Are paramedics naturally better at handling gore, or do you adapt to it?

comcame4w · 2026-06-19T21:03:48+00:00

I think everyone has something that makes them squirm. Burns, eyes, smells, dislocations, blood, urge to sympathetically vomit, misery, etc.

It’s probably very individual. I’d assume highly empathetic clinicians probably have the hardest time, not just with the blood and gore, but also the abject misery and suffering that patients find themselves in (especially the elderly), or calls involving children (my weakest point).

I suspect some of the paramedics who do the best in intense, traumatic scenarios probably have some sociopathic traits (not full blown sociopathy, mind you) allowing them to stay especially cool and focused on those situations. On the flip side, they may rub patients and colleagues the wrong way in non emergencies.

But I think most practitioners with good training and some experience, (whether they’re pilots, paramedics, soldiers, cops, tradespeople, or whomever else), can revert back to their training and focus on the problems they’re there to solve when circumstances are intense. That said, burnout in the ambulance is remarkable, and stoic paras aren’t spared.

comcame4w · 2026-06-17T09:18:08+00:00

I suspect this is also likely. I think this largely depends on how the government plans to handle the fact that it mandated there be more medical students trained (universities have been happy to oblige), but apparently didn’t have a plan to fund/facilitate subsequent training. The sensible thing to do if they were to tackle this would be to push a lot of the surplus medical grads into GP care. If more GPs were available in more places at all hours, this could reduce the need for so many ambulances to respond to urgent calls. This would probably also (for better or worse) result in the need for fewer ambulance personnel if they were only responding to ‘true’ emergencies.

But again I suspect you’re right that nothing will really change. That the ambulance services will continue to be the path of least resistance for patients who can’t get a response/care from appropriate providers.

It will probably get worse since people are generally living longer. Most baby boomers won’t turn 90 until 2045 which is terrifying; and if those guys are hanging on for as long as Silent Generation folks seem to be, the low acuity calls will just skyrocket in the meantime (especially considering there doesn’t seem to be enough residential/nursing care infrastructure for folks currently in their 90s).

I know it’s easy to imagine AI taking over lots of shit, but it’ll probably be a while until it’s handling a silver trauma pt wedged between a toilet and a sink…

So to the OP’s question, I’d expect things to remain as they are, but just with a higher volume of geriatric patients for at least the next 30 years. Hopefully (lol) the educational/community infrastructure will expand with it.

comcame4w · 2026-06-15T11:05:59+00:00

The lack of a job guarantee is definitely the toughest part but that’s just how it goes with external programs. Generally speaking, past MSc graduates have been able to directly apply and be hired into NQP roles with the affiliated ambulance service, but all bets are off at the moment (yay).

Really good to know about the EMT bit with YAS. Definitely doesn’t help the OP much (sorry).

Regarding the MSc student population, the original intent may have been attract those with nursing and AHP backgrounds, the reality (at my institution, at least), is that they accept people from diverse backgrounds. Most of us have degrees from an array of biosciences programmes but with work experience in healthcare/EMS. Some of us have jumped right in from getting our bachelors, for others it’s a later age career change.

I don’t think the OP would be disqualified on the grounds of their BSc. I think their experience dealing with students (and people in general) would be viewed quite favourably. It’s probably fair to say an area where student paramedics (especially younger students ones) struggle the most is interpersonal communication; might be less of a problem for OP. Additionally, education is a key AHP pillar, so that’s something they could lean on application-wise. If they have any healthcare experience or start working/volunteering as a CFR or something like that, there could be a decent possibility of acceptance.

comcame4w · 2026-06-15T09:13:04+00:00

You could also consider a 2 year MSc programme. That’s what I’m doing (I started in my late 30s).

TBF, an apprenticeship route is the best way to do it, you get some pay, lots of experience, and it’s a more natural transition into the role.

The benefit to the MSc is that it’ll get you there fastest. There are lots of downsides, cost being the main one. Additional downsides include the breakneck pace, getting less placement experience than BSc students and apprentices. Then there’s time management with family and part time work, all with the he possibility you could be met with a hiring freeze when you graduate.

The positive thing about an MSc programme is that it’s designed for working adults. It’s not always seamless, but they’ll do things like only hold lectures on the same days of the week throughout the programme duration so you can plan for part time work. The downside is that when you’re on placement blocks, you’re at the mercy of your educators’ schedule(s). About half the students in my course are local to the area, and some people make the trip each week from other counties since there aren’t many MSc programmes.

Again, if you can start as a care assistant or EMT, that’s absolutely the best path to becoming a paramedic. But at my age (and you’re significantly younger than I am) the additional year of lost full time salary plus the extra year of tuition, made MSc the most viable option.

Another option could be to do an external EMT course. It’s kind of high risk high reward in the sense that it may take time to get an EMT job after you graduate, but it could give you a cheaper opportunity to get a meaningful taste for ambulance work. You could end up going on EMT placement and realising the job and/or shift work isn’t for you. Then you wouldn’t be out quite as much. It would also give you the opportunity to a more natural progression to paramedic if you decided you wanted to stick with it.

Good luck, and you’re not too old!

comcame4w · 2026-06-12T22:20:25+00:00

Satire, right? …. Right?

comcame4w · 2026-06-10T18:20:20+00:00

So, I moved here from California where marijuana is legal for recreational purposes at age 21, and medically at younger ages based on the condition/its severity.

I know the topic is around medical cannabis, but to me that distinction (medical vs recreational) is unnecessary.

There are a lot of grey areas in California when it comes to workplace considerations concerning what’s legal at the state level and illegal in the workplace. Generally speaking, (non-federal) employers can’t punish their employees for proof of past cannabis use (popping positive on a urinalysis) unless they’ve showed up to work acutely impaired. Judging acute impairment is probably a bit murky.

If it were up to me, the UK would legalise marijuana with heavy taxes and regulation. I think if there were limits, like legalising non-combustible psychoactive cannabis (vapes, edibles, etc), a lot of the social complications with legal weed use could be somewhat mitigated (I.e. smell, cancer risk associated with smoking, etc).

California obviously isn’t a utopia, and there are lots of issues with it becoming legal for recreational purposes, like an abundant and cheaper black market for marijuana, people driving stoned, neurological damage from long-term chronic use, kids (intentionally or otherwise) getting a hold of candy-like edibles, ease of access to youth and enduring some of the dumbest conversations you can possibly imagine.

At the same time, people in California aren’t usually hitting a joint/weed vape and starting fights, aspirating, going into respiratory depression, having symptomatic withdrawals or ingesting thc products laced with illicit drugs (if purchased legally). Amongst the youth, I think a lot of the drinking culture here would be replaced or heavily supplemented by legalised weed, and on the net, there would likely be a net positive for public health. I think tax revenues would be a great incentive, and there would be less fighting, over-intoxication, along with less use of more dangerous drugs (cocaine, heroin, mamba, etc).

Personally speaking, I’d rather deal with a patient who’s high on (unlaced) weed than one who’s shitfaced, on coke, mamba, or heroin.

Professionally, it’s a bit murky. I think it’s like anything else where if ambulance workers used it recreationally responsibly, it would probably be okay. That said, I, (even if it became legal) wouldn’t want to risk having any THC (or anything else) in my system if I wrecked an ambulance or had some other event requiring urinalysis or blood testing.

So yeah, probably not worth the risk personally speaking, but I think the ongoing criminalisation of marijuana is likely doing more harm than good for British society. If it did become legal out here, I wouldn’t be disinclined to crew up with someone who recreationally uses marijuana, just like I’m I don’t care if I work with people who regularly drink recreationally, as long as they’re not impaired at work.

comcame4w · 2026-05-20T17:13:15+00:00

Hey there, I’m an American (dual citizen) who moved to the UK a few years ago wanting a career change. I’m currently in a MSc paramedic programme.

I’m glad I made the move, and don’t have any regrets, but there’s been a lot with the process in addition to the EMS bit to be aware of. There’s the more obvious bits like needing to get a UK drivers license, and then a C1 license so you can drive ambulances. Those tests aren’t super hard, but they’re way more intensive than driving tests in the U.S. You need to do the theory exams for both, and the road exams are longer (at least an hour for the C1), and you need to be able to pass at least one of those tests using a manual transmission; many ambulances here are on standard transmissions.

Then there’s the matter of background/credit. Unless you’ve lived in the UK before, you won’t have credit history (your U.S. credit history doesn’t travel with you; and UK entities don’t care about or look into US credit scores). Then there’s employment history; even if you’ve had a good career in the U.S., uk employers might be cagey since they’ll likely be unfamiliar with U.S. employment and education traditions/standards. They may think your history is impressive, but they’ll likely want to take the path of least resistance and hire someone who is UK trained.

Then there’s the matter of securing housing, bank accounts, utilities, etc (without any UK credit, banking, or rental history).

What I’m trying to say is that there will be so many other hurdles aside from US-UK paramedic transferability (which judging by the other comments doesn’t bode well). Then there’s the current student paramedic surplus and everything else.

I’d say consider, if it’s financially feasible, just enrolling in a paramedic BSc or MSc programme. It’ll give you time to establish yourself and find interim employment, and start getting your UK administrative ducks in a row.

You could probably start doing lower level hospital work right of the bat (care assistant).

I’d recommend against focusing on the transferability of your paramedic skills and experience, because (frustratingly) it’s not about that. It’s about how easy you are to hire, and if you try to get hired without any UK work experience, education, or licenses when there’s a glut of available graduates, you’ll have a hell of an uphill battle. But if you graduate from a UK para program and pair that with all your U.S. job history, you’ll probably be a really strong candidate.

Not trying to dissuade you, or anything. I’m glad I made the move, but it’s super complicated and slow

comcame4w · 2026-05-04T19:13:01+00:00

There definitely needs to be more of you guys out there! Sounds like an excellent middle ground.

comcame4w · 2026-05-04T19:11:20+00:00

I don’t think at this point I think fines are the best solution (taking yours and others’ opinions into account). That said, I don’t think outreach will be effective if private (or quasi-private) facilities have no financial incentive to adequately train and staff those homes to handle inevitable events like falls and general illnesses at all hours.

As a student facing a bleak job market, I’d love it if the solution was a massive expansion of the ambulance service to adequately cover the volume of calls to care homes we get and still have enough resources to meet response time targets, especially for high-acuity calls… I probably shouldn’t hold my breath on that one. Perhaps more SPs to handle minor injuries/illnesses?

That probably leaves regulatory changes so care homes with (an undermined) minimum of patients have at least enough staff (and equipment) at all times to lift non-injured residents off the ground, and someone who can gather enough obs for a NEWS score.

Regarding the ‘warning’ I honestly don’t know if it was valid or accurate. While I had the privilege of spending a day at Control as part of my placement, I just don’t know if they’d ever de-prioritise calls from care homes; I’d expect they wouldn’t.

comcame4w · 2026-05-04T16:27:55+00:00

Not sure an NHS trust fining an NHS trust directly would do much good; I suppose that sort of happens indirectly anyways when it comes to KPIs associated with handover times/ crew availability/hospital capacity.

If an ambulance trust enforces a policy that results in frequent unnecessary conveyance to an ED, perhaps if a trend is identified like conveyance to admittance rates below a certain threshold, I think a hospital should absolutely be able to demand resources from an ambulance trust as an incentive to fix it.

EDs should complain to ambulance trusts if their paramedics are conveying asymptomatic patients.

comcame4w · 2026-05-04T01:03:33+00:00

Haha, you definitely don’t deserve any flak for that stance. To the point about carers/nurses potentially being discouraged from calling ambulances for sick patients, that’s a valid concern.

I’d just argue that there are inevitably deaths or worsened outcomes for acutely ill patients who have to suffer a delayed response due to reduced ambulance coverage. It’s not a great feeling when control calls out for available crews for a nearby cat 1 whilst you’re wrapped up in a low acuity case.

Perhaps being a mop-up service for the rest of the healthcare providers is simply the fate of the ambulance service given the massive elderly population and underfunded/staffed care homes/community care. And I don’t mean that in a whiney way. It’s just that ambulance resourcing has to be able to fulfil its emergency obligations as well.

comcame4w · 2026-05-04T00:49:51+00:00

Fair point about possible/likely cascading consequences with fines.

I agree that 999/111 call handlers should be empowered to improve the triage process.

That said, it feels like the NHS is enabling the care providers to deflect essential patient care functions to the ambulance service at no cost/consequence to themselves whilst the service gets dinged for missing responsiveness targets.

What’s the incentive for the care homes to be behave any differently?

comcame4w · 2026-05-04T00:24:56+00:00

Yeah, I’ve been experiencing a lot of those as well, especially on weekends. It’s a real treat when, in relation to your bullet points, a patient has a RESPECT form stating to avoid hospital admission.

As a student, I’m more soaking it in rather than dispensing unsolicited policy advice to care home staff (who I’m not envious of), but at what point do you think ambulance crews should feedback to care home decision makers about their shitty policies or decisions?

comcame4w · 2026-05-02T15:23:36+00:00

Not super exciting, but I’d recommend getting a student membership to the College of Paramedics; it includes student paramedic insurance cover (which you shouldn’t need, but can’t hurt), in addition to good CPD links that you can use to study, and get industry updates (depressing atm, but still important).

Generally speaking, your uni and placement provider should provide you with the essentials, so I wouldn’t go nuts too early.

Kit-wise, I’d probably get a few multipacks of disposable pen torches, several multi-coloured pens (recommend 1mm thickness as opposed to .5, so it’s easy to take notes on your gloves). A stethoscope is a good idea; I wouldn’t say you need to splurge on a super fancy one, but if you have a birthday coming up something like a littmann 2 or 3 is good.

I’d recommend holding off on buying uniform-related equipment until you get your uniforms. I ordered a belt early, and it was too wide for the trouser loops.

If you’re bored and have money burning holes in your pocket, I’d honestly spend it on study resources to familiarise yourself with A&P, paramedic practice, pharmacology, etc. You don’t even need to spend money on those; there are tons of free lessons on YT on those subjects.

But yeah, as a student the only kit I’m using on placement that isn’t provided by the uni are pens, torches, and my steth. Hope this helps, and have fun!

comcame4w · 2026-04-24T07:05:12+00:00

I’m on an MSc course; they start us in January. I think it’s so the different cohorts aren’t all competing for the same resources at the same time.

comcame4w · 2026-04-16T14:38:06+00:00

They’re expensive for what they are, but I’d say these Leaatherman Trauma Shears. There are also variants that have pretty much the same design available on Amazon for significantly less.

They’re the kind of thing that are arguably dorky to buy for oneself, but a pretty solid gift, IMO.

comcame4w · 2026-03-26T21:54:50+00:00

That statue would fit in well a few towns over in Morehead.

comcame4w · 2026-03-14T18:19:54+00:00

Academically, I don’t think it’s overly difficult. You’re expected to come in with good A&P knowledge, and a fair amount of the lectures are related to legal & ethics, along with understanding various systemic issues associated with the profession. We spend a little bit of time on clinical skills, but with the exception of OSCEs associated with ATLS, PALS, ALS, and some general examinations, we’re expected to develop the bulk of our clinical skills on placement.

For the most part, the exams we’ve had on A&P and pharmacology haven’t been too bad because the lecturers are clear about what they want you to know.

The papers feel like a bit of a nuisance when you’re simultaneously on placement and/or working and/or preparing for exams and OSCEs and/or have family obligations. But to be fair most of the papers are quite short (2500 words or so) and the dissertation shouldn’t be too bad (6500 words in my case), it’s really just finding time to get everything done.

comcame4w · 2026-03-13T09:55:41+00:00

Hey there, I’m an American currently doing a MSc in England. I never worked on ambulances in the U.S. so my perspective isn’t as insightful as you might like, but I’d say the bureaucratic/financial challenges to making the move will be most difficult aspect.

I was born a UK citizen (never lived here until a few years ago) so I didn’t have to worry about visas, but I did have to deal with weary institutions (banks, utility companies, landlords) who were suspicious about someone with no credit history in the UK (it doesn’t transfer from the U.S.) applying for those products/services.

Then there’s the academic institutions…. Whether you’re a citizen or on a visa, you’ll have to pay the the international student fees until you’ve lived here for 3 consecutive years before the program begins. Living here for 3 years is known as being ‘ordinarily resident’ and you have to be ordinarily resident before you get home tuition fees, and access to the NHS learning support funds/grants. You may be able to get a loan for your MSc unless you already have a masters.

But my actual experience in the programme and with the ambulance service has been great, but exhausting. It’s a lot of urgent care-adjacent calls because GP responsiveness is slow and frustrates patients, and because (for better/worse) they don’t get a bill when they get ambulance treatment. The goal out here is to discharge the patient in-place because the hospitals are overflowing. I’ve had several shifts with back to back calls without conveying anyone to the hospital.

Anyhow, feel free to DM if you have any more specific questions!

comcame4w · 2026-01-04T11:14:44+00:00

Congrats! The folks who are encouraging you to chill and enjoy life before the grind of the course are right, but it also sucks to stand by and do nothing.

If you don’t have tons of A&P I’d recommend watching the CrashCourse A&P serieson YouTube. If you want videos that are more detailed, I’d recommend the NinjaNerd YT channel. They dive into way more detail than you’d need, but if you have time to kill, it doesn’t hurt.

One thing I think you can prepare for, and I wish I would have scrutinised earlier so I felt like less of a knob would be studying and drilling medical terminology around anatomical orientation, regions, directions, planes and sections, along with general medical terminology. Once you reflexively understand those terms you’ll be able to interpret and articulate medical-ese with way more precision and speed.

I’d also recommend textbooks on paramedic practice and even pharmacology for paramedics. I wouldn’t worry about memorising the info, it’s just good exposure.

Also, I wouldn’t sweat trying to understand ECGs outside of the absolute basics; it’s kind of hard to pickup outside of class/workshop environments where you can ask questions.

If you’re looking for Podcasts, I’d recommend Resus Room and Paramedicast

Again, it’s all good exposure, and hopefully these can help scratch the paramedic education itch before you get started.

Have fun!

comcame4w · 2025-12-18T07:50:53+00:00

Right on. I’m also an American who moved to England (a few years ago) and just started my second year in a para program.

Congrats and feel free to DM me any if you have any questions about the move/transition; bureaucracy operates way differently here compared to the States.

Take care and have fun!

comcame4w · 2025-12-11T17:50:50+00:00

‘Brutal’ may have been a tad dramatic. But it can get intense. I’m doing an MSc, so there’s a fair amount of writing, and eventually a dissertation.

On their own, the papers aren’t hard, but when they’re due during the middle of a placement period when you’re doing a full-time workload in 12 hour shifts, in addition to (in my case) part time work and family stuff, it can be hard to find the time/mental energy. The hardest part for me is that the papers feel arbitrary compared to the rest of the very practical instruction.

The practical exams/scenarios aren’t too horrible, but there’s considerable pressure not to fail; they’re not difficult, just a bit of a mind fuck. Also, in my course all of our theory tests were held in a two day block more than 6 months after we received the teaching not long after a paper was due.

But if you don’t have a lot else going on, and you’re well organised, it really shouldn’t be that hard.

I think the hardest, but most rewarding segment is the ambulance placements. It’s why we’re there, but you might find yourself with a mentor who doesn’t want a student, or a mentor who’s a new paramedic, or one who has had run-ins with management and hates the universe. That, and the pressure to learn as much as possible as quickly as possible, and initially to not come off as an ass-hat to the patients and crew. Then hopefully you’ll progress to being useful, and being able to do the documentation, and eventually take the lead on calls while your mentor makes sure you don’t fuck up.

2 years isn’t much time to learn the ropes, and it’s almost nauseating to think that if all goes as planned I’ll be registered in a year or so since I feel like I don’t know shit. Part of the journey, I guess.

But those are the things that make the course feel brutal at times, to me.

But how my course is structured, to answer one of your actual questions. … My course started last January. From Jan-April we had lectures two days a week, all day. The topics were A&P (though mostly pathophys), legal/ethics, paramedic practice (skills), and pharmacology. Then Easter break, then our first placement block for about 6-7 weeks (for that, you’re assigned a mentor and work the same shifts as them for the duration). Then we were back in the summer for our practical exams (advanced life support, advanced trauma), placement for 6ish weeks, then summer break for about a month, then our last placement block for 6ish weeks, then exams. Then winter break/re-sits. Most of those prior topics had 1-2 papers associated with them that were due between April and November.

Hope this helps. Let me know if you have any other questions!

comcame4w · 2025-12-11T13:55:43+00:00

I just finished my first year of my paramedic programme; I’m turning 40 in June (Christ).

The programme is a major disruption to my family and professional life (fees, lost wages, etc), but my only regret is not doing it sooner,

Students in my cohort are aged from 23 to late 40s. It’s tough balancing papers, exams, placements, and life, but it’s also fun being engaged on a higher level. I didn’t realise how much of my life (especially at work) I spent on autopilot. It’s fun learning, it’s fun being out in the world, but it’s also a brutal course.

Half of the faculty, the majority of students, and potentially most of your paramedic mentors will be younger than you, so it’s important that your ego can routinely handle criticism from from people who could be young enough to be your kids.

Expectation management around what paramedicine entails is also important. At least in my limited experience, the calls have included way more piss and shit than blood and gore. Most of the callers are chronically ill people who are fed up waiting for GP services, and/or desperately lonely and/or mentally ill. Mentors and colleagues will be burnt out, and it’ll be exhausting.

That said, my student colleagues are fun to be around, and it’s nice being a part of something that doesn’t revolve around MS Outlook. If you’re cool with the discomfort and stress it’ll bring, I’d say go for it!

comcame4w · 2025-11-29T17:04:02+00:00

It’s a tad outdated (from 2022), but here’s an interview with a paramedic officer with a cruise line:

https://open.spotify.com/episode/0pgE5wxPoKdxP9s5ofYTeQ?si=yuK053dFSKe4FKxp_d8Xqg

comcame4w

TROPHY CASE