Training & Continuing Education

The OCES –EMS Division has two phases of field training. The “Phase 1” process presents a structured program for transitioning new employees in to the EMS division. It is designed and constructed to provide both the employee and the agency with the greatest possible chance of success, by providing a framework that assures employees understand, develop, and can demonstrate the skills and behaviors that OCES considers essential. All employees go through the Phase 1 process. For EMTs this is the only process the employee needs to complete for independent release to practice. Paramedic employees move to “Phase 2” upon completion. See the chart below for what this process looks like.

The Paramedic candidate will begin the Phase 2 process after successfully completing the OCES Phase 1 process while hired directly into a paramedic position, or after entry into the FTEP process after successfully obtaining a paramedic credential from the State of North Carolina for paramedic academy participants.

After entering Phase 2 of FTEP, the paramedic candidate will be required to complete, at minimum, the following; 120 hours of Third Rider Precepting and Completion of Second Rider Competencies. 

After the candidate completes the requirements above, their FTO shall render a recommendation to the FTEP coordinator as to eligibility Phase 2 testing. Phase 2 Testing for probationary indirect precepting shall take place after an affirmative FTO recommendation. 

After successfully completing all requirements candidate will begins probationary indirect precepting for ALS patients. After 72 hours of probationary indirect precepting, the FTO shall make a recommendation to the FTEP Coordinator to remove the probationary indirect precepting designation.

Upon FTEP Coordinator approval, the probationary indirect precepting restrictions shall be removed, and the candidate shall assume the indirect precepting designation. The candidate shall be allowed to transport any ALS patient to the ED as lead provider with FTO and/or preceptor approval under the indirect precepting designation. The FTO or preceptor shall use good judgement of the paramedic candidate’s abilities to perform acceptable patient care in compliance with Orange County EMS protocols before giving approval for indirect precepting for each ALS patient.

Upon recommendation of FTO according to the criteria noted above, the candidate shall be eligible for probationary indirect precepting testing. The test shall consist of the following:

• Protocol and Pharmacology Test

• ECG Test including Rhythm and 12 Lead recognition 

• Medical Director administered Integrated Out-of-Hospital Scenario.

The FTO may extend the candidate’s training by no more than 120 hours after consultation with the FTEP coordinator without placing a cadet on a Performance Improvement Plan (PIP). Further extensions of Field Training shall include a PIP, the time of which is subject to approval by EMS administration. Failure to successfully complete any portion of testing shall result in remediation of the candidate.

Orange County Emergency Services EMS system recognizes that experienced paramedic providers do not require the same amount of training as newer personnel. These experienced paramedics often require less field training. Orange County Emergency Services EMS system shall use a different pathway for these providers to accelerate their release process into the field to resolve staffing problems while confirming their level of competency and meeting existing training requirements. Criteria to be an experienced Paramedic are:

•    Has 5 years of experience as a paramedic in North Carolina 

•    Has spent a total of 5 years in EMS system(s) with no fewer than 15,000 calls per year

Timeframe for the experienced Paramedic is:

• Phase 1/2 – 120 hours (5 24 hour shifts or 10 12 hours shifts) total

• Phase 3 – 144 hours (6 24 hour shifts or 12 12 hour shifts) 

Phase 1 and 2 are combined, with competencies and tasks for both phases being completed concordantly. Benchmarks for Phase 1/2 are as follows:

• 72 Hours – Completed required driving competencies, mileage, and transports. Schedule driver testing.

• 120 Hours – Completed Phase 2 competencies. Schedule Phase 2 Testing.

Phase 3 shall consist of 144 hours of training in the second provider role. The initial 72 hours shall be completed with the cadet leading any ALS calls that do not meet destination criteria and with approval of the preceptor. Final 72 hours shall consist of the cadet leading all calls with approval of the preceptor. 

Benchmarks are as follows:

• 72 Hours – Completed Probationary Indirect Precepting with a positive recommendation by FTO. 

• 144 Hours – Completed FTEP. Schedule mock oral boards and oral boards with the Medical Director. 

Testing

Upon recommendation of FTO, the candidate shall be eligible and complete the following testing:

Phase 1/2: • Driver Testing• Phase 1 Scenario Testing• Protocol and Pharmacology Test

• ECG Test including rhythm and 12 Lead recognition • Medical Director administered Integrated Out-of-Hospital Scenario.

Phase 3: • Mock Oral Boards• Oral Boards

The OCES Paramedic Academy is a contracted career transition pathway for Emergency Medical Technicians (EMT) employed by Orange County. This program is designed to assist current EMTs (temporary or full-time) in obtaining their Paramedic credential. The “academy” provides the opportunity for personnel to 1) maintain their employment in a permanent capacity and 2) receive a commensurate pay increase while completing the academy process.  In exchange for assisting in this career transition, the trainee would be contractually obligated for a period of two (2) years following successful completion of the OCES-EMS FTEP process and oral boards.