prodigy.net.