Q&A with a Paramedic

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After a recent post on Instagram, I connected with Mike, and he graciously offered to answer some questions and add his insights into being a paramedic. It's a great option for getting patient care hours for PA school, but there's a lot involved and I am certainly not an expert, so I'm happy to share his firsthand experience with you. I learned a ton from his responses! On a side note, Mike just got his first interview invite, so send him all of your good vibes. 

What steps does it take to become a paramedic?

Becoming a paramedic is certainly not an easy task, but if you are willing to put in the time, it is extremely rewarding. 

Step one: Become an EMT- Basic. Many people under value their time as EMT-Basics. People tend to want to jump straight into becoming a paramedic because you get to administer medications and perform all types of procedures. A common phrase you will hear in the EMS world is “you can’t have good ALS (advance life support) without good BLS (basic life support).” My time as an EMT Basic was essential in properly learning how to assess and determine if a patient was sick or not sick.

Step two: Find a good program and enroll. A great deal of programs will be run by community colleges (which keeps the cost down) and vary in length. Typically, it takes 12 months to complete the certification program or 2 years to complete the Associates degree. During this time, you will meet anywhere from 2-4 days a week during the day or night. My program met twice a week for 8 hours a day. Classes will run for a full year, including winter and summer. On average you will take between 15-18 credit hours a semester, but do not fear, the classes tend to piggy back off each other (i.e. Medical Emergencies and Pharmacology will be taught together). While in class, you will also be responsible for scheduling multiple ride-along shifts. This will be done during your free time and is required by all programs. Ride along shifts can be equated to clerkship time found in PA school. It is time for you to put into practice the skills you are learning. You will be required to perform a set number of assessments and practical skills to be check off by your preceptor. It may seem intimidating, but it is probably the most exciting part of class. 

Step three: Take the National Registry. The National Registry Exam is the national certification exam for paramedics that is accepted by almost all states. This is a two-part exam which consists of a practical portion and written exam. Each phase of the exam is usually taken on separate days and your program director will need to approve you to take the test. 

Step four: Find a job/state licensure. Once you have passed both the written and practical exams you will be a Nationally Registered paramedic, but that does not mean you can practice just yet. To be able to practice, you must be affiliated with an agency or hospital. As a paramedic your certification or license will need to be tied to a Physician/Medical Director. Being affiliated means that the agency recognizes you as a provider and the Physician/Medical Director approves you to operate under their license. Essentially, you need to have a job to practice. 

Side note: Most states accept national registry certification alone, but there are others that require Registry and state licensure. This will require you to take an additional state specific protocol test. 

If someone wants to become a paramedic, what is the first thing they should do?

The absolute first thing a person should do is become an EMT basic. If you are already an EMT-B, reach out to your local paramedic program and find out what their program requires for admission. Typical prerequisites for a paramedic program are Anatomy & Physiology, and basic English and Math. Some programs used to require a certain amount of experience as a EMT Basic. Programs are starting to shy away from this due to the shortage of providers. Check locally to find out.

What is the difference between an EMT and a Paramedic?

In the field of EMS, there are multiple levels of care. The most basic level is called an EMT-B or Basic. This is what most people think of when they hear the word EMT. At the basic level, school typically is a couple months. What an EMT can do is usually determined by the state and or the Medical Director, but common practices are assessments, splinting, administration of low level medications (i.e. Tylenol, aspirin, glucose paste) and the assisting of already patient prescribed medications (i.e. nitroglycerin, albuterol inhaler). Again, this is a state/physician-based decision. A paramedic is typically the highest level of EMT care found out in the field. Paramedics carry a wide range of medications as well, and the portable monitor. Paramedics are trained to make differential diagnoses and follow protocols established by the medical director when treating patients. Paramedics can perform a wide range of skills such as; intubations, IVs/IO, Needle Decompression, Cardioversion, Defibrillation, Pacing etc. As a paramedic, I also carry a drug box and based on protocol and assessment, can administer a wide range of medications.

What does a typical day on the job look like for you?

I work in a fire-based EMS system in a major metropolitan area that borders the District of Columbia. That means my department is extremely busy! The best answer to this question would be there is no typical day. That is one of the exciting parts about being a paramedic. My department works a 24/72 schedule, meaning I work 24 hours on and then have 3 days off. Shift change is at 0700hrs, but it is customary to arrive at least 1 hour before. This ensures the crew coming off does not get stuck on a late call and gives you time to settle in and mentally prepare for the day. After dropping a pot of coffee, I head over to the Medic unit with my partner and begin our morning checks of the unit and equipment. During checks we replace any expired medications or damaged equipment, perform basic maintenance checks on the unit (oil, washer fluid, tire depth, lights, sirens), then finish up by ensuring the narcotics are locked up and signed over. 

Following morning checks we drink more coffee, have breakfast, and wait for the calls to start. On average my department as a whole, runs just under 500 calls a day. The average number of calls for a medic unit is around 8 a day. A long, detailed call will take me around 2 hours to complete and a simpler call can take as little as 30 minutes. 

How will your experience as a paramedic help you to become a PA?

I have heard that PA schools really value the patient care experience paramedics bring to the table. As a paramedic, you learn the basic steps to diagnosis and development of treatment plans. You also learn how to work as a team and think on the fly. I’d like to believe that PA school admissions respect the time and discipline it takes to become a Paramedic and believe that this will translate into your studies as a future PA. 

For me personally, when I think of this question, people will automatically assume the clinical aspect of being a paramedic is most important. While I do feel I have learned a lot clinically, I also have seen that there is so much I do not know. More importantly, my time as a paramedic has taught me life qualities that I believe will help me be successful in medicine and life. Here is my not so short list.

  • I have learned how to lead and how to follow. 
  • I have learned how to be humble and ask for help. 
  • I have gained confidence in myself and my decision making. 
  • I have learned how to work as a team
  • I have learned to do more with less and think on the fly
  • I have also learned the true meaning of empathy and compassion. 

What is the craziest thing you’ve seen?

In 2015, my partner and I were dispatched as the only advance life support unit to a single vehicle motorcycle accident in the parking lot of a strip mall. A rescue squad and a basic life support ambulance was dispatched with us to make a total of 7 providers. As we were approaching the scene, the officer on the rescue squad in a panicked voice asked for an alternate channel. When questioned why, the officer yelled to start an EMS Taskforce and give him the channel. A motorcycle attempted to run a red light when he was clipped by another vehicle. The motorcycle slid into a crowd of people including several children. There were multiple critical patients requiring advance life support intervention. My partner and I jumped off the rig and were directed by the basic crew to assess a young child that was fatally injured. I began to assess the patient and directed my partner to go quickly assess the condition of the other patients. Both my partner and I were brand new medics at the time (only 1 year of experience) just off our internship. Neither of us had experienced a mass casualty incident and as the highest level of care on scene, everyone was looking to us to make decisions. What a crazy and stressful experience. 

What is the hardest part of your job?

I think so far, other than very specific calls, the hardest part of my job has been telling someone that their mother, father, brother, sister, son, daughter or friend has died. I feel that never gets any easier to say the words. I will never forget the first time I had to tell a mother their child had died. It will be an experience you will never forget. I think that is why it is important to find balance while working in medicine. Find a healthy way to relieve stress and let work go for a bit. 

Where can people find you?

People can find me on instagram @ mike_jeffe or on facebook. Feel free to reach out if you have questions about becoming a Paramedic or what it is like to be a paramedic. I will also be providing updates on my journey from EMT-P-PAC and updates of my application process.


My name is Mike. I am a first-time applicant this year and currently in my last semester of undergrad. When complete, my degree will be a Bachelors of Science in Emergency Medical Care with an Administration focus. I have been working in emergency medicine for almost 8 years now. I first discovered medicine as a transporter in the hospital. I walked through the halls of the hospital, amazed by what I saw. I honestly felt like Harry Potter when he discovered the wizarding world. Everything was new and exciting to me. I was captivated by the amount of skill, knowledge, and selflessness that surrounded me. Over the years I worked my way from hospital transporter to EMT in the Emergency Department, finally landing in the fire department where I obtained my paramedic certification. I have been with the fire department for over 6 years, operating as a firefighter/paramedic for the last four.

6 Healthcare Jobs That Will Turn You Into the Perfect PA School Applicant

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Guest Post by Mackenzie Martin

In 2013, physician assistant (PA) schools received around 18,510 unique applications, according to a CASPA Data Report. Out of all of these individuals, only a very small number—less than 30 percent—were accepted. 

From these numbers, it’s easy to see that getting into PA school is an impressive feat. So, how do people do it? Of course, they have good grades, test scores and volunteer experience, but what else sets them apart? For many schools, what differentiates a great candidate from a good candidate is hands-on patient care experience. 

Looking for ways to get certified or find opportunities for healthcare experience? Check out this search engine!

If you want to set yourself up for application success, one of the best things you can do is to start working in the healthcare field. Below, you’ll find a list of the top jobs for aspiring PA students to obtain patient care or healthcare experience required to apply:

1) Paramedic or Emergency Medical Technician (EMT) 

Emergency medical technicians (EMTs) are healthcare providers who specialize in emergency medical services. Many of them work for out-of-hospital medical care and transportation organizations. That being said, some EMTs work in hospitals, often as emergency room technicians. 

Paramedics, like EMTs, are trained to provide emergency medical care. Many people who work in this field specialize in settings outside of the hospital. For example, a paramedic may work for the fire department with the aim of stabilizing patients before they’re taken to the hospital. 

Overall, there are a few differences between EMTs and paramedics—even though many mistakenly assume they’re the same thing. EMTs are entry-level providers who have completed about 120-150 hours of schooling. Paramedics, on the other hand, are more advanced providers. They generally start as EMTs and then complete 300 plus hours of additional advanced EMT coursework to become paramedics.

2) Certified Medical Assistant (CMA)

Certified medical assistants (CMAs) are individuals who are educated in the general, clinical and administrative responsibilities outlined in the Occupational Analysis of the CMA by the American Association of Medical Assistants. The certification typically requires around one year of schooling, but some positions offer on-the-job training that’s less than a year. 

If you choose to become a CMA, you’ll be able to work in a variety of settings, from private practice to a hospital. In this role, you can expect to do a lot of things, like taking vitals, administering injections and assisting providers in various procedures. 

3) Certified Nursing Assistant (CNA)

One of the best healthcare jobs that’ll set you apart for PA school is working as a certified nursing assistant (CNA). Many think that CNAs only work in nursing homes, but there are actually hospital positions for CNAs, too. 

If you decide to work in this field, you may help patients with activities of daily living—such as bathing and dressing. People who opt to work in a more clinical setting may gain experience taking vitals and assisting nurses and other providers when needed. 

CNA training requires at least 160 hours of theory/lab work in addition to supervised clinical training. After you complete your training, you’ll need to pass a CNA certification exam, which is composed of written and practical parts. As soon as you pass both parts of your exam, you’ll earn your certification, and you can start to look for positions as a CNA. 

Individuals who opt to go this route can also try to secure a job before they work as a CNA. Sometimes, facilities will hire non-certified CNAs and fund their training (as long as it’s completed a few months after they start working). 

4) Emergency Room Tech


Emergency room technicians are CNAs and EMTs who provide patient care in hospital emergency rooms. Their exact role changes from facility to facility, but many of them assist nurses and physicians by drawing blood or inspecting and cleaning equipment. 

The emergency room is a unique place that can help you prepare for PA school. On any given shift, you could see a patient with a headache, a patient who’s taken a fall and a mental health patient. This exposure will help you gain an understanding of a wide variety of fields and may even tip you off to what area you might want to specialize in later on. 

5) Physical Therapy Aide (PTA)/Assistant

Physical therapy aides (PTAs) are medical workers who operate under the supervision of physical therapists. While assistants need to be licensed, aids can generally work without a certification—as long as they have a high school diploma. 

Although there are some programs that don’t accept this type of experience, many appreciate it and count it as direct, hands-on patient care experience. If you are thinking about this role, it’s best to look up your schools of interest first to see if they accept this type of experience. 

6) Registered Nurse (RN)

A registered nurse is someone holds either an Associates Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN) and has passed the NCLEX-RN exam. Out of the previously mentioned jobs, nursing has several advantages. First things first, the starting salary for an RN is around $66,640. Individuals who choose this route generally have the ability to save more money and sustain a comfortable lifestyle while they accrue patient care hours. 

Traditionally, RNs who seek more schooling will pursue a Masters of Science in Nursing (MSN) degree or a Doctor of Nursing Practice (DNP) degree. That being said, there are a few reasons RNs decide to go to PA school instead of another graduate program. For example, a nurse might go to PA school because they’re interested in the medical model versus the nursing model. Another advantage to PA school is the fact that many programs offer more clinical hours than some NP and DNP schools. 

It typically takes two to four years to become an RN, but there is one other option for individuals who already hold a bachelor's degree. Even if your bachelor’s degree is not in the sciences, as long as you take the necessary prerequisites, you can apply to an accelerated BSN program that takes about 15 months to complete. 

At the End of the Day

Many students are dismayed when they see that some PA schools require their applicants to have hundreds to thousands of hours of hands-on patient care. Truth be told, these numbers can be quite frightening, but they don’t have to be … If you secure one of the roles above, you’ll start accruing hours quickly and ultimately position yourself for PA school application success. 

Guest Post from Taylor - What I've Learned Being a Medical Assistant (Dermatology)

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Taylor has done some guest posts in the past, and if you haven't met her yet, she's my work (and real life) BFF and medical assistant that I work with most of the time. We're basically side by side for 8 hours while we're at the office, and we share a love of Taylor Swift, vacations, and crab cakes among many other things. Taylor is currently on her own journey to becoming a PA, and I'm thankful that she's sharing some of what she's learned along the way. 

If you're interested in how being a medical assistant can help you towards your PA goals, here's some insight into what you can hope to gain from this type of patient care experience. If you have the luxury of getting certified as a medical assistant, check out The PA Platform Search Engine to see if there's a program near you that fits your needs and get more information

When I first started as medical assistant, I had zero experience in the medical field. I had no idea what BID or TID meant, had no idea how to spell medications (Well, I still don’t. Spelling is not my strength. Ask Savanna.), and did not know a 30-gauge needle from a 15’ blade. 

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I had just graduated with a degree in public relations and had a whopping four science and math classes during my college career. The office that I worked in trained me on sight, which was quite a risk for them. I am not too familiar with Certified Medical Assistant (CMA) programs, but I am sure those students going into jobs find it easier than I did. I had a lot of learning to do and had to catch on quickly. Medical terminology and understanding how a medical practice functions were some of the first lessons that I had to learn.

I started off working at the front desk, but eventually began working full time as our PA’s medical assistant. Even from the beginning of my experience in the medical field, being able to interact with patients and assist the physician was my favorite part. I enjoyed learning about dermatology through being in the exam room with her. There is so much that you can learn while listening to a physician examine a patient!

We get to see some very interesting cases and no day is quite the same as the last. Being a medical assistant has taught me how to multi-task and how to work as a team. The biggest and most valuable lesson that being a medical assistant has taught me is that I really do want a career in the medical field. Being able to see the impact you can have on someone and the chance you get to improve someone’s quality of life is very rewarding.

My experience as a medical assistant has led me to pursue becoming a physician assistant and I do not think I would have known this without taking a risk and trying something new. Make the most of every opportunity that you are given, you never know where it might lead you! 

Other Posts from Taylor: 

If you would like to share how your experience has helped you in achieving your goals of becoming a PA, email savanna@thePAplatform.com to contribute. 

May 2017 Webinar: Healthcare + Patient Care Experience for Physician Assistant School

Hey guys!  I wanted to remind you that the May webinar will go live today at 8 PM EST.  In this month's talk, I'm covering everything associated with the healthcare and patient care experience needed for PA school.  We'll talk about why it's important to get experience, what types of opportunities are available and where to find them, how to track this information for CASPA, and I'll be answering all of your questions too!  You can check back at this link at 8 PM to tune in to the session on The PA Platform, or you can watch on Youtube here where you can also submit questions to the chat.  Looking forward to seeing you there! 

My Thoughts on CASPA's Changes to Healthcare and Patient Care Definitions


First of all, take a deep breath.  It will all be alright.  

This past week right before CASPA reopened for the 2017 cycle, there was a lot of buzz around some recent changes to the recommendations on how to classify experience on applications, and whether it should be categorized as healthcare experience (HCE) or patient care experience (PCE).  In the past, HCE was defined as working in a medical setting, but without directly interacting with patients in a way that involved their care (receptionist, billing, transport, etc.).  PCE was defined as any job in which there is direct patient interaction and care, such as nursing, EMT, paramedic, CNA, MA, etc.  These were more of roles where you were performing skills and had more responsibility.  Scribe has always fallen somewhere in between.  

Moving on to the new definitions. Here is a screenshot from the site, but you can see more here. 

CASPA's Healthcare and Patient Care Experience Definitions  

CASPA's Healthcare and Patient Care Experience Definitions  

This made a lot of people angry.  CASPA basically changed it so that CNA and MA are categorized as HCE instead of PCE, according to their guidelines.  The idea is proposed that a role is only PCE if you are more responsible for a patient's care and contributing to decisions about a patient's care.  CASPA also stated that these changes were made based on feedback from PA programs.  Obviously, this has many people who have worked hard for their hours feeling like they've wasted their time.  

I get it.  I worked as a CNA, and it's no joke.  I work with MAs all day long, and there is no denying that they are very involved in patient care.  But this may not be the case for all positions deemed CNA or MA, and I think that has been part of the problem.  If you work as an MA, but you're usually in the front office answering phones or working on prior authorizations and paperwork, that is more accurately HCE.  If you're taking vitals, performing venipuncture, and counseling patients, that's more PCE.  

Let's talk about why this will all be ok.  The final decision is up to each program, and unless they decide to change requirements last minute, all of the experience you've accrued should be fine.  CASPA gives you some discretion with statements like these: 

  • "Please review the definitions below, consider the duties which you performed during your experience, and use your best judgment to determine which category your experience falls into."
  • "CASPA advises applicants who have prerequisite requirements to confer with their individual programs if they are unsure how these programs will consider their experience."
  • "If you have any questions in regards to your experiences fulfilling an individual school’s requirements, you should inquire with that school directly."

Ultimately, you can decide where you feel like the experience should.  If it were me, I would list the experience where it was recommended based on CASPA's preferences.  But I would be very thorough in describing what my experience entailed and what my responsibilities included.  Make it clear to the programs how involved you are in patient care, but as always, be honest.  

If you're unsure about how a program will categorize your experience, the first step is to check the website and see if it's listed.  If you are unable to find an answer, consider contacting your top few programs to clarify.  Just keep in mind that they are probably getting a lot of these calls right now, so be patient.  

I hope this gives you some clarity, and if you have any questions, I'll do my best to answer or find an answer. CASPA is complicated (and confusing) at times, and I do my best to keep up, but I am not the final say!  It's also convenient that I planned for the May webinar to cover HCE and PCE (before CASPA even changed anything!).  Make sure to mark May 24th at 8 PM on your calendar so you don't miss out.  Comment below with your questions!