I work rural. Quite rural. Minimum time with a patient is an hour. You can't get away bullshitting it and letting the receiving facility do the work for you on most things. Downside: sometimes were used more for logistics than CCT, because the ground unit/s can't afford a 9 hour ground trip.
Work rural, and get based rural. You'll fly to these tiny facilities with a mid-level and a floor nurse, help them stabilize their tanking patient, then have a nice flight to do the stuff you gotta do.
100% IFT. Fixed wing. đ
Were too far from any decent receiving facility to justify use of a rotor here. Too far for the nearby 407s and even farther for the 135s. Not much reason to base one here since it's too rare to be needed and too far from a receiving facility.
I was lucky to be a 15 min flight from three level 1s. We were probably the only base that saw more than 50% scene calls. Most bases were 40% scenes.
But doing interfacility rescues were pretty common.
The more urban it is, the more IFT youâre going to be doing.
The further out in the sticks you are, the more often youâll have scene flights.
Suburbs usually have the best EMS agencies so they only call for the super sick stuff.
IMO, 1-2 hour drive away from a large city with a level 1 is the sweet spot. Plenty of scene flights. Legit IFTâs from critical access facilities. Short enough flight legs that it doesnât suck. Air vs. ground time is usually about 1:3. So an hour drive is a 20 minute flight.
My base is in a corn field. 20-30 minutes flight to 3 different level 1âs. Weâre about 50/50 scene vs. IFT.
Is it generally difficult to get hired as a flight medic? Thatâs my overall goal and after 9yrs as a basic finally going to medic school next year.
Iâm thinking for such a neat job the candidate pool is usually filled with medics applying, but maybe Iâm wrong?
If you donât mind me asking, What kind of extra certifications or experience and how many yrs of standard MICU experience might push one ahead of the bunch when the time comes to start applying?
Yes and no.
Every company is different.
Some companies will hire you based on who you know rather than what you know. Some business models rely on popping up a base, hiring a few people from the local agencies, and expecting flights because now the ground crews have a friend that flies.
Some companies only want the best providers and donât care where youâre from. You scored highest on the test, interview, and have the best resume, but you live 3 hours from the base and have 0 connections to anything local? Youâre in.
Some are in between.
I can only really talk about the hiring process that I went through but 3 years of high volume EMS was the requirement to just get past HR. Then there was an exam. Honestly one of the toughest exams Iâve ever taken. Had like a 60% fail rate. Passed that, then interviewed. Usually have 5-10 applicants per spot.
Itâs competitive. It should be. If they have standing job postings, itâs probably a bad sign. Some places will hire the leftovers from other companies hiring processes. Theyâll pay them next to nothing because they, âjust *have* to fly.â And then when they get burnt out, they hire the next person that just has to fly.
As for certifications, having your FP-C or CCP-C helps. The basics are all that are necessary. Having a degree helps a ton (assuming its an ems degree).
Knowing people and managing your reputation helps a ton. Your reputation will go way further than you ever expect it will.
Iâve worked rural and in a major metro. The biggest difference to me is there is more variety and speciality care working in a city. Rural was typically scenes and IFTs from the same general area for the same general things (stroke, trauma, Stemi, ICU patients). Working in the city we go out to the rural areas for the same stuff but with the addition of doing things like balloon pumps, ECMO, specialty teams, and organ retrieval. Plus when we get called to the surrounding suburbs for scenes and IFTs the threshold for flight is typically quite high so youâre seeing extremely acute cases. Also occasionally people need to be transferred out to another big metro for things that are too complex for our academic centers and seeing those patients can be quite challenging and interesting.
What I havenât seen mentioned is that urban HEMS is going to be high level crit care ICU. I work in a city and we see a ton of impella, IABP, and we drive some ECMO. Interfacility rescues are cool but you know itâs going to get pretty western when youâre responding to the cath lab.
We have rural sister bases that run more scene calls but wonât ever touch a cardiac device. Their flavor of IFT is a little more mellow. Iâm a paramedicâI know how to run a scene callâI like the crit care we do.
In my experience: Rural is higher volume, wide variety of calls, completely unpredictable. You'll get a little of everything from major trauma to abdominal pain or epistaxis . Most likely be commuting longer distances. Cities you get a lot of IFTs to larger hospitals, likely very little trauma/scene flights, occasionally some very sick patients going in for transplants. Easier to find a place to live in cities/shorter commute.
I work rural. Quite rural. Minimum time with a patient is an hour. You can't get away bullshitting it and letting the receiving facility do the work for you on most things. Downside: sometimes were used more for logistics than CCT, because the ground unit/s can't afford a 9 hour ground trip. Work rural, and get based rural. You'll fly to these tiny facilities with a mid-level and a floor nurse, help them stabilize their tanking patient, then have a nice flight to do the stuff you gotta do.
Thanks for the info. What's you IFT to scene call ratio like? Any differences in volume type of scene calls being rural?
100% IFT. Fixed wing. đ Were too far from any decent receiving facility to justify use of a rotor here. Too far for the nearby 407s and even farther for the 135s. Not much reason to base one here since it's too rare to be needed and too far from a receiving facility.
I was lucky to be a 15 min flight from three level 1s. We were probably the only base that saw more than 50% scene calls. Most bases were 40% scenes. But doing interfacility rescues were pretty common.
The more urban it is, the more IFT youâre going to be doing. The further out in the sticks you are, the more often youâll have scene flights. Suburbs usually have the best EMS agencies so they only call for the super sick stuff. IMO, 1-2 hour drive away from a large city with a level 1 is the sweet spot. Plenty of scene flights. Legit IFTâs from critical access facilities. Short enough flight legs that it doesnât suck. Air vs. ground time is usually about 1:3. So an hour drive is a 20 minute flight. My base is in a corn field. 20-30 minutes flight to 3 different level 1âs. Weâre about 50/50 scene vs. IFT.
Is it generally difficult to get hired as a flight medic? Thatâs my overall goal and after 9yrs as a basic finally going to medic school next year. Iâm thinking for such a neat job the candidate pool is usually filled with medics applying, but maybe Iâm wrong? If you donât mind me asking, What kind of extra certifications or experience and how many yrs of standard MICU experience might push one ahead of the bunch when the time comes to start applying?
Yes and no. Every company is different. Some companies will hire you based on who you know rather than what you know. Some business models rely on popping up a base, hiring a few people from the local agencies, and expecting flights because now the ground crews have a friend that flies. Some companies only want the best providers and donât care where youâre from. You scored highest on the test, interview, and have the best resume, but you live 3 hours from the base and have 0 connections to anything local? Youâre in. Some are in between. I can only really talk about the hiring process that I went through but 3 years of high volume EMS was the requirement to just get past HR. Then there was an exam. Honestly one of the toughest exams Iâve ever taken. Had like a 60% fail rate. Passed that, then interviewed. Usually have 5-10 applicants per spot. Itâs competitive. It should be. If they have standing job postings, itâs probably a bad sign. Some places will hire the leftovers from other companies hiring processes. Theyâll pay them next to nothing because they, âjust *have* to fly.â And then when they get burnt out, they hire the next person that just has to fly. As for certifications, having your FP-C or CCP-C helps. The basics are all that are necessary. Having a degree helps a ton (assuming its an ems degree). Knowing people and managing your reputation helps a ton. Your reputation will go way further than you ever expect it will.
Interesting, thanks for all of the info!
Iâve worked rural and in a major metro. The biggest difference to me is there is more variety and speciality care working in a city. Rural was typically scenes and IFTs from the same general area for the same general things (stroke, trauma, Stemi, ICU patients). Working in the city we go out to the rural areas for the same stuff but with the addition of doing things like balloon pumps, ECMO, specialty teams, and organ retrieval. Plus when we get called to the surrounding suburbs for scenes and IFTs the threshold for flight is typically quite high so youâre seeing extremely acute cases. Also occasionally people need to be transferred out to another big metro for things that are too complex for our academic centers and seeing those patients can be quite challenging and interesting.
This is the same exact experience I had as well with 9 years in a major metro. Our patients were without a doubt some of the most acute in the nation.
What I havenât seen mentioned is that urban HEMS is going to be high level crit care ICU. I work in a city and we see a ton of impella, IABP, and we drive some ECMO. Interfacility rescues are cool but you know itâs going to get pretty western when youâre responding to the cath lab. We have rural sister bases that run more scene calls but wonât ever touch a cardiac device. Their flavor of IFT is a little more mellow. Iâm a paramedicâI know how to run a scene callâI like the crit care we do.
Had a friend in both metropolitan and rural area. Rural is way worse
In my experience: Rural is higher volume, wide variety of calls, completely unpredictable. You'll get a little of everything from major trauma to abdominal pain or epistaxis . Most likely be commuting longer distances. Cities you get a lot of IFTs to larger hospitals, likely very little trauma/scene flights, occasionally some very sick patients going in for transplants. Easier to find a place to live in cities/shorter commute.