I’ve been meaning to write this entry for a while, but haven’t because it is going to take some major effort and explaining. The topic: The differences between Ontario and Saskatchewan in paramedic SOP’s and professional organization/designation. Oh and a little bit about how to get employed (or not). Unless you have some interest in working as a medic in either of these provinces, this will likely be an incredibly boring read. But, as far as I know there is no document like this written and it would make a handful of peoples’ lives easier (mine included) if there was. So here goes.
I’ll start at the beginning with fair warning that this is just my experience and yes I sound a wee bit bitter in some parts. Because I was.
As I mentioned in a past blog, I was trained as a PCP (Primary Care Paramedic) in Ontario. I attended a private school and finished my diploma in 1 year of fulltime studies (no summer break) which included 450 hours of practicum. Non-privatized, the program takes 2 years with breaks. Anyways, I wrote and passed the AEMCA (which thankfully is a nationally recognized exam, so I didn’t have to re-test when I got to Saskatchewan.)
Wait, why did I leave Ontario to come to Saskatchewan?
Well, to get a job of course. They have those here. Jobs that is. And lots of them, with decent pay, and the opportunity to gain hours and seniority in a reasonable amount of time.
Before I was hired in the prairies, I had begun two hiring processes in Ontario. One was in the Kawartha Lakes region, for a part time posting promising up to 24 hours biweekly…for potentially 5-7 years before gaining full time. That means living by your phone, with no benefits, and no stable income for FIVE TO SEVEN YEARS. Not to toot my own horn but I, for one, am too old, too educated, and too experienced for that noise. (Also, one of the reasons I probably didn’t get that job was because I called them out on these issues during phase three- the interview. My bad. But I think job parameters are something employers should be forthcoming with before getting to the interview phase.) And I haven’t even mentioned the tough competition. There were approximately 200 people who had made it to phase two- the written test…..and this was for ONE part time position. I talked to a few of my fellow competitors, and some of them had been out of school for over two years! No thank you- private school wasn’t cheap and I was going to have OSAP breaking down my door in a few months.
I had also started the hiring process with Peel Region. Basically the same situation, part time gig, no guaranteed schedule. It required three college campuses to hold the written testing. I can only estimate that about 2000 grads were competing for 30 part time jobs. I passed the test but realized, I don’t want to live in Peel. It’s just so….busy. I don’t even mean patient care wise- I’m just talking traffic! Ew stress. Not for this country girl thank you very much. Yes, I was being picky but I had already left one career due to stress and dissatisfaction and knew better than to repeat the process.
I was also quickly learning that most services wanted to hire their own brew. Aka- students who went to school, lived, or did their practicum in the area. This makes sense, each service has its own nuances and it’s much easier to train a person who already knows the roads, hospitals, high call volume areas, etc. However, many regions that have a paramedic school will only allow students from that school to do their practicum there. For example, I went to school in Sudbury but had wanted to do my practicum in Peterborough or the Kawartha’s. However I was denied because placement spots were reserved for Flemming students. Pardon my French but had it been my life long dream to work in either of those places, I was virtually f*cked before I even got started. Luckily, it was not my life long dream but it still pissed me off that no one informs you of these politics before taking your tuition money.
My best chances of getting a part time job, would have been to apply for Sudbury since that is where I ended up doing my preceptorship. Which I would have done, even though I didn’t really want to live there either (maybe I am a snob). Now in order to apply, you are required to do a fitness test. The fitness test is organized and held by one of the OTHER paramedic schools (Sudbury has three schools that offer the course). Funny, NONE of the students in my class got the test date memo until it was too late. Some of us (myself included) had emailed, placed phone calls, and physically gone to the school (I’m struggling not to name names here) prior to and were ignored or lied to. They refused to hold a second test for us. Oh, politics. “Angry face.”
Luckily I’ve always been a believer in keeping your options open- wide open. I had already learned the importance of this as an education grad in Ontario (I’ve have taught in 5 different places…none of them Ontario). I had sent my resume to a private service out in Canada’s bread bowl. That same week I had a nice chat with the hiring manager over Skype. He offered me a “part time” position with a regular schedule of full time hours. Full benny’s after 3 months. Boot allowance. RSP initiatives. Licensing fees paid for after one year. In house training. The whole gammit. All I had to do was get there. Uh, where do I sign up? Fortunately my fiancée’s skills allow him to be flexible job wise, and we have no kids, and no house, (aka- no responsibilities?) so we could embrace a big move easier than some of my peers.
I just made it sound horribly easy didn’t I? Well I ran into a few surprises. I just want to clarify that by no means is the list below completely comprehensive. I am simply outlining a bit of my journey between provinces so others who may wish to do the same don’t have so many surprises in store.
Surprise #1: Licensing fees aren’t exactly cheap. Since this was my first time enrolling with SCOP (Saskatchewan College of Paramedics), it cost me 500 doubloons. Ouch. Luckily, my service pays for the fee ever after. Ontario does not have a Paramedic College so your AMECA fee is a one time thing of $250. Which I also had to pay for. My credit card hates me.
Surprise #2: It costs $15 for the Ontario Ministry of Health to sign a paper from SCOP stating you wrote and passed the AEMCA. No one will phone and tell you that they require this fee, nor is it listed anywhere to my knowledge. So if things seem to be taking a long time, get on the horn because no one is going to help you! The OMH will also tell SCOP whether or not you have worked in Ontario as a medic. That comes into play in a minute.
Surprise #3: Why are there so many jobs in Sask? Do employers secretly beat their medics so no one wants to work for them? Nope. It seems that someone in the past made a wee mistake when scheduling the licensing exams. They were only holding testing once a year. That means if you didn’t graduate at the right time of year….you could be waiting a lonnnggg time before being able to work. And I thought waiting four months to write and get my results in Ontario was torture! There also aren’t that many schools in Sask teaching paramedicine. Granted, the province’s population could fit inside the Greater Toronto Area, but they still aren’t pushing through more grads than the market can sustain (AHEM-ONTARIO). The testing situation has since been rectified and they are now testing grads three times a year. But there is still a gap to be filled. Aka- me.
Surprise #4: Remember how I mentioned that Ontario will let SCOP know if you have previously worked as a medic- aka- been enrolled with a base hospital? Well, unless you have graduated within the last two years, you HAVE to have worked for a base hospital Ontario in order to get licensed in Saskatchewan. I found this out AFTER I already moved!!! Could you imagine my pickle if I wasn’t a new grad? SCOP required copies of my diploma/transcript in order to finish the licensing process. They don’t phone you. They sent an email which had conveniently got lost in my junk mail. Again, if things don’t feel right- harass the hell out of everyone involved with phone calls!
Surprise #5: I had started the licensing process in order to work in Sask two months prior to my start date. I received my certification on day two of my orientation here. I have more grey hair.
Surprise #6: Oh ya, I now work for a privatized service. The two men who own the business actually work as EMT-A’s (I will explain) along side their employees. Some people have issues with this, but so far I happen to like it. It avoids the age old complaint about Admin not caring about employee issues. They have to talk to me because we are stuck in a bus together! My issues are literally your issues pal. Being in a privatized service also means they can modify to an extent what equipment/services they provide. I cover that in more detail in the table below.
Surpise #7: Hold on to your hat for this one. In Saskatchewan I am now considered an EMT (Emergency Medical Technician). I believe this structure of designation is borrowed from the USA. However, these days SCOP can’t seem to make up its mind about whether to use the designation PCP or EMT. From what I understand people who do the PCP program have a bigger skill set and at one time a bridging program was available to EMT’s. SIAST (the main paramedic college) calls their program a PCP program. Yet, my uniform states I am an EMT. There are also EMT-As (ICP: intermediate care paramedic) that work at my base. In my opinion their skill set more closely represents Ontario PCP’s, the main difference being they are certified to do IV’s in school and not if your base hospital feels like it. There are no EMT-P’s (advanced, like ACP in Ontario) in our particular service, but SCOP has given the ok for us to hire some in July. There are also a handful of critical care paramedics that work for STARS (like ORNGE). Confused? Me too. But I hear they are working on it.
Surprise #8: My skill set got blown up. I rationalize my inability to use some of my skills like this: I am making the same amount of money. Ok, that probably won’t make me feel better the first time I encounter a patient I could do something for in Ontario, but can’t in Saskatchewan. There are a couple new things I can do that make up for it- like Nitrous Oxide. Yay for a nod at pain control. Having activated charcoal is pretty cool too. So go on, OD and break your leg when I’m on call- just don’t have an asthma attack! Fortunately, SCOP in their wisdom does a lot of studies and has realized they are getting behind the times in some aspects of patient care. They have promised some pretty significant updates by 2019 including IV therapy. Fingers crossed.
Here is the skill set comparison gist…
|SOP||PCP (Ontario)||EMT (Saskatchewan)||Private Service (Saskatchewan)|
|Airway management||Oro/nasopharyngeal airwayKing LT||Oro/nasopharyngeal airwayKing LT||Oropharyngeal airwayKing LT|
|Breathing||BVMCPAP||BVMCPAP||BVMOrdered CPAP machine J|
|Circulation||Automatic DefibSager||Automatic DefibSager||Automatic DefibSagerMAST pants (for shizzle ma nizzle, I saw them!)|
|Epi 1:1000||Allergic reactionAsthmatic bronchoconstrictionCroup
(IM and/or Nebulized)
|Allergic Reaction(IM only)||Allergic Reaction(IM only)|
|Nitro||Cardiac IschemiaACPE||Cardiac chest pain(Tabs + Spray)||Cardiac chest pain(Spray)|
|Ventolin||BronchoconstrictionMDI or Nebulized||N/A||N/A|
|ASA||Cardiac Ischemia||Cardiac Ischemia||Cardiac Ischemia|
|Diphenhydramine||Minor Allergic reaction||N/A||N/A|
|IV monitoring||See BLS||See ETPM||See ETPM|
|IV initiation||If certified by base hospital||N/A||N/A|
|Outbreak Inoculation Assistance||N/A||Yep||Not sure|
|Entonox (Nitrous Oxide)||N/A||Musculoskeletal pain||Musculoskeletal pain (yay!)|
|Oral Glucose||Hypoglycemia +(If maintaining own airway)||Hypoglycemia(Can be given buccally)||Hypoglycemia(Can be given buccally)|
For more protocol information including criteria/contraindications please see either:
Annnyyyywayyyys, I’m sure I have many more surprises in store. For example: Goodbye 10-codes, hello patching to the hospital over a cell phone. Hello rodeo and roller derby stand-bys. Hello weekly transports to Regina/Saskatoon. Goodbye ORNGE, hello again STARS (also in Alberta). Thank goodness for working in a smaller service so I actually have time to digest all the changes. Everyone here has been very supportive and has great things to say about working here for the most part, which is an encouraging sign. Swift Current has some of the cleanest air in Canada, one of the fastest growing populations, and one of the highest employment rates, which I think all contribute to peoples generally great attitudes. Ambulance fees are also pretty high which I think keeps away a lot of the BS calls (aka- I need a ride to the other end of town and it’s cheaper than a taxi- eye roll). But I wouldn’t want to live here without health insurance.
Anyways, that’s my rant. Feel free to add anything I forgot.
And good luck.