Test Day

There are three levels of emergency medical technician (EMT); EMT Basic, EMT-Intermediate, and Paramedic. Each progressive level involves more training, more responsibility, and typically, more pay. At the end of the initial training for each level, the student has to take a two part test designed by the National Registry of EMTs.

The first part of the test is a practical, "hands-on" test in which the student must demonstrate on a real person, in front of an examiner, that they are competent at their level (there are some skills that would be not be demonstrated on a real person because it would be unpleasant; we use manikins for those).

The other part of the test is a written exam, usually administered the day after the practical exam; the student must pass the practicals to take the written exam. It is 150 questions for the EMT Basic and Intermediate and 180 for the Paramedic level.

Recently, I have begun working as an examiner in the practical examinations. This usually involves sitting at a table, watching the students demonstrate their skills, and grading them based on their performance. They have to score a 70% and not commit any of the "critical fails." Overall, it's a good way to standardize the testing to make sure that all of these potential health care providers are prepared to operate a mobile ER with no direct supervision.

The students who are going through the testing process don't share my high regard for the National Registry Exam. This exam rates up pretty high on a person's list of "most nerve-racking moments." It's right behind "#1. When my parachute didn't open at first" and right before "#3. The first time I got pulled over by the police." There is a simple reason for this- in any other field, if you studied hard, received good grades and proved yourself competent during your internship, you would be guaranteed to graduate. Not in EMS.

When I walk into the building in the morning, I pass through the classroom where the students are waiting. The tension is beyond "palpable." The students that have been cutting up in class and joking around for the entire class are dead silent. The class clown's hands are shaking. Every once and a while someone will crack a joke relating to how nervous they are (like "I wish I had brought some more Valium") and some nervous laughter will break out, but it dies down quickly as if they were in a funeral and had just joked about the deceased.

The mention of Valium only makes matters worse as they start thinking about the questions that could be on the test regarding Valium.

"What are the indications for Valium?"
"What are the contrindications for Valium?"
"What is the dose for Valium?"
"What is the PEDIATRIC dose for Valium?"

As the questions start rolling in their head the notes start coming out and the cramming starts again.

After I pass through the classroom I walk into the lobby where the other examiners are gathering. Here the atmosphere is much more relaxed (for some reason). Many of us have worked the night before so the coffee pot is drained as soon as it is filled (the coffee pot in the back of the classroom never gets touched on test day; I wonder why). After a few minutes of waiting we are all assigned to stations and we go make sure everything is set up and ready to roll.

You can tell which students really took Valium and which just joked about it (I only joked about it, by the way). The ones who really did look relaxed but have a harder time with recall; the other ones' hands are shaking and they stutter as they talk.

In October I tested a group of Paramedic students. One of them told me afterwards that I was very intimidating. She said I "stared at her face the whole time." Frankly, I thought men usually got in trouble for not doing that. Oh well.

I really do enjoy being an examiner, even when I have to fail people. It's a good experience for me and it helps to keep me sharp on skills that I don't use every day.