Medics requiring to maintain a license

[MedCorps]

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

 

[MedCorps]

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

 

[mariomike]

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

 

[mariomike]

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.

 

[Armymedic]

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.

 

[mariomike]

Saw this in another thread. Figured it better to reply in a necro-thread, rather than start a new one since the topic has already been discussed, and so as not to take the original thread off-topic.

BC is/was the worst - their EMS programs were the most insular in the country. I had a first aid instructor that had been trained as a critical care paramedic in one of the best programs in North America that when he moved there, had to start as an EMA nothing and work his way up. This was so bad that other provinces wouldn't recognize BC trainining because they wouldn't recognize their's...an issue when the CAF decided to go with JIBC for the paramedic training of CAF Med Techs. The lack of recognition caused issues when everyone had to go do maintenance of competency on local ambulances not in BC. When I heard they'd go with them, I just shook my head as I saw what was coming.

Paramedic licensure is set by the provincial regulators. I was only familiar with one city, in one province.

In Ontario, to be employed as a PCP, you must first become an AEMCA.

QL5 Med Techs who wish to challenge the AEMCA require an additional of 120 hrs. minimum of on the street field placement in Ontario.

 

[Skysix]

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?

Nope. Paperwork mostly and a certain number of practice hours. And $$ of course.

 

[dapaterson]

Nurses are unconsciously incentivized to leave their profession and become HCAs, because the CAF medical system only cares about doctors.

 

[mariomike]

Medics are not maintaining their PCP licence for the same reason that they are not completing their yearly MCSP requirements.

Nope. Paperwork mostly and a certain number of practice hours. And $$ of course.

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.

 

[Skysix]

With regards to keeping a PCP certification current. Alberta is probably the easiest but not the cheapest. PCP has more of a scope of practice than EMR but less than EMT-A. Similarly EMT-P has a wider scope than ACP and marginally less (debateable) than CCP. Tab through to the NOCP and Aberta OCP pages for better details.

Home

The Alberta College of Paramedics Regulating the Paramedic Profession Together in the Service of Albertans The Alberta College of Paramedics Regulating the Paramedic Profession Together in the Service of Albertans APPROVED PROGRAMS Paramedicine education programs in Alberta must...

abparamedics.com

 

[applesoranges]

Nurses are unconsciously incentivized to leave their profession and become HCAs, because the CAF medical system only cares about doctors.

What exactly is the incentive?
Could you elaborate? Currently I'm a part of a civilian medical system and what you said sounds about right about what is going on here as well.

 

[dapaterson]

Ability to progress and get further promotion incentivizes leaving nursing to become an administrator, at the take of Major.

Many more HCA Lieutenant Colonel positions than for nurses

 

[applesoranges]

Many more HCA Lieutenant Colonel positions than for nurses

Ok, thanks, I misinterpreted HCA in my own context, 'health care aid' instead of admin. Makes sense.

 

[medicineman]

Nurses are unconsciously incentivized to leave their profession and become HCAs, because the CAF medical system only cares about doctors.

It also has a lot to do with the fact that they (at GoC, Ministerial and CFHS command levels) decided to divest us of our CF hospital system, such that if nurses want to actually nurse, they need to do a specialty prost grad like Mental Health, ICU, OR, Public Health or NP or go the HSO route if they feel they can/should do a command appointment. New embryonic/baby RN's will do some consolidiation in a hospital near where they're posted, then end up doing SLDO work at their clinic/Fd Amb or where ever they go,unless they luck out and get an airbase and fly AirEvacs...unless even that's changed since I escaped.

 

[dapaterson]

CFHS needs a total reset, without Doctors dictating how things should be.

 

[applesoranges]

CFHS needs a total reset, without Doctors dictating how things should be.

Interesting! So, my humble observations after years in emerg is that we still have a Doctor-centric system, but kinda unofficially. They would tell you all kinds of fairy tales in nursing school about how there is no hierarchy and all health care professions are equal parts of the system. But in reality not so much. We roll with all physicians' temper tantrums, because we are more easily replaceable than them. I'm not bitter about it, fair enough, I appreciate the natural selection. However, would be nice if there was an official ranking in the civi health care lol, no fairy tales.
So, the question is, are Doctors dictating how things should be in CFHS because they are higher in rank or there is some unofficial ambiguity?

 

[dapaterson]

Doctors created a system where doctors hold higher rank and are in charge.

 

[Staff Weenie]

Doctors created a system where doctors hold higher rank and are in charge.

The problem, is that in order to pay GDMO and Specialists enough to remain in the CAF, we have to give them very high rank as fast as possible. Even then, and with all benefits factored in, it's barely enough to keep them in. I've seen numerous clinicians at LCol/Col rank who have only the most limited understanding of how the CAF works. If they were only treating patients, or planning/directing clinical care, it wouldn't be so much of a problem. It's when they are trying to do joint or operational planning that it can get dicey. As for Nurses, we could probably cut the number of Reg F positions by almost 50% with virtually no impact on ongoing patient care. Most GDNO work approx 5 yrs max in a clinical role. Then they move into Admin roles - because that is the only way to move past Capt. Many start to experience significant skill fade at that time - even when they do keep their license current. And many do try hard to keep their skills up - the system does not make it easy. I once tried to find two CCNO for a Roto. Out of 14x Reg F CCNO, none were able/willing to deploy - no longer current/pregnant/didn't want to go/I'll quit.... We ended up using Res F CCNO, because they were more clinically current.

The current system is a legacy of Rx2000, and was a result of the SCONDVA Report and Croatia BOI (amongst several cornerstone documents) on the care delivered to CAF personnel. There was also a significant loss of institutional trust, in part due to a revolving door of clinicians - which led in part to the CDU system. A decision was made that going forward, all CAF HS occupations would hold an equivalent civilian license or certification. That is when the PCP qualified Med Tech appeared in the Reg F. We (at the coal face) knew from the very outset that it was just not sustainable for a variety of reasons. PCP was seen as the one qual that was accepted (mostly) across Canada, allowing our pers to be posted, or employed on DOMOPS without too much difficulty. Reality was very different though, as has been noted above.

 

[dapaterson]

As always, the CAF's biggest retention problem is who stays...

 

[RubberTree]

unless they luck out and get an airbase and fly AirEvacs...unless even that's changed since I escaped.

AE is only conducted out of Trenton now so you have to really luck out.