Julia KimUndergraduate: Washington University in St. Louis
Major: English Literature
Medical School: Donald and Barbara Zucker School of Medicine, Hofstra University
Anticipated Graduation Year: 2025
Bio: Julia Kim is a second-year medical student at the Zucker School of Medicine at Hofstra/Northwell. She majored in English Literature and minored in Biology at Washington University in St. Louis. After graduating in 2018, she worked as an EMT in her hometown of Oakland, CA, and gained invaluable life experience and friendships during her time on the box. In her free time, Julia enjoys working out, baking, and looking at pictures of her cat, Teddy.
What does an EMT do?
EMTs working on ambulances serve in two capacities – interfacility transport (IFT) or 911, which is the more well-known field. IFT is for non-emergent transports between healthcare facilities/home for patients who need medical monitoring en route (fluids, oxygen, special positioning, vitals management) and is usually scheduled in advance. A typical IFT patient is someone who requires transport to and from dialysis, or a patient who is being discharged from a rehab center back home. EMTs who work within the 911 system (responding to 911 calls) are split into basic life support (BLS) and advanced life support (ALS). The types of calls and degrees of call “acuity” (how life-threatening a call is, and how much medical intervention is required) depend on your ambulance’s level of support: usually, a BLS bus is staffed by two EMTs and an ALS bus has a paramedic or other advanced care provider. Typically, ALS ambulances are dispatched to higher acuity calls such as cardiac arrests and gunshot wounds (anything where a patient will require a higher level of intervention,) while BLS ambulances are dispatched to the lower acuity calls, but the assignment varies based on county protocol.
How do EMTs interact with other health professions workers?
In 911, fire and police are often dispatched with EMS and arrive on scene first, based on the timing of the dispatch/unit availability and staffing. In urban areas, firefighters often begin the initial assessment and provide life-saving interventions before EMS arrives to assume care and transport. In the emergency department, it is the EMT’s responsibility to give a complete report of the patient’s current condition (as well as the circumstances of the scene) and assist with physically transferring the patient to the hospital bed. As EMTs and the hospital staff work together closely to maintain seamless care of the patient, we learn a lot from each other.
What was it like to work as an EMT?
It is physically and emotionally challenging work, but nowhere else will you have the same privileges and responsibilities of meeting people where they are and being able to tangibly help. You never know what the day is going to look like, and you meet extraordinary people.
Your scope of practice varies depending on where you practice. For example, in my county, I was able to perform CPR, insert basic airway devices, administer epinephrine, Narcan, and aspirin, bandage/splint wounds, and provide basic physical assessments and take vitals; paramedics can start IVs, intubate, assess heart rhythms, perform 12-lead EKGs, administer antiarrhythmics and narcotics, and provide many other interventions that require more training.
How do you become an EMT?
You start by taking an EMT course – many community colleges, private companies, or even some fire departments offer certified courses. Course duration varies; some companies offer accelerated programs that run for 2 weeks (10-12 hours a day of studying and hands-on training) while other programs run for a few months. Cost also varies depending on where you are taking the course. Once you’ve completed the course and passed the in-course tests (which include a written component and a practical component), you move on to state/national registry exams. As a California EMT, I was required to take both the NREMT (National Registry of EMTs) and the CA exam – both are multiple choice and run from 70-120 questions (the test, which is administered online, will shut off at around 70 if you have scored a high enough grade and do not need additional questions to prove competence.)As a NY EMT, I was only required to take the NY exam.
The practical component of your EMT course involves conducting assessments for medical and trauma patients, demonstrating proper CPR and ventilation with a bag-valve device, inserting basic airway devices, immobilizing the spine of the trauma patient, and several other EMT-B scope techniques. In both CA and NY, passing your practical scenarios at the state/national standards in the course sufficed for the state/national requirements. I took my course at a private company; it took around 3 months and cost approximately $2k. At the time, I wasn’t aware of other options, and in retrospect there were some that would have been more affordable. However, I loved my instructor and classmates and benefited from the smaller class size. I took my course after graduating college, so most of it was review from premed classes on anatomy and physiology, and I greatly enjoyed the shift from theory to application.
Is this a paid or volunteer position?
Keep in mind that the position you take (paid versus volunteer) may affect the types of calls you get. It varies based on your county’s protocols and dispatch system, but some paid positions with private services only receive IFT calls, while others only receive 911 calls. Paid versus volunteer fire department EMT positions may vary as well. Most college-run EMS services only respond to calls on campus and shortly after arriving, the local EMS services assume care responsibilities are on the scene.
What is the time commitment?
I worked full-time in EMS through a service that was contracted with the government, so while we were established as a private company, we were dispatched through the county call center (along with fire and police) and were responsible for all 911 calls. Shift schedules vary in format (12-hour shifts, 3 on/4 off and then 4 on/3 off was most common) but mandatory overtime was almost guaranteed, as I was working in a busy county. On average, I worked 60+ hours a week, but it was not unusual for employees to be mandated on holidays/7+ days straight due to call volume. If you’re planning on working full-time in EMS, you will likely work a few more hours than anticipated, so going part-time or per diem is a great option.
How did your experience help prepare you for applying to and starting medical school?
Being an EMT was the single best thing I did to prepare for medical school. You meet thousands of patients from every background and in every stage of health, and you learn how to connect with all kinds of people. You gain hands-on understanding of the medical world in and out of the hospital, and you learn how to be patient, adaptable, and calm in crisis. During application season, my interviewers were very interested in my EMS experience, and I was able to draw on specific, applicable stories when answering their questions. Working as an EMT confirmed my love of medicine (especially emergency and critical care!) and helped me start school with excitement and grounding.
Would you suggest aspiring medical students become EMTs before applying or matriculating to medical school?
Absolutely. Practice-wise, the ratio of training required to the scope of interventions/variety of patient population is invaluable.
What advice do you have for someone interested in becoming an EMT?
Be aware that your 911 calls will rarely be the high-octane, “Night watch”-esque calls where you get to kick through windshields and race through traffic. Mostly, EMS work involves situations that are medically straightforward but scary to the caller, but these calls still deserve the same compassion and attention to detail as any other. Learn from veterans of the field who take pride in their work, and make sure to prioritize your mental health (especially after your first bad call – talk to your peer support teams/friends, take advantage of therapy resources, and give yourself plenty of time and comfort.) Working in EMS was an unforgettable and invaluable experience, and shaped who I am today.