Episode 47- NCEMSF

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Episode Overview

Scott and Ray take the Pre-Hospital Paradigm Podcast on the road to Pittsburgh, broadcasting from the National Collegiate EMS Foundation (NCEMSF) annual conference. They sit down with long-time collegiate EMS leaders Eric and Dr. Zach to unpack:

• What campus-based EMS looks like across the U.S. and Canada
  
  

• How student-run EMS agencies integrate with municipal 911 systems
  
  

• Challenges of turnover, funding, liability, and medical direction
  
  

• How collegiate EMS shapes careers, leadership skills, and life trajectories
  
  

• Practical advice for students trying to start, grow, or sustain a collegiate EMS program
  
  

The conversation moves from origin stories and systems design to tough issues like high-risk refusals, mental health calls, and active shooter preparedness—while highlighting the passion and energy of 18–22-year-olds running legitimate EMS agencies on their campuses.

Learning Objectives

By the end of this episode, listeners should be able to:

1. Describe what collegiate/campus-based EMS is and the range of models it can take.
   
   

2. Explain how collegiate EMS integrates (or sometimes struggles to integrate) with municipal EMS, police, and campus leadership.
   
   

3. Identify key challenges in starting and sustaining a collegiate EMS agency (funding, liability, medical direction, turnover).
   
   

4. Recognize the educational, leadership, and career-development benefits of collegiate EMS for students.
   
   

5. List several NCEMSF programs and how they support campus EMS agencies (EMS Ready Campus, HeartSafe, College EMS Week, etc.).
   
   

Key Takeaways

• Collegiate EMS is big and organized.
  NCEMSF is on its 32nd annual conference, with 1,300+ attendees representing roughly 120–130 schools, each with some form of campus-based EMS—ranging from first responder teams to full ALS transporting agencies.
  
  

• It’s almost entirely student-run.
  Most campus EMS agencies are staffed and led by students who balance classes, volunteering, and leadership roles. Medical directors and advisors exist, but day-to-day operations are often run by 18–22-year-olds.
  
  

• Models vary wildly:
  
  

  • Non-transport quick response units
    
    

  • BLS or ALS transport services
    
    

  • Foot, bike, cart, and ambulance response
    
    

  • Event medicine only (e.g., stadium coverage)
    
    

  • Hybrid models embedded within student health, campus police/security, or city EMS
    
    

• Collegiate EMS is a leadership incubator.
  Students learn scene management, crisis leadership, communication with administrators and peers, system navigation, and incident command—skills that translate whether they go into EMS/medicine or something else entirely.
  
  

• Integration with city EMS is critical.
  When done well, campus EMS shortens response times, knows the geography and buildings, and helps offload call volume from busy municipal services. The best systems build relationships through ride-alongs, joint drills, and shared QI rather than competing.
  
  

• High-risk refusals and mental health calls are major pain points.
  On college campuses, call volume skews heavily toward intoxication and mental health emergencies. Managing capacity, refusals, and risk often requires close collaboration between campus EMS, ALS agencies, medical direction, and campus mental health services.
  
  

• Starting an agency is possible—but not easy.
  Big hurdles include:
  
  

  • Administrative perception of liability
    
    

  • Securing a medical director who is more than a name on paper
    
    

  • Funding for equipment, training, and insurance
    
    

  • Convincing leadership of the value proposition (faster response times, safer campus, recruiting tool for parents)
    
    

• NCEMSF provides structure and support.
  Through its conference, educational content, and formal programs (e.g., EMS Ready Campus, HeartSafe, Merit, College EMS Week), NCEMSF gives campus agencies frameworks, networking, and recognition to improve safety and preparedness.
  
  

Segment Breakdown & Topics

1. Setting the Scene – NCEMSF in Pittsburgh

• Scott and Ray introduce the episode from Pittsburgh, PA, at the NCEMSF annual conference.
  
  

• NCEMSF overview:
  
  

  • ~32nd annual conference
    
    

  • 1,300+ registrants
    
    

  • 120–130 colleges and universities
    
    

• All represented schools have campus-based EMS, from startups to full ALS transporting agencies.
  
  

2. What Is Campus-Based EMS?

• Uniqueness of collegiate EMS:
  
  

  • Staffed primarily by student volunteers
    
    

  • Operates under state EMS protocols and medical direction
    
    

  • Often structured as student organizations, but performing professional EMS work
    
    

• Operational variation:
  
  

  • Foot teams, response vehicles, BLS transport, ALS transport, stadium coverage, standbys
    
    

  • Some agencies cover Division I NCAA football stadiums and large special events
    
    

3. Personal Journeys – Eric & Dr. Zach

Eric’s Path: Columbia → Paramedic → EPA Spill Response

• Became an EMT as a freshman at Columbia University
  
  

• Joined the campus ambulance; BLS transporting service with “1.5” ambulances serving ~35,000 people
  
  

• Saw layered EMS response in Manhattan, supplementing FDNY and providing campus-specific value
  
  

• After a degree in chemical engineering, chose to go to paramedic school rather than straight engineering jobs
  
  

• Ultimately blended engineering + EMS into a career as a federal spill responder (EPA)
  
  

• Credits collegiate EMS for foundational skills in incident management, street sense, and communication that still drive his career 20 years later.
  
  

Dr. Zach’s Path: High-School EMT → Collegiate EMS → EMS Physician

• Became an EMT in high school after initially resisting his dad’s suggestion to join a local ambulance squad
  
  

• Applied to colleges specifically looking for campus-based EMS programs
  
  

• Joined collegiate EMS at Johns Hopkins University—a running unit that literally ran to calls with campus security transporting equipment
  
  

• Met his future wife on the unit; they worked EMS together all four years
  
  

• Went straight to medical school, then EM residency and fellowship in pre-hospital medicine
  
  

• Now an EMS medical director for multiple college-based EMS services and active NCEMSF staff member
  
  

• Emphasizes how collegiate EMS shaped both his career and personal life.
  
  

4. Campus EMS & City EMS – Partnership, Not Competition

Case Western Reserve Example (Cleveland):

• BLS transport agency with two ambulances and a fly car
  
  

• Provides rapid response and familiar faces on campus
  
  

• Municipal units (e.g., Cleveland EMS) often appreciate the call-load reduction:
  
  

  • Campus EMS can handle minor BLS cases (sprains, minor illness)
    
    

  • ALS responds for higher acuity; campus EMTs provide early assessment and treatment
    
    

• Key advantages:
  
  

  • Local knowledge (elevators, building access, shortcuts)
    
    

  • Shorter response times
    
    

  • Peer-to-peer rapport and comfort for patients
    
    

Common Themes:

• When relationships are strong, campus EMS and city EMS function like any two professional agencies working together.
  
  

• Friction is rare but can occur where:
  
  

  • Campus agencies are not recognized as professional
    
    

  • Communication channels and expectations are unclear
    
    

5. BLS vs ALS & The Role of Turnover

• Most collegiate EMS agencies operate at the BLS level due to:
  
  

  • Age and time constraints (undergrads juggling full course loads)
    
    

  • The time commitment required for paramedic or ALS training
    
    

• A smaller number of agencies are ALS:
  
  

  • Virginia Tech Rescue – strong ALS program, multiple ambulances, integral to county EMS coverage
    
    

  • Agencies in some communities function as true mutual aid partners, covering floods, disasters, or city-wide incidents
    
    

• Turnover reality:
  
  

  • Every 4 years the organization completely turns over
    
    

  • Leadership continuity, culture, and experience must be deliberately handed off
    
    

  • Some agencies use faculty advisors and engaged medical directors to help maintain continuity
    
    

6. Dispatch & Communication Models

• Common activation models:
  
  

  • Campus emergency number (non-911) routed to campus security/public safety dispatch
    
    

  • Occasional direct integration with 911 PSAPs, especially at state universities with their own police dispatch
    
    

• Challenges:
  
  

  • No formal EMD—dispatch info may be limited (“you’ve got an aided”)
    
    

  • Risk of duplicate responses (someone calls campus number, someone else calls 911)
    
    

  • 911 system may be unaware of campus calls unless campus EMS deliberately activates them
    
    

• Best practice:
  
  

  • Build interoperability and clear policy:
    
    

    • When to request ALS
      
      

    • How to communicate emergent needs
      
      

    • How to avoid duplication and delay
      
      

7. High-Risk Refusals, Intoxication & Mental Health

• On many campuses, the highest-risk issue is not the big trauma but refusals—especially in:
  
  

  • Alcohol intoxication
    
    

  • Mental health crises
    
    

• Dr. Zach’s experience:
  
  

  • Worked with ALS and campus EMS to clarify when ALS must be called to assess capacity and safe refusal
    
    

  • Medical director role is often to get everyone in the same room—campus EMS, ALS agency, administration—and build shared expectations
    
    

• Mental health integration examples:
  
  

  • At Rowan University, campus EMS integrated with campus mental health resources:
    
    

    • On-call psychologists/psychiatrists
      
      

    • Peer support
      
      

    • Ability to spend extended time on scene (2–3 hours) when needed, which traditional 911 systems usually cannot
      
      

8. Start-Up & Justifying a Campus EMS Agency

Questions from the audience:

1. How do we find a medical director?
   
   

   • NCEMSF has a strong physician network and can often connect student groups with local EMS physicians or EM docs.
     
     

   • Many medical directors first meet agencies at the conference and build relationships from there.
     
     

2. How do we justify the need to campus leadership when they already have 911 and campus police?
   Strategies discussed:
   
   

   • Data:
     
     

     • How many EMS calls happen on campus per year?
       
       

     • Compare campus EMS vs municipal response times (e.g., 3 minutes vs. 20 minutes in a busy city)
       
       

   • Parental reassurance:
     
     

     • Use campus EMS as a selling point to parents at orientation:
       
       

       • State-licensed EMTs
         
         

       • On-site responders
         
         

       • Dedicated to the campus community
         
         

   • System relief:
     
     

     • Offloading low-acuity calls from busy city EMS
       
       

     • Reducing unnecessary ED visits by routing appropriate cases to student health or urgent care
       
       

   • Campus safety and recruitment:
     
     

     • A robust campus EMS is a marketing asset and differentiator for the college
       
       

3. Funding?
   
   

   • Common sources:
     
     

     • Student organization budgets
       
       

     • Student health center contributions
       
       

     • Campus police/public safety budgets
       
       

     • Donations and equipment support from local hospitals or health systems
       
       

   • Creative approaches:
     
     

     • Moving to check-and-inject epi rather than stocking costly auto-injectors
       
       

     • Phased growth (e.g., start as quick response, then expand to transport over years)
       
       

   • It’s usually a long game: some agencies (e.g., UPenn) evolved from startup to mature service over 15+ years.
     
     

4. Liability concerns & administration fear factor:
   
   

   • Liability is almost always the number one administrative objection.
     
     

   • NCEMSF encourages schools to see collegiate EMS not as a risk, but as:
     
     

     • A safety asset
       
       

     • A recruitment tool
       
       

     • A leadership laboratory for students
       
       

   • Point to the hundreds of existing programs nationwide as precedent.
     
     

9. Recruitment, Retention & Motivation

• Many agencies struggle with motivation and staffing, especially with busy student schedules.
  
  

• Strategies discussed:
  
  

  • Incentives:
    
    

    • Meal stipends
      
      

    • Free or discounted housing
      
      

    • Priority class registration
      
      

  • Experience & culture:
    
    

    • Agencies that offer strong training, event coverage, and leadership roles become highly sought after
      
      

    • Case Western example: dozens of applicants, limited training slots, waiting lists
      
      

• Some campuses see a downward volunteering trend, elsewherE demand is high—very program-dependent.
  
  

10. Supplemental Experience & External EMS Work

• Many collegiate EMTs seek additional field time:
  
  

  • Work summers at private services, amusement parks, concert venues
    
    

  • Volunteer with local fire or rescue
    
    

• This benefits:
  
  

  • The students (more experience)
    
    

  • The regional EMS system (extra staffing)
    
    

  • The campus EMS agency (backflows knowledge and maturity)
    
    

11. Dispatch, Response Models & Special Teams

• Response patterns vary:
  
  

  • On-duty in station vs. “living their life” and running from class with a bag and radio
    
    

  • Foot teams, bike teams, side-by-sides, carts, and ambulances
    
    

  • Special response in mass events (football games, rallies, concerts)
    
    

• Special teams examples:
  
  

  • Virginia Tech – high-angle rescue, search and rescue, specialized teams integrated with surrounding agencies
    
    

  • COVID-era adaptations (Rowan University):
    
    

    • EMS-staffed transport van moving COVID-positive students from dorms to quarantine housing
      
      

    • Involvement in mass vaccination clinics as observers and support staff
      
      

12. Peer-to-Peer Benefit, Alcohol Amnesty & Privacy

• Students are often more comfortable calling for help when they know:
  
  

  • Peers will arrive, not just authority figures
    
    

  • Many campus EMS agencies don’t bill, which reduces fear of a financial “paper trail”
    
    

• Alcohol amnesty policies:
  
  

  • Campus EMS often leads the push for policies that protect students who call for help in intoxication emergencies
    
    

  • Goal: remove barriers to calling 911 or campus EMS when things are truly dangerous
    
    

• Peer-to-peer influence helps:
  
  

  • Convince reluctant students to accept transport or further evaluation
    
    

  • Normalize seeking help during mental health or substance-related crises
    
    

13. Training & Medical Direction in the Collegiate Environment

• Training structure:
  
  

  • Internal training: weekly or monthly sessions, skills refreshers, simulation, operational drills
    
    

  • External training: ride-along programs with city medic units; ED shadowing with EMS-friendly physicians
    
    

• Operational training is critical:
  
  

  • Not just “how to do ABCs,” but how to call for help, request resources, document, interact with city EMS, etc.
    
    

• Medical direction challenges:
  
  

  • Easy to find someone to sign papers; harder to find someone actively engaged
    
    

  • Best practice: medical director shows up – trainings, drills, banquets, debriefs; gives students direct access (phone/text)
    
    

• Academic performance:
  
  

  • No universal GPA requirement; often only must be enrolled at the institution
    
    

  • Some benefits (housing, stipends) may come with academic performance standards, depending on the school
    
    

14. NCEMSF Programs & Campus Preparedness

Highlighted NCEMSF Initiatives:

• College EMS Week
  
  

  • Separate from national EMS Week, typically in the fall
    
    

  • Kickoff: CPR Day – encouraged mass events teaching CPR, Stop the Bleed, and basic first aid on campus
    
    

• EMS Ready Campus (Eric’s program)
  
  

  • 3-tier recognition: Bronze, Silver, Gold
    
    

  • Helps agencies build emergency management frameworks:
    
    

    • ICS training for members
      
      

    • Hazard identification (labs, nuclear reactors, chemicals)
      
      

    • Interoperability planning and communication
      
      

    • Drills, exercises, and after-action processes
      
      

  • Gold level includes ICS 300 for leadership, HSEEP-style exercises, and robust all-hazards preparedness
    
    

• HeartSafe / Cardiac Readiness Programs
  
  

  • Focused on CPR training, AED placement, public access defibrillation, and maintenance processes
    
    

• MERIT Program
  
  

  • Self-assessment and gap-analysis tool:
    
    

    • Evaluate your organization against best practices
      
      

    • Identify strengths and weaknesses
      
      

    • Build action plans to improve operations, leadership, and preparedness
      
      

15. Case Studies – Collegiate EMS in Major Incidents

• Virginia Tech Shooting (2007):
  
  

  • Virginia Tech Rescue was first on scene, initially responding to what looked like a routine med call
    
    

  • Took on early incident command and triage before system resources surged in
    
    

  • Collegiate EMS presence helped prevent an already tragic event from becoming even worse.
    
    

• Boston Marathon Bombing – MIT Officer Shooting:
  
  

  • MIT campus police officer shot during the search for the bombing suspects
    
    

  • MIT’s campus EMS was first to render care to a known colleague and part of their community
    
    

  • Highlights how campus EMS is deeply embedded in the human side of campus emergencies
    
    

16. International & Canadian Participation

• NCEMSF isn’t just U.S.-only:
  
  

  • Strong representation from Canadian collegiate EMS programs
    
    

  • Historical participation from other countries (e.g., Jamaica)
    
    

  • Structures differ internationally, but the core mission and challenges are remarkably similar
    
    

17. Closing Thoughts

• Collegiate EMS is a niche corner of EMS, but it solves real problems:
  
  

  • Faster, more familiar care on campus
    
    

  • Reduced strain on municipal EMS systems
    
    

  • A powerful leadership and career pipeline for medicine, public safety, engineering, emergency management, and beyond
    
    

• Eric & Dr. Zach emphasize:
  
  

  • The lifelong impact of collegiate EMS—professional, personal, and social
    
    

  • The passion and energy of student providers is infectious and a reminder of why many of us got into EMS in the first place
    
    

• Scott and Ray close by thanking NCEMSF for hosting and present the guests with Pre-Hospital Paradigm Podcast challenge coins as a small token of appreciation.

From The Episode