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You're A Master of What? My Take on Degrees for Paramedics

As I was sitting at work one day discussing going back to school, someone turned to me and said, “you went to college?”. My answer seemed to shock them when I informed them that I went to college and then to graduate school. Their reply was a very sarcastic “so you have a master’s degree and you’re working as a paramedic?” The reason why seemed to surprise them. Over the past few weeks I have been following the current debate over whether or not paramedics should have a degree and I figured I would give you my take on the subject from the perspective of a paramedic who had a degree going into paramedicine.

How did I end up with a Master of Science degree working as a paramedic?

I had wanted to be two things since I was a very young child, a paramedic and a physician. I had been an EMT since high school but went directly to college. After receiving my bachelors, I enrolled in a graduate program and a paramedic program simultaneously. I was really eager to become a paramedic as I always wanted, and I figured I would make the transition to medical school somewhere down the road. That fall I started paramedic school in the morning and graduate school in the evening. Yes, I really am a bit crazy. I graduated paramedic school mid-way through my master’s program and went to work as a paramedic.

But… why become a paramedic at that point?

Fulfillment, the opportunity to care for people, my love for EMS, and the money (no, that is not a typo).

Does a degree really mean more money?

One of the constant arguments I hear from paramedics when implementing a degree requirement is discussed is “if they want me to have more education, they need to pay me more” and “how can I pay for school only to come out with a paramedic salary”. The other argument I tend to hear is “well if we have a degree, they will have to pay us more”.

When I was first looking at options with my bachelor’s in biology and psychology, I found mostly lab technician and research assistant jobs. The average pay was typically between $11 and $14/hour. For a four-year bachelor’s degree, I paid over $200k in tuition and living expenses and now have a monthly student loan payment. If I went to another local college and paid in state tuition and commuted, I could have saved some money and paid $37,200 ($9,300 a year for in-state tuition). When I went to paramedic school, I paid under $10,000 and the return on investment in terms of starting pay vs. expense for school was much higher.

You would figure maybe the options would change when I got my master’s degree, right? I again looked at the job market and found more research assistant positions for around $17-18 an hour. I looked at a research position at a private non-profit institute that offered $10k a year less than I was currently making in EMS and the area had a 15% higher cost of living. Being a paramedic was still the better option. Not to mention EMS tends to have flexible schedules, opportunities for overtime or special events, the ability to work a side job for extra money, and more. Most of these positions were Monday-Friday 9am-5pm positions. That works for some people, but it did not fit my lifestyle.

Meanwhile, tuition at the local community college for an AAS is as low as $4,100 a year so a degree and paramedic school would cost under $10,000.

Does having a degree mean you automatically get higher wages in EMS or that you deserve a higher wage? No.

But do I think paramedics really need a degree to make them a better paramedic and advance the EMS profession forward? YES, absolutely.

Did my degree actually help?

Every. Single. Day.

As a paramedic student I had a much greater understanding of concepts like pharmacokinetics and acid-base balance to name just two. I saw my colleagues have difficulty grasping these fairly complex topics but to their credit, they eventually were able to grasp them without what I felt like was requisite background knowledge and context. I often wondered if it would make a difference if they had a good anatomy and physiology pre-requisite along with general chemistry and some introductory college biology. Those were the courses during my undergraduate career that laid the foundation of knowledge I needed to grasp these concepts much faster. That leaves me thinking that paramedic school could go into greater depth and paramedics could develop greater understanding if this foundation was built beforehand. Unfortunately, we do not currently have the research to demonstrate this, but it would be great to see paramedic program directors start looking at student performance based on academic background.

I often hear the argument that the only difference between having a degree and not having a degree is that those with a degree can talk to you about art appreciation and philosophy. I can assure you, I never took an art appreciation course in college. What I did develop in college beyond a foundation of knowledge was some more technical skills that are applicable in the EMS workforce. I developed critical thinking skills, the ability to interpret research, better time management, professional maturity, and the ability to write prose at a different level. All of these, useful to EMS in the advancement towards becoming a profession.

What about when it came time to care for patients? I think that foundation of knowledge helped me to better understand what was going on with my patients. It helped me to learn better clinical decision making and my psychology education in particular helped me decipher when I was making cognitive errors and helped me to reflect on my performance in the field. I also felt that what college taught me to question in terms of fact and science always encouraged and motivated me to look further. I would constantly be reading sources like UpToDate and Medscape or perusing the research on a topic after encountering something I had not seen or did not know much about. It led me to fill in many knowledge gaps and maintain a strong intellectual curiosity about what I was doing. The meta-cognition and reflecting on my performance also helped me to know what I didn’t know and where to focus my own efforts.

So, what about this degree requirement for EMS?

I think degrees are absolutely essential for paramedics to advance the profession of paramedicine forward. I do not think there needs to be a bachelor’s degree or higher requirement for most paramedics, but I think an associate in applied science program with appropriate foundational knowledge courses in biology, chemistry, and anatomy and physiology would suffice to create a better and more well-rounded paramedic. It would be nice to see bachelor’s degree programs available for those who want them with an emphasis on critical care and flight, business, or EMS education. I think that in the future, wages will rise because of the degree requirement. Not necessarily because paramedics have a degree. But, because paramedics will be able to prove their value and the value of having a knowledgeable, skilled, prehospital clinician that contributes to the healthcare system. I think that we need research and data to support this value before the wages will follow. When nursing pushed towards a degree requirement, they had this in place beforehand. We are really putting the carriage before the horse with demanding more pay before the degree requirement is in place. I also do not think the implementation of a degree requirement alone will drastically change the current scope of practice for paramedics. It may allow for a few additional topics and skills to be added to the curriculum because the pre-requisite knowledge will exist.

Let’s move EMS forward, in a productive way! It is time we start advocating for our own profession by creating professionals through quality education!

Tom Latosek, MS, NRP, CCP-C

Tom is a practicing paramedic and EMS educator who is interested in EMS research, and advancing the profession of EMS through education. Tom has practiced in a variety of EMS clinical settings and teaches a variety of courses for a healthcare education company. Tom holds an MS in neuroscience and a bachelor’s degree in biology and psychology and is currently a second-year medical student.

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