Posted on Apr 24, 2014
SSG Genaro Negrete
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I've danced around this for some time. I'm not sure as to the technical stipulations regarding Paramedic level certification.

The Army, in conjunction with the NREMT, established that an MOS qualified 68W maintain a Basic level EMT certification. To that end, MEDIC Table training and testing (IAW TC 8-800) covers the required continuing medical education credits required to re-certify that Basic level license. The cost of all this training/testing is not passed directly to the soldier, as he or she needs it to maintain MOS qualification.

Now, if the medic decides to us other means (Tuition assistance, scholarship, etc) to pay for and get certified as a Paramedic through the NREMT, how would this affect their standing with Army medicine?

Would the Army still cover the cost of CME's and all other requirements to maintain the Paramedic certification? Once licensed at the Paramedic level, would the NREMT allow that individual to step back down to Basic level if he or she can't maintain the higher level license?

The pessimist in me wants to say the Army will not foot the bill for this one. Could a medic then be State certified Paramedic and simultaneously Basic certified by the NREMT?
Posted in these groups: 999fe279 MedicEmt logo EMTCertification Certifications
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SFC Medical Platoon Sergeant
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I think the whole concept of medics in the Army should be revamped. I have been a Paramedic for over 10 years now and I have worked in many organizations from BCTs, MMBs, Emergency Departments, Nursing Supervision, to USAF Contingency Areomedical Staging Facilities (CASF). I think the military should train and promotion based on skill levels. Currently, there are 3 levels to EMTs: EMT, A-EMT and Paramedic. Of course, other factors would come into play with promotion and that could be a totally different conversation. But, if we as professionals within our organization (United States Army) want to better Army Medicine and strengthen the 68W NCO Corp, then why not be lords of our craft. As it stands right now, most of our medics can stop a bleed on the battle field and package a patient based on the situation. At best, they are functional on the battle field but they could be so much better. At one time, I proposed an idea to the AMEDD 68W SGM: I proposed to attach promotion to certification. Meaning, in order to make the rank of SGT, the Soldier would have to have at least EMT-Basic (EMT now). In order to be promoted to SSG, EMT- Intermediate (A-EMT now). In order to be DA selected to SFC, must be a Paramedic. What this would do is validate promotions within 68W career field and arm Soldiers at each level with a solid knowledge base to train their Soldiers. This screams competency! So, to better answer the original question: Yes, I believe the Army should pay to maintain Paramedic’s certification. It only helps to Army by having a more qualified medic. Currently, the Army does cover the recertification fees but it is a painful process to get a PALS, ACLS and Paramedic Refresher course. Every installation has ACLS and PALS programs; it’s just difficult to get into the courses. Priority goes to RNs and Docs. I think the Army will slowly move towards Paramedics but it will take time. Air MEDEVAC units have already started replacing their EMTs with Paramedics. At the end of the day, it all boils down to cost and information. Most Army Docs/RNs don’t know what the scope of practice is for a Paramedic and continue to use their current medics as CNAs. In summary, Paramedics will become a factor within the military and someone will figure out the cost savings to retain quality medics to be trained as Paramedics.
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SFC Medical Platoon Sergeant
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Excellent points on both sides (SSG Boyd and 1LT Cooper). I agree with 1LT Boyd about starting early in your career to progress to the level of paramedic. I might be telling my age a little but when I first pitched that idea, it was about 10 years ago when the army had combined 91C and 91B to form 91Ws. It was a win/loss for the medics. Back when we were 91Bs there were no certification requirement except BLS. After the conversion, it was mandated all medics would be at least EMT-Basic, PHTLS/BTLS and Trauma AIMS certified. It was a move in the right direction but only opened up medic positions for 91C at the senior level (SFC, MSG, and SGM). I’ll answer the question to cost and standardization.
Cost: Would you believe me if I said it would not cost the Army any additional money. Think about it, across all services we like to recreate a wheel. The University of Maryland and Central Texas College are in just about every location that any military base is. That being said, each military member gets $4,500 per year allocated. My question, why not partner with selected colleges to enhance our work force. The nuts and bolts of this idea could be figured out and it cost nothing that is not already being allocated.
Standardizations is simple: There is already National and State standards that the Army and Air Force are held to for certification. State certification have just opened up a couple of years ago, it was only Nation Registry standard. Which makes sense, after all the United States is hardly a 3rd World Country.
SSG Boyd, I use to think that 68W was the 2nd largest MOS but that either was not true at the time I though it or changed after the realignment to the BCT concept. I think 68Ws are behind ordinates now. So many mechanics and I still can’t get my vehicles running, lol…
An additional way to cut cost would be to understand what paramedics bring to the table. You could definitely cut some of the nursing positions inside of Emergency Departments and fill those positions with paramedics. Es and cheaper than Os! Other ways would be to eliminate administration jobs, some are needed and others are just over flow. There are many ways to find money, you just have to have strong leaders that are willing to look for it. I could probably talk about the topic for an extended amount of time but the bottom line is, the Medic Corp would be better if it had more paramedics in it!
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SSG Genaro Negrete
SSG Genaro Negrete
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This would be amazing. But I think the bean counters would temper that thought with the overall pass:fail ratio for the MOS. I don't think we should pander to such a statistic, but it would be foolish to think it doesn't come across someone's desk in the overall planning process.

I've often thought 68W E5's should be BLS-I certified and E6's should have ACLS. My original thought was that as the primary trainers in a BCT model, the E5's can ensure all medics maintain CPR and BLS certs and E6's can further shape trauma learning by incorporating cardiac issues and AHA treatment principles.

Would it be appropriate to mandate a soldier use his/her TA benefits to maintain an Army required job qualification?
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SSG Medical Nco, Platoon Sergeant
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I am currently an NREMT-B to satisfy my Army requirement as a Medic, but I am also a Florida Paramedic and EMT. I had to get my Paramedic and State EMT certification on my own, with only the National Guard repayment for my Exam costs being covered. As it was explained to me when I went through AIT in 2005, the military was supposed to strike a deal with NREMT to provide a Military Paramedic certification to all Medics (USAF, Army, Navy, once the 3 schools aligned at Ft Sam Houston. Well, that time came and went, but since the bean counters got involved a few years ago, the military's favorite thing to say is that there is no money for it now. I do agree that something has to give though, because we are trained in advanced procedures from the start, that are Paramedic level skills, yet when you apply them in a non-military environment, you risk lawsuits due to working above your EMT certificate, IF your state acknowledges NREMT to begin with. As for mandating a SM to use his/her educational benefits and pay out of pocket, to acquire or maintain certification, that is illegal. The Army has to pay for and provide training to maintain certifications, hence the TC 8-800 requirements, online CEU webpages provided at no cost, and numerous recert classes, unless the SM has been given ample opportunity and has not gained the certification needed for recert. Making a SM pay out of pocket simply cannot happen. Another way of making it work would be to make the E-5 and E-6 an instructor in BLS, ACLS, PHTLS, PALS and whatever else you can think of that would assist the unit medics in their recertification. No schools to get a slot for, no classes to pay for. If we can constantly teach CLS, why cant we teach the other classes for real certification? The Army is providing a lot of valuable training, but not providing usable certifications.
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TSgt Aerospace Medical Service
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A great theory in all; however, until leadership allows the departure of the one size fits all attitude, potential and human resources go to the way side. Until we can cease misappropriating resources under the guise of “career progression” or promoting to a desk, we put the breaks on having the medics possible, where they can make a difference. When you have critical care/certified flight paramedics working family health clinics or deployment health clinics under GMOs that no little to nothing about high acuity medicine, those highly skilled assets wast away and for their own sanity, jump ship for a real job. That would take a little thing called “Human Resources” knowing their people and knowing what assets are available, instead of a SNCO in the assignment section somewhere across world using computer algorithms to cram pieces into holes regardless of their shape. Even reporting a shortage on an MOS/AFSC that can “fit” the purpose of another MOS/AFSC simply because you’re not authorized another body in that second position. Now your highly skilled, trained, specialized asset becomes another record reviewer, blood pressure taking, diaper weigher. Like so many things, fraud/waste/abuse applies only from perspective of the highest paid onlooker.
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SGT Squad Leader
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There are certain ASIs for the 68W mos that do require a paramedic certification, such as flight paramedics. Speical Operations medics require a paramedic certification and the Army helps maintain those certifications as well. If the soldier receives the paramedic certification from the civlian side, it is the soldier's responsibility to maintain it on the civilian side. My former 1SG is a paramedic firefighter out of Arizona, and when he had reclassed to 68W, he did not have have to do the NREMT portion of the school because his paramedic license supercedes it, and the NREMT HQ wouldn't have allowed him to take the test in the first place because of that. Now if he decided to retire from the fire department and his paramedic license expired, he would be DMOSQ, and would have to be sent by the army to get certified NREMT.
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SSG Drill Sergeant
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That would be a great solution, however, to sum everything up in two words..................B-B-B-B-B-B-Budget Cuts!!!!
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