BYU - Idaho PARAMEDIC PROGRAM APPLICATION

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BYU - Idaho PARAMEDIC PROGRAM APPLICATION INSTRUCTIONS: 1. Complete all BYU-Idaho admission requirements and be accepted to BYU-Idaho by track deadline. Date Application for Winter/Summer 20 Summer/Fall 20 2. Complete Paramedic application and return by track deadline to: Paramedic Program BYU-Idaho, Clarke 145 M Rexburg, ID 83460-0695 1. NAME - LAST FIRST MIDDLE 2. U.S. SOC. SEC. NO. 3. MAILING ADDRESS CITY STATE ZIP CODE 4. TELEPHONE-HOME I-NUMBER EMAIL ADDRESS 5. BIRTHDAY 6. PLEASE CHECK ALL THAT APPLY Male Single Mission Female Married Area Military Divorced Fire Training Widow(er) 7. HIGH SCHOOL GRADUATION DATE 8. COLLEGE(S) ATTENDED DEGREE NO. OF CREDITS EARNED 9. EMT CERTIFICATION DATE CERTIFIED EXPIRATION DATE STATE OR NATIONAL REGISTRY 10. LEVEL OF CERTIFICATION STATE OF ISSUANCE MONTHS AMBULANCE EXPERIENCE 11. NAME OF EMPLOYER ADDRESS SUPERVISOR S NAME TELEPHONE 12. Have you ever been convicted of a felony? If answered yes, explain Yes No Please attach an unofficial transcript, a photograph and a one page personal essay discussing yourself and reasons for becoming a paramedic and a copy front and back of all EMT certifications.

BYU-Idaho PARAMEDIC PROGRAM APPLICANT REFERENCE FORM DIRECTIONS TO THE EVALUATOR: Please complete all parts of this form and mail within one week to: Paramedic Program BYU-Idaho, Clarke 145 M Rexburg, ID 83460-0695 DIRECTIONS TO THE APPLICANT: Please fill in your name, Social Security number, and mailing address. While it is not required, you may wish to execute the waiver of your right to review this evaluation. Whether you do or do not, this evaluation of you will remain confidential and will be restricted to only members of the program s Admissions Committee. RECORDS ACCESS WAIVER Unless this section is signed and dated by the candidate, the candidate has the right to review this letter of recommendation. date signature APPLICANT S NAME SSN - - Last First Middle APPLICANT S MAILING ADDRESS Number Street City State Zip Code REFERENCE INFORMATION: How many years have you known the applicant? Your relationship to the applicant is that of: Employer Supervisor Teacher Commanding Officer Co-Worker Personal Acquaintance Other Clergy Your occupation is: Physician Nurse Other Health Professional Physician s Assistant Administrator Clergy Other (Specify) EVALUATION OF APPLICANT: Please evaluate the applicant by checking after each trait, the box that most nearly represents your opinion of him/her. Compare the applicant on each item with a representative group of peers whom you have known during your professional career who have similar experience and training to the applicant. If you feel that you lack sufficient knowledge to give a definite rating of any item, give your best estimate of his/her ability on that scale and also check the box for inadequate opportunity to observe. NOTE: Even though a person may be low in some areas, you may highly recommend them. Sometimes this form will help us be aware of areas where we can help students improve. J:\John Lewis\ parappacs05.wpd

ADDITIONAL COMMENTS AND INFORMATION: Please comment further on any of the above items and give any additional information that you feel may be helpful in evaluating this applicant. What do you consider to be the candidate s major weakness: What do you consider to be the candidate s major strengths: POTENTIAL DIFFICULTIES: Are you aware of any personal family problems which may interfere with the applicant s ability to complete this training program satisfactorily? Yes No (if yes, please explain) SUMMARY RECOMMENDATION: I highly recommend this applicant for admission to the Paramedic Program. I feel that this candidate is qualified and competent for admission. I do not recommend this applicant for admission. This reference form was completed by me personally, and it is my understanding that the information provided will be used only by the BYU-Idaho Paramedic Program and will be held in confidence. Date Signature Name and Title (please print) Address Telephone Number ( ) Extension If you have questions concerning this form, you may call the Paramedic Program Director: (208) 496-1244. Mail completed form to: Paramedic Program BYU-Idaho Clark 145 M Rexburg, ID 83460-0695

PLEASE EVALUATE THE APPLICANT IN THE FOLLOWING AREAS Circle the Numbers That Describe the Applicant Best MOTIVATION/DRIVE: to become a paramedic; enthusiasm toward a health career; extent to which the individual applies self. INTELLIGENCE: learning capacity, comprehension, keenness, mental quickness. RELIABILITY: capacity to finish tasks & duties on time & of good quality. Honors commitments. Uninspired Average Self-starter: systematically a hard worker Doesn t Understand Average Learns quickly Doesn t complete, Average Always completes avoids responsibility accepts responsibility, consistent, dependable INDUSTRY: capacity to work initiative, self-reliance. decisive APPEARANCE: neatness in person & dress, maintains a standard of COOPERATION/ATTITUDE: ability to work with other persons--good manners, attitude toward life, school, job, etc. PATIENT RAPPORT: congenial, considerate, likeable, understanding, sympathetic, kind toward those with problems. ADAPTABILITY/CREATIVITY: to varying situation & persons, open-mindedness, progressive. INTERPERSONAL RELATIONSHIPS: concern for, gets along with others, sincerity, interested in peers, coworkers, teachers, employers. ORAL: communication skills, grammatical, good diction Not a self-starter Average Self-starter Untidy, poorly Average Well groomed groomed Negative attitude Average Very positive attitude Harsh, has little Average Gentle, kindness patience shown towards people with difficulties Very little Average Exceptionally adaptable and creative Inappropriate Maintains Works well with others behavior satisfactory relationship Expresses self Average Excellent expression, poorly fluent WRITTEN: communication skills, grammatical, concise, clear. Expresses self Average Excellent poorly expression, fluent

ACCEPTANCE OF PERSONAL FEEDBACK: reaction to feedback. Resents Positive, eager to know, utilizes responses effective PROBLEM SOLVING: Ability to identify & solve problems. STRESS/ANXIETY RESPONSE: deals with stressful, anxiety-producing situations. HEALTH: extent to which health or physical disability problems affect performance. INTEGRITY: extent to which the candidate displays an ethical code. Poor Solves problems easily Very poorly: ineffective, Excellent: handles comes unglued calmly & effectively Health problems interfere Health almost never frequently interferes Cheats, bluffs, untruthful, Always honest, admits blames others for mistakes errors, truthful, trustworthy J:\John Lewis\ parappacs05.wpd

BYU-IDAHO PARAMEDIC PROGRAM APPLICATION INFORMATION PACKET

Dear Applicant: Thank you for inquiring about the BYU-Idaho Paramedic Program. We appreciate your interest. This program is designed to help students attain both an Associate Degree and/or Paramedic Certification. If you are interested in becoming a paramedic, please fill out an application and submit it by th th November 12 for Winter/Summer track or March 11 for Summer/Fall track to: Paramedic Program BYU-Idaho, Clarke145 M Rexburg, ID 83460-0695 You must also apply to BYU-Idaho and must be accepted as a full-time student. If you desire to become a paramedic, but have not completed the prerequisites in general education for the Associate Degree, you will find a list of those prerequisites in the BYU-Idaho catalog. You should plan to become a student at a college or at BYU-Idaho and satisfy the prerequisites, or be in the process, before applying to the Paramedic Program. If you have any questions or need assistance in applying, please contact us. If you are interested in an exciting career in Paramedicine, please let us know. Sincerely, John Lewis Paramedic Program Director BYU-Idaho, Clarke 145 M Rexburg, ID 83460-0695 208-496-1244 Enclosures

PARAMEDIC PROGRAM BYU-Idaho The Paramedic Program is a 12-month program designed to train students in Prehospital Emergency Care as an EMT Basic and Paramedic. The Associate Degree in Paramedicine, when completed, offers the student National Registry certification as an EMT-Paramedic and a certificate of course completion. The certification program includes 2 ½ (two and a half) semesters of class work and one 48-hour internship. CANDIDATE SELECTION STANDARDS THE EMT-PARAMEDIC CANDIDATE SHALL BE: 1. At least 18 years of age 2. A high school graduate or equivalent 3. Able to speak, read, and write English 4. Be free of addiction to alcohol or drugs 5. Physically and mentally capable of performing the tasks required in emergency work as an EMT-Paramedic The candidate must have satisfied the prerequisites for entering the program or be in the process of taking the required classes. MATERIAL THAT SHOULD BE SUBMITTED TO BYU-IDAHO PARAMEDIC PROGRAM Completed Paramedic Application including: 1. An unofficial transcript 2. 3" x 4" picture of yourself 3. Essay about yourself indicating why you feel you should be admitted to the Paramedic Program 4. A copy of all EMT and CPR certifications or indication of when you will receive them. 5. Copy of transcript of college courses to include Anatomy and Physiology 6. Three letters of reference 7. COMPLETE APPLICANT REFERENCE FORM - This should be completed by someone other than a family member. 8. Letter of evidence of ambulance or fire experience if possible. J:\John Lewis\ parappacs05.wpd

PROGRAM STRUCTURE The student receives basic and advanced training in the following areas: CLINICAL Hospital clinical training is performed at Eastern Idaho Regional Medical Center, Mountain View, and Madison Memorial Hospital. Clinical training includes rotations performed on 8-12 hour shifts. Hospital Clinical includes the following: Emergency Room, Operating Room/Anesthesia, ECG, IV Therapy Team, Recovery Room/Post Anesthesia, Intensive Care Unit/Coronary Care Unit, Pediatrics and Neonatology, Obstetrics/Labor and Delivery, Psychiatric Health, and Geriatrics and Rehabilitation. AMBULANCE INTERNSHIP Internship Approved by Paramedic Committee 100 ALS calls minimum. 50 team leader experiences minimum. 480 hours PRACTICAL LABS SURGICAL LAB - Cardiac Drugs & Surgical Procedures ADVANCED LIFE SUPPORT LABS - PEDIATRIC LABS - TRAUMA LABS - ADVANCED CARDIAC LABS - CERTIFICATIONS Basic Cardiac Life Support - BCLS Advanced Cardiac Life Support - ACLS Prepare for Prehospital Trauma Life Support - PHTLS or BTLS Pediatric Advanced Life Support - PALS HAZMAT Awareness NREMT - Paramedic J:\John Lewis\ parappacs05.wpd

GENERAL EDUCATION REQUIREMENTS Communications Computation Take 1 Course: ENG 111; 111C; 111H 3 Take 1 Course: MATH 108; 108H; 110; 110H; 112****; 221 3 credits unless indicated Human Relations Take 1 Course: PSYCH 111; 111H; 201; 201H; SOC 111; 111H; 112; 112H; 357 3 Related Skills Take 1 Course: Comm 102; 150; 150H; ENG 311; 311C; 311H; 312; 312C; 312H; 316; 316C; 316H; ENGRT 125; IS140; SIGN 101 3 Religion MAJOR REQUIREMENTS 8 credits: take all 3 courses Take 7 religion credits, 4 of which must be Book of Mormon Bio 264 Human Anatomy & Physiology I 4 First part of a two semester course to prepare students for further study in the health and medical fields. Bio 265 Human Anatomy and Physiology II 4 Includes the circulatory, lymphatic, respiratory, urinary, digestive, endocrine, and reproductive systems Chem101 Introductory General Chemistry 4 An introductory course covering basic concepts in general chemistry. Para 181 EMT- Basic Emergency Medical Technician training design to qualify student to become ambulance attendants. 6 Para 241 Professional Seminar I 1 Ambulance and professional experiences. Para 242 Professional Seminar II 1 Ambulance and professional experiences. Para 250 Assessment Based Management I 1 Ambulance scenarios with assessment based management for trauma and medical patients. Para 251 Assessment Based Management II 1 Ambulance scenarios with assessment based management for trauma and medical patients - adults,pediatric, & geriatric.

Para 256 Patient Assessment 1 1 Introduction to medical and trauma assessment. Para 257 Patient Assessment 2 1 Advanced medical and trauma assessment. Para 260 Preparatory 4 Preparatory fundamentals Para 262 Pharmacology 1 Use of medications in the pre-hospital setting. Para 264 Airway I 1 Airway anatomy, physiology and management. Para 270 Special Considerations 3 Assessment and management of neonate, pediatric, geriatric, special patients, challenged patients, etc. Para 274 Trauma I 1 Presentation,discussion and testing of traumatic injuries involving pediatric, adult, and geriatric patients. Para 278 Medical Emergency 4 Pathophysiology, assessment and management of patients with medical disorders and emergencies. Para 280 Cardiology I 3 Cardiovascular Anatomy & Pathophysiology, assessment and management of patients with cardiac problems. Para 285 EMS Operations I 1 Mass Casualty Incident Command, HAZMAT Awareness, Search and Rescue Awareness. Para 287 Cardiology II 1 Pathophysiology, assessment and management of cardiac and respiratory emergencies. Para 288 Differential Diagnosis/Clinical Decision/Lab 3 Critical Evaluation and Clinical Decision Making, Assessment and Management of Emergencies. Para 291 Paramedic Hospital Clinical I 1 Hospital experience. Para 292 Paramedic Hospital Clinical II 1 Hospital experience. Para298R Paramedic Ambulance Internship 6-Jan Preceptor Internship with 911 ambulance services.

CAREER OUTLOOK The new graduate can function as a Paramedic in any state that accepts D.O.T. training and National Registry certification. Because of current Paramedic shortages in most major cities, graduates have many choices, both as to geographical location and work preference. EQUIPMENT MATERIAL TO BE PURCHASED BEFORE BEGINNING THE PARAMEDIC PROGRAM Flashlights, penlights, protective glasses, EMS uniforms, and EMS holsters are the student s responsibility. Immunizations MMR, Tetanus, Hepatitis B, and TB Test series are required prior to starting invasive procedures. This can be done at the student health center. J:\John Lewis\ parappacs05.wpd

PERMANENT FILES PARAMEDICS When you start the Paramedic program, the following material must be in your permanent file and must be complete and current. 1. College transcript 2. Drivers License 3. BLS (CPR) certificate - copy 4. Basic EMT certificate - copy 5. A current pictures of yourself - 3", 4", or 5" 6. Letters of recommendation from two doctors 7. Certification of all ambulance time--official letters on official letterhead if you have been working 8. Immunization Records J:\John Lewis\ parappacs05.wpd

PARAMEDICINE EMPLOYMENT OPPORTUNITIES Students graduating in Paramedicine and satisfactorily completing the National Registry Paramedic Exam have tremendous opportunity for immediate employment. PAY SCALES IN CITY AREAS INCLUDE: Paramedic starting salaries $30,000 per year up to $65,000 Crew Chiefs or Shift Supervisor earn $40,000 to $80,000 BENEFITS: (Benefits vary according to service but many are listed below) Paid Vacations Holiday shift pay Preceptor pay Paid CE (Continuing Education) Credit Union PPTO (Paid Personal Time Off) Medical, Dental, Vision and Life Insurance (Many health insurance plans for Paramedics pay 100%) Retirement savings plan with employer contributions Relocation allowance Uniforms are usually paid PARAMEDICINE OFFERS: Large Service Area: Paramedic positions offer a variety of call volumes and patterns as well as varied geographic and demographic work locations. Services offer varied work assignments designed with the employee in mind to provide a compatible, flexible, and enjoyable work pattern. TIME - Shifts can be 24 hours on 48 hours off; 10 hours, 4 days/week: or 13 hours, 3 days per week: or 8 hours 5 days/week. Shifts vary according to the service. MANAGEMENT POSITIONS: Paramedics often have opportunities to increase their status in the system by a change of position and pay increases according to the degree of training. Number of years in the field causes pay scales to increase by yearly increments. Associate degrees or Bachelor s degrees enhance the possibility of obtaining management positions and often bring an immediate 1% to 4% increase in pay. Some language experience often increases wages upon hiring usually around 1%.

MANAGEMENT SUPPORT: Many services have supervisors available 24 hours/day who respond to personal or professional problems and are extremely supportive of the paramedic. PLACEMENT: BYU-Idaho does not have a placement service. However, BYU-Idaho students completing their program at BYU-Idaho often move into positions as they finish their internships. Currently, 85 percent of Paramedic students who certified at BYU-Idaho were hired into Paramedic positions with major ambulance services or are continuing their education in the medical field.

EMPLOYMENT OPPORTUNITIES: Expanding opportunities are available to the student who has a paramedic degree. Some of the positions filled by paramedics include: Recruitment Officer Field Training Officer Shift Supervisor EMS Coordinator EMS Instructor Operations Manager Dispatcher Air Medicine County Preceptor Senior Medic Paramedic/RN Critical Care Transport Team State Regional EMS Coordinator ER Tech or ED Paramedic Nuclear Medicine Tech Organ Transplant Team Anesthesia Paramedic J:\John Lewis\ parappacs05.wpd