Training

Weighing the Pros and Cons of Higher Education in EMS

Issue 12 and Volume 41.

Last year I graduated from a university as a paramedic in my 30s. Undertaking the journey to return to school after working in EMS for around 10 years wasn’t something I took lightly. I completed a bachelor’s degree in paramedicine at one of the few universities offering this in the United States.

EMT training can theoretically be completed in an accelerated program within just three weeks, since it’s only 110–150 hours of vocational training.1 This is the minimum national standard to staff a BLS ambulance and care for the sick and injured.2 For paramedics, program hours vary, but are often the same or less than barber school in many states.3,4

American paramedics aren’t required to hold a degree, yet are responsible for administering a plethora of powerful drugs and performing invasive procedures semi-autonomously with no immediate supervision. If these are the requirements set forth by our profession, why would an EMT or paramedic complete a degree in EMS? Is it a waste? Let’s break it down.

Con: Pay

If you’re working as a field provider for a private ambulance company, the chances of you earning significantly more money with an EMS degree vs. someone with a certificate are probably low. This is likely due to the minimum standards set forth by our industry, and how quickly the industry can train more willing individuals. There’s currently an adequate supply of EMS providers whose warm bodies can easily fill that seat in the ambulance with or without your fancy degree.

Although it may show you have demonstrated the ability to achieve a college degree, there’s no major incentive for an ambulance company to pay you significantly more than someone without a degree. They can meet their contractual obligations and run their business with non-
degreed providers for around the same cost.

Many EMTs and paramedics who earn degrees in subjects other than EMS often move on to make more money. So don’t expect to get rich after graduating with your paramedicine bachelor’s.

Con: High Personal Cost

According to the U.S. Department of Education’s National Center for Education statistics, completing a four-year bachelor’s degree in the U.S. will cost you an average of $23,872 per year, for a total of $95,488. Meanwhile, completing an associate’s degree at a two-year college will cost an average of $9,574 per year, totaling a much lower figure of $19,148.5

Unless your employer gives an economic incentive for degree holders, field paramedics may find little-to-no financial return of investment for the degree. However, it should be noted that tuition costs vary greatly, and if you can demonstrate financial need for help obtaining your degree, you may be eligible for free money to complete it through federal student aid.

Federal Pell grants often pay for large portions, or even all of a two-year college tuition, and don’t need to be paid back. This program isn’t just for kids graduating high school and people in poverty, but also working adults returning to school, including traditional as well as online learning. Your local college or university can assist you in evaluating if you qualify for assistance. You can also obtain a quick and instant estimate online by using the Free Application for Federal Student Aid (FAFSA) website.6

Con: Don’t Need It

If you’ve ever taken an educational methodology or psychology course, you may have been introduced to the concepts of intrinsic and extrinsic motivation.

In a nutshell, intrinsic motivation is the desire to do something because it’s interesting and brings you enjoyment. On the other hand, extrinsic motivation is doing something for an external reward or, in some cases, avoiding consequences.7

A lot of providers I speak with simply say they don’t need a paramedicine degree, and, in a way, they’re right. For field providers who are content with their current level of pay, job satisfaction, and merely meeting the minimum industry standards to do the job, they don’t need a degree. While some may argue for the bigger picture of our profession and the possible benefits of obtaining a degree, from an individual standpoint there’s currently little motivation to do so for a purely extrinsically motivated individual.

Pro: Professional Ownership of Industry

How many paramedic names did you see the last time you picked up a professional peer-reviewed medical research journal? Part of being in a profession is conducting our own research. What’s ironic about EMS is that a lot of research used in evidence-based prehospital care isn’t done by prehospital providers. Research, which often dictates how and why EMTs and paramedics do things, is done vastly by doctors and nurses.

Doctors and nurses have a long history of conducting research and publishing literature. Evidence-based medicine demands—and will continue to demand—a fresh flow of research and scientific inquiry. EMS providers must step up to the plate and not only contribute to evidence-based medicine, but claim ownership of our industry by carrying out our own research instead of acting like puppets on a string. Conducting scholarly research requires, as you might have guessed it, a scholar. In the professional and academic world of medicine, this can only be achieved by obtaining higher education.

Furthermore, policymakers and shareholders need properly educated and credentialed experts in prehospital care to dictate change in EMS and all related realms. By having more EMS providers with higher degrees, we can not only contribute to the scientific community, but start to make our voice heard and advocate for our industry at different levels. The only way of achieving autonomy for our industry and advancing this profession is by EMS providers getting degrees.

Pro: Competitive Positions

Although a degree may not do a lot for you financially as an EMS field provider, it can certainly give you a competitive edge for other EMS positions where there may be hundreds or thousands of other qualified applicants, like air medical services and high-paying municipal jobs. Some municipalities and companies award points for degree-holding applicants.

Anything and everything that can give you a competitive edge will help. A lot of people may have alphabet soup certification cards in everything under the sun, but how many of them have a degree in this profession? By earning your degree in EMS, you’ve proven to yourself, society and our industry that the minimum standards weren’t good enough for you. That’s something you can carry with you on and off the job.

Pro: Leave the Ambulance

For some, an EMS degree may be a way off the road and into something different. Unfortunately, it seems EMS is bleeding out its degree holders, many of whom often change careers completely once obtaining a degree for higher pay and job satisfaction. I’ve lost countless partners over the years who’ve moved on to physician assistant school.

Although we need degreed providers in our industry, there are other options with an EMS degree. Obtaining your degree opens other career paths. Within the EMS industry this could include management, policymakers, researchers, directors, chiefs, etc. A degree can also lead to medical school, a physician assistant program, or graduate school. As long as you follow the prerequisites for those individual programs, obtaining your bachelor’s degree in EMS can shorten the time it takes to complete a higher degree because you’ll likely be able to transfer all, or most, of those EMS-related credits. A bachelor’s in another major may not provide as many transferable credits.

Pro: Power in Numbers

Pay for EMTs and paramedics remains arguably low compared to other allied health professionals and emergency responders. It seems like everyone wants to be a hero and there’s no shortage of applicants—all you need is a GED and a love for lights and siren. Many EMS providers even do this job for free, as a volunteer side job.

What if our industry raised the standards to requiring a two-year degree? We may start to transition from a vocational trade to a true medical profession. This may steer away a large portion of Ricky Rescues who blast out of EMT school in a few weeks, and we could see an industry-wide raise in pay and probably more respect from our other healthcare peers. Slowly, more evidence-based medicine could be contributed from prehospital care providers and we could start to claim ownership of our own profession. We could organize more as an industry and be recognized more as a profession. We can learn a lot from our other allied health comrades such as respiratory therapist and athletic trainers—professions that all require degrees for entry-level practice and make significantly more than EMS providers, according to the U.S. Department of Labor Bureau of Labor Statistics.8–10

Pro: Teetering on the Edge

A large portion of two-year colleges in the U.S. offer associate’s degree programs for paramedics. Many others offer online degree completion programs for already-certified paramedics. Although requirements vary depending on the area and institution, a large number require the already-certified paramedic to only complete two semesters for degree completion, or less than a year in some programs. Paramedics are teetering on the edge of already earning a degree, so why not just do it?

Don’t sell yourself short. I’ve been there and I’ve done it, and I’ll tell you that taking English 101 from my laptop at the ambulance station isn’t nearly as difficult as a highly condensed paramedic program. I found many of the other courses I took both on campus and online to be easier than my paramedic courses. The majority of them didn’t feel as difficult or rushed.

Paramedics have already demonstrated they can succeed at academia, but many of us stop just shy of the finish line for a degree. With the low cost of community college tuition, plus the availability of federal financial aid, and flexible online degree completion programs, there’s a degree waiting for many of you. Even if it means taking classes at the station or in the ambulance via distance learning.11,12

Pro: International Opportunities

America is one of the only English-speaking, developed nations that hasn’t started to move our paramedics toward requiring a bachelor’s degree. Countries such as the United Kingdom, Canada, Australia, New Zealand and South Africa either all require their highest-level paramedics to have a bachelor’s degree, or are moving toward that requirement and have already transitioned many diploma and certificate programs into degree programs.13–17 I’ve been living outside the U.S. for the past five years, and I’ve seen many multinational employers and health authorities start to require a bachelor’s degree in EMS. So if you ever thought about working abroad, you might want to consider a degree.

Conclusion

A degree in EMS may not pay off for every EMS provider. Having a degree often makes no difference in pay or scope of practice.

The job of an EMT and paramedic is difficult and demanding. However, the pay is low and burnout takes its toll on many of our industry’s best and brightest. This profession isn’t young anymore; paramedics have been around for 50 years, and prehospital care has been around much, much longer. If we ever want to be a true medical profession (and reap the benefits that come with that), we’re going to need degrees.

References

1. EMT immersion program. (2015.) Warriorschool. Retrieved July 27, 2016, from wwwwarriorschool.com/courses/medical-training/emt-immersion-program-21-days/.

2. What’s the difference between an EMT and a paramedic? (n.d.) University of California Los Angeles Center for Prehospital Care. Retrieved July 27, 2016, from www.cpc.mednet.ucla.edu/node/27.

3. Emergency medical technician–Paramedic. (n.d.) Commision on Accreditation of Allied Health Education Programs. Retrieved July 27, 2016, from www.caahep.org/Content.aspx?ID=39.

4. How to get your WA cosmetologist license: Graduate of a school or apprenticeship program. (2015). Washington State Department of Licensing. Retrieved July 27, 2016, from www.dol.wa.gov/business/cosmetology/get_school.html.

5. Fast facts: Tuition costs of colleges and universities. (2015.) U.S. Department of Education Institute of Education Sciences National Center for Education Statistics. Retrieved July 28, 2016, from https://nces.ed.gov/fastfacts/display.asp?id=76.

6. Who gets aid? (2015.) Federal Student Aid. Retrieved July 28, 2016, from https://studentaid.ed.gov/sa/eligibility#basic-criteria.

7. Kendra C. (June 21, 2016.) Differences between extrinsic and intrinsic motivation. Very Well. Retrieved July 28, 2016, from www.verywell.com/differences-between-extrinsic-and-intrinsic-motivation-2795384.

8. Respiratory therapists. (Dec. 17, 2015.) Bureau of Labor Statistics, U.S. Department of Labor. Retrieved July 28, 2016, from www.bls.gov/ooh/healthcare/respiratory-therapists.htm.

9. Athletic trainers and exercise physiologists. (Dec. 17, 2015.) Bureau of Labor Statistics, U.S. Department of Labor. Retrieved July 28, 2016, from www.bls.gov/ooh/healthcare/athletic-trainers.htm.

10. EMTs and paramedics. (Dec. 17, 2015.) Bureau of Labor Statistics, U.S. Department of Labor. Retrieved July 28, 2016, from www.bls.gov/ooh/healthcare/emts-and-paramedics.htm.

11, Online degree completion. (n.d.). Camden County College. Retrieved July 28, 2016, from www.camdencc.edu/academics/departments/paramedic-science/online-degree-completion.cfm

12. Online paramedicine bachelor’s degree completion program. (n.d.) Central Washington University. Retrieved July 28, 2016, from www.cwu.edu/admissions/sites/cts.cwu.edu.admissions/files/slick_emt.pdf.

13. Recognition of current ambulance practice. (2013.) Queensland Ambulance Service. Retrieved July 28, 2016, from https://ambulance.qld.gov.au/rocap.html.

14. Become a paramedic. (n.d.).The New Zealand Paramedic Education & Research Charitable. Retrieved July 28, 2015, from http://nzparamedic.org/become-a-paramedic/.

15. Entry requirements and training. (n.d.) National Health Service. Retrieved July 28, 2016, from www.nhscareers.nhs.uk/explore-by-career/allied-health-professions/careers-in-the-allied-health-professions/paramedic/entry-and-training/.

16. Expressions of interest: Bachelor degree paramedics. (2016.) National Ambulance Company. Retrieved July 28, 2016, from www.nationalambulance.ae/careers2/job/23/1/list.html.

17. Guide to becoming a paramedic in South Africa. (2016.) Paramedic Training Spot. Retrieved July 28, 2016, from www.paramedictrainingspot.com/guide-to-becoming-a-paramedic-in-south-africa/.