In Part I of this discussion, we talked about what defines a profession. Part II dealt with the requirement for a robust Continuing Professional Development program. In this final piece, I would like to review the organisational requirements of a College, and the overall implications of Paramedic Self-Regulation for the individual, and the profession as a whole.
What Would The Manitoba College of Paramedics Look Like? And what would it cost?
Looking at other professional colleges, there is a wide variety of organizational makeup. Some governing bodies had as many as 15 employees, and others listed only two on their websites. As well, each had various committees for such areas as Continuing Education, Membership, Disciplinary Actions, etc. One would assume that these committees were made up of the membership, and possibly with public representation as well.
One would assume that the College would be required to retain legal counsel, as well as have financial guidance and oversight. Then we must take into account the physical assets required, in the shape of office space and equipment. It would be difficult to put a dollar figure to the potential operating costs required. I was able to find a few annual reports which I have linked to at the bottom this section. Table 1 lists some figures from these reports for comparison.
| Organization | Membership as of 2016 | 2016 Operating Expenses | 2016 Revenue | Number of full/part time employees |
| Alberta College of Paramedics | 8294 | $6,623,000 | $6,045,000 | 10 to 15 |
| College of Licensed Practical Nurses of Manitoba | 4024 | $1,346,000 | $1,648,000 | 13 |
| College of Registered Nurses of Manitoba | 14,040 | $7,243,000 | $6,411,000 | 34 |
Table 1: Comparison of three Self-Regulatory bodies in Canada
The exact organization format would be determined by the requirements of the College, as set out by the Transitional Council which was recommended in the Toews Report on Paramedic Self-Regulation.
- Alberta College of Paramedics 2016 Annual Report
- CLPNM 2016 Annual Report
- CRNM 2016 Annual Report
- Toews Report on paramedic self-regulation May 2017
What Will It Cost The Paramedic?
There will be four areas of cost for the individual Paramedic. The first will be an annual licensing fee. This could vary depending on the licensing level of the provider. A number of colleges I found to have different fee schedules, based on the status of the member; active or inactive, student, graduate, as examples. The exact amount would be largely based on the operational budget requirements of the College, which should be solely funded by membership fees (including licensing, penalties and fines, investment returns, etc.). The second would be our union dues, which we are all currently paying now. The third would be the cost of any continuing professional development programs we undertake to meet the requirements of the College. Currently we pay a membership fee to P.A.M. for this purpose. The fourth cost would be for individual liability insurance, which would most likely be a requirement of holding a license. I am sure there are a number of Paramedics already paying for this now.
What Role Would P.A.M. Play?
Self-regulation would mean the requirement for practitioners to maintain their own Continuing Professional Development portfolio. This would most likely eliminate the need for the Con-ed program offered by the Paramedic Association of Manitoba. So what would their role be?
This is where I might get a little controversial, but here is the role I envision for P.A.M. Physicians and Nurses in Manitoba have their own colleges, which are the licensing and censorship bodies for those professions. They also each have an advocacy and bargaining organization; the Manitoba Nurses Union, and Doctors Manitoba.
For Paramedics in the province, there are three different bargaining units; MGEU, MAHCP, and UFFW for the fire-medics. With a name change to differentiate the organization from its former self, I envision PAM as the one advocacy and bargaining unit for all Paramedics, with the exception of Fire-Paramedics, who would remain under their own union. Although the number of members would not rival something like MGEU, we would have a union that looks out for the best interest of Paramedics alone, both at the bargaining table and in the media. I truly believe this is what we need. Paramedics should no longer be lumped in with other Technical-Professionals like home care, dietary, etc.
The Big Picture
For any of this to come to fruition, step one is that all Paramedics must be on board with the changes. To do this, we can no longer ask “What’s in it for me?” Instead, the question must be “What is in it for us?” It will be a difficult task to get everyone to see the bigger picture, and how in the long run it is best for the growth of Paramedicine as a profession in Manitoba, and Canada. We must speak as one united voice, for only then will we be able to move forward.
Thank you for reading, and as always, please feel free to leave your comments. This is always about starting conversation.