The Experience Gap: Why Your Next Paramedic May Have Never Seen What You’re Seeing

By Scott Ash, EMHA, BS, AAS, NRP
The Paramedic Hive™
Built for Those Who Answer the Call

Not too long ago becoming a paramedic was as much apprenticeship as it was education. 

Many new paramedics spent years riding as EMTs prior to promotion. They spent hours in vehicles with experienced clinicians who taught them more than just textbooks tactics. They taught nuance. They taught you to identify a patient who looked too well to be ok. They taught you when it was appropriate to simply sit with a patient. They taught you medicine was about knowledge, but it was more about judgment. 

Those aren’t lessons you learn from a lecture. 

Those are lessons earned over years of experience. 

We’re Living in a Different Era Now. 

Today’s graduates walk away from college knowing more medicine than ever before. From complex pharmacology to twelve lead ECG’s, mechanical ventilation, ultrasound, evidence-based medicine, it seems every year there are new procedures and therapies that were simply not around when many of us became paramedics.

But today’s new employees are also walking into a profession with staffing shortages, increased call volumes, and dwindling numbers of experienced mentors available. Add that to the expectation that they’ll go from nothing to suddenly working as clinicians alone in one of the most chaotic environments in medicine. 

And that’s not a problem with new graduates. That’s a problem for EMS. 

Experience Cannot Be Learned in a Classroom

In many professions you can perform the same task day in and day out with expected outcomes. Not in EM. No two calls will ever be the same. Sure, you can teach trainees to read an ECG. Sure you can teach them medication dosages. Sure you can have them practice intubations on a mannequin until they’re blue in face. But no amount of training can prepare someones first time having to tell a family their loved one has died. No simulation is going to replicate holding a compressible chest knowing you have to make the call to terminate. No textbook can teach what its like to look into the eyes of a critically ill patient when you have no perfect answer, only your assessment, your judgment and time working against you. Those are the moments that shape experienced clinicians. And experience can’t be downloaded in an ambulance.

Medicine Has Changed… Dramatically 

Ironically, as the medicine our paramedics are expected to know continues to grow by leaps and bounds. Patients are older, with more complicated histories. Technology is constantly advancing. Treatment protocols grow more sophisticated by the year. At the same time an entire generation of paramedics is reaching retirement age. The result has been a widening experience gap. Not because new paramedics aren’t competent, but because there are fewer veterans left to mentor them and bridge the gap between education and experience.

The Value of Mentorship.

Who was that one paramedic that changed your career? Was it the partner that stayed calm and talked you through your first pediatric arrest? Was it your FTO that made you defend every assessment you made (not to be mean but to make you think)? Was it the old school medic who showed you that sometimes medicine is just about sitting with a scared patient and listening? 

I know those people for me, and I will never forget them. They didn’t see me simply as another coworker. They saw themselves as stewards of our profession. Every generation of paramedics has something to teach the next. If we lose that, we all fail.

Your Patients Won’t Know the Difference 

No patient cares how long you’ve been a paramedic. When they call 911, they want the person who arrives at their door to not only know what they’re doing, but to have done it before. They have every right to expect that. Which is why mentoring is so important.
The objective isn’t to create the perfect paramedic right off the bat. Decades of continued education and experience have already done that for us. What mentoring provides is new employees who care enough to learn more and become safe clinicians. Which is why those of us with more experience have an obligation to those coming behind us. How we Can Mentor the Next Generation 

Want to close the experience gap?

Stop vilifying new graduates. Start investing in them. Build your FTO programs. Encourage veterans to mentor new employees. Take continuing education that forces you to think not just about what to do, but why. Ask questions of those who came before you. And realize when you gain that experience you have an obligation to pass it on. Think About Your Why 

I’ll never forget my first real defining call as a param

edic. You know the one I’m talking about. The one that changed you. New paramedics deserve the opportunity to have those calls too. Not to feel abandoned in their biggest moment of need, but to learn from the people around them that care enough to invest in their future. 

Emergency Medicine starts one partner at a time.

One mentor at a time. One Patient at a time. 

Want the generation after you to be great paramedics? Don’t just give them a certificate. Give them your experience. Because someday they’ll be doing the same for those who come after them. And that’s how we keep the profession