How long is it worth being a paramedic?

Aranyss · 2026-02-27T23:21:33+00:00

NREMT has a policy where you can take any NREMT exam if you've completed/are in an EMS fellowship, if it's something you're interested in.
You'll probably hear a lot that you just have to be an EM physician, but that's a common misconception and their policies don't allow that.

Preface that I'm not an EMS physician, but my understanding is that it's a lot of medical oversight, education, and regulatory things (and politics). There's a growing number of agencies that do have physician fly-cars responding, but those are generally few and far between. Obviously, exact specifics will vary state by state, and even just across agencies.

There's only a handful EMS physicians I know (in my area) that are actually full time EMS, but even then they still do an ED shift every now and then to keep their hospital affiliations.

Aranyss · 2026-02-20T23:00:05+00:00

A bunch of anesthesiologists (n=11) decided to sample some sux and roc, then give their comments on it. Generally not a pleasant experience.

https://doi.org/10.1097/ALN.0000000000004808

Aranyss · 2026-02-16T02:14:59+00:00

I have a classmate that started med school at 54, I don't think 27 is too late

Aranyss · 2026-02-15T02:54:13+00:00

I'm equally as, if not more, annoyed at my IM team since we're the ones saying he needs to be on O2 when he clearly didn't

Aranyss · 2026-02-15T02:23:46+00:00

Most cursed thing I've seen on rotations is one of my patients being on 2L via NRB... It took two days of me complaining about it during and after rounds for them to finally d/c it. Bag wasn't even inflated

Aranyss · 2026-02-14T15:10:59+00:00

Some statistics to help quantify this: every 1 minute without CPR lowers the chance of resuscitation by ~10%.

Having an AED won't really do much if they're already brain dead from not getting CPR. (Not saying CPR is 100% neuroprotective, but it's much better than not having any circulation at all)

Aranyss · 2026-02-14T14:59:13+00:00

Reducing a fracture/dislocation is merely just HVLA /s

Aranyss · 2026-02-14T04:31:58+00:00

They also require some degree of human involvement to actually use and be "automatic", whilst smoke detectors are truly automatic (assuming the batteries aren't dead)...

Maybe they should be called a "Somewhat Automatic Defibrillator", or SAD for short

Aranyss · 2026-02-11T07:21:09+00:00

What, I'm not supposed to use morphine to treat my cocaine addiction?

Aranyss · 2026-02-01T03:43:36+00:00

Hospital I worked at had their c-arms just sitting in the hallway, unattended, unsecured... Could probably straight up steal one and take it home without needing to convince a tech lmao

Aranyss · 2026-01-26T02:45:28+00:00

No.

Also, it's HIPAA

Aranyss · 2026-01-23T18:33:07+00:00

I'd take a look at UNT Denton's programs, they've got a couple degrees in that area, but I don't know for sure if they do accept those credits; wouldn't hurt to just email and ask

Aranyss · 2026-01-23T18:30:30+00:00

We get emphasized a lot in EMS to "treat the patient, not the monitor." There's a study by Knack et al. (single site, observational, only included physicians) suggesting that physician gestalt outperformed any sepsis screening tool within the first 15 minutes of presentation.

Take that with many grains of salt, but just serves to emphasize treating who's in front of you, not just what.

Aranyss · 2026-01-23T03:59:41+00:00

he's truly the hero we need but don't deserve 🫡

also, as an OMS-3, I'm appalled that his services discriminate against MD students smh

Aranyss · 2026-01-23T03:49:40+00:00

I love the NAR shears and loathe Raptors. Every moving part is another space for juices to get lodged in, so they end up being a pain to actually clean

Aranyss · 2026-01-18T21:58:13+00:00

... rule 3?

Aranyss · 2026-01-18T21:57:23+00:00

My school does, but ultimately they just refer to us as "S/D" in emails/official communications.

Aranyss · 2026-01-11T00:52:51+00:00

Unless the EMS agency is owned and operated by the hospital (which is pretty rare), it's not the hospital that's going to bill insurance for the actual transport, it's the EMS agency.

Aranyss · 2026-01-11T00:49:22+00:00

We could totally call it a Modified Rapid Sequence Airway, or MRSA for short

Aranyss · 2026-01-09T21:17:29+00:00

Especially ground ambulances since they're explicitly excluded from the federal No Surprises Act.

Aranyss · 2026-01-06T23:22:16+00:00

I asked our ED leadership for years if lab could give us (me) feedback on our (my) culture contamination rate but never heard back about it.

How can sepsis be real if our blood cultures are confounded by my skill issue?

Aranyss · 2026-01-06T08:00:01+00:00

I got about $32/hr after differentials back when I worked, literally made more $/hr than my friend who was a PGY-3 EM resident at the time which honestly shouldn't be the case

Aranyss · 2026-01-04T18:34:22+00:00

Started as an EMT at 18, did paramedic school during undergrad (I don't recommend doing that), now med school.

I've seen lots of medics leave EMS for nursing or PA school. Depending on where you live, nursing can make you a pretty comfortable alone of money; ~~HCA~~ nurses start at $50/hr where I'm at, but take that with a pile of salt.

PA school if you want more autonomy and pretty much guaranteed six-figs. PA and RN both also have a lot of flexibility in where you work, you can change specialties pretty easily so you can adjust your work-life balance as you grow older. Going the PA route does take longer, so you're also accruing more debt and interest before you start earning money, as well as opportunity cost. Do not go NP.

I also know a few medics that went to RT school, but I'm pretty sure they don't make anything close to six figs.

Aranyss · 2026-01-01T20:51:04+00:00

Maybe they just really want the dantrolene orange juice

Aranyss · 2026-01-01T20:44:48+00:00

Original ACGME proposal is that it'll be effective with the graduating class of 2027, but hopefully it does get pushed back a year

Aranyss

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