Surviving Paramedic School: Be Flexible, Embrace Uncertainty

What’s it like to go to paramedic school? Before I can even think of an answer when I'm asked that question, I feel catecholamines kick in, as if a preceptor just told me the next tube is mine.

Maybe that sounds exciting to some of you, but for me, upgrading from EMT was an unnatural act—scary, hard and nothing like the seamless exercise I’d imagined. I wasn’t even sure it still made sense for me to change careers and work full-time in the field.

In my opinion, success in paramedic school has lots to do with expectations: The easier you think it’ll be, the more trouble you’ll have. Not knowing what I was getting into certainly lengthened my learning curve. I made the mistake of assuming the curriculum wouldn’t be a problem because I’d already earned a degree and thought I had plenty of EMS experience (a whole two years!).

Becoming a paramedic was harder for me than getting my bachelor’s degree, mostly because I hated people watching me perform. I hadn’t factored those incessant over-the-shoulder evaluations into my expectations. I almost quit. (During four years of engineering school, my practical skills had been graded in only two courses, and one of them was Phys Ed.)

When I became a paramedic instructor, I started to see how important flexibility was for incoming students. The ones who succeeded not only adapted to circumstances that were different than they’d expected, but they also weren’t wedded to erroneous assumptions like these:

1. I can make room for paramedic school without major changes to my life. Expect the curriculum to be all-consuming. There's little time for anything else. Explain to your significant other that you’ll be away a lot and when you’re home, you're going to be sleep-deprived, cranky and preoccupied. Some relationships won't last until graduation.

Corollary 1A: No reason to cancel that ski trip. Don't schedule vacations during school; in fact, don't plan any recreational activities. And don't take days off just because you feel like it. It’s easier than you think to fall behind, and there won’t be any teachers or guidance counselors waiting to help.

Corollary 1B: Volunteering as often as possible will reinforce what I’m learning. Volunteering has merit—just not during medic school. Hanging around at the squad may sound like ideal study time, but it hardly ever works out that way. Plus there’s the risk of ending up on a lengthy call and missing class. Don’t expect instructors, preceptors or course directors to excuse lateness or absence because of your service to humanity.
 
2. Studying is overrated. If we exclude the ridiculously gifted among us who remember and understand everything they read or hear the first time, the rest of us need daily repetition and reinforcement. Practical rotations help, but you also have to hit the books and think about what you’re learning.

Corollary 2A: My EMS experience will get me through. In my 11 years on the faculty of a well-known paramedic program, I didn’t see any correlation between the number of years students had accumulated in EMS and the likelihood that they’d graduate. Even AEMTs who’d already covered some of the ALS material didn’t seem to have an advantage.
 
3. Healthy habits are nice to have, but not essential. Eat nutritious meals as often as you can and try to set aside at least six hours a day for sleep—especially before exams. If you’re not able to do either, remember that sugar is elementary brain food. Tactical candy bars helped me stay alert during more than one test.
 
4. Nurses don’t know nothin’. You’ll hear this from some medics who heard from other medics that nurses need step-by-step direction. Do the field of emergency medicine a favor and let that rumor stop with you. Not only is it untrue, it’s demeaning to people who’ll be contributing to your evaluations—an unwise application of free speech. In fact, don't bad-mouth anyone—classmates, teachers, preceptors, administrators—no one. Deal with disagreements in private or not at all.

Corollary 4A: Old medics don’t remember anything. Here’s what they’ll most likely remember: how much of a pain in the ass you were when you tried to impress them with wisdom culled from textbooks.

Corollary 4B: Doctors don’t know what I know about street medicine. Correct. They know much more, except maybe the part about lower back pain.

5. I paid tuition; they’ll make me a medic. To think of paramedic school as just another service provider would be a gross miscalculation. You, the customer, aren’t always right. Unfair things will happen. You won't always understand why you got a test question wrong, why you were criticized or why some classmates did better than you. Even if you’re a good student and a nice person, sometimes you’ll have to work extra hard to get by. Your tuition is just another at-risk investment.

The worst mistake you can make in paramedic school is a combination of all the above: failure to adjust to a new reality for the duration of the program. Expect lots of work—much more than you had in high school—and little help. Be flexible, keep an open mind, don't make excuses and just concentrate on getting the best results you can.

To those who’ve started paramedic school or are thinking of doing so, what else would you like to know? E-mail editor@emsworld.com.

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