Guide to College Majors in Emergency Medical Services

We have not lost faith, but we have transferred it from God to the medical profession.
--George Bernard Shaw

What is an EMT/Paramedic Degree?

Degrees in the applied science of emergency medical services (EMS) are very specialized. They provide essential training for professional emergency medical technicians (EMT) or paramedics. Although a college degree in emergency services (or similar) is not a mandatory prerequisite for work in emergency medical service, it does provide a solid foundation for those seeking certification, which all 50 states require.

To obtain national certification from the National Registry of Emergency Medical Technicians (NREMT), prospective EMS employees must pass a national exam. Candidates may not even take this exam until after they have met several educational requirements. To meet these pre-certification requirements, students have a variety of educational options to choose from, including certificate programs from community colleges, hospitals, and municipal departments. Many schools now offer online degrees in emergency services management.

Since jobs and salaries in the EMS field vary greatly in scope, employers require different levels of certification depending on the position. Where some jobs may only require EMT-Basic certification, other jobs may require certification at the highest level, EMT-Paramedic. The prospective EMS student should carefully evaluate her career goals and become familiar with these levels of certification before committing to a particular training program.

Preparing for EMS Training

Prospective EMS students should evaluate whether they have what it takes to thrive in this job. Even the training for this high-stakes career is intense. This job will expose you to gruesome accidents, dangerous situations, and extremely high levels of stress. Most EMS jobs are physically and emotionally demanding, but can also be very exciting and rewarding as well.

The recent popularity of realistic medical dramas on television has served the dual purpose of educating the public while increasing their awareness of EMS-related employment opportunities. Although highly glamorized, these shows provide some insight into the type of person that might thrive in the EMS environment. What these dramas usually fail to show, though, is the amount of training and knowledge that these professionals must obtain before earning the opportunity to save a life.

Any student wanting to pursue EMS training should be physically and emotionally fit, should have good communication skills and a desire to help people, and should be able to make good decisions under pressure. EMTs must also possess a vocabulary of basic medical terminology, certification in cardio-pulmonary resuscitation (CPR), and a clean driving record.

Many educational programs require a high school diploma (or GED) for admission. Some programs may also require students to be at least 18 or 21 years of age. Several even require a criminal background check and drug-screening test. Requirements differ by program and by the level of certification represented. For example, programs focusing on the high-level certification of EMT-Paramedic often require new students to have already obtained EMT-Basic and CPR certification, as well as some field experience.

Aspiring EMS professionals should be aware of their state's certification requirements prior to taking the exams, as well as what personal questions will be asked of them when taking the tests. For example, some exams may ask about the history of their health, chemical addictions, and criminal behavior, as well as their EMS employment history, including any disciplinary actions, suspensions, or lawsuits.

Researching EMS

The best advice for someone planning to pursue EMS education is to be proactive. Learn as much information as you can about your educational and career options before deciding. This information can be gathered by speaking with experienced EMS professionals, by requesting meetings with faculty, students, and alumni of EMS educational programs that interest you, and by searching online.

Career Education in Emergency Medical Services

EMT and Paramedic Training

Because students pursuing EMS education have very diverse educational backgrounds, professional experience, and career goals, there are many options available to suit their differing needs. Students with a high school diploma (or GED) may prefer to pursue an associate's degree. Working professionals can seek continuing education or additional certifications. All professionals must continually renew their certifications to remain valid. Renewal involves continuing education requirements that differ by state. Online degrees in EMS management are popular among certified EMTs and paramedics who want to move into supervisory roles.

First Responder
The First Responder certification is usually required for police officers and firefighters, although some departments require the higher EMT-Basic certification. Certification programs involve training in basic life-support skills that a paramedic should know when he arrives at a traffic accident or fire.

EMT-Basic programs generally provide instruction in:

Basic medical terminology
Anatomy
Physiology
Patient assessment
CPR
Immobilization of fractures
Bleeding control
Childbirth
Hazardous materials
Blood-borne pathogens

These programs also provide hands-on experience performing physical exams, assessing trauma, administering oxygen, maintaining airways, performing semiautomatic defibrillation, and training to drive an emergency vehicle. Students gain this experience during 100 to 120 hours of classroom training, 20 to 50 hours of internship with a field rescue or ambulance service, and 10 hours in the emergency room of a hospital. Internships are always under the supervision of a "preceptor" who is a certified and experienced paramedic.

EMT-Basic (EMT-1)
The fundamental requirement for practicing EMS technicians, the EMT-Basic is a 110-hour course with a nationally standardized curriculum. It covers all the techniques in the First Responder course, with the addition of such topics as patient assessment, handling airways, and treatment of infants and children. It also offers a course on EMT well-being, including personal safety and stress management.

EMT-Intermediate (EMT-2 or EMT-3)
EMT-Intermediate programs, which may not be offered in some states, require an EMT-Basic certification for admission and usually consist of an additional 35 to 55 hours of instruction and field training in patient assessment, intravenous fluids, EKG interpretation, anti-shock garments, basic medications, and esophageal airways. In states that offer EMT-Intermediate certification, this certification is suggested, but not always required, for admission into EMT-Paramedic programs.

EMT-Paramedic (EMT-4)
EMT-Paramedic programs require an EMT-Basic certification for admission. They usually take the form of two-year associate's degree programs that may involve 750 to 2,000 hours of extensive coursework, field training, and hospital rotations. Students learn advanced EMS procedures, such as 12-lead EKG interpretation, needle decompression for collapsed lungs, nasal intubation, cardiac pacing, intraosseous canulation, and administration of medications to treat cardiac arrest, diabetic reactions, allergic reactions, and respiratory complications. Admission to some EMT-Paramedic programs may require letters of recommendation and documentation of work performed during internships.

Certificate Programs versus Degree Programs

Certificate programs allow you to add a particular certification to your resume without spending years getting a degree. These programs may be offered through police, fire, or health departments, as well as through some hospitals and non-degree programs at colleges and universities.

Certificate programs are usually most attractive to:
- Students wanting to get their basic certification as quickly as possible to apply for an entry-level job
- Professionals in the EMS field wanting to obtain a higher level of certification for advancement or promotion

In recent years, the availability of online certificate programs has made this option even more attractive, since both students and professionals can often work an online program into their existing work schedule. For EMS professionals who already possess the required clinical experience, online continuing education programs can help expand their knowledge of medical theory, safety and administrative practice.

Degree programs in EMS and paramedic services usually center on the management side of the field (these degrees may not include a clinical aspect and thus are often available online). Students interested in medicine who are not sure exactly how they want to be involved may wish to earn a more general degree in health sciences. Students whose career intentions definitely point to the EMS field will appreciate the specific instruction of a more specialized degree. Unlike certificate programs, most degree programs, either general or specialized, will require a set of general education courses (usually math, English composition, social science, etc.) designed to boost students' communication and critical thinking skills.

When deciding between certificate programs and degree programs, you should evaluate your immediate and long-term goals. Research your program options, both locally and online. Among the factors you should consider are class size, schedule, completion time, clinical exposure, preceptors, tuition, housing, and graduation placement rates. After narrowing your choices to fewer than 10 programs, contact admissions advisors to become familiar with any application requirements.

Once certified at any level, EMTs and paramedics must continually renew their certification by obtaining campus-based or online Continuing Medical Education (CME) credits.

What can you do with a College Degree in EMS?

Career specializations in Emergency Medical Services

There are many employment opportunities within the EMS field, including fire departments, police departments, hospitals, and ambulance services (both public and private). Some EMTs find work in the corporate or industrial world (like on an offshore oil platform) and others supplement their full-time employment by offering their services as an independent contractor for things like sporting events or film shoots.

A few of the many EMS-related career opportunities include

Ambulance EMT or Paramedic
Firefighter
Search and Rescue (SAR) Medic
Ski Patrol Medic
Critical Care or Flight Paramedic
EMS Instructor

Related Careers
EMTs and paramedics are qualified to do many things besides fieldwork. Some move on to become dispatchers, instructors, physician assistants, or even sales personnel for companies that sell emergency medical equipment. If an EMT-Paramedic wishes to advance beyond fieldwork, opportunities exist as supervisors, operations managers, and administrative or executive directors of emergency services. Others may wish to return to school to become registered nurses, physicians, or other healthcare professionals.

The skills that typify an EMT or paramedic are valuable in many situations beyond emergency medicine and pre-hospital care. Many employers appreciate employees who can think on their feet and make levelheaded decisions under stressful and even life-or-death circumstances. Some other careers that require these types of skills are air traffic control, law enforcement, and all branches of the military.

Salary Expectations for EMT/Paramedic Careers

In the field of EMS, compensation is highly dependent upon certification level, as well as range and extent of experience. According to a 2006 study by the Bureau of Labor Statistics (BLS), the median annual income for EMTs and paramedics is about $27,000 per year. Another recent study cites annual salaries at the following levels: - EMT-Basic: $25,000 per year - EMT-Intermediate: between $24,000 and $32,000 - EMT-Paramedics between $35,000 and $40,000 However, the American Medical Association recently reported that EMT-Paramedics earn between $40,000 and $46,000 per year.

All of these numbers can be a bit confusing (and possibly misleading) due to the many different arrangements at the local level (from volunteer to full-time EMS services), and with EMTs working in so many different arenas of emergency medicine. For example, different pay scales and benefit packages are in place at hospitals, fire departments, and private ambulance services (police and fire departments tend to have better retirement plans). Therefore, it would be safe only to say that salaries increase with each certification level, especially with the highest level of EMT-Paramedic. Salaries also tend to vary due to geographic location and working conditions.

Trends for Careers in Emergency Medical Service

In recent years, the field of emergency medical service has entered a period of transition that has begun to place more and more responsibility on EMTs and paramedics. Many factors have contributed to these changes, including the growth of population centers, the rising medical needs of baby-boomers, and the public's changing view of disaster response.

These trends, in combination with a decreasing percentage of volunteer responders and an increasing demand for higher certification standards, will most likely result in a continuation of the higher-than-average demand for qualified employees in the field of emergency medical service.

The EMT Oath

"Be it pledged as an Emergency Medical Technician, I will honor the physical and judicial laws of God and man. I will follow that regimen which, according to my ability and judgment, I consider for the benefit of patients and abstain from whatever is deleterious and mischievous, nor shall I suggest any such counsel. Into whatever homes I enter, I will go into them for the benefit of only the sick and injured, never revealing what I see or hear in the lives of men unless required by law.

I shall also share my medical knowledge with those who may benefit from what I have learned. I will serve unselfishly and continuously in order to help make a better world for all mankind.
While I continue to keep this oath unviolated, may it be granted to me to enjoy life, and the practice of the art, respected by all men, in all times. Should I trespass or violate this oath, may the reverse be my lot. So help me God."

- Written by: Charles B. Gillespie, M.D.
Adopted by the National Association of Emergency Medical Technicians, 1978

What can you do with an EMT Certification?

Career opportunities for an EMT differ greatly depending upon level of certification, so anyone wishing to enter this field should know what her responsibilities will be within each certification standard.

First Responder
The lowest level of certification is usually required of the people who tend to arrive first at the scene of an accident, such as firefighters and police officers. Their responsibilities are to provide basic emergency medical care until other EMS personnel have arrived at the scene.

EMT-Basic (EMT-1)
A basic certification as an Emergency Medical Technician allows someone to be employed as an entry-level EMT. Responsibilities of an EMT-Basic include assessing an emergency scene, controlling bleeding, applying splints, assisting with childbirth, administering oxygen, and performing basic life support skills, including CPR.

EMT-Intermediate (EMT-2 and EMT-3)
In most states that offer intermediate training, it can be obtained in either EMT-Shock Trauma or EMT-Cardiac. These certifications increase an EMT's roles and responsibilities to include administering intravenous fluids (and some advanced medications), using manual defibrillators, and using advanced airway techniques and equipment during respiratory emergencies.

EMT-Paramedic (EMT-4)
The highest level of certification rewards recipients with a tremendous amount of responsibility at the scene of a medical emergency. They are authorized to provide extensive pre-hospital care, which includes administering drugs orally and intravenously, interpreting electrocardiograms (EKGs), and performing endotracheal intubations.

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