Canada, the second largest country on the planet, expects to see continued employment growth for paramedics over the next six or seven years, especially as more and more are assigned to nontraditional roles, working in assigned locations like hospital emergency rooms instead of ambulances.
A Canadian primary care paramedic who works for Toronto EMS, the largest paramedic employer in Canada with 850 paramedics, believes that some of the growth has been the result of a new perception from the public, which now realizes that paramedics are more than “ambulance drivers offering blankets and oxygen.”
Paramedic Training in Canada
Paramedics in Canada are certified as either a primary care paramedic (PCP), a critical care paramedic (CCP), or the advanced care paramedic (ACP). In order to become a paramedic, the applicant needs to successfully complete a course of training which can vary in different provinces.
The Alberta College of Paramedics is the regulatory body for paramedics in Alberta, which sets the province’s standards for program approval. Graduates from approved programs are eligible to take the Provincial Registration Examination in order to apply for registration with the College.
It’s necessary to know the requirements for certification in the paramedic field. Ontario requires certification in standard first aid for anyone who wishes to work as a PCP or primary care paramedic. This first aid certification, which takes 75-80 hours and is conducted by the Red Cross, is a prerequisite for most of the paramedic training programs.
Community colleges offer paramedic certification and diplomas in paramedic training. In order to qualify for admission, the student must be a high school graduate with at least a C average in English, mathematics, biology, and chemistry. Medicine Hat College and the University of Toronto offer undergraduate degrees in paramedicine. In order to be admitted, students must have a diploma in paramedic training.
However, even before beginning the training program to become a paramedic, the student must have all required immunizations, have a class “F” driver’s license, demonstrate a high level of both mental and physical fitness, complete a CPR course, and attend a mask fit testing.
The police background check must return a clean history, as well. The person who wants to become a paramedic must also demonstrate the ability to interact with patients, hospital personnel, and others who will be first responders in a crisis situation.
Levels of Paramedics in Canada
- Primary Care Paramedic
The PCP is at the entry level of the paramedic profession, with duties that include providing basic medical care, the administration of oxygen, administering IV, cardiac monitoring, semi-automated external defibrillation, administering medications such as aspirin, epinephrine, nitroglycerine and more for emergency conditions, as well as performing trauma immobilization. If the PCP receives additional training, he or she is authorized to provide medical care on the level of the Advanced Care Paramedic, or ACP.
In order to become a PCP, the prospective paramedic must take the two-year Primary Care Paramedic Program of training and pass the provincial PCP exam, after which the successful graduate can obtain employment at an ambulance company or a medical institution, first obtaining the approval of the local medical director.
In Ontario, a student can sign up for the Emergency Medical Care Assistant exam after completing the college paramedic exam. If the student fails the exam, it can be retaken two more times. If the student fails all three times, he or she must complete remedial training before taking the test again.
- Advanced Care Paramedic
Although jurisdictions and provinces such as New Brunswick and Quebec don’t have ACPs, Advance Care Paramedics are greatly in demand in Canada’s health professions. ACPs are qualified to carry 20 different medications, although those medications may differ significantly from region to region. ACPs are also trained to perform intubation, intravenous therapy, place external jugular IV lines, perform needle thoracotomy, obstetrical assessment, and administer pain relief. An innovation in Canada that has had a profound effect on patient survival rates allows ACPS discretionary direct 24-hour access to PCI labs, bypassing the hospital emergency departments.
Before becoming an ACP, the paramedic must work as a PCP between 6-24 months. The applicant needs to complete the 1200-hour ACP training program, passing all required exams and certification programs as required by the particular Canadian province in which the paramedic is employed.
- Critical Care Paramedics
CCPs have prior experience working with ambulances and responding to 911 emergency calls. A CCPs expertise is focused on the critical and intensive care unit level care, stabilizing and transporting patients in hospitals with limited resources to programs that can provide a higher, and in many cases, life-saving, level of care. A CCP provides care that would otherwise be administered by a physician or nurse. In addition to providing the care levels that are administered by PCPS and ACPs, the CCP is trained to administer medication infusion pumps, mechanical ventilation, and monitor arterial lines.
In order to rise to the highest paramedic level, the CCP program, which takes a year to complete, the applicant must have worked for one year as an ACP, be certified in basic trauma life support and advanced cardiac life support, and have aeromedical certification.
The Paramedic Salary in Canada
Paramedic wages for Canadians depend on their level of experience as well as the province in which they work.
For paramedics in Ottawa, the salary ranges from $70,000-$90,000 a year for a PCP; $90,000-$100,000 annually for an ACP, and $100,000-$155,000 for CCPs.
Paramedics working in Alberta are often employees of the Alberta Health Services EMS and are unionized, with a starting salary of $70,000. Paramedics working in the oilfields, where a lot of paramedics are employed, have a daily wage of around $650. Saskatchewan, with its rural areas, has a great demand for more paramedics, so employment opportunities are expected to increase there.
Paramedic salaries, although they vary according to education and region, don’t match the salaries of firefighters and police officers. This is regarded as unfair by members of the paramedic profession, who feel that they save lives on the same scale as fire fighters and police officers,
Paramedics in some areas of Canada are also trained as firefighters or police officers. In 2005, paramedics were given the status of Public Safety Occupation, which made them eligible for early retirements as are their fellow police officers and firefighters.
The work shift of a paramedic in Canada isn’t a typical eight hour day; 10-14 hour shifts are not uncommon, and even 24 and 96 hour shifts are often part of the work load. But the work, the responsibility and the hours take their toll, putting paramedics at an increased risk of developing post traumatic stress disorder. Despite this challenging reality, job satisfaction in the field is high and paramedics feel that the intangible benefits of their work are what make the difference.
Paramedics and the Canadian Provinces
Canada, which is made up of ten provinces and three territories, does not have a uniform system of certifying its paramedics. The National Occupational Competency Profile (NOCP) marks particular skills, knowledge, and abilities as synonymous with a given level of paramedic practice, but each province retains its sovereignty in legislating emergency services that are represented within its boundaries.
However, most of the provinces are moving toward recognizing the NOCP delineation of the profession. This will help to allow paramedics from different provinces to work in other provinces, regardless of the titles.
How to Become a Paramedic in Ontario
A person who wishes to become a paramedic in the province of Ontario must be qualified as an Advanced Emergency Medical Care Assistant (AEMCA) or have training and qualifications that are the AEMCA equivalent as determined by the director of the Emergency Health Services Branch.
The Ontario Paramedic Equivalency Process offers the opportunity for paramedics who are not graduates of the Ontario College Paramedic Program to present their qualifications in order to determine if they are eligible to challenge the AEMCA Theory Examination. The equivalency process phases include the validation of the applicant’s educational and work experience, and qualifying evaluations.
You can also read our article on paramedic programs in Ontario for more specific information.
The following colleges offer paramedic training that meets the requirements for certification:
- Algonquin College
- Cambrian College
- Centennial College
- Confederation College
- Durham College
- Fanshawe College
- Humber College
- Loyalist College
- Niagara College
- St. Clair College
United States paramedics who wish to work in Canada need to know that requirements vary in the different Canadian provinces. Therefore, there’s no single process for a U.S. paramedic to qualify in the country. However, a paramedic has the option of applying for equivalency with the Ministry of Health of Long Term Care (MOHLTC).
How to Become a Paramedic in Toronto
Potential paramedics in Toronto need to meet specific standards, including:
- Be able to read, write and speak English fluently
- Not have received, during the year immediately prior to employment as a paramedic, four or more demerit points recorded on his or her record by the Registrar of Motor Vehicles
- Maintain a valid driver’s license
- Not have been prohibited under the Criminal Code (Canada) from driving a motor vehicle in Canada
- Be licensed to drive an ambulance
- Have no communicable diseases
- Hold proof of current immunizations
- Not have been convicted of any crime involving moral turpitude for which the person has not been pardoned.
- At the time he or she commences employment and every 12 months thereafter, be certified in cardiopulmonary resuscitation
- Be a graduate of a Paramedic Program from an approved community college or private college in Ontario.
Paramedic Association of Canada
The Paramedic Association of Canada, originally founded in 1988 as the Canadian Society of Ambulance Personnel, is the representative voice of Canadian paramedicine. It has a membership of over 14,000 paramedicine practitioners across the country. The mission of PAC is to provide quality care for the public through leadership in the advancement of the paramedic profession.
Paramedicine continues to advance in Canada. In January, 2014, Ontario’s Ministry of Health announced that Ontario would invest $6 million for community paramedicine programs. The Paramedic Association of Canada voiced approval of this expansion of programming designed to improve access to home care and community support services for the elderly, as well as for patients suffering from chronic conditions.