Making Our Lowest Common Denominator EMT Even Lower

Kudos to NAEMT, which sent a letter to Virginia House Delegate Kathy Byron opposing a bill that would require less time to become an EMR and EMT. VA House Bill 1010…

Provides that regulations of the Board of Health governing qualifications for certification of emergency medical services providers shall require no more than 40 hours of classroom instruction for certification of an emergency medical services provider as an emergency medical responder or emergency medical services first responder and no more than 80 hours of classroom instruction for certification of an emergency medical services provider as an emergency medical technician.

Why? According to this WDBJ news report:

“We hear all the time from potential volunteers, ‘Boy, I’d love to really do this, I’d love to volunteer at the rescue squad, but that’s a lot of hours for me to do,'” says Chief Jack Jones, Jr. of Bedford County Fire & Rescue.

This serves providers, not the communities who depend on them.  With what we are expected to do there should be a lot of training.  We need to raise our minimum education standards, not lower them.  If things like Narcan, supraglottic airways, and CPAP are to be added to the minimum requirements, then the minimum requirements must be even higher.

Fortunately Roanoke Fire Chief Dave Hoback counters:

“The healthcare community has changed tremendously. There’s a lot of new technology and lot of things that have changed in the health community because of home health and everything else that EMTs and basic providers have to be aware of. 80-hours is not enough,” says Hoback.

I teach with the allied health department of a community college.  I learned that some of the health profession that require an associate’s degree include:

Surgical technician

Dental hygienist

Physical therapy assistant

Occupational therapy assistant

Veterinary technician

Medical laboratory technician

Nuclear medicine technician

Respiratory therapist

Ultrasound technician

There is also a diploma programs to become a licensed practical nurse (LPN), which is about a year.  There is an associate’s degree program to be a medical assistant, though other schools offer a diploma for this after 10 months.  While an associates degree program for nursing is offered, most area hospitals in our area require nurses to have a bachelor’s degree.

The point is that all of these healthcare professionals work as part of a team in a mostly controlled environment.  Their professions – and the market – require this amount of education before entry. They also require some clinical rotations before graduation.  Compare that to the requirements to become an EMT, who is expected to perform by them self, under stress, and in uncontrolled environments.  Under the revised National EMS Education Standards, with 150  hours of instruction and 8 hours of “observation” in a healthcare setting.  EMTs are not required to demonstrate any of the skill they are taught on live patients, or even see the back of an ambulance before becoming certified.  This is much less than any other First World country.  The minimum requirements in Canada are a two-year degree program, and a three-year program is required in Australia.  Now these are the minimum requirements, and some programs do much more than this.  But the bill in Virginia actually puts a cap on the number of hours for EMR and EMT classes.  At hour 40 or 80, apparently the lights go out.

If you live in a community where a politician or EMS administrator says that no one will show up for your emergency if training standards are increased, ask them who shows up now.  Ask how long their response times are, what their cardiac arrest survival rate is (based on the Utstein Criteria), what their STEMI call to balloon time is, if they use CPAP, and if they carry pain medication.  If they cannot rattle off the answers to those questions within a few minutes, you should be concerned.  Cutting the required education hours will not fix anything.

If you make minimum wage as an EMT, and wonder why a medical assistant in a doctor’s office makes more, this is why.  They are more educated than you are, and the market for their skill set demands a higher salary than yours.

If you are an EMS provider who promotes lower education standards, you are holding the profession back.  Doing so serves yourself.  Please do not pretend to be acting in the best interest of the community.

With increasing cardiac arrest and STMI survival rates, community paramedic programs, and an increasing number of paramedics involved with research to find evidence-based practices, I believe there has never been a more exciting time to be in EMS.  The group of EMS providers who promote bills like this are trying to throw all of that away, and we must not let them.





  1. I think, reducing the classroom training hours for emergency medical care providers and technician is a big joke. It seems those who support reduction of classroom training for EMT and EMR are completely unaware of the health care field. They are forgetting the advancement in the medical care technologies, because at the time of emergencies, if EMTs and EMRs are not proficient in using these modern lives saving medical care apparatus, the result will be death of the injured or critically ill patient. In addition, at the emergency site, there are no doctors or licensed or registered nurses for consulting, but it is the whole responsibility of emergency medical care provider to provide prehospital care in difficult situations. What will happen if EMT or volunteer is not fully trained or competent? The answer is simple; the patient may die before he is transported to hospital or emergency facilities. All these reasons clearly show that the training hours for EMTs and EMRs must be increased to make them competent for safety of public health and quality care.

  2. When I first read your story here, I thought you were saying kudos for the possibility of lessening the amount of hours and training it would take one to become an EMT. I stopped dead in my tracks and said “Wait–what?!”

    So I’m happy to see I simply read that first sentence incorrectly.

    I understand where, if I’m a young person who is deeply passionate about helping people and loves medicine and healthcare and such, that I would want to get trained and land a job as quickly as possible–especially if you need a job.

    But I do think this speaks to the larger culture of wanting things done immediately. As you mentioned, we have communities and patients out here that are depending on EMTs and paramedics to, well to put it bluntly, know what the heck they are doing. Training for a job and career such as this should not, in any way, be something that’s rushed or hurried along for the sake of making the process faster and getting ambulance services and hospitals employees as a quicker rate.

    I think if many people had their way, they would love to be able to take an online course to become an EMT and receive a certification after two hours–like watching a movie. This is a job that requires a lot of education and training, and certainly not less.

    • emspatientperspective says:

      Thanks Mike. I do not think that lowering and placing a cap on the number of hours for EMT classes will attract highly motivated people who want to practice quickly. I think it will attract even more low performers who want to become heroes with as little effort as possible. These are the people we need to weed out, both with more stringent screening and harder classes.

Speak Your Mind