American EMS - Would you work in Ontario?

[vs-eh?]

Reading the several posts regarding Centralized Testing and overall lack of jobs for PCP's in Ontario, it lead me to this post.

I have asked this question before within other posts, but I never seem to get a response. So here goes, I will brake down some givens (i.e. for this argument assume you have these) to facilitate the overall descision making process...

American EMT-XYZ wishing to work in Ontario...

1) You are able to work in Ontario, and cost of living is not an issue

2) EMT-B or under is not worth anything in your application process. You have to do 2 years of education.

3) EMT-I...I'm not sure but assume it won't be worth anything and very likely you won't be allowed to challenge provincial exams and the PCP process. You will have to do 2 years of education.

4) EMT-P...I only recall one person on this forum mentioning reciprocity for Ontario. I believe that person was an EMT-P (I don't recall which state or whether they were NR, which I'm not sure would even matter here) and was only granted reciprocity for PCP. This means that you would have to do another year of college to be an ACP (EMT-P equivalent but likely with a much lesser scope).

5) You're a firefighter as well? Wouldn't mean much of anything. Paramedics and FF function separately here, and FF are arguably more difficult due to lesser overall required education, more people for spots, etc...

Basically let's go under the assumption that you want to come to Ontario and become a paramedic (PCP). You have no prior experience in EMS and have no post-secondary education prior. You are now in a program. The programs themselves are generally quite difficult to get into (say they take about 5-10% of applicants, which will obviously vary depending on where the college is). But for this argument, you are in...

1) 2 year full-time college course load (I won't discuss 1 year programs). Tuition is say 6-8 grand for the 2 years.

2) You will likely be competing with a fair number of university or college educated people that have degrees or diplomas prior to entering the program. This obviously has an advantage. The reason I will not give the average American prior post-secondary education is because generally speaking on this forum, it appears they don't have it/not available.

3) The average attrition (failure) rate seems to be around 40-50%. This means in a starting class of say 50 people, 20-25 will not make it through to the end. Most of these people are gone after first year.

4) A portion of the education (as it should be) are breadth education modules. Meaning you have to take electives that are not EMS related. Say these encompass 1-3 hours of in class time per week. The grade to pass non-EMS related courses is 60%, for EMS courses it is 70%.

5) All in you will spend 800-1000 hours didactic, 100-200 hours clinical, and 350-500 hours precepting. Your scope of practice will then be comparable to an EMT-B with 5 drugs available to them.

So you can handle that...

1) You enter into a process where upwards of 700 people are competing for say 70-100 jobs. Basically say you have a less than 20% chance of being hired. Keep in mind that you could have been stellar in class, but had a bad day in one of the 3-4 days of testing. You are basically SOL for a year with most of the "major" Ontario services. There are other options but for the most part (all things being equal) say the odds of getting a job as a PCP in Ontario are ~ 20%.

The benefits?

1) Pay - The average PCP makes anywhere between $25-$34 per hour. Usually can get overtime pretty good. It is not unheard of here for PCP's making $100k+ here. Obviously ACP's make more (but not that much more) per hour than PCP's.

2) Basically all municipal service's - corresponding union, health/insurance, job security/mobility. There is obviously some play within those, but if you manage to stay on with a service for a year or more, you basically have a job for life.

3) Education.

With all that, if you could, would you move to Ontario to become a PCP? Please answer the poll and offer a response to your decision. Any anybody can correct me if I am in error on points made.

[ncmedic309]

No, I wouldn't take the job...

Here's the main reason:

I'm a paramedic - why would I want to take a job that's going to allow me to have reciprocity, but only at the basic level? It's my understanding that the American EMT and Canadian PCP are about identical in terms of scope of practice. It wouldn't be a lateral move, it would be a move that would put me behind in my career. Where's incentive in that?

[vs-eh?]

No, I wouldn't take the job...

Here's the main reason:

I'm a paramedic - why would I want to take a job that's going to allow me to have reciprocity, but only at the basic level? It's my understanding that the American EMT and Canadian PCP are about identical in terms of scope of practice. It wouldn't be a lateral move, it would be a move that would put me behind in my career. Where's incentive in that?

1) I was referencing only one person that I recall. But even if that was consistent across Ontario...Do you not think that is a problem? You being an EMT-P in North Carolina, yet a PCP here? That your education would only (potentially at maxiumum) allow you to practice as a PCP. I am not degrading PCP's (or EMT-P's) for that matter, I am just making a point. Dustdevil, I believe was looking at reciprocity in various provinces, maybe he could shed some light...

2) People see scopes of practice and equate that to education. That is poor reasoning. Again, would you rather have an educated paramedic practicing at a lesser scope, or a lesser educated paramedic at a more advanced scope? Plus in this province (for the most part), you don't have options.

3) I tried looking at your education via the website you linked in your myspace. I couldn't tell for sure what the curriculum was. Please link or clearly spell out what the curriculum was with your EMT-B and EMT-P program.

[AZCEP]

http://www.nhtsa.dot.gov/people/injury/ems/EMT-P/

There's the links for the base requirements for all American paramedics. Some areas will add to this, but this is the minimum.

The EMT curriculum is also available from the same site.

Now to the question at hand. No, I would not work in Ontario. The competition for a job that I'm already doing with a comfortable salary without the level of taxation enjoyed in the province says "Nay".

I'm all for more educated providers, but the comparison is a fairly weak one in this case. Taking a provider with an educational background out of a system that supports them, and placing them in one where they will not be able to perform what they have been educated to do just is not a good idea.

I've tried this several times in different areas in the states, and the culture shock was impressive, at best. Oppressive at worst. As ncmedic alluded, the difference in scopes wouldn't be worth the increased pay. The change in scope would be backwards for most. Now, if you can offer up this educational program to some EMT candidates, there might be a calling.

[ncmedic309]

People see scopes of practice and equate that to education. That is poor reasoning. Again, would you rather have an educated paramedic practicing at a lesser scope, or a lesser educated paramedic at a more advanced scope?

Your right, some people do equate scope of practice to education. However, I'm not one of those people. The EMT curriculum in the U.S. is a joke at best. There's no doubting that the U.S. is behind in the times when it comes to educating it's EMS providers. The curriculum for EMS providers in Canada is probably one of the best you will find in the world, but that's just my opinion. I have the upmost respect for the EMS education system in Canada and only hope that one day the U.S. will adopt similar standards. Moreover, I would rather have an highly educated paramedic, functioning at the highest and most beneficial level of scope than either of the previous two that you mentioned.

I tried looking at your education via the website you linked in your myspace. I couldn't tell for sure what the curriculum was. Please link or clearly spell out what the curriculum was with your EMT-B and EMT-P program.

I'm unsure of where you attempted to obtain your information? Either way, if you would, please visit the following link and you should get the answer to the majority of your questions. If not, please ask, I will fill in the blanks.

NC Medical Board Approved Skills and Medications (PDF)

[ncmedic309]

Here's a couple more for you that might be more beneficial...

EMT Cirriculum

EMT-P Cirriculum

[JPINFV]

If I was a medic:

1. Taxes

2. Cold weather sucks

3. Joking, but am I?

4. Taxes

5. Do I get credit for the college courses I've already taken?

[Thunderchild145]

I've got to say no. You said in the orginal post that EMT-XYZ in the US would come to Ontario, the only catch is that if you aren't an EMT-P in the US, then your liscense doesn't mean anything. Not to mention my main point, and that's that medics in the US learn advanced skills and a lot of drugs. Granted, the education time is very short, but the scope is there. It would be rediculous for them to give up those advanced skills and drugs just because the amount of time they went to school is about the same as what the PCP went through.

In short, if EMT-XYZ can do skill ABC or give drug DEF, then regardless of how long they spent in school, that should be reflected on reciprocity for me to even consider moving.

[scratrat]

No way!!!

It's cold there..and it snows!!!! YUCK!

[paraloco]

VS-eh, I'd rather have an experienced medic of whatever level with the tools to save my life, if circumstances called for it. I won't care if he/she/it can quote Plato, or explicate a poem, or solve a differential equation, because that skill set would not be relevant to the task at hand. I recently made a differential diagnosis that a NP with a master's degree missed (because she did not do a complete assessment or HOI) She had been a flight nurse at one time. Tons of edumacation. It didn't benefit the patient that day. Tell us how your increased level of education changes your practice. Why are so many degreed people pursuing a job which requires a certification? If memory serves, you've posted similar threads before. It's starting to feel like you are looking at your popsicle, then at mine, and fear that mine tastes better. Come ride with us.