Medic School Tips

[merchan5967]

I'm getting ready to start the prereqs for medic school, which, in the state of AZ are prehospital pharmacology and emergency cardiology. The latter I'm not too worried about because it's an on campus class. Pharmacology, on the other hand, is online. I was a medical tech (EMT-B/MA) in the Air Force for 4 years and have some exposure to pharmacology, and I really struggled with it. It is a critical skill for medics and I want to do well (and have to). Does anybody have any tips or study techniques thats might help me get through the class? Thanks in advance.

[nairB]

note cards helped me in medic class as far as pharm goes, drug on one side, dose, indications and contraindications etc on the other side. also very easy to take them with you when you have a little extra time and your bored for a quick review due to portability. Cardiology on the other hand is tough i know some people stuggle some dont. I found it very interesting so that helped me keep my nose in the books, study hard and dont let up. Its only as hard and long as you make it. Youll get what you put into it. Trust me, put it all forth the first time through so you dont have to retake something. Dont understand something, ask, at least where im from the instructors were fantastic they would give you as much time as you needed with them one on one till you got it. and the other medics i worked with were the same way, they said if you need help ask. But if you didnt ask you didnt receive. Good luck.

[merchan5967]

note cards helped me in medic class as far as pharm goes, drug on one side, dose, indications and contraindications etc on the other side. also very easy to take them with you when you have a little extra time and your bored for a quick review due to portability. Cardiology on the other hand is tough i know some people stuggle some dont. I found it very interesting so that helped me keep my nose in the books, study hard and dont let up. Its only as hard and long as you make it. Youll get what you put into it. Trust me, put it all forth the first time through so you dont have to retake something. Dont understand something, ask, at least where im from the instructors were fantastic they would give you as much time as you needed with them one on one till you got it. and the other medics i worked with were the same way, they said if you need help ask. But if you didnt ask you didnt receive. Good luck.

Thanks for the advice. I'll definately do the note cards. I've heard medic school is really hard so any advice is very much appreciated. I am a little worried though since most of my medical experience in clinic and EMS is military in nature so I'm not as experienced as I'd like to be. I'll just study my a*# of and hopefully I'll do ok. Thanks again.

[nairB]

no prob hope it helps, any other ques. feel free to shoot em, im not very familiar with the military stuff tho but im sure they are similar in some way or another.

[Theaxemancometh]

As Nair said, flash cards and it wouldn't hurt to have a digital recorder as well! Personally, I used 3x5 flash cards, and took those bad boys where ever I went. (Dept. of Motor Vehicles, while waiting for a table as restaurants, by the poolside, at the beach...etc) You get the idea! Also the digital recorder with headset comes in handy in the car, bike riding, jogging, sex (just kidding), or at work, if you're allowed. One other thing that helped me is to not just learn the typical stuff: right dosage, right route of administration, right patient. But really immerse yourself into the uses of the drug and the treatment modalities. Especially if it's a drug that is controversial and may be changed or pulled from inventory because of problems. You're obviously going to remember that drug because there's controversy attached to it. Use what ever memory tricks and devices you need and you'll get through it! Good luck!

"The Axeman"
____________
"Purpose, Truth and Passion Yields Power and Dominion IN ACTION!!!"

[merchan5967]

As Nair said, flash cards and it wouldn't hurt to have a digital recorder as well! Personally, I used 3x5 flash cards, and took those bad boys where ever I went. (Dept. of Motor Vehicles, while waiting for a table as restaurants, by the poolside, at the beach...etc) You get the idea! Also the digital recorder with headset comes in handy in the car, bike riding, jogging, sex (just kidding), or at work, if you're allowed. One other thing that helped me is to not just learn the typical stuff: right dosage, right route of administration, right patient. But really immerse yourself into the uses of the drug and the treatment modalities. Especially if it's a drug that is controversial and may be changed or pulled from inventory because of problems. You're obviously going to remember that drug because there's controversy attached to it. Use what ever memory tricks and devices you need and you'll get through it! Good luck!

"The Axeman"
____________
"Purpose, Truth and Passion Yields Power and Dominion IN ACTION!!!"

Thanks Axeman, I definately plan on using the notecards.

[technotech]

Nice tips ..thanks

[TNFF319]

As Nair said, flash cards and it wouldn't hurt to have a digital recorder as well! Personally, I used 3x5 flash cards, and took those bad boys where ever I went. (Dept. of Motor Vehicles, while waiting for a table as restaurants, by the poolside, at the beach...etc) You get the idea! Also the digital recorder with headset comes in handy in the car, bike riding, jogging, sex (just kidding), or at work, if you're allowed. One other thing that helped me is to not just learn the typical stuff: right dosage, right route of administration, right patient. But really immerse yourself into the uses of the drug and the treatment modalities. Especially if it's a drug that is controversial and may be changed or pulled from inventory because of problems. You're obviously going to remember that drug because there's controversy attached to it. Use what ever memory tricks and devices you need and you'll get through it! Good luck!

"The Axeman"
____________
"Purpose, Truth and Passion Yields Power and Dominion IN ACTION!!!"

This is what I did. The recorder really helped.

[jgraham]

I am always concerned when someone tells me they are not too concerned with Medic school. At least for me it was one of the toughest things I ever did. Mind you, i was only an average student in high school and during my junior college time, but I know I was not in the minority.
Study hard, it's going to consume all of your time and energy. Once you are done you will really like the job. I know I do...........

[footprints07]

I agree with everyone else about the cards, I just finished medic school and I work two full-time jobs so it kicked my butt twice as hard as the other kids who just got out of high school and live at home.... the 72 drugs were definately the hardest part of school for me, and having no experience will make a little bit more of a challenge, but you get out of medic school what you are willing to put into it, so my advice is to know patient assessment! I was the only one in my class with ambulance experience, so I saw the struggle they had, but they also didnt study hard either (comes with age i guess) I used flash cards for anything and everything I needed to study, from systems to diseases, if it works, make it. My preceptor gave me a great idea for drug, he told me to break them down to each category you had to know, ie: class, mechanism of action, indications, contra, adverse reactions and dose was what we had to know, so do each one on a seperate card so you dont get overwhelmed looking at the whole drug, then I made a card with all the info on it, i carried those ones around with me every where, and then used the big stack to study at home. Anymore questions feel free to ask I would be glad to help.. I know I asked a bizillion questions when i went through, and still do to this day. ... oh and KNOW YOUR EKG'S - if you cant read a rhythm it will kill you in class and in the field.
Good luck! Its hard work but WELL worth it in the end, I am sooo glad I finally went we had a lot of fun.

[johnsonizzle]

Brady Prehospital Pharmacology. Great book (big book).

Also, knowing physiology is just as important as learning the drugs because if you don't know the difference between sympathetic/parasympathetic nervous system, smooth/skeletal muscles, alpha./beta receptors, etc, then your pharm book will be like reading a Klingon manuscript.

Good luck.

[BCLepore]

I think this article that I cut from one of my books will help you understand what you are in for. Best of luck to you. I am still licensed as a Paramedic. Working on a medic rig with a good partner was one of the best times in my career.

Paramedic School
Tom Rollins, a graduate of the Daniel Freeman UCLA Paramedic program,
wrote the following article. Rollins has agreed to share his experiences with
future firefighters, so that they may make an informed decision when deciding
to go to paramedic school.

The decision to go to Paramedic School is one that should not be taken
lightly. It will be one of the most challenging periods of your life, and to jump
into it without serious thought, preparation and planning could spell disaster
to your goal of becoming a firefighter. With that said, it can also be one of the
most rewarding periods of your career in the fire service.

I thought I was ready for paramedic school when I applied a few years
back. I was working as a reserve firefighter in a very busy part of Los Angeles
County and ran multiple 911 calls every shift. I had already attained an A.S.
degree in Fire Science at a local college, put myself through a fire academy
and was working one 24-hour shift a week as the fourth person on a very
busy engine company.

The final straw was when I spent two nights in line to get a job application
for a local fire department. The first night of the line-up, a battalion chief walked
the entire line with a handful of applications, handing them out to anyone who
could show him a paramedic card. The rest of us stood in line another 30
hours. By the time I got to the front of the line, they had run out of applications.
Instead of taking tests with 2000 of my closest friends, I told myself that this
was going to be the last time I slept on a sidewalk just to see the job go to a
paramedic. I was convinced that the next natural progression to becoming a
firefighter was attending paramedic school.

I was overly confident in my abilities as a student because I had sailed
through the courses toward my college degree with very little effort. In addition,
EMT classes were a breeze for me. I had completed some upper division
college classes at the state university level in Biology and Pre-Dentistry (I
had aspirations of becoming a dentist before I realized my true calling was in
the fire service). I was actively instructing first aid and CPR classes for about
eight years prior to applying. Little did I know what lay in store for me. I came
to find out that my story was quite typical of my future classmates as well.
This brings up a good point. Are you going to paramedic school just to be
able to check a box on your job application? Or are you going because you
have a real desire to learn more about pre-hospital care? I saw many “box
checkers” fail out of the program because the effort it took far exceeded the
desire to have a “P” nailed onto the end of their EMT card.

If you are hired
as a firefighter/paramedic, you will be expected to work as a medic probably
for quite some time. If you don’t like being a medic to begin with, it’s bound
to show. You are going to be a very unhappy person who is being scrutinized
on every call. It’s hard enough to be a rookie firefighter without the pressure
of being a paramedic at the same time. So give some serious thought about
jumping into paramedic school if you’re not ready or not really willing.
To get into a paramedic school you have to meet some basic requirements.
Since they vary greatly from school to school and state to state, I won’t go into
them here. After these requirements are met, a typical program will require
you to take a basic EMT-1 level test. This is the first weeding out process you
will encounter. My school had a minimum acceptance level of 85% to go on
in the process. After that you are invited to take basic math, reading, writing
and comprehension tests. The third step is an oral interview similar to a fire
department oral board, where they ask you a few situational questions and
your reasons for wanting to become a paramedic.

If you are accepted, you go in for an orientation and receive your books.
I suggest bringing a large backpack and parking as close to the front door
as possible. You will most likely be assigned some study material before the
first day of class. The first morning you walk in, expect a quiz. The instructors
are testing your ability to follow directions. If you don’t score well on your first
quiz after having weeks to prepare, the instructors will have a nice one-sided
conversation with you in which you do most of the listening. “How are you going
to keep up throughout the program with only hours of study time instead of
weeks and score above 80% on every quiz?”

On the first day of instruction a doctor spoke to our class and told us that
he demanded excellence in us. We were going to learn at a pace that was
similar to a first year medical student and would be expected to perform at
that level as well. If anyone didn’t think that they could hack it, he invited them
to quietly leave at the end of his address, no questions asked and receive a
full refund of their tuition. He said that for the rest of our lives (yes that’s right,
the rest of our lives) we would remember paramedic school and what we had
to endure to graduate. And I can assure you, truer words were never spoken.
You will always remember your time spent in medic school.

It’s not that the subject matter is all that hard; if given two years to prepare
and study, I’m sure that most people could graduate. The problem is that
many programs teach the course in six months. Talk about putting a ten-pound
chicken in a five-pound bag! So as you can probably see, medic school is all
about mastering a vast amount of information in a short amount of time.
A paramedic program is typically broken up into three phases: didactic
(classroom), clinical and field internship phase. I was tested every day with
written quizzes or skill stations. The minimum passing level in my program
was 80%. No grading curves, no excuses, no missing classes and no sleep.
OK, I’m joking. I was able to sleep one to three hours on most nights during
the classroom phase.

The following suggestions will help you prepare for and get the most out
of each phase of school. Through planning and preparation you can increase
your chances of graduating and getting your paramedic license.
Before even applying to paramedic school, I suggest you take a semester
course of Anatomy & Physiology (lecture and lab) at a local community college.
In fact, many programs are starting to include this as a prerequisite. This is a
good foundation class and you should work hard in it. Keep in mind that most
paramedic schools demand at least 80% to pass; you should be in the upper
90% in every pre-paramedic course you take.

Next is a basic EKG (Electrocardiogram) course. You don’t need to master
12 lead EKG’s yet, but it wouldn’t hurt. Basic EKG courses are taught in three
days or less. Know every cardiac rhythm taught to you and know it well. Be able
to read a rhythm strip at a glance, not with five minutes of debate with calipers
in one hand and flash cards in the other. Your field internship instructors will
expect you to know this cold.

A course in medical terminology, ACLS (Advanced Cardiac Life Support),
PALS (Pediatric Advanced Life Support) and any other course that you can
think of that will expose you to pre-hospital medical training are all feathers
in your cap to help you get into paramedic school and succeed. If your basic
math skills aren’t what they should be, make sure you do whatever you must to
get them there. Pharmacology is all about fractions, decimals and conversions
factors. Study up on your metric system, paying particular attention to volume
and mass measurements like milligrams and cubic centimeters.

Many programs are now offering a paramedic prep course to help students
be successful. All these courses count when it comes to admission time. Many
people apply to paramedic school and the competition to get in is growing
every day. If you can show that you are better prepared than the next person,
chances are you will get the slot and not end up on the ever-growing waiting
list. The school wants you to succeed.

Another good way to prepare for a paramedic program that is often
overlooked is to become the best EMT-1 you can be. Let the paramedics
that you work with know you want to prepare yourself for paramedic school.
I bet they will let you do some patient assessments and run through some
patient simulations. I spoke to a paramedic program instructor who said
patient assessment skills are severely lacking in his new students. Your field
internship will go much more smoothly if you have actually done a few patient
assessments and not merely acted like an IV pole on all of your 911 calls. The
key is to get in there and get the experience.

Some fire departments insist that their rookies do ALL the primary
assessments prior to the paramedics taking over with the advanced stuff, so you
might as well get your hands dirty. When the medics are doing something you
don’t understand, ask them after the call why they chose that certain treatment.
Get to such a level of competence that you can predict what medication is
going to be administered and why. You will be doing the same thing in the near
future, so pay attention.

A huge leg up in preparing for paramedic school is knowing your drugs.
There can be over 100 pre-hospital drugs to learn and most of it is just rote
memorization. You don’t have to know what the drug does to memorize its
dosage, indications and contraindications. By knowing this prior to the first day
of class, you will buy yourself some much needed time to study other subjects
(or sleep) while everyone else is struggling with pharmacology. Visit any
paramedic school and they will gladly sell you the most current pharmacology
handbook.

You can also use this visit as important face time. Speak with an instructor
or sit in on a lecture if you can. Talk with some of the zombie-like students and
ask them how you could be better prepared for your class. When it comes time
to take the oral interview, you may see a familiar face on the other side of the
table.

Another way to get experience is to volunteer for some of the simulation
stations at the school to which you are applying. Often the school is looking for
mock patients for the current class. This will give you an opportunity to see how
the students are tested and what constitutes a pass or fail in a skills station.
You would be surprised how often the program needs volunteers. And again,
this is more face time for you to talk with the instructors and get information
that other applicants will not have. The competition for that spot in the next
class is high; all the above things will hopefully tilt the odds in your favor.
When you do get that acceptance letter you need to prepare both mentally
and financially. In my paramedic class we lost right around 40% of the students
by graduation. A lot of these students were trying to work a job while in the
program. If at all possible, do not try to work while in paramedic school if you
are in a full-time, six to eight month program.

The didactic period will last from 9 to 16 weeks depending on the school
you attend. This is usually a Monday through Friday 8 a.m. to 5 p.m. schedule.
But that is just class time. Next you have to drive home and eat and then
study. You must explain to your family and friends that you are unavailable to
do anything for the next 9 to 16 weeks. No nights or weekends off; these will
be spent studying. All free time will be spent studying material, working on
your assigned project, or preparing for the next test. All of your loved ones will
have to excuse you from any other responsibilities during this time. If you fill
your plate with anything other than paramedic school, you will most likely fail.
Class failure rates in the 30% to 40% range are not uncommon.

The next step in the program is called the clinical phase, during which you
will spend about 180 hours in a busy hospital emergency room. A lot of this time
will be spent starting IV’s and generally angering your patients in the process.
You will also get the chance to practice your patient assessment skills. Do as
many assessments as you can. If you don’t show any aptitude, the nurses
will be more than happy to forget about you and move on to someone who is
more interested in becoming a better paramedic intern.

Some people use the clinical phase to coast and relax before going out
to the field internship. Don’t become one of these people. When a paramedic
comes in with a patient, listen to how he or she gives report. Ask the medics
what drugs were administered in the field and why they gave them. Listen to
incoming 911 calls if you are in a base station hospital and ask the nurses for
pointers on how to talk on the radio. When a patient needs to be intubated,
make sure you volunteer for it. Sometimes the doctors forget that this is in your
scope of practice and will do it themselves, but they might let you do it if you
speak up. I got to do a number of intubations this way. When a trauma or full
arrest patient comes in, make sure you’re not off doing something else less
important. Get in there and practice your mega code skills and listen to how
others run the code. Take notes as soon as possible after the code and write
down everything you didn’t understand or were confused about. Go over the
code with the nurse and ask questions.

The field internship is the 3rd and probably most challenging portion of
your schooling. You will be riding out with a busy paramedic unit for at least
20-25 shifts of 24 hours in length. Many paramedic programs have a difficult
time placing students because the paramedic preceptors are taking you on
as a favor to the school and/or program in general. Keep in mind that your
preceptors get no extra pay for accepting you into their lives and they are doing
you a favor! All they get out of the deal is more paperwork, more hassle and
more headaches. In return they get to mentor new paramedics and this is why
they really do it. If you are lucky enough to be able to do your internship at a
municipal fire department where you will be working with highly experienced
and knowledgeable paramedics, the whole crew is taking you under their
collective wing. Treat this opportunity as you would a rookie firefighter position,
because you may be one at this department if everything goes well.
I highly advise trying to find your own internship before you start paramedic
school. This way you can get a good internship in a busy fire station and get
the most out of your time. It’s better to be graded on ten calls per shift than
two. Imagine the upper hand you would have on an oral board if you were a
paramedic intern at that department. Need I say more?

No paramedic internship goes perfectly. Your preceptors don’t expect
perfection on your first shift except in one area – pharmacology. You may have
remembered that I mentioned this at the beginning of the chapter. In your
first shift it is common for the preceptors to question you on drug dosages,
indications and contraindications to get a feel for how much you have prepared
yourself for the field internship. If you can’t rattle off all your dosages like a
4th grader recites the alphabet, a whole new can of worms may be opened
up and they will start questioning everything you learned. Not a good way to
make that first impression. Know your drugs, know your drugs, know your
drugs…there, I said it three times.

Keep a positive attitude at all times when you are in your field internship.
When you mess up a call, and you will, learn from your mistakes and move
on. Visualize your next call going perfectly. When your preceptors tell you to
change or add something to your patient assessments, do so immediately.
Never argue with your preceptors or disagree with them in the middle of a call.
There will be plenty of time to discuss the run on the way back to the station.
During your internship you should never tell your preceptors how you will deal
with patients in the future; just keep your comments to yourself and try to learn
as much as possible in your 20 shifts.

The assessment form that your preceptors fill out every shift has a section
in it that grades your ability to take instruction and criticism. You will be amazed
that what seems like a stupid idea on shift number five makes perfect sense
on shift 18. A sure way to fail is to argue, disagree, or not follow instructions.
The valedictorian of my class failed his field internship because of his inability
to take instruction.

Make sure the rig you ride on is the cleanest, most well-stocked rig in the
city. When the next shift comes in and checks out the rig, everything should be
fully stocked and in its place. The scope is clean and shining with a new roll
of printer paper. The EKG patches are overflowing out of the pocket and the
leads are wiped clean. The drug cabinet has no expired drugs lying around
in the dark hidden corners. (A nasty little trick preceptors like to do is hide an
expired drug in the bottom of the meds box.) The drug box is scrubbed to a
shine and all the brass on the clasps is polished.

When you come back from a call, restock any item that was used on the
patient. Never let the scope batteries run low, or an audible alarm will sound off
telling everyone on the next call that you are slacking. Empty out a compartment
and wipe it clean, throw out any trash and put everything back in its proper
place. Make sure you don’t leave any oxygen bottles empty. If you find any
medical equipment that you don’t understand and can’t give a drill on with ten
minutes notice, ask your preceptors.

When you have nothing to do, your nose is in the books. Every firefighter
who sees that rig will know a paramedic trainee is on it because it will be
shining when it comes down the street and every paramedic who works on
the rig will not have to lift a finger when it comes to restocking it. If you work
hard at everything you do in your 20 or so shifts, you are showing everyone
how much you want to be there and do well. A good trainee acts a lot like a
good firefighter rookie.

Paul Lepore
Division Chief