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By Dave C. Oleson, M.S., EMT-P

In recent years, I have come to the conclusion that EMS workforce shortages (at least in California) seem to be cyclic. Whether public or private, transport or non-transport, single or dual-role function (read fire-based EMS), there always seems to be a desperate need of qualified personnel – specifically paramedics – to staff our provider ranks. Throw in the constant movement of EMS providers from one green-field to another in search of that ‘better’ EMS job that pits salary, retirement, working conditions, equipment, or response area against putting down the ‘roots of longevity’ in a community or agency/department and it’s easy to see why we constantly wrestle with this need. Add the usual attrition, and this is all in a normal cycle. Add a pandemic that decimated (and continues to do so) the profession, and we are now in a 5-10 year deficit for personnel – in my opinion, that seems impossible to make up.

A Better Pipeline for the EMS Workforce

So, the question becomes: How can we improve a pipeline for entry-level personnel to fill those open EMT and eventually paramedic positions? Most private and public providers in my region are screaming for our local educational institutions to ‘ramp-up, add or speed up’ our training to place personnel in the field quicker. Even the words give me the bare minimum so I can put them to work, then I’ll send them back to you later to complete their training has been uttered. I am still not sure how that one would work. In my county, both paramedic training institutions have responded by increasing cohort size and the number of courses offered each year, in addition to increasing EMR and EMT classes. Providers are beginning outreach in earnest to try and meet this request and are even going to campuses offering sponsorships and entry-level jobs (like vehicle support technicians) that lead to EMT. Still, it isn’t working – at least not at the rate they would like to see. Too little, too late to make up the deficit plaguing the EMS workforce.

The answer has always been: partner with your local community colleges or EMS educational training institutions. For those EMS leaders grappling with the worker deficit who are not intimately involved with local training institutions beyond having been a student at one point, this means getting on their advisory committee. Not only is this an accreditation requirement of all public (and some private training institutions), but this group is mandated to be made up of a prescribed cross-section of employers, current and past students, clinical and field partners, local government, institutional leadership, community members-at-large, and…this is the kicker…local high schools with established pathways to EMS, or healthcare. There it is. Your local, community college-based training institutions already have the established network, access, and voice for the future EMS workforce.

How to Start EMS Community Partnerships

So how does this work? If you are currently in a leadership position at a training institution and aren’t engaging your feeder schools, you are missing a golden opportunity to strengthen the future workforce for EMS through outreach. Nationwide, healthcare programs (HOSA, Skills USA competitions, etc.) are currently being offered in high schools where entry-level EMS courses are a natural fit. In conjunction with the training institution and high school, the advisory committee determines the need and desire to expand beyond your typical college, on-campus course offerings. This can be a monumental task for both institutions – fitting a college class into the limited space of a high school student’s instructional day. Then, how to classify the class -dual enrollment, articulation, or programs like College and Career Access Pathways (CCAP). There are rules to follow in terms of hours per week, meeting days and times, length of the course, and of course, questions about clinical and field requirements that may or may not place age limitations on who can attend. All of the questions mentioned above require a beginning – engagement. Whether you are a manager or chief officer of an EMS provider (public or private) seeking to find a way to improve applicant pools, or an educational institution looking in earnest for ways to serve your community, the answer to begin the longer-term commitment towards addressing this issue is forming a partnership.

One can certainly argue that the industry needs to look at other things to keep the current workforce intact – like working conditions, salary, benefits, and the educational correlation. While I agree with that, it is not the scope of what I am trying to get across. My purpose is to give just one potential solution to the problem of a healthy, future workforce. Think about what attracted you to EMS; it doesn’t matter whether you ended up as a single-role provider for public, private, transport, non-transport. Dig deep, remember what it was. For a fraction of you reading this, your revelation that EMS was for you might have come while in high school or sooner. But for most, like me, I’ll wager that it came later in life during college. I have often thought about my path if an EMS course had been available during my high school years.

Investing in the Future of EMS

For us right now, we need to invest in the future of the EMS workforce and make long-term, sustainable commitments to improve the pipeline by engaging and partnering with our EMS educational institutions. More than ever before, outreach has to occur at every conceivable level in your community. Aisles need to be crossed between public and private, yielding new partnerships and alliances towards addressing the issue of our future EMS workforce and recruitment. Yes, this can be a 2 to 5 year or longer investment, but we need to start somewhere.

I sincerely hope that this reaches leaders who have already begun this process. But, I suspect there will be many to whom these concepts are new. If you might be in the latter group, you have your work cut out for you. Take heart…you aren’t alone in your struggle to find qualified EMS personnel to fill your ranks. Although this might seem a daunting task to get an EMS course developed and approved at your local high school level after navigating your state and/or local EMSA and educational institution, then market and gain attendees, it’s completely doable. All good things take time to accomplish if you are going to do it right. But for now, just begin.

About the Author

David C. Oleson currently serves as a Department Chair and Director for the Victor Valley Community College District, Department of Emergency Medical Services. Professor Oleson holds a Master of Science Degree from Grand Canyon University in Leadership with an Emphasis in Disaster Services and Crisis Management, and a Bachelor of Science Degree from Loma Linda University in Emergency Medical Care. He has served the communities of Southern California as a licensed paramedic for over 28 years and an educator for over 20 years at various medical education programs in the accredited college setting and community-based organizations. David has served in the capacity of an emergency medical technician/paramedic on an ambulance, firefighter/fire apparatus engineer/volunteer administrative captain, flight paramedic, urban search and rescue medical specialist, and volunteer EMS specialist for a moderately sized fire department. He has served as an Adjunct Instructor for the Emergency Medical Care Program at Loma Linda University, Department of Cardiopulmonary Sciences. Presently, his responsibilities include oversight of the EMS Department at Victor Valley College as the Director and Department Chair. He attends to over 500 students and 54 faculty members annually in three distinct sub-disciplines, including Emergency Medical Responder and Emergency Medical Technician and Paramedic. David is heavily involved in developing/mentoring his staff, outreach to the community, and speaking to K-12 students about careers in Public Safety. Additionally, he has been an invited international speaker at HPSN World – 2013 to discuss EMS Medical Simulation. 

David is a Southern California native and lives in Yucaipa with his beautiful wife of 23 years, Dinora, and their son Christian – 18 years old.  

Join the discussion 2 Comments

  • Skip Kirkwood says:

    The best way to maintain an EMS workforce is to focus on retention, not on recruitment. There is literature that pretty authoritatively shows that experience matters. The cost of vacancies is vastly under-stated – that money could be used to provide clinical career ladders much like the hospitals provide nurses. Our community has got to stop thinking in terms of easily-replaceable workers!

    • David Oleson says:

      Hi Skip!
      Totally agree. Until we get to that point, however, we need to keep a steady pipeline of future EMS workers flowing. My area of the U.S. is in a panic mode for EMT’s and Paramedics – both public and private, fire based and transport. Educational institutions have historically relied upon the ‘create it and they will come’ – without any planning for outreach to the K-12 crowd. Those same public and private agencies in my region have just assumed that the educational institutions would continue to pump out the usual numbers. Now, there is no way we can keep up with the vacancies. Some predict the shortage to continue for the next 5-10 years.
      How do you think public and private entities can shift now to begin retaining versus being satisfied with high turnover? Pay is one way, benefits are another… But I totally agree with your idea that career pathways for advancement need to be established to give EMS providers an option and reason to continue their education. Privates are losing personnel to Fire-based agencies due to the same reasons you present – upward career ladders. Those simply do not exist in sufficient numbers for single role EMS professionals in the private sector.

      I’d love to continue the conversation. You can email me at: dave.oleson@vvc.edu or ffpm241@yahoo.com anytime!

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