Paramedic Program 2021 Application

Portland Community College

Emergency Services Department

Emergency Services Department Mission Statement

To train and educate Emergency Services professionals to excel in meeting the needs of the community.

PCC Cascade Campus

EMS Department - PSEB 133 909 N. Killingsworth St.

Portland, OR 97217 (971) 722-5570

Fax: (971) 722-5535

The Portland Community College Paramedic Program is accredited by the Commission on Accreditation of Allied Health Education Programs

(www.caahep.org) upon the recommendation of the Committee on Accreditation of Educational Programs for the Emergency Medical

Services Professions (CoAEMSP). Program #600374 Commission on Accreditation of Allied Health Education Programs

1361 Park Street Clearwater, FL 33756

727-210-2350 www.caahep.org rev. 7/20

The Portland Community College (PCC) Paramedic Program is designed as the last step in the formal education for entry level Paramedics. Successful completion of the Paramedic Program year will lead to the AAS degree in Paramedicine.

Functional Job Analysis Paramedic Characteristics

A paramedic must be a confident leader who will accept the challenge and high degree of responsibility entailed in the position. Excellent judgment along with the ability to prioritize decisions quickly, be self-disciplined, able to develop patient rapport, interview hostile patients, and communicate with diverse multi-cultural groups and ages is required. Must be able to function independently at optimum level under stress, remain calm, and assume leadership roles with confidence. A desire to work with people and the ability to meet the physical, intellectual and cognitive requirements demanded by the position are critical. Physical Demands

A paramedic’s job involves very heavy lifting (50 – 180 pounds or more) frequently and involves climbing, balancing, stooping, kneeling, crouching, crawling, reaching, handling, feeling, talking, hearing and seeing on a frequent basis in less than optimal conditions. Intellectual Demands

High school graduate/equivalent. Learning ability and intelligence slightly above average is required for a paramedic to acquire the skills and knowledge necessary to do the job.

Portland Community College Paramedic Program Information The PCC Paramedic Program is limited to 24 students; alternates may be selected. The selection process is competitive; therefore, all materials submitted must be complete and accurate. Entry consideration will be given to those with EMS field experience. This includes military, agency affiliated search & rescue, ski patrol, volunteer or paid EMS and/or Fire work experience, in a hospital or community clinical environment. All applications will be reviewed. Mandatory Pre-Paramedic Course. Enrollment in EMS 238 Fall 2020 is required of students accepted into the 2021 paramedic cohort. There are 3 Face-to-Face labs November 17-19, 2020 in addition to an online portion. EMS students must pass both a criminal background check and drug screen before participating in mandatory clinical experiences. Criteria for passing these are determined by the clinical site(s). The associated costs of all background checks, drug screens and reviews are the responsibility of each student. Failure to pass any of the required criteria will constitute unsuccessful completion of the EMS course(s). Failure of the course(s) or criminal background check(s) or drug screen(s) will not be grounds for tuition or fee refund. If you feel you need to get more information prior to being accepted into the program regarding your background contact Mark Hornshuh, at 971-722-5570 PCC does not provide medical liability coverage. If you are injured and incur medical expenses, you are responsible for those expenses. First day of class attendance is mandatory. Check a current PCC schedule for class times and days each term. Any Student not present during the first class meeting, on time, will be considered a “No Show” and will be disenrolled from the program. Please contact the course instructor if you have any questions regarding this policy.

For financial aid information at PCC, visit our website: http://www.pcc.edu/resources/tuition-fees/payment-info/financial-arrange.html. The Paramedic Program Applications will be available in June for the following Program year, which begins in January. The Following provides information on requirements for and prerequisites to acceptance into the Paramedic Program. TO APPLY:

Preferential evaluation is awarded to applications which are organized and complete. Incomplete applications may be rejected.

§ Applications accepted JULY 21, 2020 thru SEPTEMBER 30, 2020

§ Submit complete PCC Paramedic Program application packet (see listing below):

EMS email: ems@pcc.edu Mailing address: PCC Cascade Campus, EMS Dept – PSEB 133 PO Box 19000, Portland OR 97280-0990 Physical address: 909 N Killingsworth St, Portland OR, 97217 Public Services Education Building (PSEB) - Room 133

If you want an application review at the time you bring in the application, please schedule a review appointment: 971-722-5570

REQUIRED VERIFICATIONS AND SUBMISSIONS (to be included in your competed application packet):

� Copy of current Oregon EMT, AEMT, EMT-Intermediate license; (out-of-state students should allow at

least 12 weeks for licensure when applying for reciprocity with the Oregon Health Authority, EMS & Trauma Systems Office.)

� Copy of current American Heart Association BLS Healthcare Provider certification

� Copy of High School diploma (or unofficial transcript) / GED or College Degree

� Official College transcripts submitted in sealed envelopes with the school’s official stamp or seal.

PCC transcripts may be unofficial copies. If you have already submitted other school official transcripts to PCC Student Records and there has been no additional coursework at that school, an unofficial transcript copy will be acceptable and must be included as part of your completed application. Missing transcript copies will constitute an incomplete/rejected application.

� Completed Paramedic Program Prerequisite Review Form (included in the application packet.)

� ‘Personal Statement’. This statement gives you an opportunity to indicate your unique qualities and

professional goals as a Paramedic. This statement need be no longer than one page. Application process includes consideration of: medical experience, military service, grades, previous degrees earned, written exam, skills simulation, completeness of application, etc.

Paramedic Application Following 9 Pages.

PORTLAND COMMUNITY COLLEGE

Note: All information on the application must be typed or printed legibly.

NAME: Last First Mi

Date of Application: PCC G#: (must be admitted as a student to PCC to obtain G#)

CONTACT INFORMATION: Mailing Address:

Street Address: (if different than mailing)

City:

State: Zip: County:

PCC Email: __________________________________________________________ Personal Email:_______________________________________________ (optional) Cell Phone: ( ) Home Phone: ( ) Work/Pager: ( ) By submitting this application, I acknowledge that PCC may be required to provide some of my student information to the Oregon Health Authority, EMS & Trauma Section, in order to process my Paramedic application. Additionally, I understand that some of my student information is necessary to be provided to NREMT and certain professional and clinical sites (hospitals, ambulance agencies, et. al.) for eligibility regarding required clinical components and National testing processes (e.g., criminal background check initiation and results, drug screen results, attendance information and, potentially, information about passing classes.). I hereby give my consent to release information as needed. _________________________________________________________________________________________________________

(Applicant Signature)

EDUCATION Name of High School: City: State: Year Graduated: (or indicate “GED”)

Official College transcripts required (unofficial copies OK if official already submitted to PCC; PCC transcripts can be unofficial).

Please list all undergraduate institutions you will be using to satisfy coursework requirements.

NAME OF INSTITUTION / STATE CERT / DEGREE (if applicable)

PARAMEDIC PROGRAM APPLICATION

List all health-related training courses attended. Include training as EMT, nurse’s aide, medical assisting, or courses such as CPR or ACLS. NAME OF COURSE OR

TRAINING SCHOOL / AGENCY CERTIFICATION DATES ATTENDED

PATIENT CONTACT EXPERIENCE: FT = Full-time / PT = Part-time List all health care experience in which your responsibilities allowed for direct patient contact (e.g., nurse, EMT, aide, medical assistant, ambulance/fire service)

Employer: Supervisors Name: Contact Phone Number: ( )

Your position Title: Months/Years: FT PT Volunteer Patient contacts per week:

Employer: Supervisors Name: Contact Phone Number: ( )

Your position Title: Months/Years: FT PT Volunteer Patient contacts per week:

Employer: Supervisors Name: Contact Phone Number: ( )

Your position Title: Months/Years: FT PT Volunteer Patient contacts per week:

Employer: Supervisors Name: Contact Phone Number: ( )

Your position Title: Months/Years: FT PT Volunteer Patient contacts per week:

(If you need more space, please list and attach additional experience on a separate sheet of paper.) EMT License Number: State: National Registry Number: Level:

Level: Expiration Date: Expiration Date:

REFERENCES Identify below the three individuals (not related to you) whom you have requested recommendation in support of your application.

Name: Occupation:

Telephone:

Name: Occupation:

Telephone:

Name: Occupation:

Telephone: _________________________________________________________________________________________________________________________________ I give PCC EMS permission to contact the above references regarding any matter in this application. Signature____________________________________________ Date: _____________________________________

Last First Middle (must be admitted as a student to PCC to obtain G#)

Highest college degree awarded: ______________________________________________

Prior to beginning the EMS 200-level course of study, the Paramedic Program prerequisites OR their equivalents must be completed with a ‘C’ grade or higher by the end of FALL TERM of the year of application.

Ø see Notes on next page for exceptions to the course completion requirement

Required Course title &

Quarter Credit Units

COURSE INFORMATION (Dept/Course# / Transcript Course Title only required if different from listing)

Dept & Course #

Transcript Course Title (if not completed, list

‘In-Progress’ or ‘To Be Taken’) Name of Institution Term / Year Credit

Hours Grade

Human Anatomy & Physiology I

(Bi231 or higher – 4 quarter credits)

Human Anatomy & Physiology II

(Bi232 or higher – 4 quarter credits)

Human Anatomy & Physiology III

(Bi233 or higher – 4 quarter credits)

Public Speaking

(COMM 111 or higher / 3-4 quarter credits)

(Formerly SP 111)

Psychology & Human Relations

(PSY 101 or higher / 3-4 quarter credits)

Introductory Algebra – 2nd

Term

(Math 65 or higher – 4 quarter credits)

English Composition

(WR 121 or higher / 3-4 quarter credits)

PCC Paramedic Program Prerequisite Review

(Fill out regardless of attaching transcripts) NAME: ____________________________ PCC G#: _______________________

Continued next page

Required Course title & Quarter Credit Units

COURSE INFORMATION (Dept/Course# / Transcript Course Title only required if different from listing)

Dept & Course #

Transcript Course Title (if not completed, list

‘In-Progress’ or ‘To Be Taken’) Name of Institution Term / Year Credit

Hours Grade

Introduction to EMS

(EMS 100 – 2 or 3 credits) (or FP 101)

EMT Part 1

(EMS 105 – 5 credits)

EMT Part II

(EMS 106 – 5 credits)

Emergency Response Patient Transport

(EMS 114 – 1 or 2 credits)(or FP 232)

Crisis Intervention

(EMS 115 – 3 credits)

Emergency Medical Tech Rescue

(EMS 116 – 3 credits)(or FP 201)

Medical Terminology

(MP 111 – 4 credits)

Health & Fitness for Life **

(HE 295+PE 295 – 3 credits)(or FP 289)

NOTES:

** HE 295+PE 295; One 4-credit General Education Course – are allowed to be completed with a grade of ‘C’ or higher by the end of Fall Term of the Paramedic Program year

SEE NEXT PAGE FOR GENERAL EDUCATION CREDITS

GENERAL EDUCATION ELECTIVE AAS DEGREE REQUIREMENTS REVIEW

Must complete 16 credits of General Education (Gen Ed) Elective Courses (in addition to Program prerequisites previously listed): see PCC Catalog for listing of approved

Gen Ed electives for Associate of Applied Science degree (AAS).

The 16 credits of Gen Ed electives must include at least one 4-credit course from each of the three categories listed below; 2 Program prerequisites can also be used to satisfy Gen

Ed requirements if on approved list of Gen Ed electives. One possible configuration is listed below – this option would require one additional Gen Ed elective in any area:

• Arts & Letters - (COMM 111 or higher could be used)

• Social Science – (PSY 101 or higher could be used)

• Science and Mathematics - (Bi 112 can be used: it’s not a program pre-requisite, it’s a prereq for a program requirement)

**4 credits of General Education can be completed later than Summer Term of the application year (must be completed with a grade of ‘C’ or higher by the end of

Fall Term of the Paramedic Program year)

Required Course title &

Quarter Credit Units

COURSE INFORMATION

Dept & Course #

Transcript Course Title (if not completed, list

‘In-Progress’ or ‘To Be Taken’) Name of Institution Term / Year Credit

Hours Grade

DO NOT WRITE IN THE BOX BELOW – EMS OFFICE USE ONLY

Date Application received Complete: YES NO Reviewed by: ________ Accepted: YES NO ALTERNATE Date Letter Sent:

Portland Community College Emergency Medical Services Training

PARAMEDIC PROGRAM APPLICANT SURVEY

Today’s Date _______________________ Year you are applying for_________

Please put check mark at appropriate answer.

1. Age:

18-25 yrs__ 26-35 yrs__ 36-45 yrs.__ 46 plus__ 2. Gender:

Female__ Male__ Non-Binary__ Prefer not to answer__

3. Ethnicity: Caucasian__ African-American__ Asian__ Filipino__ Pacific Islander__ American Indian__ Hispanic__ Other__

4. Do you have dependents living with you? (e.g., children under the age of 18, parents or grandparents) Yes__ No__

5. Are you a single parent? Yes__ No__

6. Number of children living at home: None__ 1__ 2__ 3__ 4__ 5 or more__

7. One-way travel distance from residence to campus:

0-10 miles__ 11-20 miles__ 21-30 miles__ 31-40 miles__ 41 or more miles__

8. Average weekly hours of employment: Not employed__ Employed 40 hrs. or less per week__ Employed more than 40 hrs. per week__

9. Have you had previous paid work experience in EMS or health care?

Yes__ No__

10. If you responded yes to item 9, please indicate which experiences apply to you: Nurse Assistant__ LVN__ RN__ Health Information Services__ Medical Dental Hygiene__ Radiology__ EMT__ Paramedic__ Psych. Tech__ Supportive Personnel__ (housekeeping, dietary, etc.)

Military Medic__ Assistant__ Medical Clerk__ Other__________________

(write in other)

11. Years worked in EMS or healthcare:

Less than 1 yr.__ 1 yr. or more but less than 3 yrs.__ 3 yrs. or more but less than 6 yrs.__ 6 yrs. or more__ N/A__

12. Previous volunteer experience in EMS or healthcare:

Student__ Fire Dept. Volunteer__ EMS Volunteer__ Other Health Care Service__ N/A__

13. Highest post-high school education level completed:

None__ Less than 2 yrs.__ Associate degree__ Bachelor’s degree__ Master’s degree or above__

14. Your primary place of residence for the past 12 months:

In this country__ Out of country__ Out of state in USA__

College courses completed with a C average or better. Mark all that apply:

15. EMT__ 16. Anatomy__ 17. Physiology__ 18. Microbiology__ 19. Chemistry__ 20. English__ 21. Math__ 22. Biology__ 23. Medical Terminology__ 24. Psychology__ 25. Sociology__ 26. Humanities__ 27. Cultural Pluralism__

28. Are you receiving a scholarship or financial aid?

Yes___ (If yes, complete items 29-33. Mark all that apply) No ___ (If no, skip to item 34)

29. ___Pell Grant (including SEOG & Oregon Opportunity Grant) 30. ___Employer 31. ___Federal Work-Study Program 32. ___Local organization scholarship 33. ___Other

34. Are you (or think you may be) eligible to receive a Grant through any of the following?

Yes__ No__ Don’t know__

Pell Grants, Work-Study, JOBS, JTPA, SST, General Assistance, AFDOC, any other form of economic public assistance and/or annual income level below $7,500.00 for single person, $15,000.00 per couple with $1,000.00 additional for dependent child.

35. Did you enter this program as a/an:

Generic Student__ Re-entry__ Other__

36. The main reason you chose this program: Required to maintain existing job__ Retraining after layoffs__ Career ladder opportunity__ Career change__ Lifetime goal__ Other__

37. How did you learn about the PCC paramedic program?

College counselor__ Employer/co-workers__ Friends__ Former student/graduate__ Professionals practicing in field__ College catalog__ Program brochure__ Internet__ Career/health fair__ Independent research__ Hospital/Fire Dept.__ Other__

YOUR TIME TO COMPLETE AND RETURN THIS SURVEY IS GREATLY APPRECIATED! IF YOU HAVE

ANY QUESTIONS, PLEASE CONTACT THE PCC EMERGENCY SERVICES DEPARTMENT: 971-722-5570

Paramedic Program Applicant Survey 2021