Medic Courses - A word of warning
Many of our First Responder candidates, especially those from the Security industry, will ask "What course can I do to become a Medic?"
There a myriad of exotic sounding courses which purpose to take the candidate from First Aider to Medic for remote and hostile environments...in just 5 days.
ATOM • Clinical Trauma Responder • COBRA • Combat Medic • D13 Medic • EMT • H/HEMS • Immediate Emergency Care • Long Range Reconnaissance Patrol Medic • Medical Assistance in Challenging Environments • MIRA • Pre Hospital Emergency Care Course • Pre-Hospital Emergency Care Practitioner • Pre Hospital Emergency Care Practitioner • Pre-Hospital EMT • Protective Team Medic • REMIT • Remote Emergency Medics Course • Remote & Hostile Medicine • Serpent • Security & Law Enforcement Emergency • Specialist Training for Overseas & Remote Medics • SPECTRE • Tactical & Close Protection Critical Care Training • Tactical Medicine • Tactical Team Medic • Tier 1 Medic Course • Trauma and Environmental Emergencies in Remote Areas • VIPER
What do these courses mean?
What is a 'Medic'?
Historically the term Medic has been shorthand for a practitioner of Medicine; i.e. a Doctor, Physician, Medical Student. In the UK the term Medic is specifically used to differentiate a Doctor who has followed a career in medicine accredited recognised by the Royal College of Physicians, as opposed to a career in surgery.
The term has been popularised through military recognition of Combat Medical Technicians or Corpsmen. Think of any war movie and you will hear someone scream "Get me a Medic!".
So does a short course from a commercial Training Provider make you a Medic? Of course not. But this term is seen in a staggering array of exciting course names.
This vast choice does not help the customer choose an appropriate or credible course.
This article will help you choose a credible course provider in the first instance but when it comes to "Medic" courses, you need to look a little deeper and understand what you will walk away with.
FPOS plus Extended Skills
Approximately half of the available Medic courses available in the UK describe the course as FPOS / FREC plus 'extended' or 'additional' skills. You will leave with the original certificate, accredited by Awarding Organisation, as well as an In-House certificate to cover the extra skills.
These skills might include IV or IO infusion, Needle Decompression or even Intubation and Chest Drains. Registered Healthcare Professionals as well as many Training Providers share the concern that these skills are simply not appropriate to be delivered to lay-people and in such a short time.
A Paramedic will typically need to successfully intubate 25 times on live casualties in an observed clinical setting before they are 'signed off' to apply this skill. You may practice this once or twice on a mannequin.
The reason that it takes so long for a skilled practitioner to become qualified in these advanced skills is not because they are necessarily difficult but because of the consequences of them going wrong.
A Paramedic will be operating under their professional registration with the Health and Care Professions Council, in the same way that Nurses are governed by the Nursing and Midwifery Council and Doctors by the General Medical Council. The professional memberships provide them with, among other things, liability protection. Who will protect your actions? Certainly not the Training Provider.
Are you 'qualified' to use these skills?
No.
Will you be employed on the strength of these skills?
No.
If something goes wrong, will you be liable?
Yes
Approved by the Royal College of Surgeons
Another claim made by many Medic courses is that the course is Approved by the Royal College of Surgeons (RCS). Sounds impressive.
Any Training Provider can have their course Approved by the RCS as long as the basic elements of the course are concurrent with Manual of Core Material, written by the RCS's Faculty of Pre-Hopsital Care (FPHC).
This Manual is the RCS's guidelines for Basic Life Support and the management of injuries and illness in the pre-hospital setting. The Manual of Core Material is the guidelines on which the FPOS syllabus is based.
The RCS only approve a course on the elements of the course which match the guidelines. The RCS do not approve the extended skills such as IV therapy or surgical airways and they certainly do not 'qualify' the successful candidate.
If the only recognition the Medic course offers is RCS Approval, you leave the course with a certificate which does not qualify you to use these skills.
What about MIRA? - Medicine in Remote Areas
MIRA is one of the most popular courses for those who have completed an FPOS-I and are looking to develop their skills. But not all MIRA courses are the same...
In 2004 Exmed (now owned and trading as Iqarus) created the MIRA course which originally catered to a very niche market of Expedition Leaders, members of the Press and Aid Agency workers who operate in remote areas.
Following the invasion of Iraq and the subsequent rebuilding program under the US Department of Defense, there was an unprecedented growth in Private Security firms who were employed to provide protection to DoD and civilian engineers.
Given the limited range of advanced First Aid courses commercially available at the time, MIRA was adopted by several UK Private Security firms as an advanced First Aid course which was appropriate to the nature of this environment; a high incidence of serious injury, far from help. And Exmed enjoyed the commercial growth of their qualification.
Unfortunately, the term Medicine in Remote Areas cannot be protected by Copyright or Trademark as it is a 'generic term' and in the last couple of years several enterprising Training Providers have, quite legitimately, created their own MIRA courses. Not developed over the last 8 years through close liaison with employers and practitioners but quickly put together in the interest of commercial gain. Not all MIRA courses are the same.
Iqarus' MIRA is a relatively expensive course, delivered over 5 days. A few minutes of on-line searching will find 'MIRA' courses for significantly less and delivered in 3 days. Result!
If a MIRA qualification is on a job specification under the 'desirable' section, and you have a MIRA qualification the HR manager may very well tick that box, oblivious to the fact that you may have the qualification but do not have the skills or knowledge that they desire.
Real First Aid Ltd has no commercial interest in Iqaurs, we certainly are not paid to endorse them, essentially they are a competitor but in the interest of objectivity and recognising credible alternatives we are happy to recommend the Iqarus MIRA course for those who require it as it is a well regarded, recognised course taught by experienced Paramedic trainers who share our ethics of training.
The Rationale
The argument for extended skills makes complete sense; in remote environments where there is a prolonged time to definitive care, there is a need to provide the casualty with advanced medical skills to compensate for the delay in reaching definitive care.
If you have completed a short course which has included these a few weeks, months or years ago and practiced these skills once or twice on a mannequin, are you the person to provide these skills?
The tragic reality is that due to the nature of their injuries some casualties will die, despite the best care available to them and regardless of when it is administered.
A worse reality would be that someone died because of the care they received; the wrong care from the wrong person. If you are providing the care, you are responsible. It is that simple. Having attended a course and armed with a well stocked medic bag there may well be a temptation to apply skills you are neither confident or competent in, whether it is warranted or not.
The Rare Exception
Some Private Security workers, NGO employees and a very small number of expedition leaders are able to operate at an advanced level but within very strict limitations:
Group Protocols
Some organisations will have Group Protocols written by their Medical Director - usually a Doctor - which will state that in a particular situation, a named person (or persons) can administer a specific treatment, which would ordinarily be beyond their remit of 'first aider'. Examples include the administration of IV/IO fluids, certain interventions such as needle decompression or the administration of a limited range of drugs.
The Group Protocols are strictly bound to the situation and the contract of employment. A person will not be able to apply these skills when they are not working for that company (including when on leave) or when they are back in their home country.
Tele-Medicine
In emergency situations, a person may be in a position to administer certain treatments under the online instructions of a Doctor.
In both of these situations a Healthcare Professional accepts responsibilities for the vicarious treatment of a casualty by another person, which grants that person some degree of immunity (as long as their treatments was within the guidelines or as instructed and their skills were current).
Tier 1 and 2 Medics
Within the Oil & Gas and Private Security industries there is often a differentiation between Tier 1 and Tier 2 medics.
Tier 1 Medic: A First Aider, regardless of what Medic courses you have completed. In the Oil &Gas industry courses such as FPOS and other Medic courses are sometimes referred to as Level 2 Healthcare Providers or Advanced First Aiders, to differentiate the extra skills from First Aid at Work. It is still all First Aid.
Tier 2 Medic: A Combat Medical Technician 1, Paramedic or Nurse. That is it. There is no Tier 2 Medic course.
Offshore Medic: This is sometimes considered Tier 3 by some companies. The HSE Offshore Medic course is an immersive, 4 week program which is only available CMT 1's Paramedics, Nurses etc; the course does not train one to become an offshore medic, it prepares medics for working offshore. The course expects you to arrive already with the clinical skills and abilities.
There have been a number of cases recently when unscrupulous Training Providers have taken on - and passed - individuals who do not meet the entry criteria. These people, who are now short of £2,500 course costs will never be employed as an Offshore Medic, despite having a piece of paper.
So is there any point in attending a Medic course?
For some people there is a clear benefit from gaining further skills and knowledge.
Necessity
If you are traveling or working further afield, there is benefit to developing your skills and abilities to help you provide the best possible care within your skillset to compensate for the delay in reaching definitive care. In this case look for a credible training provider who can help you develop basic skills and apply them to the environment you will be working in and with the equipment you will have available.
Do not be tempted by advanced interventions but by the ability to do the basics well, in challenging conditions.
Employment
In some cases MIRA or ATOM are cited as desirable or essential for certain Private Security contract. If that is the case, do you MIRA training at Iqarus and your ATOM course at G4S. It is as simple as that. If the employer is looking for a Medic, they will employ a Paramedic or above.
Continuous Professional Development
If part of your work involves the role of a First Aider, there is always merit in developing skills and knowledge and remaining current. Read more about CPD here.
Summary
Whether you choose Real First Aid or any of our competitors, makes sure you do some basic research, understand what you are paying for and what you can realistically benefit from the course.