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Home > EMS Products > Education
January 29, 2008
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The Ambulance Driver's Perspective
by Kelly Grayson

How Much Is Enough Experience?

By Kelly Grayson

So, I’m trying to figure out where I go from here. Do I get my EMT-Intermediate, or do I go straight into paramedic school? How long do I need to be an EMT-Basic before I’m ready for paramedic school?


Between colleagues, former students and various posters on EMS internet forums, it seems I’m asked that question several times a week. Every green EMT (and plenty of ripe ones) wants to know when he’ll be ready for the big, bad marathon of paramedic training. Everyone wants to know how much experience is enough.

The trouble with using experience as a guide is that the final exam often comes first and then the lesson.
— Author Unknown


You see, “experience” is such a nebulous word. Speaking as an educator, I find that for every EMT whose street time has honed his assessment skills and taught him the clinical presentation of various disease pathologies, there is another who has learned little more than the location of all the fast food joints that offer EMT discounts.

If I’m lucky, that’s all he’s learned. All too often, that street experience has taught him how to be lazy, cynical and rude, and I have to devote precious classroom time to helping him unlearn all that experience. Give me the green EMT every time; they’re easier to teach.

Many of my colleagues would advise green EMTs to gain several years of street experience before enrolling in paramedic school. They fail to consider the great variable in the equation: the partner.

Every new EMT envisions being paired with a grizzled veteran who can take a green individual under his wing, mentor and teach him the tricks and wisdom that can’t be taught in the classroom. Frequently, they get the other type of partner — the one who despises rookie EMTs and couldn’t teach an armadillo to dig a hole in the ground.

As the saying goes, “There are a few paramedics with 20 years of experience, and there are many more with one year of experience, twenty times.”

That’s the value of education, folks. It gives us the framework to learn from our experiences. It gives us the context to interpret that unusual presentation correctly, and realize that a clinical zebra is simply a horse with a custom paint job.

I’ve learned that every student views a new learning opportunity through a prism of their past experiences. If they have the right attitude and a strong educational background, that prism can refract a muddied clinical presentation into something much clearer. With the wrong attitude, however, or a weak education, that prism can distort the clearest of pictures into something unrecognizable.

From this ambulance driver’s perspective, that experience is best gained in an educational program with a strong clinical component - not on the job. Many prospective students shy away from such paramedic programs because they often take longer or are more expensive. Don’t make that mistake.

A “boot camp”-style paramedic program may graduate you quicker, but you likely won’t get the clinical experience under a trained preceptor that you’d get in a longer program. On the flip side, the college-based, “zero-to-hero” programs designed to take a raw student all the way from layperson to paramedic won’t teach you much relevant EMS knowledge unless that program includes an extensive clinical component. Not every program is created equally, and there is more to consider in choosing a paramedic program than the tuition cost.

So what did I say to the rookie EMT who asked me for advice in the beginning of this column?


***BLATANT HYPOCRISY ALERT!***


I told him to find a good paramedic program with trained preceptors that required a great deal of clinical time, and enroll in it. I told him not to worry so much whether it was a college degree program or not. I told him not to overlook the private or in-house programs, but to remember that quicker and cheaper is not necessarily better. I told him that a stop at EMT-Intermediate wouldn’t buy him much of an advantage in paramedic school. I told him if he chose to work as an EMT while he went to paramedic school, to ignore any partner who scoffed at his school assignments and said, “You don’t need to know that on the street.”

That’s a path I, myself, chose not to take. After five months as an EMT, I took a paramedic “boot camp” that lasted fifteen weeks and cost only $600. The entire program was 800 hours — the bare minimum required by DOT. I like to think that it didn’t hamper me much over the past 15 years, but I had the luxury of working for a small company that mentored its new EMTs and paid more than lip service to education.

Then again, that was my experience. Yours may vary.

About the author


Kelly Grayson, NREMT-P, CCEMT-P, is a critical care paramedic in Louisiana. He has spent the past 18 years as a field paramedic, critical care transport paramedic, field supervisor and educator. He is a former president of the Louisiana EMS Instructor Society and board member of the LA Association of Nationally Registered EMTs.

He is a frequent EMS conference speaker and contributor to various EMS training texts, and is the author of the popular blog A Day In the Life of an Ambulance Driver. The paperback version of Kelly's book is available at booksellers nationwide. You can follow him on Twitter (@AmboDriver) or Facebook (www.facebook.com/theambulancedriverfiles), or email him at kelly.grayson@ems1.com.

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