Paramedics are highly trained medical professionals that have an incredibly important role in the NHS, dealing with life-threatening situations on a regular basis in a pre-hospital setting. They are often the first people at an emergency and will try to stabilise a patient before they are taken to a hospital and can be assessed by a doctor. A paramedic is not the same as a doctor. However, they are trained to triage patients, assess their clinical status and manage them in emergency situations. They can often interpret investigations such as ECGs, and perform certain emergency and lifesaving medical procedures. They work differently to doctors as the majority of their work is done in a pre-hospital setting. This may be in a patient's home, on the roadside, in a store or public space, or in the back of an ambulance on the way to a hospital. Unlike a doctor, a paramedic is not an independent practitioner, and are unable to order medical tests, imaging, procedures or prescribe medications. They are not involved in the ongoing management of a patient once they are safe in a hospital setting. Paramedics will handover to a doctor, and will continue their work on the frontline.
If your interest in medicine stems from wanting to deal with challenging and stressful situations where you make life-saving decisions, then a career as a paramedic may be perfect for you.
We have discussed the role of a doctor in previous articles where we compared its role to a nurse and physician associate and so without being too repetitive, we will try to consider its difference with a paramedic more specifically. Paramedics deal with the immediate management of severely unwell patients which involves responding to emergency calls, assessing and stabilising patients then deciding whether a patient needs to be taken to hospital or not. The role is incredibly varied on a day-to-day basis and one moment you may be using a defibrillator on a patient in a cardiac arrest and another delivering twins from a mother at her home. Paramedics have a very short period of interaction with patients, unlike doctors who may care for patients for days at a time on the wards or for several years in the case of general practice.
They have similar skillsets to doctors in that they are trained to assess and manage patients, using some of the same equipment and medicines that doctors often use. The most alike profession to a paramedic would be that of emergency medicine (EM) doctor as they will deal with very sick patients and have limited patient interaction. However, EM doctors will work in a hospital as opposed to in the community, so they have more facilities and more people to help them, therefore the assessment and treatment is more specialised compared to paramedics who effectively run a mobile emergency clinic. Paramedics work with a great deal of uncertainty and risk as they attend to life-threatening incidents with limited capacities. They usually work in teams of two, with a technician or assistant supporting them unlike doctors who work in multi-disciplinary teams involving other healthcare professionals such as nurses, HCAs, physiotherapists etc.
There are increasingly more roles for paramedics in the community, specifically in GP practices where they help assess and manage patients there. Ultimately though, the role of a paramedic involves managing patients in an acute and emergency setting. With medicine, doctors can choose to opt out of this and train in specialties that are less stressful, where patients are more stable both in the community or in a hospital.
You can become a doctor after being a paramedic, but you will need to go through the same pathway that other graduates have to go through, i.e. a graduate entry medicine programme or an undergraduate medicine course. There is no alternate pathway and so you will therefore go through the same application process as graduates of other courses (or undergraduates) competing for a place to study medicine. Although, the experience of being a paramedic will be incredibly helpful in studying medicine, particularly in the clinical years, it will not necessarily advantage you over other aspiring applicants to gain a place. Consequently, it will still take 4-6 years to graduate as a doctor.
There are several routes to become a paramedic. The most common is to undertake a full-time degree in paramedic science. Other options include undertaking a paramedic degree apprenticeship or entering a student paramedic programme.
The paramedic science degree is a 3/4 year full time course, which, like most healthcare courses consist of a theory element which is taught on the university campus and a practical element where you will be on placement shadowing qualified paramedics. You can find out more about individual courses on the respective university websites, a list of universities is here https://www.thecompleteuniversityguide.co.uk/league-tables/rankings/paramedic-science.
Studying paramedic sciences has financial benefits over medicine as it is a shorter course and is one of several healthcare courses (others include physiotherapy, midwifery, nursing) in the UK that offer most students a £5,000+ bursary (no need to repay) annually on top of the standard university student loan.
A paramedic degree apprenticeship is like other apprenticeships where you will be learning whilst also working. For these you must apply through an ambulance trust rather than through UCAS and as it is an apprenticeship, tuition fees will be covered by your employer. You can also apply through an ambulance trust to be a student paramedic where you will train with that trust specifically, similarly to the apprenticeship model. However, these options are highly competitive as places are very limited across the UK.
Once you finish these courses you become registered with the HCPC and can work as a qualified paramedic in the NHS. Once qualified there are also postgraduate degrees available in paramedic sciences and although these are not needed to become a paramedic, they will allow you to undertake more advanced specialised roles. These are not to be confused with graduate – entry paramedic courses which are pre-registration courses that students who have studied a related health course can undertake to gain a registration with the HCPC and become a paramedic. Similarly to medicine, you can improve your application to study paramedic science or to join an apprenticeship by gaining experience in healthcare, a common route is to volunteer with St John Ambulance or other emergency healthcare related organisation/charities.
The time taken to become a paramedic can vary depending on the route you take. Most aspiring paramedics will undertake the paramedic medicine course for which you usually need 2-3 A levels and 5 GCSEs or an equivalent BTEQ/NVQ/Access course but check individual universities for their requirements. These courses are usually three to four years, upon finishing which you will then need to register with the Health and Care Professions Council to have a licence to work as a paramedic. Apprenticeships may require less formal qualifications but emphasise soft skills like experience and possession of a driving license. Time periods for apprenticeships can vary but are usually around 4 years but remember that although apprenticeship involves a small salary and paid for tuition it is much more competitive than a university degree.
It is important to note that some universities may make it a prerequisite that you have a driving licence when applying for a paramedic medicine course and so please check this well in advance of considering an application as learning to drive can take some time and may be expensive. However, even if a university may not ask for a driving license, once you qualify most trusts will ask for one to work with them so it is advised to try and get a licence as soon as possible.
Paramedics are paid via the Agenda for Change system in the NHS and start at band 5 which in 2022/2023 Is £27,055 (this will likely improve when you qualify) and after two years improves to £33,706. This can rise further to beyond £40,000 depending on your experience and seniority. Watch this space however, because there is a lobby to improve paramedic pay in line with inflation which could change the salary prospects significantly. A usual paramedic will work 36-38 hours a week which will include nights, weekends, bank holidays, and long hours. Fortunately, the job prospects of a qualified paramedic are almost guaranteed as they are always in demand in the NHS.
A paramedic is an incredibly rewarding job as you’re on the frontline dealing with exhilarating scenarios and quite literally saving lives. They see patients in a range of settings, presenting with all kinds of different emergencies. They need to be able to remain calm and work well under extreme pressure. There main responsibility is the initial management and stabilisation of a patient, and bringing them to safety. If this sounds like the kind of life you want, where you're not as concerned with the ongoing medical management of the patient and following them up, being a paramedic could be right for you. On the other hand, being a doctor demands even more responsibility as doctors have ultimate decision-making power with regards to the management of a patient. If this interests you, then Medicine may be the career path for you. Doctors also have the option of training in specialities that are not so physically and emotionally demanding if they don't like working in the acute/emergency setting, whereas this option doesn't exist for paramedics.
Author: Dhillon Hirani
Editor: Dr Latifa Haque