ABSTRACTS
Early Attrition from EMS after initial EMT certification: A Statewide Analysis of California EMTsAuthor: Qiuyi Chen | Student | City College of San Francisco Associate Authors: Bowden, Attica | Chen, Qiuyi | Duncan, Alida | Ulstrup, Emily | Washick, Marshall
Introduction EMT certification serves as the entry point into the EMS workforce, yet a large portion of new clinicians leave within their first certification cycle. Understanding who leaves and why is essential for workforce planning. A 2024 study by Cox et al. highlighted disparities in EMS licensure longevity across gender and racial groups. Building on that, we focused on early attrition among newly certified EMTs in California using more recent data to reflect current workforce trends. Methods We conducted a retrospective cohort analysis using data from the California EMS Authority Central Registry. The sample included individuals who received initial EMT certification between January 1, 2021, and December 31, 2024, excluding those with prior EMS credentials. Certification status was assessed two years post-issuance, allowing for grace-period renewals. Early attrition was defined as failure to renew EMT certification or transition to paramedic. Multivariable logistic regression was used to assess associations between attrition and self-reported gender and race or ethnicity. Results Out of 9,205 newly certified EMTs, 5.6% (n=516) transitioned to paramedic, 41.7% (n=3,841) recertified, and 52.7% (n=4,848) did not recertify within two years. Women had significantly lower odds of retention compared to men (OR 0.55, 95% CI 0.502–0.6, p<0.001). Compared to White EMTs, Asian EMTs had lower odds of remaining certified (OR 0.65, 95% CI 0.57–0.74, p<0.001), while Hispanic/Latino EMTs had higher odds of attrition (OR 1.37, 95% CI 1.24–1.52, p<0.001). Attrition odds did not significantly differ among other racial or ethnic groups. Conclusion Significant gender and racial disparities exist in early EMT attrition. These findings highlight equity and retention challenges within EMS. A key limitation is the lack of data on employment characteristics such as agency type or work status. Further qualitative research is needed to explore whether early exits stem from discrimination, career redirection, or unmet support needs—insights critical to strengthening the future EMS workforce.
|
