The National Registry’s Board recently reversed a longstanding policy that candidates testing for paramedic certification must come from a program with a CAAHEP accreditation or CoAEMSP’s letter of review (LoR) in the accreditation process.
This reversal begins a new and dark age in EMS.
For anyone who was around when the NREMT announced the policy requiring accredited programs, it was earthshattering—and gutsy. The NREMT made a bold step to standardize and professionalize the paramedic. The number of accredited programs skyrocketed and increasingly moved toward college-based programs and degrees.
This move was not without cost. It became more challenging to hold a paramedic course or start a program. Smaller and independent programs couldn’t stay in the game.
Things changed. Mainly for the better. For students, for programs, and the profession. Many forget that this was simply the culmination of a 5-step process outlined in the 1990s EMS Agenda for the Future and EMS Education Agenda. We asked for this. We saw it as our future.
Over the years, voices have asserted that accreditation was too onerous and burdensome. The consistency and structure required in self-studies, site visits, and the recordkeeping work each year strained against our “patch it with duct tape and shoestring to make it work” upbringing in EMS. It taxed our excitement-driven, short attention span, street-based mindset. It taxed tradition.
But we needed that.
We agree that accreditation is a lot of work. We believe it could be made easier. But we also think it is necessary to have standards, define and level the playing field, and provide reassurance when a program earns and maintains accreditation.
All other allied health professions demand this. Frankly, EMS does not have the best record of policing ourselves.
If those who believe that the NREMT and CoAEMSP are the reasons for their failing students and personnel shortages put as much effort into improving their EMS education as they are complaining things are too difficult or unfair, they wouldn’t have an issue.
For those who believe the NREMT is the issue, it is time to look in the mirror.
The anti-NREMT and anti-accreditation drums have been beating louder recently. States that choose to lower the standard and create their own examinations, part of the reason we believe the NREMT adopted this policy, will return to a “teach to the test, everyone knows what is on it anyway” mentality. Let those states go. They’ll be back. If the NREMT eliminates the accreditation requirement for paramedic, it will never come back. The genie will be out of the bottle.
”If those who believe that the NREMT and CoAEMSP are the reasons for their failing students and personnel shortages put as much effort into improving their EMS education as they are complaining things are too difficult or unfair, they wouldn’t have an issue.
We wish the NREMT would take a different approach. One of strategy, education, and continued commitment to quality. The blood is in the water now. Sharks are circling. The NREMT flinched first. What will we lose next?
If we do away with the concept of EMS being part of the healthcare system, the most significant risk of the slippery slope created here; we will have to live with the costs. We predict the only actual paying jobs will be with the fire service. Privates will continue to suffer. Our protocols will become less autonomous over time and more restrictive. We will be considered more of a technician than a clinician in the eyes of people who could have been our healthcare colleagues. We will move steps closer to the “ambulance driver” persona we fight so hard to get away from.
How would you feel if your physician, nurse, respiratory therapist, or ultrasound technician came from a program that chose not to be accredited? Do you think there could be a difference in the quality of the practitioner? Would the school realize they could do more with less and cut corners? Maybe staffing shortages encourage programs to reduce the number of hours and skills to graduate, and hey, let’s not take the national exam. Let’s make our own exam. We will get more people out there more quickly.
More quickly, not better. Not by a long shot. We don’t want that in our healthcare professionals. We don’t want that in our paramedics.
EMS just took a giant step backward. The NREMT is making the wrong decision. We can only hope that individuals, schools, and states do the right thing: choose CAAHEP accredited programs and maintain program accreditation.