Author Topic: Medics requiring to maintain a license  (Read 25777 times)

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Offline Dushana72

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Medics requiring to maintain a license
« on: October 12, 2012, 18:21:48 »
Hi all,

I heard from my Sgt earlier in the year that CF Medics are now being required to actually maintain a licence in a province. Is there anyone who can shed a little more light on this? Rumor? Or is there some source I can read?

Thanks all.

Will Johnson

Offline MedCorps

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Re: Medics requiring to maintain a license
« Reply #1 on: October 12, 2012, 20:36:08 »
I was talking to the Branch CWO about this a few weeks ago and then asked some questions to some of the HQ people in the know. 

The question was being asked if Med Techs should be compelled to keep their PCP license current after it is earned and paid for as part of their QL3 program. It turns out when the Credentials Cell did an audit that only 17% of Med Techs had kept their license current after the initial licensing event in BC or QC during QL3. This came as a surprise to a whole bunch of senior officers.

So two questions were asked:

1) Why are Med Techs not maintaining their license, even with the TB/CF offering to pay for it?
2) What would be the cost to get all of those that had expired back to full license if they make this a requirement of the MOS.

The answer to #1 was varied based on a bunch of factors.  Some of them really good reasons, some of them piss poor reasons. 
The answer to #2 was a crap load of $$$.

As such the Surgeon General decreed (I have seen the minutes) that Med Techs will only be required to gain a license once, as part of their initial QL3 program (although Quebec is a slightly different story right now, but the same concept exists). This meets the requirements of the last Auditor General Report and Chief of the Review Services reports to clinically professionalize the NCM MOSIDs within the CFHS using civilian standards. 

After this initial licensing on the QL3 the Med Tech can choose to keep their license current if they wish and if service requirements allow. The TB/CF will pay for it and will support "on car" rotations via the Maintenance of Clinical Readiness Program (MCRP).  If they do not maintain their license it is not the end of the world and core Med Tech competencies will be maintained via the non "on car" facets of the MCRP and at periodic mandatory visits to the 1 Canadian Field Hospital Simulation Centre in Valcartier. I am told that the program at the Sim Centre will become much more formalized with visits being tracked and various competency rated on a GO / NO GO metric.

I hope that helps. Let me know if you have more questions here or by PM.

MC

Offline mariomike

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Re: Medics requiring to maintain a license
« Reply #2 on: October 12, 2012, 20:44:05 »
To add to the above, I received this reply in August 2012 from the Toronto Emergency Medical Services Education & Development Unit:

"Back in 2007 the military approached the MOHLTC to accept their QL5 Med Techs if trained at JIBC, to be permitted to challenge the AEMCA. In the past the Ministry has permitted this, but has required an additional of 120 hrs minimum of field placement in Ontario.
 
To obtain these hours you could participate in a Med Tech Field Placement Program. Currently there are several Military Med Tech Field Placement Programs that have been implemented across Ontario. This Program offers Med Techs both QL3 and QL5 the opportunity to obtain these 120 hours, in addition to having the ability to be Temporarily Certified to perform Medical Directives consist ( sic ) with that of a Primary Care Paramedic in Ontario while doing their ride alongs. Some services that currently offer this program are: Ottawa, Toronto, Renfrew County, and possibly Simcoe County. There may be a couple other services that offer it as well.
 
In the past three years we have offered this program to 57 Med Techs.
 
The process generally calls for writing the AEMCA in addition to possibly a practical skills test (has been done in the past - but not always depending on qualifications and education)."

Edit to add:

There was an agreement posted on the CFHS website between the CF and the Ontario MOHLTC allowing QL5's to challenge the AEMCA exam.

The link no longer works.

"Recognition of QL5A & Challenge of AEMCA exam:

Reference A is a confirmation letter by the Ontario Ministry of Health and Long-Term Care, Emergency Health Services Branch, recognizing the CF QL5 Med Tech as meeting the PCP requirements to challenge the AEMCA exam, all QL5 Med Techs are encouraged to prepare for and write this exam with approval through their Chain of Command.  Upon successful completion of this exam, those Med Techs will have access to On-car opportunities to complete their MCSP in Ontario."

Paramedicine is provincially regulated. Requirements and issue of a licence to practice are set by the individual regulators.


 
« Last Edit: October 12, 2012, 22:03:03 by mariomike »

Offline HappyWithYourHacky

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Re: Medics requiring to maintain a license
« Reply #3 on: October 12, 2012, 21:02:21 »
Interesting. I never realized that medics actually earned their licenses on their QL3s. Are medic protocols the same as a BC PCP?

Offline MedCorps

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Re: Medics requiring to maintain a license
« Reply #4 on: October 12, 2012, 21:28:23 »
Currently Med Techs more or less use the protocols that they have been trained in, be it BC or QC or the standardized sets learned at the Canadian Forces Health Services Training Centre or during the civilian contacted Advanced Emergency Care module of the QL5A qualification. 

The existing Med Tech protocols are currently being reviewed and revised, but the PCP protocols will be a hybrid between the BC and QC protocols with the prime factor being that they meet the needs of the CF.  In many cases they will be very close if not exact copies when said protocols meet the CF needs.  After all that is how the Med Techs were trained initially and if they work in BC / QC they cannot be all that bad right  :nod:. Surprisingly the protocols are pretty close in most cases.

However there will be a number of protocols that will not be BC or QC driven.  This will be then the scope of practice exceeds the civilian PCP National Occupational Competency Profile or when there are clear operational / geographic reasons.

When Med Techs are working on-car with a civilian service as part of MCRP they will be expected to use the protocols of the service for which they are guests. 

MC

Offline HappyWithYourHacky

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Re: Medics requiring to maintain a license
« Reply #5 on: October 12, 2012, 21:43:20 »
Currently Med Techs more or less use the protocols that they have been trained in, be it BC or QC or the standardized sets learned at the Canadian Forces Health Services Training Centre or during the civilian contacted Advanced Emergency Care module of the QL5A qualification. 

The existing Med Tech protocols are currently being reviewed and revised, but the PCP protocols will be a hybrid between the BC and QC protocols with the prime factor being that they meet the needs of the CF.  In many cases they will be very close if not exact copies when said protocols meet the CF needs.  After all that is how the Med Techs were trained initially and if they work in BC / QC they cannot be all that bad right  :nod:. Surprisingly the protocols are pretty close in most cases.

However there will be a number of protocols that will not be BC or QC driven.  This will be then the scope of practice exceeds the civilian PCP National Occupational Competency Profile or when there are clear operational / geographic reasons.

When Med Techs are working on-car with a civilian service as part of MCRP they will be expected to use the protocols of the service for which they are guests. 

MC

Thanks. I only ask because Sar Techs also do their program through the JIBC(same as Med Techs?) and are not required to earn a licence at any point. The protocols do change after course however, I believe they reflect the BC PCP protocols very closely (It's been awhile). There are some "advanced" skill/protocols added at the QL6A level that fall somewhere in between PCP and ACP as far as I can tell.

Anyways, point being that I am curious as to why Med Techs are required to earn a licence and Sar Techs are not required...especially since Sar Techs patients are 99.9% Canadian civilians.

Offline Adam

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Re: Medics requiring to maintain a license
« Reply #6 on: October 12, 2012, 21:45:03 »
Medics are not maintaining their PCP licence for the same reason that they are not completing their yearly MCSP requirements.  And its not because Med techs lack motivation or drive. 

I have been a Medic for 11 years.  I'm on my 6Th posting, and have been licensed as a PCP in 5 different provinces.  I have spent thousands of dollars trying to maintain a licence but I have finally given up.   11 years in, and I have only had 2 shifts on Amb through the MCSP program.

Until the CoC gets serious about providing real MCSP for Medics (that EHS in Canada will honor),  most Medics will not be able to maintain a licence.

What I would really like to know is, how CF Nurses can maintain their licence?  They face the same constraints as Medic, Don't they?

Offline Dushana72

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Re: Medics requiring to maintain a license
« Reply #7 on: October 12, 2012, 21:47:23 »
So the fact remains that Med Techs are NOT actually required to maintain their license beyond earning it once at JIBC, and the French equivalent?

Offline Rider Pride

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Re: Medics requiring to maintain a license
« Reply #8 on: October 12, 2012, 22:05:15 »

What I would really like to know is, how CF Nurses can maintain their licence?  They face the same constraints as Medic, Don't they?
No they are not. Their occupational organization has different requirements, and their employment requires them to work outside the military to maintain competency.
"Return with your shield, or upon it."

Offline HappyWithYourHacky

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Re: Medics requiring to maintain a license
« Reply #9 on: October 12, 2012, 22:08:34 »
Medics are not maintaining their PCP licence for the same reason that they are not completing their yearly MCSP requirements.  And its not because Med techs lack motivation or drive. 

I have been a Medic for 11 years.  I'm on my 6Th posting, and have been licensed as a PCP in 5 different provinces.  I have spent thousands of dollars trying to maintain a licence but I have finally given up.   11 years in, and I have only had 2 shifts on Amb through the MCSP program.

Until the CoC gets serious about providing real MCSP for Medics (that EHS in Canada will honor),  most Medics will not be able to maintain a licence.

What I would really like to know is, how CF Nurses can maintain their licence?  They face the same constraints as Medic, Don't they?

What is a MCSP and what does it entail?


Offline Rider Pride

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Re: Medics requiring to maintain a license
« Reply #10 on: October 12, 2012, 22:08:46 »
I heard from my Sgt earlier in the year that CF Medics are now being required to actually maintain a licence in a province. Is there anyone who can shed a little more light on this?

No, Med Techs are not required to have a provincial paramedic license.
"Return with your shield, or upon it."

Offline Rider Pride

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Re: Medics requiring to maintain a license
« Reply #11 on: October 12, 2012, 22:11:06 »
What is a MCSP and what does it entail?

It is called MCR AKA Maintenance of Clinical Readiness now. And if you do not know, it is either because you are not Reg F and/or have not been properly informed by your chain of command.
"Return with your shield, or upon it."

Offline MedCorps

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Re: Medics requiring to maintain a license
« Reply #12 on: October 12, 2012, 22:18:00 »
Correct.  Earning it once during the QL3 is the only requirement.  No requirement to continue on with holding a license currently exists.

I think Adam's comments are good.  That is the reason the MCSP has just been considerably overhauled to the MCRP and that civilian on-car rotations are now and optional versus required (this is second hand info, truth be told I have not looked at the new MCRP in depth, but rather attended a meeting on it and then skimmed the documents). 

The MCRP is much more attainable then the old MCSP is the premise.

The CF cannot reach universal agreement with all geographically co-located EHS's to allow Med Techs to meaningful on car ride along experience. This is the reality of a provincially regulated system that is municipally managed / administered. There have, in some cases, also been union issues I am told.  The CFHS is working hard at securing other MCRP hospital based rotations in all locals through the use of MOUs established by the National CIMIC Cell.  Hospitals seem to be little easier to work with for some reason. 

Agreed, some of the biggest reasons why we only have a 17% maintenance of PCP license rate for Med Techs is operational / training tempo, geographic location of on-car opportunities, local ambulance service pre-requisites for on car rotations, and number of on-car billets available. In the vast majority of cases it is not lack of motivation. 

When the reality hit all of the higher ups the conclusion was obvious that it is just not feasible to have all Med Techs maintain licenses even if they wanted them to do so. In the end there is no occupational specification requirement to do so and attaining a civilian provincial license once at the start of ones career meets the requirements of the CF, the Auditor General, and the Chief of the Review Service.

I do not know much about the SAR Tech situation / initial qualifications so I do not feel right at commenting.  I can only suggest that SAR Techs may not have come under scrutiny of the Auditor General / CRS over the past decade and a half and are not now held to the Accreditation Canada standard for health care organizations.

Nursing Officers / Medical Officers / Pharmacy Officers / Social Work Officers / Physiotherapy Officers are much smaller in total numbers per MOS then Med Techs and are required by occupational specification, the Auditor General, agreements with various Provincial bodies, a few federal laws, and now importantly Accreditation Canada to maintain a civilian license (in at least one province), hence why it has occurred.  It has been a challenge for some of these groups to maintain their civilian license especially when the deployment cycle was high. It has been easier (in most cases) to transfer one of these licenses from province to province and once you are licensed in the province getting you into a hospital / clinical placement that is in the geographical location of your posting  is not all that difficult for the CIMIC folks and it can usually occur with a phone call. Many of these professionals are also moonlighting which has helped things.

Good conversation. 

MC 

Offline MedCorps

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Re: Medics requiring to maintain a license
« Reply #13 on: October 12, 2012, 22:21:17 »
What is a MCSP and what does it entail?

MCSP is the Maintenance of Clinical Skills Programme.  It is now defunct.  It had been replaced by the MCRP, which is the Maintenance of Clinical Readiness Programme. 

It is a formal, soon to be better tracked program that is used to ensure that health care professionals (including Med Techs) in the Canadian Forces Health Services keep their clinical skills sharp and ready to be used should they be required either within Canada or while deployed.

MC 

Edit: to clearly indicate MCSP is now defunct. 
« Last Edit: October 12, 2012, 22:30:33 by MedCorps »

Offline HappyWithYourHacky

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Re: Medics requiring to maintain a license
« Reply #14 on: October 12, 2012, 22:29:00 »
MCSP is the Maintenance of Clinical Skills Programme.  It is not defunct.  It had been replaced by the MCRP, which is the Maintenance of Clinical Readiness Programme. 

It is a formal, soon to be better tracked program that is used to ensure that health care professionals (including Med Techs) in the Canadian Forces Health Services keep their clinical skills sharp and ready to be used should they be required either within Canada or while deployed.

MC

Thanks again. I am assuming it is comparable to our MOCOMP. We spend a week a year in a clinical setting(ER and OR) practising our skills. This year we are also potentially throwing in two days on car. All skills and protocols practised are recorded and signed by a preceptor then sent to the JI for assessment and "storage".

Rider Pride. I am not a Medic and it seems there is a difference in the way our trades are run. I find this interesting as we have the same course, taught by the same institution at our base.
« Last Edit: October 12, 2012, 22:32:49 by HappyWithYourHacky »

Offline MedCorps

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Re: Medics requiring to maintain a license
« Reply #15 on: October 12, 2012, 22:33:42 »
No, Med Techs are not required to have a provincial paramedic license.

I will add, just so there is no confusion...

Med Techs are not required to have a provincial paramedic license once they have earned a provincial paramedic license during their initial QL3 PCP training.

If you do not manage to get your license during your QL3 PCP training, you will not become a Med Tech. 

MC

Offline MedCorps

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Re: Medics requiring to maintain a license
« Reply #16 on: October 12, 2012, 22:39:26 »
Something else just struck me....

This conversation only applies to Reg F Med Techs. 

If you are a Res F Med Tech you might in the very near future (or already) be required to maintain a PCP license.  Failure to do so will result in a revision to the Med A (Medical Assistant) MOS from the Med Tech MOS and the requirement to maintain AMFR II (Advanced Medical First Responder Level II) certification . 

MC

Edit: Spelling

 
« Last Edit: October 12, 2012, 22:47:30 by MedCorps »

Offline Rider Pride

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Re: Medics requiring to maintain a license
« Reply #17 on: October 12, 2012, 22:41:25 »


Rider Pride. I am not a Medic and it seems there is a difference in the way our trades are run. I find this interesting as we have the same course, taught by the same institution at our base.

Seen...checked your profile.

When you compare, remember that Med Techs are trained initially as basic paramedics at the beginning of their careers with the goal of developing the medic to become a Physician Assistant at the WO level.

You guys are just paramedics who wear bright orange suits with a really cool systems to get to the patient and transport them to the hospital where real medical people can fix them.   (  ;D  just kidding )



"Return with your shield, or upon it."

Offline HappyWithYourHacky

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Re: Medics requiring to maintain a license
« Reply #18 on: October 12, 2012, 23:06:36 »

Seen...checked your profile.

When you compare, remember that Med Techs are trained initially as basic paramedics at the beginning of their careers with the goal of developing the medic to become a Physician Assistant at the WO level.

You guys are just paramedics who wear bright orange suits with a really cool systems to get to the patient and transport them to the hospital where real medical people can fix them.   (  ;D  just kidding )

Really? That's very cool. What a qual to earn. I'm a little disappointed in myself for not knowing more about your trade given how closely we relate....well at the PCP level anyways. ;)

Offline Dushana72

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Re: Medics requiring to maintain a license
« Reply #19 on: October 12, 2012, 23:09:41 »
Well, it looks like I will be eating some humble pie....I was so sure I read it in a canforgen that we had to actively maintain a license....oh well. Always wondered what crow tasted like....lol

Offline MedCorps

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Re: Medics requiring to maintain a license
« Reply #20 on: October 12, 2012, 23:11:30 »
Remember the PCP qualification is only 1/6th of the total QL3 Med Tech medical skill set (although takes up a large chunk of the QL3).  We also have in-patient / casualty holding, primary care, operational medicine, clinic support, and field medical skills that are required of them...

MC


Offline MedCorps

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Re: Medics requiring to maintain a license
« Reply #21 on: October 12, 2012, 23:13:49 »
Well, it looks like I will be eating some humble pie....I was so sure I read it in a canforgen that we had to actively maintain a license....oh well. Always wondered what crow tasted like....lol

I do not think there is a CANFORGEN on this.  There WAS a Surg Gen AIG message on this indicating all Reg F Med Techs had to earn the PCP qualification at least once.  We still have a number of older QL3's who never bothered to bridge to the new PCP qualification and this AIG was targeted at them. 

MC

Offline mariomike

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Re: Medics requiring to maintain a license
« Reply #22 on: October 12, 2012, 23:29:09 »
Anyways, point being that I am curious as to why Med Techs are required to earn a licence and Sar Techs are not required...especially since Sar Techs patients are 99.9% Canadian civilians.

Licensure, at least in Ontario, is only required by Flight Paramedics:
http://www.e-laws.gov.on.ca/html/regs/english/elaws_regs_000257_e.htm#BK4
« Last Edit: October 13, 2012, 07:49:34 by mariomike »

Offline mariomike

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Re: Medics requiring to maintain a license
« Reply #23 on: October 14, 2012, 14:50:39 »
The CF cannot reach universal agreement with all geographically co-located EHS's to allow Med Techs to meaningful on car ride along experience. This is the reality of a provincially regulated system that is municipally managed / administered. There have, in some cases, also been union issues I am told. 

It could have something to do with the cost and availability of Field Training Officers ( FTO ).

29 things changed this year as the result of a Coroner's Inquest and $10-million civil suit against Toronto EMS.

Some of those changes will likely have a "ripple effect" across the province.

#25 was that probies Probationary Paramedics must now be accompanied by an FTO for at least 12 weeks.

That is in addition to precepting paramedic students from the two "farm teams", Humber and Centennial colleges. 

Hospitals seem to be little easier to work with for some reason. 

The department has a long list of SOP's for students.

These are the two that I recall hearing the most problems with:

• Each Observer, during the course of their Ride-Along will follow the directions given to them by
their host Paramedic crew and other emergency service responders when required. Failure to do
so may immediately end the Ride-Along opportunity and prevent them from taking advantage of
any future opportunities.

• Only one student or observer is permitted to ride with an ambulance crew at a time. If a student
or observer is assigned to a single paramedic who is being partnered with another single
paramedic who also has a student or observer, priority will be given to the student or observer
assigned to the station in which the crew will be working. The other student/observer will be
sent home or re-assigned, where appropriate.













« Last Edit: October 15, 2012, 13:09:32 by mariomike »

Offline Rider Pride

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Re: Medics requiring to maintain a license
« Reply #24 on: October 28, 2012, 11:43:59 »
To answer the opening post question:

Med Techs are not required to maintain a provincial licence. Hence, the CF will not pay for a Med Tech to hold a provincial licence in the province they are posted to.

Med Techs are allowed to get and maintain a provincial licence, but that expense shall be incurred by the member themselves.
"Return with your shield, or upon it."