Can a poorly training medic become a good medic?

[Ridryder 911]

As a professional EMS educator, I see many variables. What I have determined is that there are those that have the advantage of having access and resources; but it does not make up the one that has the drive to become the best!

It is the internal drive that one must possess to really make the difference. This person, recognizes their potential limitations of learning environment but compensates by taking the initiative of studying hard, obtaining information .. (non traditional method).

I use the analogy of those in medical school. Harvard vs.. (almost any state university) Does one that graduates from such an institution automatically make them better?... No, they study the same material, usually have the same clinical exposure.. So what's the difference? .. Usually, it's the drive and make up of the person. Harvard (and of course others) have a higher demand, expect more, higher competition..

So those that graduate from a distinct program usually have that drive, have that motivation to excel and be the best! The same is true in many Paramedic programs.. I still say, we are WAY too easy on most medic students! The harder you demand, then those that REALLY want to excel will be left!

Good luck!

R/r 911

[Just Plain Ruff]

And let's not forget Ebola and marburg viruses. Swine flu, bird flu, skin necrotizing mrsa, VRSA, VRE and many others.

Bed sores that we get no training on, long term vent patients, post cath patients and many many others.

AICD's and magnets and all that stuff.

Don't get any of that stuff in the books do ya?

So where do you go to get education on that stuff? A good refresher only scratches the surface. Medpub is a great resource.

New England Journal of Medicine and JAMA are also good places to go. Expensive subscription but you will get stuff you normally don't get anywhere else.

Good luck

[ERDoc]

AICD's and magnets and all that stuff.

:punk: :punk:

[HERBIE1]

Ruff had a great idea about the refresher course. Also, as several have noted, every so often we get thrown a curve ball we have never learned about.

Example:

A couple years ago, we received a notice from a local hospital that 2 patients in our area recently had LVAD's implanted and were being discharged home. (Left Ventricular Assist Devices). I assumed they were similar to balloon pumps, but honestly I had no friggin clue what these things were. Luckily, soon after this, a local hospital offered a seminar- sponsored by the companies that manufacture the devices. It was one of the best decisions I ever made. I got to play with the devices, see what they did, how they operated, learned what to do if the device or one of it's parts failed, how to resuscitate these patients(NOTHING like you would expect) learned what to do if a patient calls and has one,, who to contact to reach out for help on the device, and much, much more. We even met several patients who had the device implanted, and they explained what they were all about, issues they have had with the devices, and how best to help them. There is no way in the world I would have known what to do if I had not attended this class. I ended up educating others about it, but there is no substitute for getting the information first hand, and thank gawd I did spread the word because shortly after that, one of them ended up dealing with a patient with an LVAD.

Point being- you'll never be fully prepared for what you will see- regardless of the quality of your education. With all the medical advancements, we need to be on our toes and keep up on current trends.

Reread your texts, reread your notes, retake your exams and quizes. Ask people to quiz you to be certain you have a good grasp of the material, and constantly ask questions. You can make up the gaps in your knowledge- it will just take a bit of work. As for the clinical aspect, once you are comfortable with your knowledge base, the skills and confidence will follow. That is always the hardest part- regardless of your paramedic education and training.

Good luck.

[DFIB]

For me knowledge translates into confidence and speed. I mean the more confident I am with my understanding of the the more confident I feel on the streets. I was just doing clinicals and got to watch a my preceptor doubt his/herself and withhold a treatment that he/she knew was in his/her protocol and would benefit the patient. She was momentarily unsure of the knowledge tha resulted in the loss of confidence in the treatment. The patient was fine but the preceptor had to explain. It was a great learning experience for me.

I study every chance I get and if I can't remember something I go back and read it again.

Also I have made my own Quick Reference Guide that I carry with me. It contains the stuff that I consider important or that I have a hard time remembering. Constantly refreshing my knowledge is key to me.

[Kaisu]

The thing that really got to me out in the field was that because the vast majority of EMS providers in this area are in fact highly trained but poorly educated, the main source for valid information (experienced providers) for others was not an option for me. Make sure the person giving you the info is reliable.

I overcame this particular deficiency by doing my own independent research, including but not limited to, running questions by some of the truly smart people on this site.

When I finally got into a station where I wasn't run off my feet with call volume, I could actually do follow up with doctors and hospitals too.

I am currently in a quandary. I know enough to know that large areas of my medical knowledge are sadly lacking. What do I do? Do I get more medical education (real education btw - not bullshit refreshers)? and if I do that, then do what? I love the field.

I wish our system was more like Canada, where you HAVE to have a minimum of 2 years of college level to even ride on the ambulance and a 3rd year for ACLS.... BUT I am beating a dead horse

Cheers

[paramedicmike]

I am currently in a quandary. I know enough to know that large areas of my medical knowledge are sadly lacking. What do I do? Do I get more medical education (real education btw - not bullshit refreshers)? and if I do that, then do what? I love the field.

What do you want to go to school for? You have several options. MD/DO school. PA school. RT school. RN school. I think you'd be surprised at how you can bring what you learn in additional education to your practice as a medic.

Sure. With the time and financial investment involved you'd spend most of your time after school in your new field. But that doesn't mean you can't bring it back and continue to contribute to the field practice. You could even turn that new education and experience into teaching opportunities for EMS providers thereby ensuring that other providers can continue to grow.

It can be done. And you could do it.

[croaker260]

Hey all,

I certainly agree with most of what was said already. I am, however, I am going to offer a slightly different perspective. This is based on my experience in our hiring process and then over the following months training the new hires in our FTO process.

For what its worth, our FTO process is a minimum of 4-6 months long, typically being 6 months to 9 months for a brand new medic. It is based on the law enforcement San Jose Model and we have used it for about 15 years with very good results.

Anyway, Over the years I have seen multiple students from these "medic Mills" (we have a couple in the area" come and intern, and then come and try to get hired. Over the years we have had a number of graduates from the year long medic mill courses get hired, though I cant recall any of the "fast track" (6 months) medics actually completing the process.

I will say that as a general stereo type the ones from the medic mills tend to test poorer, and subsequently tend to have a steeper learning curve than their more traditionally trained counterparts. The knowledge gaps are larger, but most importantly the typical students who tend to fall into the propaganda traps of these schools tend to be students coming directly out of their EMT courses and have no previous experience in EMS. This also contributes the many challenges they face.

That said, we have many who have done quite well at our service, but it definitely takes them longer to get there. I attribute this directly to our FTO program. An organized, structured, professionally ran and validated FTO program can overcome many of the gaps and challenges that these students will face. The front line in this is of course the FTO's , how you select them, how you train them, how you retain and motivate them...but that is a different discussion.

For you, in addition to all of the above answers, I would suggest seeking out a service with an actual FTO/FTEP program (not just a glorified preceptor or orientation program) and try to get on. Your learning process will be greatly accelerated, and this in turn will help your professional development.

[Kaisu]

An organized, structured, professionally ran and validated FTO program can overcome many of the gaps and challenges that these students will face.

Amen to that brother.

PS.. can you change the size of your font. You have great things to say that are really hard for us old people to read. :-)

[akflightmedic]

Amen to that brother.

PS.. can you change the size of your font. You have great things to say that are really hard for us old people to read. :-)

Done.