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Editorial Board Guillaume Alinier Director of Research, Hamad Medical Corporation Ambulance Service, Doha, Qatar; Professor, Simulation in Healthcare Education, University of Hertfordshire, UK Ayesha Bal Paramedic, West Midlands Ambulance Service Trust, UK Aidan Baron Extended Care Paramedic and Clinical Lead, Community Health Support NSW, Australia; Visiting Researcher in Urgent and Emergency Health Care and Workforce Research, Kingston University London, UK Tony Bleetman Consultant in Emergency Medicine; Honorary Associate Professor, University of Warwick Medical School, Coventry, UK Malcolm Boyle Associate Professor and Academic Lead in Paramedic Education, Program Director Paramedicine Programs Griffith University, Australia Dr Mike Brooke Doctor and Advanced Paramedic, Tameside Hospital NHS Trust/North West Ambulance Service NHS Trust UK Tanoh Asamoah-Danso Paramedic, East of England Ambulance Service Trust, UK David Davis Clinical Lead, Integrated Urgent Care Workforce Development Programme, NHS England; Fellow and Mental Health Spokesperson, College of Paramedics; Founding Fellow, Faculty of Clinical Informatics, UK John Donaghy Senior Lecturer, Paramedic Science, Anglia Ruskin University, UK Georgette Eaton Consultant Paramedic (Urgent Care), London Ambulance Service NHS Trust, UK Kerry Gaskin Principle Lecturer, Advancing Clinical Practice; Academic Lead, CPD and Paramedic Science, Allied Health and Social Sciences Academic Unit, University of Worcester, UK Pete Gregory Head of Allied Health Professions, University of Wolverhampton, Wolverhampton, UK Sigurd Haveland Paramedic and Divisional Clinical Lead, Primary Care and Emergency Services, Gibraltar Health Athority Andrew Kirk Assistant Director for Education and Organisational Development, East Midlands Ambulance Trust, UK
Joanne Mildenhall Paramedic Team Leader, South Central Ambulance Service NHS Trust, UK Dr Tom Mallinson Prehospital Doctor, BASICS Scotland, UK Ian Mursell Consultant Paramedic, East Midlands Ambulance Service NHS Trust, UK Ian Peate Viiting Profesor, Northmbria University, UK John Renshaw Senior Lecturer in Paramedic Science, Wolverhampton University, UK Alan Rice Associate Professor, Paramedic Practice, Department of Paramedic Science, Kingston University and St George’s, University of London, UK Lynda Sibson Telemedicine Manager, East of England Stroke Telemedicine Service, Addenbrookes Hospital, Cambridge, UK Ceri Sudron Senior Lecturer and Paramedic Science Course Lead, University of Wolverhampton, UK Kacper Sumera Deputy Head of Education, East Midlands Ambulance Service NHS Trust, Nottingham, UK Sammer Tang Public Health Registrar, Gloucestershire Hospital NHS Foundation Trust, UK James Taylor Project Manager, Cambridge University Hospitals NHS Foundation Trust, UK. Carl Webster Senior Lecturer and Paramedic Science Course Lead, Nottingham Trent University, UK Mark Woolcock Consultant Paramedic; Lead Clinician, Cornwall Health Out-of-Hours Aimee Yarrington FCPara, Clinical Team Mentor and Midwife, West Midlands Ambulance Service NHS University Foundation Trust, Shropshire, UK
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ISSN 1759-1376 Printed by Pensord Press Ltd, Blackwood, NP12 2YA
EditorialEditorial
Career crossroads
As both a paramedic and a junior doctor, I am often being asked about the journey into medicine. The conversation perhaps stems from an acknowledgment that paramedicine can be tough, and within all of us is an intrinsic desire to grow and advance. For many of us who join the profession full of passion, we may find ourselves at a crossroads, glancing at a future decades down the road and wondering to ourselves, ‘Do I want to be on an ambulance in 20 years?’
Paramedicine is ultimately a human profession, and one that draws together a very broad set of skills. It is not just a clinical profession, and it is quite unique among the health professions. Paramedicine teaches a way of thinking that is entirely distinct. It shares a resemblance to the way engineers and logisticians analyse processes, the way chemists assess rate-limiting factors, and sits in a highly specialised area of clinical practice. It is for this reason that paramedics have become such a desirable pool to recruit from for advanced practice roles in the UK. Our profession incorporates improvisation, theory of space control, rapid appraisal of crowds and people; indeed, there is a very good reason that it has taken many academics multiple attempts to come up with a definition of paramedicine (and I would argue we aren’t there yet.)
The opportunities available to paramedics are increasing dramatically. Aside from the clinical aspects of the role, there are opportunities in education, academia, management, public health, governance, the private and corporate world, and roles we have not even seen yet.
A primary difference I often reflect on between paramedicine and medicine is the way in which problem solving is approached. Medicine’s system of training is such that it equips its learners with an ability to continue solving through each clinical challenge or obstacle and integrating them as we go, whereas paramedicine’s heuristic can become overwhelmed or overloaded once too many complexities are introduced. The trade-off is that medicine is usually slower. One of the additional professional traits of the paramedic profession is our ability to implement a plan: fast. While the paramedic heuristic model is not capable of problem solving beyond a certain number of clinical problems; we are capable of solving logistical and operational challenges that other clinicians simply cannot grapple with. No hospital clinician could figure out how to remove a 190 kg unconscious patient from a third story bedroom where the doorframe is too small for a stretcher. Yet we do that—sometimes routinely.
It is important to consider what fulfillment in life and self-actualisation look like for you as an individual, and how much energy you are willing to input and invest to receive that. If one’s identity is tied to a clinical profession, for the investment of energy required to become a paramedic and maintain one’s professional practice, there is little question that being a paramedic is one of the best careers in the world.
However, paramedicine does have a ceiling—especially when it comes to clinical and professional autonomy, the width and breadth of our professional domain, and control over how one works. Pushing that ceiling upwards can be hard and exhausting. Alternatively, medicine is far more demanding. The barrier to entry is incredibly high and the years of training required, as well as the maintenance of practice, mean that it demands a far greater investment of time and energy. Medicine may offer some the potential for fulfillment, autonomy, and realisation of their potential that they feel unable to achieve within paramedicine.
However, it is crucial to appreciate that medicine cannot offer the things that paramedicine can; certainly not until years later. The yield of energy input to fulfilment output favours paramedicine, and we need exceptional leaders and advocates to advance the profession from within. JPP
Aidan Baron is editorial board member of Journal of Paramedic Practice
Journal of Paramedic Practice • Vol 16 No 8
https://doi.org/10.12968/jpar.2024.0063 313
