Dr. Bryan Bledsoe recently wrote an article, entitled, “Is EMS a Trade or a Profession?“. Some of what he said I agree with, but many of his points I don’t. Unlike a “trade”, Paramedics must possess complex knowledge and skills necessary to provide rapid and specialized clinical assessments, which often requires critical clinical judgment, advanced life saving/sustaining procedures, often is austere environments and without direct supervision. Paramedics do have a standardized curricula [National Curriculum for Paramedics], which is regulated by the National Highway Traffic Safety Administration (NHTSA). The NHTSA is a part of the United States Department of Transportation (USDOT).  How can a “profession” that performs procedures that only MD’s perform [and in some institutions, only anesthesiologists perform] be regulated by the NHTSA? And to make matters worse, that last time that curriculum was updated was in 2009. Do you think medicine has changed in 7 years? 

Dr. Bledose commented, “So why in 2016 is paramedic education still based upon an archaic curriculum administrated by the USDOT? I don’t know”. If Dr. Bledsoe, one of the leading medical educators in this country and leading author of EMS books doesn’t know, who does? 

The time is NOW to lobby the federal government to establish a Paramedic National Oversight Board that would be responsible for: 

  1. establish standards of practice
  2. establish core competencies
  3. establish educational requirements and a paramedic residency program
  4. determine qualifications of applicants for licensure, and
  5. discipline licensees who do not adhere to those requirements. 

Dr. Bledsoe stated, “In my other job, I am a medical school professor. My role is to educate medical students and residents in emergency medicine. There is not a standardized curriculum that we must follow. There are not certain textbooks that must be read. Instead, we are given a set of competencies that all graduates must attain prior to graduation. This is common of professions and virtually unheard of in trades.”

Medical School certainly has a core curriculum, For example, in your first year the following Fall classes could include: 
  • Medical Biochemistry (8 weeks)
  • Human Anatomy (15 weeks)
  • Medical Embryology (8 weeks)
  • Medical Genetics (4 weeks)
  • Medical Physiology (5 weeks)
  • Academic Colleges (weekly)

There are specific textbooks that are recommended for each of these classes. Paramedic School is no different; they have mandatory classes and recommended textbooks.

Dr. Bledsoe stated, “There are various components of each competency that must be mastered. However, it is left up to the individual program to determine the best way to achieve those competencies. Instead of documenting the number of hours in class, or similar checkboxes, residency programs must show evidence of how they use educational outcomes to improve individual resident and overall program performance.”

In Paramedic clinical training, there are core competencies that must be mastered before your clinical coordinator will send you to test. Those core competencies include Patient Assessment, Medical Knowledge, Professionalism, etc., just like medical school. 

Dr. Bledsoe stated, “Unfortunately, paramedic education looks more at the number of hours in class, the number of hours in the lab, the number of hours in the hospital and the number of hours on the ambulance.” Hours and procedures are documented. However, Paramedic students are not sent to test until they have mastered the core competencies. Medical Residents also keep track of their hours and procedures. 

Where we agree is, “It is time for the national standard curriculum to go away.” It’s time for this country to have a national paramedic oversight board to not only establish core competencies and educational requirements but to determine qualifications of applicants for licensure. Who is onboard?

 

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