raduate Degrees: Are They Worth It for EMS?

      In the May issue, we looked at the importance of four-year college degrees for EMS professionals. This article examines the next step--advanced degrees--for those looking to move up in the EMS world.

   There's a lot to consider when trying to figure out if pursuing a graduate degree is the right path for you.

   That's especially true for those in EMS. Many of us wonder about the value of graduate education, and the impact it can have on our careers. Some typical questions are: What types of graduate degrees are out there? What will a graduate degree help me achieve? Will it help advance my career? What will it teach me? Do I really need a graduate-level degree to succeed as a supervisor, manager or executive in the diverse world of EMS?

   Our industry is undergoing some profound changes right now. The first generation of EMS executives is starting to retire. These are the folks to whom we sometimes point and say, "They did it without degrees--why can't I?" There are two answers to this question.

   The first is that the original generation of EMS leaders was inventing modern EMS as they went along, and many grew up within organizations and systems that could have done better with some science and academics in the mix. The second is that many of the early leaders in fact had academic credentials to support their accomplishments--Jim Page, Jay Fitch, David Boyd, John Chew, Bill Brown, Walt Stoy, Gregg Margolis and Baxter Larmon come to mind, all with at least master's degrees, and several with doctorates.

   EMS is now competing for scarce resources in a challenging environment--one where those who allocate resources demand proof that money spent will result in an appropriate return. Proof of value requires research, analysis and advocacy--skills learned only in the higher-education environment. If our industry is to effectively meet the challenges of the future, it will need leaders who can work effectively in environments where their "competitors"--city, county and state department heads, program directors, and other managers--possess graduate academic credentials as a matter of course.

   A graduate degree attests not only to knowledge of a specific subject matter, but also to one's commitment, tenacity and dedication. It suggests that no matter what the degree is in, the holder has the ability to do research, think critically, write persuasively and understand and advocate for complex concepts and processes.

   The EMS community has a tremendous need for leaders. One does not become a leader just through education, but having core abilities like these will help an aspiring leader be more professionally effective, smoothing the leadership development path.

   Besides leaders, though, EMS needs educated specialists to establish a body of knowledge for our profession. We have a wealth of clinical research, contributed mostly by our physician colleagues. But outside the medical realm, we have a dearth of knowledge about our business. In many cases, important decisions are based on things like anecdotal information, personal opinion, charisma and rhetorical skill. Sit and chat for a few minutes, and you can probably come up with a whole menu of topics that cry out for good research. What deployment model is most effective at delivering response performance? Do dynamic deployment and streetcorner posting improve it? What is the impact of that model on our line personnel? Does the size of the ambulance influence the delivery of patient care? What about the health and safety of personnel? A graduate degree will help equip you to answer these questions and more.

DEGREES TO CONSIDER

   Before you say, "That's not for me!" consider the many degree options available.

• Master of Public Health (MPH) is often seen as a health-specific MBA, but that's not the case. This degree is designed to educate the graduate student in the five core public health disciplines: health services administration/management, biostatistics, epidemiology, behavioral sciences/health education, and occupational/environmental health sciences. In recent years, some schools have developed programs in the emerging field of public health preparedness.
• Master of Business Administration (MBA) typically exposes students to a variety of subjects, including economics, organizational behavior, marketing, accounting, finance, strategy, operations management, international business, information technology management, supply chain management, project management, government policy and ethics. Students traditionally study a wide range of courses in the program's first year, then pursue a specialized curriculum in the second. This degree is recognized internationally and is good to have if you'll be involved in any facet of EMS systems operation, planning or finance.
• Master of Public Administration (MPA) is well recognized in public safety and government circles, and generally focuses on public policy and/or governmental issues. Its core curriculum usually includes microeconomics, public finance, research methods/statistics, policy process and analysis, ethics, public management, leadership and program evaluation/performance measurement. The MPA is considered the basic credential for many city and county department head and executive positions, so it should not be overlooked for those considering advancement in the public sector.
• Master of Science (MS) is generally seen as a generic degree, and what it covers varies quite a bit depending on your area of concentration. You can get MS degrees in finance, public health, mathematics, etc. There are often "non-thesis" options for degrees that involve pure coursework, as well as those that include theses or capstone research projects. The purpose of the thesis is to research a specific topic using appropriate techniques, adding to a discipline's overall body of knowledge.
• Master of Education (MEd) is a fairly specific degree with education and learning as its target. The curriculum covers cognition, functional knowledge and foundations of education. This degree should prepare the holder for teaching future educators as well as for leadership and management positions in EMS education.

   All master's degrees, depending on the coursework selected, will allow candidates to learn about personnel issues, problem solving, overall organizational structure and management, financial practice, decision-making and other general administrative issues. Under normal circumstances and with full-time study, most take two years to complete. On a part-time basis, it can be significantly more.

DOCTORATES

   Although a master's degree may be all you deem necessary to further your career, there are several doctoral-level degrees that should be examined as well.

   Doctoral degrees fall into two categories. The first is the terminal professional degree. These include the MD (medicine), JD (law), PsyD (psychology) and DDiv (divinity). These degrees are the basic or entry-level academic credentials for their professions. The second category involves terminal degrees at the highest level of fields of academic study. The PhD is the most common of these, followed by the DSc (Doctor of Science) and several others. Terminal academic degrees are intended for those interested in research and teaching, and involve substantial and rigorous research projects culminating in the publishing of dissertations. This process is intended to continuously build the body of knowledge in a particular discipline through an ongoing research process. Some of the more applicable doctoral degrees for EMS professionals include:

•    Doctor of Philosophy (PhD) is an advanced academic degree awarded by universities. In much of the English-speaking world, it has become the highest degree one can earn and applies to graduates in a wide array of disciplines in the sciences and humanities. In many fields the PhD has become a requirement for a career as a university professor or researcher. In addition, many PhD graduates go on to careers in government, nongovernmental organizations, social service agencies or the private sector.

     The requirements for PhDs vary throughout the world, but there are a number of common factors. Candidates must submit a thesis or dissertation consisting of a suitable body of original academic research that is in principle worthy of publication in a peer-refereed context. In many countries candidates must defend their work before panels of expert examiners appointed by their universities; in other countries, dissertations are examined by panels of experts who stipulate whether they are passable or what issues must be addressed before they can be passed. There is usually a prescribed minimum period of study--typically 2–3 years full time--before the thesis is submitted. This requirement may be waived for academic staff submitting portfolios of peer-reviewed published work. PhD candidates may also be required to successfully complete a certain number of additional, advanced courses relevant to their areas of specialization.

• Doctor of Public Health (DrPH) is an advanced professional degree for those who intend to pursue or advance careers in public health. They face the particular challenge of understanding and adapting scientific knowledge to achieve gains in people's health. This degree leads to careers in high-level administration, teaching or practice, where advanced analytical and conceptual abilities are required. The DrPH program develops all competencies included in Master of Public Health programs, with increased emphasis on areas like problem solving and the application of public health concepts. The MPH is usually an entry requirement for this program.
• A terminal degree traditionally granted by universities' colleges of education, the Doctor of Education (EdD or DEd) prepares students for academic, administrative, clinical or specialized positions in education. A typical U.S. EdD usually requires several years of coursework as a doctoral student, a comprehensive exam and, at its conclusion, a dissertation. The dissertation, which presents the candidate's research and findings, is submitted to a dissertation committee. Specializations within the EdD can include curriculum and instruction/teaching, education policy, higher education, educational administration, educational leadership, and language/linguistics. The EdD is recognized for university appointment and may be accepted as training for administration positions in education (principal, superintendent, etc.).

CONCLUSION

   Attaining a graduate degree doesn't simply demonstrate intelligence; it proves your ability to identify and accomplish a long-term, difficult goal. It also shows you have initiative, dedication to your personal success and the ability to overcome obstacles.

   Look at the EMS classified ads, and you'll see that most supervisory/management positions say things like "Bachelor's required, master's preferred." Employers, as a rule, value degrees and education.

   Complex operational methodologies, changing reimbursement regulations and significant compliance issues are all part of day-to-day operations for EMS managers. With that comes a great deal of interaction with other healthcare professionals, emergency services and management personnel, hospital administrators, even insurance company representatives. The EMS profession is moving in the direction of highly educated, informed management. The days of the management-level opening going to the person with most seniority are coming to a close. Experience is no longer enough. True professionals attain upward mobility through a combination of education and experience.

   Make no mistake, enrolling in a graduate-level course of study shouldn't be a decision made lightly. It entails a lot of work, and it won't be easy. It is also important to know that graduate-level education is considerably more costly than undergraduate education. However, the results are well worth the effort. Education is portable and gives you flexibility you may not otherwise have when it comes to changing jobs, locations or careers.

   This leads us back to one of our original questions: Is a graduate-level degree necessary for success as an EMS manager? Although you have to answer that question yourself, here are a few things we believe: It doesn't necessarily matter what your degree is in, but that you've taken the journey to achieve it. No matter what you're learning, when you're a student of life, you're open to ideas, practicing creative problem solving, interacting with people who have different experiences and beliefs, and taking risks. That is what is important about education--it gives you tools and ideas to change the world.

Graduate Degrees for Aspiring EMS Managers

   Several academic institutions offer graduate-level degrees specific to management of EMS organizations and systems. As a rule, these types of programs are targeted at experienced EMS clinicians who aspire to management or teaching positions. If you're planning to spend your career in EMS, it may be worthwhile to contact one of these institutions. The majority of academic institutions have distance-learning programs that may fit your schedule.

   One good example of the variety of programs available comes from the University of Maryland, Baltimore County (http://ehs.umbc.edu), which offers three alternatives for graduate students: administration, planning and policy; preventive medicine and epidemiology; and education.

   George Washington University graduate education offers a master's program in Emergency Services Management geared toward preparing students for leadership positions, particularly in EMS (www.gwumc.edu/healthsci/programs/ems_ms). And a recent addition to the degree menu is the Master of Arts degree offered by the Naval Postgraduate School's Center for Homeland Security and Defense (www.chds.us/?masters/overview). This degree is for individuals whose careers are focused on homeland security, public safety and national defense; recent graduates have included an FDNY battalion chief, several high-ranking police officials, military and public health service officers, etc. This degree, valued at $45,000 or more, is offered free of charge.

   Raphael M. Barishansky, MPH, is program chief of public health emergency preparedness for the Prince George's County (MD) Health Department and a member of EMS Magazine's editorial advisory board. Contact him at rbarishansky@gmail.com.

   Skip Kirkwood, MS, JD, EMT-P, EFO, CMO, is chief of Wake County EMS in North Carolina and a member of EMS Magazine's editorial advisory board. Contact him at skip.kirkwood@wakegov.com.