Emergency Medical Responder Career Opportunities in BC
Hello, folks! Welcome to Medic in the Trees, Professional Responder edition. My name is Kieran, I am a Primary Care Paramedic in Vancouver, as well as the Lead Instructor for Coast Wilderness Medical Training’s Professional Responder Training programs, where I oversee delivery of our First Responder, Emergency Medical Responder, and Wilderness First Responder courses. In this series of posts, I will answer your questions about the field of professional medical response from training and careers to tips, tricks and techniques.
This first entry into our series is going to be a long one, but this is a question that a lot of people come to me with, and it is a bit complex.
There is a higher demand for Emergency Medical Responders (EMRs) in BC today than there ever has been before, with lots of different roles offering good wages and flexible schedules. However, if you’ve been trying to figure out exactly where these opportunities are, and how to access them, you are not alone. As Coast’s Lead Instructor for our EMR program, I spend a lot of time talking to potential, current and former students, helping them to answer this question. The truth is that there is significant demand for trained, licensed EMRs in BC - but finding those careers, understanding the pros and cons of each, and navigating your EMR future is not always straightforward.
That’s why this week’s installment of Medic in the Trees is all about the
Top 5 Careers for Emergency Medical Responders
What is an Emergency Medical Responder?
Before diving into each of these career opportunities, let’s start with a very brief background as to what an Emergency Medical Responder is, and what EMR training consists of. EMR is the entry level license to the field of paramedicine in British Columbia. Emergency Medical Responders were originally placed in community-level ambulance roles, and if you live outside of a big city in Western Canada, there’s a good chance that the ambulances you see on your streets and highways are staffed by EMRs. If you live in a major urban center, you’ve certainly seen trained EMRs in a variety of other roles, because the EMR license has become a required prerequisite to a wide variety of career opportunities. This is because Emergency Medical Responder is a provincially-administered medical license, which means that employers can expect more reliable competency, consistency and quality of training from EMRs then, for example, from someone holding a first aid certificate.
EMRs are trained and authorized to provide a wide range of basic life support treatments, including oxygen and medication administration, bleeding control, wound care, splinting, pain relief, performing CPR, and quite a bit more. However, the real EMR skill is learning to conduct good assessments of sick or injured patients so as to make informed decisions that determine the best care pathways for them.
As licensed medical professionals, Emergency Medical Responders are held to higher standards than first aid attendants. This includes requirements for ongoing training and professional development, maintaining competency and skill, and expectations of professional behaviour befitting a uniformed role as a medical professional.
If you are wondering how you can fit into that role, imagine the person that you would like to respond to your grandmother if she were sick. Now go and act like that person. Unless you really don’t like your grandmother. In which case, do the opposite.
How Long is an Emergency Medical Responder Course?
A full Emergency Medical Responder course requires 80 hours of in-class instruction. If you already have a First Responder, OFA-3 or WFR certificate, you might qualify for 40-50 hour EMR Bridge training. Upon successful course completion, you will write a provincial exam and attain your EMR license.
You can expect your EMR course to be intensive and challenging - after all, in only 80 hours you are going to train to respond to life-threatening emergencies as a paramedic or fire fighter, be able to make quick assessment and fast decisions, and be able to provide top notch ongoing care.
When choosing your training institution, be sure to ask about the support they provide during and after your course - that support can make all the difference in determining your success!
What are the Top Job Opportunities for Emergency Medical Responders?
With that, let’s take a look at the jobs. This is, by necessity, an overview of the positions - you will certainly still have questions. If you think EMR might be for you, I encourage you to reach out to a career specialist at Coast for a free consultation. We can answer your questions, and help you to understand how each of these opportunities might fit with your specific goals, situation, and lifestyle.
1. Respond to Medical Emergencies on Ambulance with BCEHS
Let’s start with the longest and most complex of these options - working on ambulance with British Columbia Emergency Health Services.
What does an EMR with BCEHS do?
In British Columbia, if you want to work on an ambulance, you have one option - the British Columbia Emergency Health Services. Fortunately, it's a pretty great option. (Bias alert: I am a happy paramedic with BCEHS - opinions may differ.) As an EMR on ambulance you will do most of the things that you imagine paramedics doing - you will respond to emergencies, provide necessary airway, breathing and circulation interventions, treat wounds and injuries, extricate and transport patients, and provide ongoing care during transport to hospital. You might also be the first point of contact for people experiencing mental health emergencies, adverse living situations, domestic violence or neglect, and other non-medical emergencies, and it is important that you are prepared to be sensitive and compassionate, while maintaining a good knowledge of the resources available to the community in which you are working.
What are the Advantages to Working with BCEHS
This is the role that EMR was built for, and there are a lot of advantages to following this path, including
Superb Training Opportunities: BCEHS considers EMRs to be basic life support specialists, and invests quite heavily in preparing you for this role. BCEHS employees get quite a bit of additional and ongoing training to upgrade and maintain their skills, including better assessment techniques, more insight into pertinent elements of anatomy, physiology, and pathophysiology, and more equipment and tools to provide better patient care.
Control Over Your Own Schedule: EMRs usually work in casual, part-time positions based on your schedule - you give your availability for each month, and BCEHS schedulers work within that availability. Control over your own schedule gives you the opportunity to easily work as a part-time EMR while accommodating another job, education, or family responsibilities.
Block Scheduling: As an EMR, you will usually work outside major urban centers - think Lillooet, Gibsons, Smithers, Salt Spring Island, Boston Bar, even Prince Rupert, rather than Vancouver, Kelowna and Prince George. However, you will typically be scheduled for continuous ‘blocks’ of 2-6 12 hour on-call shifts. During your shifts, you live at the ambulance station - bedrooms, kitchens and basic facilities are provided - or explore the community, until an emergency occurs, and your services are required. This system allows EMRs who live in the city to work in smaller surrounding communities by reducing the need to travel back and forth.
Mobility Opportunities: Once in the ambulance service, it is relatively easy to move around to different stations. If you’d like to see a different part of the province, you just transfer to a different station and go work there as an EMR.
Keep Your Stick on the Ice: There is no substitute for practice, and working as an EMR will get you very familiar with providing care to a wide variety of patient presentations and conditions. Furthermore, unlike any other EMR role, working for BCEHS will put you in charge of patient care decisions - a truly professional level of autonomy and responsibility for another person’s wellbeing that is difficult to find in other EMR roles.
Are There Any Disadvantages to Working with BCEHS?
Oh, yes. However, before we talk about them, it is worth noting that if you like being an EMR, you will likely want to upgrade your training to Primary Care Paramedic in the future anyway, and most of these disadvantages are significantly mitigated if you become a PCP.
Wages are Good - Financial Security is Not: The hourly wage when working as an EMR is about $31 an hour, including vacation pay and in-lieu of benefits. This sounds pretty good for a training investment of 2 weeks and $1500! However… there is a catch. Buckle up - this is a bit complex.
Remember how I described EMR positions as casual, part-time? They are also on-call. So, in most stations, during your shift, you are being paid a $2 per hour on-call wage until you are called out, at which point you go to your full EMR wage for at least 4 hours. In many stations, the volume of call-outs is high enough that you will earn a reasonable income per shift on average, but you have to be prepared for the occasional skunking, when you are on shift for 12 hours and earn $24. With flexibility and a little cleverness, you can earn a very good wage as an EMR, but if you are looking for the security of knowing exactly what you get for the hours you work, you might find this structure a bit stressful.
Depending on the station, there are also other pay structures for EMRs within BCEHS, including a Scheduled On-Call position that guarantees you at least 8 hours wage out of every 24 hours, but none offer full-time pay.
Limited Opportunities in Large Urban Centers: Aside from working the occasional patient transfer shift, EMRs have almost no opportunity to work in the city. If you live in Vancouver, Victoria, Kelowna or Prince George, you will be doing some travelling to work your EMR shifts.
A Stressful Job That is Not For Everyone: In every conversation about working EHS - or any emergency services job - this is the elephant in the room. In this role you will deal with people who are having the worst day of their lives, and then you will go and do it again. You will see death and pain on a regular basis. It is impossible to be unaffected. BCEHS has taken significant steps to providing the resources necessary to mitigate the critical incident stress that comes along with the job, but you must be prepared to access them, and to develop your own strategies to leave the job behind when you go home at the end of each shift.
The Bottom Line
EMR is a really accessible way to find out if pre-hospital medicine - paramedicine - is for you. Demand is unprecedented, and it is pretty easy to get an interview with BCEHS. The trade-off is a lack of stability - you have to be ready to weather some unpredictable scheduling and wages. However, if you think this field is for you, I strongly recommend you get your EMR and apply for a part-time position with BCEHS. It really can be a great job - you solve problems all day, work with great partners, and have a lot of autonomy in your decision making.
If you are considering a part- or full-time career with BCEHS, I use this form to set up a free consultation with myself, or one of our other experienced career specialists. We can answer all of your questions about the career, the course, licensing, and more.
2. Provide Primary Care with Your Local Fire Department
What does an EMR with the Fire Department Do?
Fire fighters are emergency response generalists - many people are not aware of the many vital roles that fire fighters perform in their community. Aside from managing structure fires, fire fighters also perform rescue services, make accident scenes safe, manage hazardous materials and spaces, help keep the public safe through education and equipment checks, rescue kittens from trees, and - yes - provide life-saving medical interventions at the scene of an accident or medical emergency.
Advantages
Strong Team Environment: Working with a fire department usually means working as part of a consistent crew over a long period of time. This means building a solid team dynamic, and really knowing the people who you work with every day. Support within your crew tends to be very good, which can be helpful in mitigating the effects of traumatic calls.
Upward Mobility Opportunities: Fire departments are more hierarchical than emergency health services, creating leadership and upward mobility opportunities as you gain experience.
Work in Your Community: Working for your local fire department usually means building a career in, and working for, the community you live in. There is often a strong sense of attachment between a community and its fire department - and, as an added bonus, your bed is never too far away!
Stable Schedule and Salary: Most municipal fire departments offer full time positions with security and benefits, and the pay is great, compared to other Emergency Services. Starting salaries are between $65,000 and $70,000 a year, and in most communities, you can expect to be closing in on $100K after 5 years of service. (Volunteer fire departments are obvious exceptions to this, and come with their own non-financial benefits.)
A Wide Variety of Training Opportunities: As our communities’ emergency response generalists, firefighters get a wide variety of ongoing training to keep their skills sharp.
Disadvantages
“Disadvantages to choosing ‘hero’ as a career path? Say it ain’t so!” “I’m sorry… it is so.”
Less Medical Training: As mentioned , firefighters are generalists, and the breadth of training and skills they require leaves far less time to upgrade or maintain their medical skills, compared to EMR-specific roles. Basically, if you work fire, your EMR course is the extent of the medical training that you will receive - so do your research, choose wisely, and get the best training that you can get!
Less Patient Care: In Canada, firefighters do not transport patients to hospital. This means that, while firefighters often arrive on scene first and perform invaluable airway, breathing and circulation interventions, responsibility and decision-making for a patient's care are usually handed over relatively quickly to BCEHS paramedics responding on ambulance. Unfortunately, this means that many firefighter EMRs don’t get to take part in longer term patient care, which means they don’t always get to see the full effect of their decisions.
Significant Investment, Very Competitive: Emergency Medical Responder is only one element of the basic training necessary to apply to your local fire department - expect to spend months of intensive preparation and over $10,000 just to get your prerequisites. Once you do have those qualifications, the field is very competitive, with dozens or hundreds of applicants for each position.
Limited Opportunities to Change Communities: Fire departments are municipal, and it is usually impossible to move to a different city or community without giving up your accumulated seniority and rank.
Critical Incident Stress: As with paramedics, firefighters are often part of other people’s worst days, and it can affect you strongly. It is important that you work as part of a supportive crew, access the resources your service provides, and take the initiative to separate your career from your personal life.
Bottom Line
If you make the cut, working for a fire department is an excellent and enviable job, with great community, lots of respect, and often-fantastic working conditions. The only drawback from and EMR perspective is that the medical role is not emphasized - if you want to provide top notch medical care, or even if you just find the medical stuff interesting, a part-time job as an EMR with BCEHS alongside your fire department position will give you access to more training and opportunities to provide complete patient care.
3. Safeguard the Slopes with Ski Patrol
Many ski patrol organizations accept EMRs as part of their team. If you love skiing and can’t get enough of the slopes, using your EMR license to join a paid ski patrol team can be a great way to support the skiing community and spend even more time on the mountain!
What does a Ski Patroller Do?
As a patroller, you will respond to accidents and medical emergencies on your mountain, work as part of a great team of like-minded skiers, and might perform ancillary duties like participating in avalanche control and general upkeep of the resort. You will also get to do a ton of skiing.
Advantages
Fun: This is fun. Very fun. You get to do something you love, get paid for it, give back to the skiing community, feel a well-justified sense of accomplishment and pride, and look good doing it!
Access: Ski the trails before they open in the morning, and after they close at night. See the mountain in a way that few people get to experience.
Great Practice: Ski Patrollers perform acute care for accidents and medical emergencies, as well as extended care during packaging and transport to the base for handover to ambulance. You will get very good at managing musculoskeletal injuries, including traction splinting, pain control, as well as team response and handling logistically difficult extrications.
Advanced Training: Many ski patrol organizations include advanced training protocols that allow you medical interventions, medication administration, and pain relief options that EMRs on ambulance don’t have access to.
Disadvantages
The Pay: No one gets into ski patrol for the money. If you don’t see this as an extension of your skiing lifestyle, you might find the salary very disappointing. $18-$20 per hour is the norm, and most ski patrol organizations require a full time commitment, so you will have limited opportunities to supplement your income during the ski season.
Seasonal: I think this goes without saying.
Some Risk: Patrolling is probably the item on this list that comes along with the highest risk of physical injury. Even if you are a very strong skier, you can expect to be responding to accidents on the most difficult areas of the mountain as well as out-of-bounds areas, and accidents are likely.
Bottom Line
Fun. This is just tons of fun, while working in a highly respected role with a great team while doing what you love. If you can afford it, ski patrol is a really good option when paired with a part time EMR position on ambulance with BCEHS - ramp up the ambulance work in the off-season, and then balance out with ski patrol once the snow flies.
4. Support an Industrial Workforce as an Occupational First Aid Attendant (OFA-3)
Here in BC, if you want to be hired as a first aid attendant at an industrial or construction site, or in any workplace, you have to have an Occupational First Aid certificate. There are three levels, with OFA-1 offering the fewest opportunities, and OFA-3 offering significant opportunities for dedicated work as a first aid attendant at large and remote locations.
Many people don’t realize that EMR is a pathway to OFA-3! Once you have your EMR license, you can apply for an OFA-3 equivalency. Holding an EMR license along with your OFA-3 certificate opens a LOT more doors, and might lead to better working conditions and higher paying opportunities. (Here at Coast, there is no extra charge for your OFA-3 - we facilitate the paperwork and handle all associated costs for our EMR students!)
What Does an Occupational First Aid Attendant (OFA-3) Do?
To be honest… not much. Most of these positions are standby positions that are required by the province, but stringent safety requirements on industrial sites these days means that accidents are few and far between. Expect to spend 12 hours a day on your site, either in a medic trailer or a specially outfitted Mobile Treatment Unit with a small patient care area on the back. You might have some light administration duties to perform, and it is up to you to ensure that your equipment is clean and ready to go, but most of your time will be spent waiting.
Advantages
Lots of Free Time: OFA-3 is a great opportunity to get a lot of studying done, and get paid doing it. It is not unusual to have 8-10 hours of a 12 hour shift to yourself. If you enjoy watching movies for hours on end… well… after a couple of weeks, you might find that you don’t enjoy that quite as much as you think you do.
High Demand: Provincial legislation requires some work sites, especially those that are difficult to access or quite distant from the nearest hospitals, to have OFA-3 attendants on site in order to be operational. Some specifically require an EMR license as well as OFA-3 certification. This means that, at any given time, there are always lots of first aid opportunities throughout BC for someone with an EMR and OFA-3. These jobs are mediated by local companies who negotiate the contracts and provide the equipment.
The Pay is Good, Expenses are Low: OFA-3 attendants usually start at about $300 per day, with higher wages for those holding an EMR license. You also will either stay on site, or travel back and forth to a nearby staff house, which reduces your ability to impulse-spend your salary while at work.
Disadvantages
Work is Seasonal: Many specific industries only work during certain seasons, or they move around based on weather and climate. If you make this your full time job, you can expect to switch jobs or move around several times during the year.
Remote Work: Most OFA-3 positions - and certainly the ones that pay the best - are located in remote parts of the province, quite distant from even the closest communities. Food and accommodation are provided, but if you work in these positions you can expect to spend 2-3 weeks away from home at a time, without access to most familiar amenities.
Skills Atrophy: As mentioned, these sites tend to be very safe - accidents are rare, and serious accidents rarer still. It is very difficult in these circumstances to find the self-drive and resources necessary to keep your skills up, but it is still your responsibility as a licensed EMR to be ready to respond competently if an emergency does occur.
Not Stimulating: Seriously. Weeks at a time. If you’ve been thinking of taking up harmonica or writing a novel, this might work out, but otherwise… it's just piles of time with very little going on.
Bottom Line
This can be a good temporary job, and an excellent way to make some money while reducing expenses for a while. For some people, it might accommodate other goals perfectly, and be just what they need. However, if you are considering a career in pre-hospital medicine, this should be seen as a VERY temporary gig - otherwise, back it up with part time work on ambulance during your off time to keep your stick on the ice. Skills atrophy is very bad - just ask your patients.
5. Care for Low Acuity Patients with Patient Transfer Services
EMRs working for private patient transfer companies perform important support roles in our healthcare system. These organizations transport non-emergency patients when up-care, down-care, or specialized treatments are required. Transport may be between home and a healthcare facility, or from one healthcare facility to another.
What does an EMR working patient transfer do?
Working with a patient transfer company, you will interact with nurses, doctors and other healthcare professionals, getting hand-over reports on your patients, and sometimes delivering those reports after transfer is complete. You will assess and monitor your patient, and inform the receiving facility of any changes or developments. If a patient declines unexpectedly, you will be called upon to perform the entire range of life-saving interventions available to you as a licensed EMR. Most importantly, you will be a human connection to someone who can be feeling overwhelmed, including taking the time to explain procedures, interpret medical language to plain English, or just hold someone’s hand when they are scared.
Advantages
Extended Patient Care: You will get to interact with your patients over longer periods of time, ranging from 20-30 minutes to several hours. This will give you a chance to use your assessment and monitoring skills - such as repeat blood pressure checks - and keep those skills sharp.
Familiarity with Healthcare Facilities: You will access and learn about the many different facilities and types of care available in our healthcare service. In fact, EMRs who work patient transfer are usually more familiar than anyone else on this list with the different aspects of healthcare in our province.
Informal Knowledge: Through conversations with patients and with sending and receiving healthcare professionals, you will have the opportunity to learn about various conditions, medications and treatments. As your knowledge increases, you will become increasingly comfortable - and competent - with patients experiencing complex or serious illness.
High Demand: Without rapid, efficient, coordinated patient transfer, acute care centers would quickly become clogged. As our population ages, more of these ancillary healthcare support positions are needed to keep the system running smoothly.
(Relatively) Low Stress: Your patients will typically all be stable, and you are unlikely to be faced with a patient who is in acute danger of requiring life-saving interventions. That said, you might have patients who have recently gotten bad news, or who are quite scared, and supporting these patients can take a psychic toll.
Disadvantages
Less Familiarity with Primary Care: Because so many of their patients are stable, EMRs working patient transfer are a lot less experienced at providing emergency interventions. This can make a later move into emergency response challenging.
Less Stable with Lower Pay: Although demand is high, these positions are often not as stable as working in emergency response, and salaries tend to be lower. A typical patient transfer position starts at about $25 per hour.
Bottom Line
If you aren’t certain whether or not working a high acuity ambulance or fire position is for you, patient transfer is a great way to get some direct care experience without the high stress of emergency response. Working on patient transfer, you will quickly learn if you are interested in going further - or you might learn that this vital comfort and transport role is exactly what you have been looking for.
Summary
Although EMRs are found in many roles, these five jobs offer the best opportunities for EMRs in BC right now:
Paramedic on ambulance with the British Columbia Emergency Health Services.
Firefighter with your municipal fire department.
Ski Patrol safeguarding the slopes when the snow flies.
Occupational First Aid Attendant after having your EMR license recognized as OFA-3 equivalent.
Non-Critical Patient Transfer transporting patients within the healthcare system.
Bonus Careers - Other EMR Opportunities
Although these five EMR opportunities are among the most common, Emergency Medical Responders are found in many other roles as well, both working in a full EMR capacity, and also in roles where EMR training is considered an asset. Some of these roles include,
Event Medicine
Sports Medicine
Police
Lifeguarding
Outdoor Education
Coast Guard
One note about all of this… if you are outside British Columbia, these opportunities might look a little bit different than they are described here, or there may be additional roles for EMRs in your community. Do your homework, learn what opportunities exist in your jurisdiction, and let me know if there’s anything I’ve left out!
If you have any questions about any of these roles, or if you think EMR might be for you, please do not hesitate to email us with your questions, or book that free 15 minute career and course consult where we can answer all of your questions, and have an in depth discussion about your interests, goals, and any concerns you might have.
Stay safe, and see you out there!
Kieran Hartle (PCP-IV)
Programs Director,
Coast Wilderness Medical Training