The American Academy of Emergency Medicine Emergency Medical Services Section (EMSS-AAEM) strongly opposes the proposed changes to the current National Registry of EMTs (NREMT) accreditation requirements. The current proposal, as written, would allow state agencies to determine eligibility criteria for NREMT certification. These state agencies would not be required to follow any nationally approved standards, thereby degrading the very concept of a nationally registered provider. This concept is antithetical to the concept of being an NREMT.
In the open letter to the National EMS Community, the Chair of the National Registry Board of Directors (NRB) states that “stakeholders and State Officials have challenged the National Registry on the Committee on the Accreditation of Allied Health Education Programs (CAAHEP) and Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions (CoAEMSP) requirements, and as a result, the NRB chose to add eligibility options.” There is no clear statement as to what these concerns are, leading members to speculate as to the basis of requests from these unnamed stakeholders.
Without an understanding of who is asking for change and for what purpose, it is difficult to respond appropriately as membership is left to guess at the root concerns. The complaint may stem from concern with CAAHEP or CoAEMSP. If this is the concern, then an open discussion with these entities needs to occur. It is possible that the complaint stems from potential workforce shortage concerns. The presumption may be that new, potentially more accessible-eligibility requirements will solve the EMS and prehospital workforce concerns—they will not. The NREMT must make clear the concerns for membership to understand and address them collectively.
AAEM agrees with the NRB that there is a “…necessity and importance of quality education for all EMS Students, which is achieved through standardized approval and accreditation processes.” This is precisely what NREMT has achieved through years of blood, sweat, and tears—to accredit EMS providers through CAAHEP and CoAEMSP.
The education process of CAAHEP is rooted in practices and competencies that have been validated over many years. The current NREMT proposal throws these best practices out the window. It is not just the culminating NREMT examination but the education and assessment of that education that is key to a successful provider. The current NRB proposal discards the quality improvement processes honed by CAAHEP and CoAEMSP and puts the education of America’s prehospital providers at risk, which will erode the level of care that our community members have come to expect.
Furthermore, CAAHEP and CoAEMSP have previously affirmed the requirement of EMS physician involvement in the education of all EMS professionals. State-level politics may not recognize or may work to undermine the EMS Physician’s role in the prehospital care of patients. National standards need to continue to recognize the importance of EMS physician collaboration to ensure the adaptation of initial education to meet the complexity and changing environment of prehospital medicine, and to prevent stagnation of educational standards for prehospital clinicians.
The American Academy of Emergency Medicine Emergency Medical Services Section strongly opposes the National Registry Board plan to lower the national standards of NREMT education and recommends the NRB to reject Resolution 22-13.
Respectfully submitted on behalf of the American Academy of Emergency Medicine and the Emergency Ultrasound Services Section of the American Academy of Emergency Medicine.
Jonathan S. Jones, MD FAAEM
President, American Academy of Emergency Medicine
C. J. Winckler MD, LP
Chair, American Academy of Emergency Medicine – Emergency Medical Services Section (EMSS-AAEM)