Today’s question again deals with issues of paramedic registration.  My correspondent says:

If I am an Ambulance Officer or a Volunteer in an Ambulance service, either private or public and meet paramedic registration requirements then why can I not call myself a paramedic by law?

Let me post this from SJA WA:

SJA Specific FAQ- As questions are asked the answers will be populated on this section for all Paramedics to review.

Q -If I am a current SAO [Student Ambulance Officer] and already hold a paramedic Science Degree am I required to be registered?

A– St John does not require a SAO who holds a degree to be registered as St John are not employing you as Paramedics nor are you calling yourself a Paramedic. However, you may be eligible for registration and may apply if you wish to. If you do not apply within two years of graduation (as a new grad) you will need to demonstrate that you have undergone a minimum number of hours of supervised practice with a Paramedic – as a St John SAO you will meet this requirement during the time you are a student prior to promotion to Paramedic.

Is this not wrong in the way in which this is put across and in fact, it reads like double standards?

I’m not exactly sure what my correspondent means by ‘wrong in the way in which this is put across’ or what are the double standards, but I do think it is problematic and by explaining why it may address my correspondent’s concerns.

Today (19 October 2018) anyone in Western Australia can call themselves a paramedic. Presumably the term ‘paramedic’ means something to St John (WA) but the meaning they give the term only applies to St John (WA).  I can call myself a paramedic in WA and whilst St John (WA) (and in fact anyone else) may not recognise that I’m a paramedic, I commit no legal wrong in using the title (provided I’m not seeking to mislead or deceive in trade or commerce).

What St John do mean by the term ‘paramedic’ is not explained on their website.  The St John (WA) website talks about the Graduate Student Ambulance Officer program for those with a paramedicine degree, the Student Ambulance Officer – Registered Nurse Pathway and the Student Ambulance Officer program where students will complete their degree from Curtin university whilst employed by St John (WA). All of these are pathways to employment as a paramedic without defining who or what is a ‘paramedic’.

The Australian Paramedical College in an undated page refers to employment with St John (WA).  This is not an official website but I will assume it’s correct for the sake of the argument.  It says to be employed as a qualified paramedic an applicant needs:

Employed with a recognised Ambulance Service within the last 12 months

Hold a Paramedic Health Science Degree or equivalent

A minimum of 2 year’s work experience and demonstrate the following experience and tenure;

  • Victoria Ambulance Service – MICA level with at least 2 years on road experience at that level
  • New South Wales Ambulance Service – Intensive Care Paramedic level with a minimum of 2 years on-road experience
  • Queensland Ambulance Service – Critical Care Paramedic level with a minimum of 2 years on-road experience
  • St John Ambulance, Northern Territory- Advanced Care Paramedic level with a minimum of 2 years on-road experience
  • All other Ambulance jurisdictions- Evidence of working within a recognised Ambulance Service for a minimum of two years within a scope of practice equivalent to that of St John Ambulance, Western Australia.

If that is correct (and as I say this is not from St John (WA) but I’ll assume it is correct) then St John (WA) would appear to define ‘paramedic’ as a person with a relevant degree and 2 years work experience at the intensive care/critical care/ advanced care level.

On 1 December 2018 all that changes.  From that date only a registered paramedic can use the title ‘paramedic’ and Paramedic will mean ‘a person registered by the Paramedicine Board as a paramedic’.

If you are employed as a student ambulance officer by St John (WA) (or anyone else) and you ‘meet paramedic registration requirements’ then you can apply for registration.  If you are registered then you are a paramedic.  If you do not apply for registration then you are not a paramedic and cannot call yourself a paramedic.   Who is, or is not, a paramedic will be determined by the Paramedicine Board not the employer.

The first part of the post that is attributed to St John (WA) is therefore correct.  It says:

Q -If I am a current SAO [Student Ambulance Officer] and already hold a paramedic Science Degree am I required to be registered?

A- St John does not require a SAO who holds a degree to be registered … However, you may be eligible for registration and may apply if you wish to.

The Health Practitioner Regulation National Law ss 86-93 provides for student registration.  If you obtain student registration (assuming that the Paramedicine Board choses to register students) then you can call yourself a ‘student paramedic’.  If you are accepted for general registration then you are a Paramedic – no matter what St John (or any other employer) wants to call you.

One path for registration is to hold an approved qualification. The list of approved qualifications can be found at https://www.ahpra.gov.au/education/approved-programs-of-study.aspx?ref=paramedicine.

People qualify for registration as a medical practitioner but that does not mean that they can then work as a neurosurgeon or set up their own practice as a GP.  New graduates are employed on different terms to members of the Colleges of Surgeons or General Practitioners but they’re still doctors.  An ambulance service may chose to employ graduates on terms that limit their practice and subject them to supervision and further career development training.  But if those students meet the requirements for registration and chose to register then they are paramedics.

I would suggest an employer like St John (WA) will have to change the names of its programs.  For example, the Graduate Student Ambulance Officer program may become the Graduate Paramedic program.  If students at Curtin register as student paramedics, the Student Ambulance Officer program may need to become the Student Paramedic Program.  These are examples of the sort of matters that will have to be addressed as the registration process settles down and people come to grips with its impact.  As noted elsewhere there will be significant industrial issues that will have to be addressed – see Paramedic registration and changing the terms of employment (February 16, 2018).

What of the statement ‘St John are not employing you as Paramedics nor are you calling yourself a Paramedic’.  That statement only makes sense if ‘paramedic’ means a person with ‘a relevant degree and 2 years work experience at the intensive care/critical care/ advanced care level’; but that is not what Paramedic will mean after 1 December.  If a person is a graduate with an approved qualification and registered, and is then employed, they are being employed as a graduate and therefore as a paramedic, even if they are not being employed as an intensive/critical/advanced care paramedic.  They may be subject to the same supervision and restriction as a person employed today as a ‘Graduate Student Ambulance Officer’ but from 1 December, if they register, they are a paramedic and that is the reason they are being employed.  They will also be able to call themselves a paramedic.

Conclusion

It is all semantics (‘the branch of linguistics and logic concerned with meaning’).  Today St John restricts the title ‘paramedic’ to ‘a person with a relevant degree and 2 years work experience’.   After 1 December 2018 the title will be restricted to ‘a person registered as a paramedic with the Paramedicine Board’.  No doubt St John (WA) will have to change the language it uses in job descriptions, employment programs etc even if those changes will have little practical difference for new graduates – other than they will be able to call themselves paramedics if they are registered.