Divining the right role, capabilities, structure, and Regimental System for Canada's Army Reserves

[Kirkhill]

Well having seen my teaching girlfriend and my wife attempt to breech the walls of "Professional Associations" Apparently it was to hard for the BC teachers association to confirm what the University of Montreal was teaching in their special needs course. And a Law Degree from London England is apparently worth nothing in BC and by the way you have to study tax law coming in, despite the course being optional in UBC. The fact that the head of the Law Society at the time was author of said textbook was purely a coincidence. Plus let's have someone with 10 years experience, article with someone who has 5 years experience to "Learn the Canadian way". Where upon she spent most of her time telling her employer " Yea you can't do that and no that won't work, because.....". I have other stories from other people in other associations, I know the purported reasoning behind the idea, but they have becoming the walls to keep out messy foreigners with different ideas.

Foreigners? You mean like graduates from the next province over?

It is like the bad old days when we couldn't ship milk and beer from province to province.

But we could ship milk and beer from province A into the States and from the States into province B.

I can more easily find work in the States than I can in Canada and then work on Canadian projects for an American employer. I don't need to jump through the professional hoops to work for the Yanks. And they can always find a willing ring and stamp to work with in Canada for a fee.

 

[mariomike]

My suggestion goes no further than to say that we can build up the military's reserve (and RegF) health services manpower by recruiting high school graduates and providing them financial assistance to earn a civilian health care degree or certificate while providing them with full-time summer training on the military component of their trade in exchange for some form of obligatory service.

The tuition fee might not be a major obstacle. Most students ( that I knew ) went to college straight out of high school, and were still living with mom and dad. It wasn't like they had to "go away to college" and live in a dormitory, as - unless they lived in a remote area - most paramedic colleges are in the community. Humber and Centenial colleges were our local "farm teams".

The financial assistance at my former College would be $7,521.00 for the four semesters required to receive their diploma. That would prepare them to challenge the provincial paramedic examination.

Additional requirements may apply. The requirements for the additional credential(s) are determined by the granting body, which is independent from the College.

In additon, $1,000 - uniforms and other medical supplies; $800 - books; $640 - driver education fee ; $400 - CEPCP Educational Certification fee for students placed with York Region.

full-time summer training

Regarding that,

Paramedic students require more than 400 hours - ten 40-hour weeks over two summers - work placement as student / observers with their assigned municipal / regional paramedic preceptor crew. I think the CAF calls it "ride-along", or something like that.

That's minimum. Some log every shift they can get.

Not sure how much "obligatory service" the PRes would expect in return for their investment?

It's easy to see why many people think otherwise, but the fact of the matter is most professionals work in jobs where they can do untold damage to a member of the public if they are not controlled.

Ain't that the truth.

Which is why Base Hospital insisted,

45.16 (b) The City confirms that it has liability insurance and agrees to maintain such insurance.

The only real sure thing about all this is - If you call 9-1-1, they will send Base Hospital paramedics from a licenced paramedic service.

Go cheap with "Paramedicine Practitioners", or whatever they call themselves - you get what you pay for. Your only remedy is a court of law.

In Ontario, might be cheaper in the long run- and less liability - to ante up for Paid Duty paramedics from a licenced municipal / regional paramedic service.

 

[dapaterson]

Maybe that's because teacher and nurses associations are really just unions in disguise. Anytime that you add bargaining powers to organizations they are really unions in sheep's clothing.
...
We're off topic here.

ONA = Union. CNO = Professional association. Different bodies, different roles.

Like the Canadian Bar Association - a lobby group for the interests of the law profession (no licensure) vs the provincial bar associations which regulate the profession. (Except in NB, where CBA membership is mandatory.)

 

[Blackadder1916]

Regarding the highlighted part, is Delegation of Controlled Medical Acts something the PRes does under the CPSO delegation policy to turn off-duty paramedics into "fully qualified combat medics'?

CPSO - Advice to the Profession: Delegation of Controlled Acts

www.cpso.on.ca

CPSO - Delegation of Controlled Acts

This policy sets expectations for physicians about when and how they may delegate controlled acts, through either direct orders or medical directives.

www.cpso.on.ca

For those who (like me) have strong pedantic genes, first off there is no trade in the CAF called "combat medic", there are two medical branch trades Med Tech (for those who have been 'qualified' as PCPs) and Med A (a reserve only trade for those not PCP qualified); and secondly the "CPSO" is applicable only to Ontario. For clarity, "qualified" doesn't mean that there is a continuing need to maintain a license/registration in a Canadian jurisdiction, just that they had successfully completed a recognized training program that leads to registration as a PCP in a province or territory.

Now to your question.

Yes, no, maybe, maybe not, possibly, it depends, whatever, doesn't apply. Even if stationed in Ontario, military physicians can practice without being licensed in Ontario (same holds true for all the other provinces and territories). The caveat to that is they would not "normally" see civilian patients so their ability to work in a civilian hospital, moonlight at a doc in the box or making connections for their post-military second career is severely limited. But that doesn't mean the same practice of 'delegation of controlled acts' is not used for CAF Med Techs/Med As. In fact it is much more stringent and formalized than back in the day when I was 'practicing medicine' without a license.

Though the Med Tech Scope of Practice document included in this 2017 Request for Proposal (for Emergency Medical Advisory Services) is dated from 2014, in the similar solicitation that was posted last month the same Scope of Practice is referenced and linked (just not viewable as it is a .mil link). Go to page 29 of the following pdf to view MEDICAL TECHNICIAN QUALIFICATION LEVEL THREE - SCOPE OF PRACTICE, 28 MAY 2014 (the QL 5A follows). It should give you a better understanding of how the CAF delegates controlled acts to Med Techs.

https://buyandsell.gc.ca/cds/public/2017/04/06/02c700f003eb821e3ce1eb4da11a69ba/rfp_w6369-17-a007-b_en.pdf

 

[mariomike]

For those who (like me) have strong pedantic genes, first off there is no trade in the CAF called "combat medic", there are two medical branch trades Med Tech (for those who have been 'qualified' as PCPs) and Med A (a reserve only trade for those not PCP qualified); and secondly the "CPSO" is applicable only to Ontario. For clarity, "qualified" doesn't mean that there is a continuing need to maintain a license/registration in a Canadian jurisdiction, just that they had successfully completed a recognized training program that leads to registration as a PCP in a province or territory.

Now to your question.

Yes, no, maybe, maybe not, possibly, it depends, whatever, doesn't apply. Even if stationed in Ontario, military physicians can practice without being licensed in Ontario (same holds true for all the other provinces and territories). The caveat to that is they would not "normally" see civilian patients so their ability to work in a civilian hospital, moonlight at a doc in the box or making connections for their post-military second career is severely limited. But that doesn't mean the same practice of 'delegation of controlled acts' is not used for CAF Med Techs/Med As. In fact it is much more stringent and formalized than back in the day when I was 'practicing medicine' without a license.

Though the Med Tech Scope of Practice document included in this 2017 Request for Proposal (for Emergency Medical Advisory Services) is dated from 2014, in the similar solicitation that was posted last month the same Scope of Practice is referenced and linked (just not viewable as it is a .mil link). Go to page 29 of the following pdf to view MEDICAL TECHNICIAN QUALIFICATION LEVEL THREE - SCOPE OF PRACTICE, 28 MAY 2014 (the QL 5A follows). It should give you a better understanding of how the CAF delegates controlled acts to Med Techs.

https://buyandsell.gc.ca/cds/public/2017/04/06/02c700f003eb821e3ce1eb4da11a69ba/rfp_w6369-17-a007-b_en.pdf

That is interesting. I asked my former employer about former CAF members applying as PCPs, and received this reply,

Back in 2007 the military approached the MOHLTC to accept their QL5 Med Techs if trained at JIBC, to be permitted to challenge the AEMCA. In the past the Ministry has permitted this, but has required an additional of 120 hrs minimum of field placement in Ontario.

To obtain these hours you could participate in a Med Tech Field Placement Program. Currently there are several Military Med Tech Field Placement Programs that have been implemented across Ontario. This Program offers Med Techs both QL3 and QL5 the opportunity to obtain these 120 hours, in addition to having the ability to be Temporarily Certified to perform Medical Directives consist ( sic ) with that of a Primary Care Paramedic in Ontario while doing their ride alongs. Some services that currently offer this program are: Ottawa, Toronto, Renfrew County, and possibly Simcoe County. There may be a couple other services that offer it as well.

In the past three years we have offered this program to 57 Med Techs.

The process generally calls for writing the AEMCA in addition to possibly a practical skills test (has been done in the past - but not always depending on qualifications and education).

There was an agreement posted on the CFHS website between the CF and the Ontario MOHLTC allowing QL5's to challenge the AEMCA exam.

Recognition of QL5A & Challenge of AEMCA exam:

Reference A is a confirmation letter by the Ontario Ministry of Health and Long-Term Care, Emergency Health Services Branch, recognizing the CF QL5 Med Tech as meeting the PCP requirements to challenge the AEMCA exam, all QL5 Med Techs are encouraged to prepare for and write this exam with approval through their Chain of Command. Upon successful completion of this exam, those Med Techs will have access to On-car opportunities to complete their MCSP in Ontario.

From what I have read on here, "access to On-car opportunities to complete their MCSP in Ontario" was a problem.

 

[Colin Parkinson]

There is a shortage of Paramedics in BC. Train up some reservists and put them onto Class B to work in Vancouver and Surrey, it be like combat first aid as well. You could likley get BC to help fund it as well. I think the US did this in major cities back in the 90's helping US medics learn to deal with gun shot wounds)

As for no combat medics, judging by what we are see in Ukraine, you might need that category. As unlike Afghanistan there will be little chance of a helicopter evac to take the causalities away. I would expect to see a "Combat Medic" to have to hold and care the patient(s) for longer and triage them as they care for a large number of them in the battle zone until conditions permit evacuation by foot or vehicle. (Note I am not belittling the hard work our medics did in Afghanistan, just this is a way different kind of fight)

 

[mariomike]

There is a shortage of Paramedics in BC. Train up some reservists and put them onto Class B to work in Vancouver and Surrey,

I know you're serious. But, sort of funny remembering back a quarter-century ago.

The CAF shoveled us out. That's as close as they ever got to 9-1-1 Operations.

We said thank-you at the time. But, have not heard the end of it since. < smile emoji

Even during SARS, when when 436 Toronto paramedics - out of a department of 800 - were on quarantine, there was never a suggestion of calling in the army.

Yes, the CAF were in some nursing homes during Covid.

Don't know what the deal is in B.C., but, the CAF was never turned loose on 9-1-1 operations in this town. Not ever.

 

[MilEME09]

We tend to advertise the sexy trades, and just like in the civilian world who pushed everyone needs a degree, after 30 years you get a labour force not targeted to the needs of society. We need to push and advertise that medics, mechanics, supply management, etc. It will take time to change the mind set but we need to redefine sexy and what recruit to what we need.

 

[KevinB]

I know you're serious But, sort of funny remembering now.

Only help I ever got on a job from the Army was about a quarter century ago, when they shoveled us out.

We said thank-you at the time. But, have not heard the end of it since. < smile emoji

Even during SARS, when when 436 of us - out of a department of 800 - were on quarantine, there was never a word about calling in the army.

They were in some nursing homes during Covid. But, have never worked 9-1-1 operations. Not in this town, anyway.





View attachment 77179

It’s fairly common down here still that Mil Medical pers will help in civilian hospitals.

Prior to GWOT 18D students would often attend certain city hospitals to work in the ER for actual gun shot trauma near the end of their course. After they have worked on live animals.

The D ends up be qualified to do about anything short of neuro surgery.
Including prescribing drugs, and conducting major surgery.

I really don’t understand WTF Canada is so concerned about what Medics and Paramedics can and can’t do when off duty.
Whatever happened to ‘Do no harm’ and the whole hippocratic oath.

 

[GK .Dundas]

It’s fairly common down here still that Mil Medical pers will help in civilian hospitals.

Prior to GWOT 18D students would often attend certain city hospitals to work in the ER for actual gun shot trauma near the end of their course. After they have worked on live animals.

The D ends up be qualified to do about anything short of neuro surgery.
Including prescribing drugs, and conducting major surgery.

I really don’t understand WTF Canada is so concerned about what Medics and Paramedics can and can’t do when off duty.
Whatever happened to ‘Do no harm’ and the whole hippocratic oath.

Four words, lawyers and insurance companies.

 

[FJAG]

It’s fairly common down here still that Mil Medical pers will help in civilian hospitals.

Prior to GWOT 18D students would often attend certain city hospitals to work in the ER for actual gun shot trauma near the end of their course. After they have worked on live animals.

The D ends up be qualified to do about anything short of neuro surgery.
Including prescribing drugs, and conducting major surgery.

Our Med Os used to do that too to get surgical experience. Not sure if it's still a thing or not.

 

[mariomike]

I really don’t understand WTF Canada is so concerned about what Medics and Paramedics can and can’t do when off duty.

Don't know what the off-duty rules are for CAF medics.

In our Dept., if Base Hospital decertifies a paramedic, for any reason,

Base Hospital
45.16 (c) Any Paramedic removed from Paramedic duties because of decertification by the Base Hospital, shall be placed in another position until the merits of their decertification are dealt with in a forum that provides due process. If the removal is for just cause, the disciplined Paramedic may grieve under the grievance/arbitration process of the Collective Agreement.

Failing the grievance / arbitration process, "Hello Parks Dept."

So, the smart thing to do is play ball with Base Hospital, and follow their Medical Directives.

Whatever happened to ‘Do no harm’ and the whole hippocratic oath.

Doctors take the Hippocratic Oath. We followed Doctors Orders.

 

[KevinB]

Doctors take the Hippocratic Oath. We followed Doctors Orders.

My point was those Doctors Orders seem to be counter to the Oath.

 

[Skysix]

On a slightly different tangent, a possible structure that might lend itself well to reserve units. Based on an approximately 100 person multidisciplinary "task force" concept.

https://twitter.com/x/status/1643832673872363520

 

[GR66]

On a slightly different tangent, a possible structure that might lend itself well to reserve units. Based on an approximately 100 person multidisciplinary "task force" concept.

https://twitter.com/x/status/1643832673872363520

I'm not sure that Russia is the best model to base our military doctrine and structure on at the moment.

 

[MilEME09]

I'm not sure that Russia is the best model to base our military doctrine and structure on at the moment.

It's a great case study of what not to do though!

 

[OldSolduer]

We tend to advertise the sexy trades, and just like in the civilian world who pushed everyone needs a degree, after 30 years you get a labour force not targeted to the needs of society. We need to push and advertise that medics, mechanics, supply management, etc. It will take time to change the mind set but we need to redefine sexy and what recruit to what we need.

Those mundane ones - Logistics, Repair, Medical pers, administrative pers and many others are ALL needed to make an Army run efficiently.
The infantry guy doesn't get ammo or food, mail etc unless ALL the support trades are there.

 

[mariomike]

The infantry guy doesn't get ammo or food, mail etc unless ALL the support trades are there.

Victory is the beautiful bright-colored flower. Transport is the stem without which it could never have blossomed.

Winston Churchill

 

[Kirkhill]

Putting this here because "National Service"

BLUFs

A new “Great British National Service” should be created that automatically signs up every 16-year-old in the UK, a think tank report backed by Penny Mordaunt has proposed.
The scheme would see teenagers spend a fortnight away on a civic exploration trip and be made to complete a certain amount of volunteering hours in a year.
The programme would not be mandatory but teenagers would have to opt out if they did not want to join, in contrast to the existing civic service scheme, which requires people to opt in.

Polling conducted for the Onward report by JL Partners found that three times as many young people aged 16 to 21 support national service than oppose it.
Francois Valentin, a senior researcher at Onward, said: “With so many younger people feeling lonely, ill-equipped for the workplace and disconnected from their community and nation, it’s time for a bold idea to stop a generation from falling further into crisis.
“National service can be a unifying experience, teaching people the skills they need to succeed. It is not an outdated idea from history, but a modern solution more and more countries are using to help young people.

Penny Mordaunt backs ‘Great British National Service’ volunteering scheme​

Commons leader says a civic programme for teenagers could help develop ‘resilience, skills and pride’

ByBen Riley-Smith, POLITICAL EDITOR30 August 2023 • 9:30pm

Ms Mordaunt is backing a revamp of the National Citizen Service set up under David Cameron CREDIT: Julian Simmonds for The Telegraph
A new “Great British National Service” should be created that automatically signs up every 16-year-old in the UK, a think tank report backed by Penny Mordaunt has proposed.
The scheme would see teenagers spend a fortnight away on a civic exploration trip and be made to complete a certain amount of volunteering hours in a year.
The programme would not be mandatory but teenagers would have to opt out if they did not want to join, in contrast to the existing civic service scheme, which requires people to opt in.
That could see as many as 600,000 teenagers take part, according to estimates – far above peak participation in the existing National Citizen Service, which was created by David Cameron.
The project aims to encourage Britons from different backgrounds to mix, as well as repair some of the damage that Covid-19 lockdowns inflicted on young people’s education and preparation for the adult world.
The proposal, in a new report by the think tank Onward, has won the support of Ms Mordaunt, the Leader of the House of Commons.

‘Tap into the energy and imagination’​

In an article for The Telegraph, Ms Mordaunt writes: “No one is more effective at helping others than a willing volunteer. Nothing is more rewarding than serving your community and nation.
“Many young people are struggling with their mental health, to find purpose and feel a sense of belonging.
“Stepping forward to help others could be part of the answer. Service can help build the resilience, skills and pride in their community and country that many need.
“National service is an old idea, but today, the centre-Right think tank Onward has unveiled its proposal for a modern version. I can understand its motives for doing so.
“They hope to harness young people’s goodwill and community spirit, tap into the energy and imagination of the next generation, and promote good mental health and resilience. I applaud these objectives.”
The idea of having a scheme that encourages young people to play an active role in British civic society has long been a debating point in Westminster.
Mr Cameron’s National Citizen Service, set up after the Conservatives entered Downing Street in 2010, was a central plank of his “big society” vision.
The new proposal, dubbed the Great British National Service, would go a step further by enrolling all 16-year-olds automatically, thereby overcoming the challenge of getting young people to sign up.
The scheme takes its inspiration from a similar idea that is already up and running in France, called Service National Universel, established by Emmanuel Macron, the French president.

Young people ‘ill-equipped for work’​

Polling conducted for the Onward report by JL Partners found that three times as many young people aged 16 to 21 support national service than oppose it.
Francois Valentin, a senior researcher at Onward, said: “With so many younger people feeling lonely, ill-equipped for the workplace and disconnected from their community and nation, it’s time for a bold idea to stop a generation from falling further into crisis.
“National service can be a unifying experience, teaching people the skills they need to succeed. It is not an outdated idea from history, but a modern solution more and more countries are using to help young people.
“Creating a new Great British National Service would be a popular answer to young people’s challenges. It would help them develop the skills, mental resilience and national pride many lack.”
Rory Stewart, host of The Rest is Politics podcast and a former international development secretary, said: “A clear, bold, essential idea – provocative and important – and if done with conviction and energy a wonderful gift to young people and for the country.”
Dan Jarvis, a Labour MP, also backed the proposal: “A national civic service would develop skills, improve mental wellbeing and enhance a sense of belonging among Britain’s young people.
“I would like to see all young people offered the opportunity to participate in a voluntary national scheme.”

Penny Mordaunt backs ‘Great British National Service’ volunteering scheme

Commons leader says a civic programme for teenagers could help develop ‘resilience, skills and pride’

www.telegraph.co.uk

Young people crave the purpose and responsibility National Service can provide​

A youth volunteering force based on principles of civic pride and community is an old idea ripe for reinvention
PENNY MORDAUNT
LEADER OF THE HOUSE OF COMMONS
30 August 2023 • 9:30pm

No one is more effective at helping others than a willing volunteer. Nothing is more rewarding than serving your community and nation. Many young people are struggling with their mental health, to find purpose, and feel a sense of belonging. Stepping forward to help others could be part of the answer. Service can help build the resilience, skills and pride in their community and country that many need.
National service is an old idea, but today, the centre-Right think tank Onward has unveiled its proposal for a modern version. I can understand its motives for doing so. They hope to harness young people’s goodwill and community spirit, tap into the energy and imagination of the next generation, and promote good mental health and resilience. I applaud these objectives.
Other nations, including Switzerland, the USA and Germany, have long used civic service to help new generations grow and develop. But for a scheme like this to work, it needs to work with the grain of Britain, like the “whole of society” approach I embedded in our new National Resilience Strategy. Let me explain why.
Throughout history, Britons have felt a strong instinct and motivation to protect each other. We see this most at a time of national crisis. It’s been called the Dunkirk spirit, but it is on display every day, all year round. From winter, when tractor drivers help clear the snow, to summer, when volunteers run community programmes.
We saw it during the pandemic, when a million people stood forward to deliver food parcels and administer injections. As a coordinator for National Resiliency in the Cabinet Office, I witnessed this first-hand. It was deeply moving. That’s when I knew that the full answer to national resilience lay in willing, capable, organised, motivated and skilled volunteers. These acts represent the values of our nation. Personal responsibility is at the heart of it. And this is something that we should be encouraging in the next generation.
I’ve often thought about what makes someone take personal responsibility. For some, it’s a necessity. For others, it’s personal pride. For me, it’s duty. You can’t grow up in a naval town and not understand this. There is no greater personal responsibility than risking your life for your country. You can’t witness that duty, service, love and dedication without feeling a direct and personal obligation. That’s why the notion of military national service endures.

A nation of enthusiastic volunteers​

A total of 13 million of us regularly volunteer. We are the nation of the RNLI, Mountain Rescue, Search and Rescue, St John Ambulance and the National Trust. These charitable organisations are often more nimble, responsive and innovative than many of their public sector counterparts. Why? Because a volunteer is worth 20 pressed men.
The belief in taking personal responsibility for yourself and others is what took me into politics. I believe it defines Conservatism. Socialism dilutes personal responsibility. Conservatism concentrates it. A responsible state needs responsible citizens.
Onward recognises that government should have an interest in this. However, I believe this should be in convening and enabling citizens. A new national service scheme should be optional, not mandated. The more government intervenes, the less scope there is for enterprise, social and commercial. The more government compels a behaviour, the less likely it is to be sustainable. The volunteer – armed and engineered with personal responsibility, enterprise and initiative – is one of the most powerful agents on Earth. They harness the most natural instinct we have.
The pandemic necessitated a greater government involvement than our country was used to, or comfortable with. And like wartime, this was necessary but not sustainable. Too much government threatens to extinguish the fuel that keeps the national engines turning.
If personal responsibility is efficient in the public sector, then private enterprise is essential outside of it. Both represent the key benefits of freedom. We are, as a country and as individuals, fiercely self-reliant, hugely inventive and highly capable when we are allowed to be. It’s deep in the character of all four nations.
Onward is to be congratulated for this work. Their objectives and motivations are right. But for them to succeed they should limit the role of the state. Let’s be bolder. Let’s trust the higher motives and values of the British people. This could be assumed to be naïve because it does not guarantee cooperation, however, it does create possibility, opportunity and hope. Onward’s research shows this is also what young people want. Let’s harness their eagerness to help others and connect them with their communities and nation.

Young people crave the purpose and responsibility National Service can provide

A youth volunteering force based on principles of civic pride and community is an old idea ripe for reinvention

www.telegraph.co.uk

 

[daftandbarmy]

Putting this here because "National Service"

BLUFs

Penny Mordaunt backs ‘Great British National Service’ volunteering scheme

Commons leader says a civic programme for teenagers could help develop ‘resilience, skills and pride’

www.telegraph.co.uk

Young people crave the purpose and responsibility National Service can provide

A youth volunteering force based on principles of civic pride and community is an old idea ripe for reinvention

www.telegraph.co.uk

Because National Service was so well received last time?