The Bridge from Military Medic to Paramedicine

As time passes some things get worse and some things get better. With the transition from active-duty military service to a civilian career many times service members are starting over, which as many know is a daunting task. I got off active duty in 2014 and at that time I saw no clear path to utilizing my already existing skills and knowledge towards a career as a paramedic. In other words, there were no bridge programs at the time, you had to sit through all the classes do all the practical and clinical hours. Today however several bridge type programs exist and many states have introduced legislation to correct this oversight. In order to better understand the why, and how long this took so long to achieve it is important to look at roles and the history of both military medicine and civilian paramedicine.

If you were to trace the roots of combat medicine back it starts as many things do with the romans. But a better more recent example would be the lolly pop boys, who were the forerunner to todays Navy Corpsman. These sailors began work in the earliest days of the Navy and assisted the ships doctor in all types of medicine and surgical procedures. Training was mostly on the job and endorsed by the surgeon that they supported. In WW1 we begin to see what resembles military medic today. Independent medics going out assigned to units, providing and coordinating care of soldiers back to war time hospitals. Throughout history military medicine has continued to improve as a whole. More recently in 2010 the military opened a joint school where all the service sends their medics for initial entry training. Topics covered are very similar to that of an EMT-B , paramedic, or even what is taught in many nursing schools. Given the broad range of topics covered in the school the role of military medics is also quiet broad. Many service members work in clinics or military hospitals in what would be described as tech style roles. Others serve with units providing stand by coverage for training events, assisting with the unit clinic seeing sick call soldiers, or potentially serving on medevac platforms. Within each of these roles their scope of practice may vary greatly but generally they are allowed to perform procedures which the unit physician has trained and authorized them to complete. This could be anything from giving out Motrin to emergency doses of fentanyl, or even blood products and chest tubes in the field. While college credits vary based on what school you choose to attend the basic initial entry level medic training is accepted by most community colleges (or equivalent schools) at between 30-60 credits in a health care related field.  In addition to college credits shortly after the joint enlisted medical training center open all members who completed the school were able to test for their national registry EMT-B. However, obtaining further civilian certifications such as your paramedic certification while on active duty was difficult as the military’s only school which produced paramedics was the 18D-Special operations sergeants’ course. But in early 2020’s the Army began to offer the combat paramedic course open to a broader group of soldiers. According to CoAEMSP data the program has a 100% employment rate within one year of graduation with nearly 60% of graduates opting to remain in the service. The course is sponsored by the Uniformed services university (the military’s medical school)

The history of paramedic does not have the extensive deep roots that we find with military medicine but none the less it was born from necessity. EMS in general started with funeral directors using their hearse to transport patients to the hospital or the police using their cars or vans to move people to the hospital. Then in the 1967 the first paramedic service was formed in Pittsburgh PA by the Freedom House Ambulance Service. The first paramedics were trained by physicians and had approximate 300 hours of instruction. The role of the paramedics continued to be professionalized and increased throughout the decades with vast expansion of the paramedic model beginning in Los Angeles County. It’s important to emphasize some of the major differences in training and practice between military medics and paramedics as shown in the chart below.

Today based on years of advocacy we are beginning to see military medic training being recognized by states and allowing transitioning soldiers the opportunities to finish paramedic school through a bridge program. The first such program in the country was at Lansing Community College. The program worked with the Department of Defense to understand the training of military medics and agreed to transfer the DOD college credits making the process of paramedic school much quicker. The current curriculum takes approximately 28 weeks which is a savings of 4-5 months as compared to traditional paramedic students. In the below references additional information can be found on several other programs which offer military bridge programs, and even military medic to nurse bridge programs as well. The benefits of having experienced military medics fill the ranks of the civilian paramedic workforce cannot be underestimated. Across the field of EMS recruitment is down, but job growth/demand continues to steadily rise. Making it easier and more efficient to transition military members into this role can only serve to better our industry as a whole and improve both patient outcomes and transitioning soldiers’ outcomes as well.

References

Combat-Medic-Health-Care-Sepcialist-BS-Health-Sciences-Degree-Map-September-2017.pdf

METC program creates path to college degrees > Joint Base San Antonio > News

medcoe.army.mil/combat-paramedic-program/

National_VABP_report_military_to_civilian_bridge-programs_healthcare.pdf