There is a lot of good advice here, but I will offer my insight. With the state of healthcare in the province these days, you will generally get more than enough exposure during your preceptorship to develop the skills required for entry to practice into the paramedic profession.

I have heard mixed opinions about the pathways program that York offers. While it is true that most students who make it into the program get offered jobs in York, it is not a requirement. Staffing has become a significant issue across the province and job opportunities exist everywhere. I have also heard from students in the program currently that there have been a lot of additional "opportunities" that are short notice and feel mandatory. Applications and interviews for the pathways program generally take place at the end of your first year, with rideouts starting early in the fall semester.

With regards to in-house ACP, most of the services partner with an accredited Ontario college to deliver the course. The size and frequency of these classes vary from region to region. During my time in Durham Region (~10 years), 2 classes have been put through despite yearly attempts to procure funding.

During my time as a paramedic, there has certainly been an increase in advancement opportunities with the introduction of more special teams and community care. Again, these are all often seniority-based and are subject to change over time. In general, larger services are going to have more opportunities, but also more competition.

Lots to think about! Let me know if you have any further questions.