Challenging the NREMT-P exam

[bcrosspac]

Hi:

I am a PGY-1 EM resident at Duke. I have previously worked as a paramedic, ER nurse, and ER Physician Asst over the last 13 years (all licensed in Florida). Like a dummy, I let my paramedic license expire several years ago. Now, I am trying to get involved in pre-hospital education here in Durham and would like to challenge the NREMT-P exam. I emailed the Natl Registry without a response. Does anyone know if this is possible? I would appreciate any info. Thanks....Bill Cross, DO

---

Members don't see this ad.

 

[FoughtFyr]

Hi:

I am a PGY-1 EM resident at Duke. I have previously worked as a paramedic, ER nurse, and ER Physician Asst over the last 13 years (all licensed in Florida). Like a dummy, I let my paramedic license expire several years ago. Now, I am trying to get involved in pre-hospital education here in Durham and would like to challenge the NREMT-P exam. I emailed the Natl Registry without a response. Does anyone know if this is possible? I would appreciate any info. Thanks....Bill Cross, DO

There is a proces for physicians to challenge the registry. Call the NREMT, they will send you the requirements.

- H

 

[PACtoDOC]

I too am in your same situation. I was a P before I was a PA, and I will graduate from medical school next year. But my understanding is that as a physician, you should be covered to function in an EMS capacity without ANY certification as long as the medical director signs off that you can. And since one day soon you may be a medical director, that should be rather easy!! I too would like to have my gold patch back, but I can't quite think of why it would hinder me to not have it. And to hell with it, just wear your old gold patch on your turnout gear anyway. Who is going to accuse a physician of impersonating a paramedic? Besides, once you get that patch back legitimately, you end up having to do recert and stuff like that which is more of a pain in the rear.

 

[streetdoc]

I'm curious if there was anything official from registry on challenging the test. I too let registry expire and my state cert. has 3 months left. why do we feel bad for letting go???

streetdoc

 

[pushinepi2]

Dr. Cross,

Hey up there at Duke.... what in the world do you want your medic renewed for? Maybe one of your other previous professions (RN, PA) should take precedence. I've kept mine, though.. Florida rules are quite stringent with regard to renewal and challenge. The NREMT, as previously stated, does provide for challenging the exam. I think, however, that you need to have at least an active EMT license? In any case, if you can put yourself through the ridiculousness of another EMT-B course, you'll be able to challenge most any medic certification. Florida EMS law, as I recall, allows for the following providers to take the paramedic exam provided that they have a current EMT license: PAs, DOs, MDs, DDSs (believe it.) Interesting thread. Does this have something to do with the ability to fly? I can't imagine how maintaining a current EMT-P cert would position you more favorably...

Push

 

[southerndoc]

The NREMT no longer allows physicians to challenge it's NREMT-P exams. In the past, it allowed physicians, nurses, and even medical students to challenge the NREMT-P exam if they had NREMT-I certification. This is no longer true.

Your best bet is to actually call NREMT. They never reply to their emails.

You may can challenge the North Carolina exam (not sure if they are a registry state).

 

[hospPA]

I was just an "I" before I was a PA. I actually let that lapse, but kept the RN instead. I felt it would do me more good in the future (hasn't really yet) and was easier to maintain. Just pay my money every two years and that's it. The EMT thing requires quite a lot in terms of refreshers and such. I no longer work on the rigs and do not have the time to put in for all that right now.
When I worked in EMS, my RN license gave me a sort of pseudo supervisory position over all of the other fire and EMS staff on my small dept. I was not an officer, but my chief looked to me and the other RN's to make the decisions. I have heard this from an MD on another dept who is treated the same way.
I am quite sure an RN can function on a rig and perform to his or her training so I cannot see why an MD could not. Also, I believe a flight nurse friend of mine successfully challenged the med exam in WI.
It seems elementary to allow one with a higher level of training in this country challenge the exam.
Good luck.
Pat

 

[emtp2pac]

Pat- I think an rn must also have taken the micn(mobile intensive care) course
in order to ride on an als rig, at least in california where I used to work as a medic. just having an asn/adn does not make one ready to ride on 911 calls.think about the rn's you know who work in skilled nursing facilities. would you want them running codes and traumas?these are the same folks who skip out of the intubation station when they take acls" because we will never have to do that".

side note: when/if the original poster gets his emt-p back look into reciproicity for the state of pennsylvania. they issue lifetime emt-p certs that require only minimum cme to keep up. you can then transfer this cert to any other state that accepts reciprocity. I worked as a medic during pa school there and still have a current emt-p cert although I haven't been on a rig in > 10 years.

 

[DSM]

I am trying to figure out why a physician would WANT to keep their Paramedic status. Sure we all worked darn hard to get our EMTP but didn't we or aren't we working 10 times as hard to get our Physician status????

I am confused. I guess I am a bit long in the tooth as a medic but I will not mind letting my EMT P lapse in order to get my physician status.

 

[12R34Y]

For me it kind of sentimental and nostalgic. Every time my cert comes up I just can't bear to let it go.

I also think that having EMT-P behind my name will lend a little more credence to the paramedics I'll be lecturing/training as an EM doc. Kind of telling them that I'm "one of them" and have been there too.

I always hated the docs who lectured us and had NO idea what it was like in the trenches.

later

 

[emtp2pac]

as long as you ever graduated from an emt-p program you can list emt-p on your cv and name tag. you just can't work as a medic in the field without current active/online status. you are basically a paramedic on inactive status indefinitely.

 

[bcrosspac]

For me it kind of sentimental and nostalgic. Every time my cert comes up I just can't bear to let it go.

I also think that having EMT-P behind my name will lend a little more credence to the paramedics I'll be lecturing/training as an EM doc. Kind of telling them that I'm "one of them" and have been there too.

I always hated the docs who lectured us and had NO idea what it was like in the trenches.

later

That is pretty much why I was trying to challenge the exam. I have basically hit a brick wall with attempting to challenge the NREMT-P exam OR the North Carolina state exam. I will probably give up this idea for now. As an intern, I don't have any time to pursue pre-hospital stuff anyway. Thanks for the input.

 

[niko327]

as long as you ever graduated from an emt-p program you can list emt-p on your cv and name tag. you just can't work as a medic in the field without current active/online status. you are basically a paramedic on inactive status indefinitely.

Is this really true? I figure the EMT-P is just a certification, not a license (big problem with that but that is another matter entirely), so when it expires that's it, isn't it?

 

[deleted6669]

yes and no...
yes your cert has expired and you can't work as a medic but the fact that you graduated from paramedic school doesn't go away just because you are not working as a medic....it's a lot easier for a medic with an expired cert to getback on line than someone who never went to medic school and has to start from scratch.
many places to get reactivated you just have to show current acls/btls/pals, pass the written again and do 10 precepted ridealongs. takes about 2-3 weeks.

 

[pseudoknot]

In California an MD, RN, MICN, or PA can get a paramedic license, although there are some minor hoops to jump through:
http://www.emsa.ca.gov/Para/emtpfaq.asp

 

[EM Junkie]

I have been going through a smilar situation. I am certified an an EMT-B, and in my 3rd year of medical school. I wanted the authority from the medical director to begin doing more procedures on the ambulances (start iv's at the very least). He agreed, but then changed positions after considering the insurance implications (ie: I would not be covered by the city or my medical school while acting outside of the EMT-B realm).

Any ideas on how I might challenge the EMT-I exam? Any other ideas on a way around this problem?

Thanks for any help you guys can offer!

 

[pushinepi2]

Your post brings up some interesting issues surrounding the delivery of prehospital care. As you know, EMTs and Paramedics operate under the authority of a medical director via an elaborate system of online/offline controls. The protocols, while far from perfect, are designed to systematize emergency medical care in a chaotic and often unpredictable environment. Even full fledged physicians cannot just automatically assume control of an incident occuring out of hospital in which EMS is involved.

Many states have even more complex rules revolving around the, "intermediate" practitioner. Florida, for example, does not recognize the EMT-I as part of the prehospital team. Thus, challenging an exam won't take you very far. There are several things you can do to broaden the scope of your pre-hospital experience:

1. Select a residency with STRONG ems foundations- UMass, for example, has resident physicians who are not EMT-Bs or EMT-Ps acting as first responders on Lifeflight.
2. Challenge the paramedic exam. As a certified EMT-B, you'll have the foundations necessary to sit for the paramedic exam once you obtain a medical license
3. Taking an EMT-I course will only frustrate you further.. Imagine pulling up on a destablizing MI patient and only being able to start an intravenous fluid infusion or use an epi-pen! The scope of EMT-I practice is often limited to intubation and a few emergency medications.

Best of luck. I've found this issue difficult to surmount. Its difficult to juggle the roles and responsibilities of "doctor" and "medic." If you really miss working in the field, then be sure to carefully research EM residencies (if that's indeed your niche) that encourage prehospital involvement.

 

[Apollyon]

For me it kind of sentimental and nostalgic. Every time my cert comes up I just can't bear to let it go.

I also think that having EMT-P behind my name will lend a little more credence to the paramedics I'll be lecturing/training as an EM doc. Kind of telling them that I'm "one of them" and have been there too.

I always hated the docs who lectured us and had NO idea what it was like in the trenches.

later

This is verbatim the post I would have made. On my business card, it is "MD, EMT-P". I worked too hard to let it lapse. And, as you say, I think it gives me street cred with the paramedics.

 

[deleted6669]

This is verbatim the post I would have made. On my business card, it is "MD, EMT-P". I worked too hard to let it lapse. And, as you say, I think it gives me street cred with the paramedics.

ditto. mine reads pa-c, ms, emt-p

 

[OSUdoc08]

So far, it appears that the only valid reason for maintaining EMS certification after becoming a physician is "street credit."

For those of us who don't really care what others think of us, especially EMS personnel, what are the potential benefits of maintaining the EMS certification?

Will it help with securing a job as an EMS medical director?
Are there limitations for practice or educational opportunities for those without the certification?

As an emergency physician, I cannot clearly see a benefit to renewing my paramedic license, just to have extra initials after my name, but I have not ruled it out. If I can see some clear benefits, I may reconsider.