In the time I have been a member of this site, I have seen so many valid discussions which turn into spitting matches of EMTs vs. Paramedics. One of the things that it seems might help is to remember the EMS concept that a Basic is an EMT, an Intermediate is an EMT and, though they are often want to admit it, a Paramedic is an EMT...I can just see medics all over the world having small MIs when they read that.
First of all, we simply must stop comparing the training of EMTs of any level in the US to that of our brothers and sisters in Canada, Australia and elsewhere. The training and scopes of practice are simply not the same. An EMT here is not the same as an EMT in Canada.
Secondly, I disagree with the fact that the training of EMTs (as one author noted, particularly basics) is insufficient. In my experience both as someone who has spent a year in medical school and is now a National Registry EMT-B/D, when people start complaining about training being insufficient, it is most often not the fault of the training, but the fault of the one being trained. Maybe people should start asking themselves, did I LEARN material and interventions or did I memorize it long enough to get through an exam. I think often, especially with students at the basic level, the latter is the case. As far as clinicals go, my training program required 20 hours of clinical time divided between ambulance and hospital. I completed almost 3 times that many hours, including 24 hour shifts in Level I trauma centers, where I assisted physicians and nurses, administered treatments to patients whose care was placed in my hands and regularly performed neuro exams on patients. Perhaps the best question to ask is not whether the training is sufficient, but whether you took full advantage of the opportunities for training and learning made available to you. I have seen students in clinical settings, both Basic and Paramedic, sitting in lounges drinking coffee waiting for the next "interesting case." When we begin to argue about who is well trained and who is not, perhaps we should be intelligently discussing who took advantage of the opportunities made available to them and who sat around on their thumbs until their shift was over so the nurse manager could sign off on a "clinical rotation."
As for BLS vs ALS, this question doesnt even exist in my area. Every single crew has a BLS Basic and an ALS paramedic. There is never any need to see what a patient needs and then call for an ALS intercept. ALS providers are already on scene ON EVERY CALL. In fact, several of our private agencies have three person crews consisting of a Basic and two Paramedics.
Whether you are training to become a Basic, a Paramedic, a CCP or a Basic or Medic specialist, the question is not how good was the training, but rather how well did you train. Yes, I plan to move on to Paramedic level. But I am also proud to be an EMT-Basic. I worked very hard during my 176 hours of training (not 120) and came away feeling that I had mastered the skills of assessment, splinting, patient stablization, bleeding control, labor and delivery, wound care, breathing treatments, scene size up and the 100 other things that we were trained to do.
If you are an EMT and feel that your training was insufficient, then by all means have the good sense to get out of the ambulance and back into the classroom. If you are a Paramedic who feels that the Basics with whom you work are ambulance drivers, why dont you let them participate in the patient care they were trained to give. Basics and Paramedics should work together, hand and glove, not servant and master.