This week, Aebhric O'Kelly is joined by David Page, a paramedic with more than 40 years of experience spanning frontline EMS, education, accreditation and research. David directs the Prehospital Care Research Forum at UCLA and is closely involved with the International Paramedic Registry (IPR).The conversation explores the enormous variation in paramedic education and practice around the world. David discusses his work with training centres in more than 20 countries and explains why sophisticated simulation facilities are not necessarily required to deliver excellent education.Chapters00:00 – Meet David Page: 40 years of paramedicine, research and education.01:45 – Assessing EMS Education Around the World: Lessons from training centres in 23 countries.04:30 – Simulation Without the Million-Dollar Lab: Creating effective training with limited resources.05:20 – What Is the International Paramedic Registry?: Establishing international standards for paramedicine.08:01 – Learning from the US National Registry: Why independent certification matters.10:28 – Defining Levels of Paramedicine: Responder, basic and advanced practice.13:03 – What Should Every Paramedic Know?: Building and validating 1,028 international competencies.17:32 – Is IPR Becoming an International Standard?: Adoption, recognition and international mobility.19:44 – Certification vs Licensure: An important distinction for international paramedics.21:47 – Degree vs Certification: Does graduating from university prove clinical competency?26:47 – Does a Degree Guarantee Competence?: Why David argues for independent verification.28:20 – US vs UK Paramedics: Who Is Better?: Why minimum standards matter more than comparison.29:17 – When the Same Job Title Means Different Skills: Comparing paramedic education and scope internationally.30:35 – Does Programme Length Matter?: Why three years of education can mean very different things.33:40 – Australia's Nurse–Paramedic Model: Different professions and different clinical environments.36:43 – The UK Paramedic Model: Degrees, registration and the changing ambulance workforce.39:36 – Germany, Spain and European EMS: Different routes to prehospital practice.41:50 – Does France Have Paramedics?: Looking beyond professional labels.44:12 – Can Nurses Take the IPR Exam?: Why hospital expertise does not automatically equal prehospital expertise.44:52 – Paramedicine Is a Specialty: A separate environment requires a separate body of knowledge.45:25 – Research, Education and Clinical Practice: David's three-legged stool of paramedicine.46:56 – “Soak It Up, Buttercup”: David's advice for the next generation.47:38 – The Privilege of Being a Paramedic: Human dignity, patients and why the work matters.

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