The Commission on Accreditation of Allied Health Education Programs (CAAHEP) shows that 355 of the 609 accredited paramedic programs offers an associate degree in paramedicine. In addition, there are 11 accredited programs that offer a bachelor degree. Unfortunately, the compromises made to squeeze a paramedic program into a two-year community college degree creates a challenge for those wanting to move on to obtain a bachelor degree.
The 2013 requirement by the National Registry of EMTs (NREMT) that candidates successfully complete a CAAHEP-accredited paramedic program as an eligibility requirement for National EMS Certification testing was the final step in a 13-year process to raise the educational requirements for entry-level paramedics as laid out in the EMS Education Agenda for the Future: A Systems Approach.
Hundreds of dedicated educators, regulators, professional organizations, caregivers, and employers worked to complete this difficult and contentious journey. This was accomplished in a multi-step process:
- 2000: EMS Education Agenda for the Future
- 2005: National EMS Core Content
- 2006: National EMS Scope of Practice Model
- 2009: National EMS Education Standards
Getting all of the required elements from the 2009 National EMS Education Standards required college program directors to find the absolute minimum general education requirements for a 120 semester hour terminal associate degree. Associate degrees are recognized as a higher education degree. Certificate and diploma programs are not.
A Terminal Condition
There are two types of associate degrees: transfer and terminal. A transfer degree is called an Associate of Arts (AA) or Associate of Science (AS). These degrees have the same level of General Education courses that would be found in the first two years of a bachelor degree.
A terminal degree is a professional or technical degree that meets an industry requirement but is not intended as a stepping-stone to a bachelor degree. Most of the paramedic associate degrees are terminal degrees.
General Education deficit
Often the General Education courses in a terminal degree are vocationally focused and will not be accepted as a transfer credit by a four-year college or university. For example, the university I worked in would not accept Technical Writing as equivalent to the second-semester English Composition II general education course.
When I was a program director, my university’s General Education requirements were 19 semester hours:
- 6 semester hours of English Composition
- 3 semester hours of College Algebra
- 3 semester hours of Statistics
- 3 semester hours of Humanities
- 4 semester hours of a Physical or Natural Science with lab
Most of the students with a paramedic associate degree arrived with 3 semester hours of English Composition and 4 semester hours of Anatomy and Physiology. We used to accept them in the program, with the documented guidance that they would complete their missing general education courses as soon as possible, either through our university or transfer in credit from a recognized and accepted academic institution. 75% of these students had their graduation delayed by one or two semesters, or never completed the bachelor degree program, as they struggled through the last of their general education courses, usually math or statistics.
Apparently, our experience was not unique. A March 2018 survey of the 11 online bachelor degree completion programs aimed at adult paramedics showed many of them require completion of general education before admission into the program. The student that struggles to complete the general education courses impact’s the educational institution’s performance in student resilience and time-to-complete degree. These are two measurements that impact the institution’s performance evaluation.
The Academic Marketplace and what Fire Fighters accomplished
When Ed Kaplan started the Fire and Emergency Services Higher Education (FESHE) initiative at the National Fire Academy, the goal was to “Establish an organization of post-secondary institutions to promote higher education and to enhance the recognition of the fire and emergency services as a profession to reduce loss of life and property from fire and other hazards.”
The model curriculum for 2-year and bachelor degree fire science programs established a pathway from the terminal associate fire science degree to a bachelor degree. The same model was used for an EMS degree program, but the March 2018 survey only found one institution using the FESHE EMS curriculum for its online degree completion program.
12 semester hour General Education gap challenge
Paramedics with a terminal associate degree are on their own in meeting the 12-semester hour general education gap. Mathematics is the biggest challenge, as many state community colleges require assessment tests to increase student success in passing College Algebra. Some students have completed the assessment and were told they need to complete up to 6 semester hours of non-transferrable credit math preparation courses before enrolling in College Algebra.
As EMS Agenda 2050 and a new Scope of Practice complete their development process I hope that we can construct a stable and consistent academic pathway from paramedic to Ph.D.