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Helicopter on Ramp at EMS Flight Safety Network

It hurts me to write this.

For years, I’ve been the “EMS fly guy.” Not only because I’m good at getting people hired, but because it’s the number one question on the top of every paramedic, pilot and nurse’s mind:

“How do I get paid to fly on a trauma helicopter?”

To some degree, this entire site is an answer to that question. You’ll learn more about getting an air medical flight job here than maybe anywhere else on the web.

But there’s one giant problem…

It’s the wrong question.

And I’ve known it for years.

And I’ve said nothing.

Not because I’m an asshole (well, maybe). No, the real reason is I felt like we were serving the needs of the market. People wanted to know how to fly air medical, so I created courses and a membership site teaching them how.

But Then I Noticed Something Horrifying…

A big percentage of my students couldn’t get a flight job, no matter how hard they tried.

And the worst part:

It wasn’t their fault.

They were doing all the homework. They were applying my techniques.

Except none of it was working. Not for some of them, anyway.


At first, I thought it was because I sucked. Maybe my techniques didn’t work, maybe the homework was too difficult, or maybe I was just a lousy teacher.

But then I noticed something…

A small percentage of students who initially struggled would all of a sudden take off like a rocket. For six months, they worked their butts off and got nowhere, and then BOOM, they would get an offer, and a second offer, and a third.

So many offers they could pick where they wanted to fly and what equipment they wanted to fly in.

So, I started investigating. What were these students doing differently than all the others?

Did they work harder? Were they better medics? Were they just smarter? Did they have powerful connections?

Turns out, the answer was none of the above.

The only commonality between all of our success stories is they changed the question they were asking. Instead of asking how to fly on a trauma helicopter, they asked a different, much less obvious question.

And it changed everything.

The Single Most Important Question for Wannabe Flight Crew

Ready to hear the question?

Here it is:

“Am I what the flight program wants?”

I know, it probably doesn’t make any sense.

Are you what the flight program wants? Of course you are! They’re looking for flight medics. You’re a medic who meets their qualifications. You’re what they want.


Actually…it turns out the answer is no. People think you can fly based on medical or aviation qualifications, but you can’t.

Of course, that statement isn’t surprising in and of itself. It’s logical that some really qualified medics, nurses and pilots could never put the whole “get a flight job” process together and get hired.

But the reality is worse. Far worse.

The Brutal Truth about Flying Air Medical

After working with hundreds of students, I can confidently say there are only a handful of situations where your actual qualifications make that much difference.

For instance, ever noticed how many flight medics come from busy metropolitan 911 systems? Or how many emergency room nurses move on to flight nursing?

Of course not.

And why?

Because it doesn’t matter.

It’s not about their qualifications. Even though we wish it were. Because that would make getting a flight job a lot easier, right?

But it’s not about qualifications.

It’s about what the flight program wants — at that moment in time.

And the really crappy part is — what flight programs want changes over time. It’s not linear. It’s not as simple as do these steps, apply, get a flight job.

There’s more to getting hired than do this, then that, then get hired.

Five Tests Every Flight Candidate Must Pass

For months, I researched what successful flight applicants do that other applicants don’t do, and I found five criteria or “tests” every flight job applicant passes before they get hired.

These five tests are evergreen. That’s the good news.

Even as flight programs change what they want in applicants over time, these tests remain constant. These tests are something you can expect to pass if you want to fly.

And here’s the thing:

To get hired, you need to pass all five tests. If you can’t, you will never succeed, no matter how hard you try.

On a more positive note, passing all five of these tests practically guarantees you can fly somewhere. All that’s left is doing the work to make it happen.

Ready to find out what the tests are?

Here you go:

#1 Technical Competence

If a helicopter company or health system requires a specific qualification, you must have it.

If that sounds like a duh, no-brainer . . . good.

Because here’s the problem: A lot of flight applicants are head-strong and ego-driven and more than willing to overlook things like personal qualifications.

“Oh, so what if I don’t have a pilot license yet. I’ve accomplished every goal I’ve ever set out to do. And I can make this happen too!”

I respect the confidence. But if you’re going to pilot an air medical helicopter, you’re going to need pilot certification too. See the point?

It’s the same point for the med folks. You must meet the specific qualifications required of the position. This is non-negotiable.

#2 Team Player Background

Do your co-workers piss you off? Are you so fed up with their bad attitudes that you don’t care anymore?

That’s not good. In fact, it’s a very bad thing. And that attitude can hurt you. Even if your assessment is true, it still can hurt you.

Here’s why:

Flight teams care about your past. Flight teams care whether you were a team player or not. Flight teams want team players.

Here’s what matters the most: whether or not you’re considered a team player by your peers.

Note that I said by your peers, not by EMS and air medical management. These are two completely different things.

Here’s why you need to be considered a team player by your peers.

Almost all flight interviews have some element of a team review. Typically, a panel of current flight team members will interview candidates to determine their ability to mesh with the current flight team.

The initial (and most important) team assessment is what I call “the beer test.”

What’s the beer test? You already guessed it, right?

When the flight team asks themselves “would I have fun drinking a beer with this guy or gal?” and answers yes, you pass. If they answer no, you fail. If they answer somewhere between yes or no, your past is scrutinized for the answer.

This is the moment when your past attitudes and behaviors matter. This is why treating others with kindness and respect (whether earned or not) is important.

#3 Ability to Work Autonomously

One of the many benefits to EMS and air medical careers is the ability to be your own boss.

Reality is you spend greater than 90% of your time unsupervised.

This can be a blessing or a curse depending on your background and work ethic. Air medical managers are super tuned-in and sensitive to this fact.

Why? Because how you act as flight crew goes directly to their reputation as a manager.

They will not risk hiring someone who could make them look bad. They also work very hard to eliminate candidates they perceive as someone who needs validation or praise every time they turn around.

You might be thinking, well isn’t developing the team their job? Yes, you are correct . . .BUT

Put yourself in their situation. All other things being equal, wouldn’t you prefer to hire the person who can take action and solve problems on their own?

#4 EMS Street Cred

Your reputation as an EMS operator is important. You don’t have to be known as the ace of the base, but you do need a reputation as competent and confident.

This isn’t something to worry about in most cases.

If you’re doing things “normal” paramedics, pilots and nurses do, you’re probably meeting this criteria. The only way you don’t meet this requirement is if you have numerous trouble areas in your past.

One med error or tail rotor stinger in need of new paint are not career-ending events. Neither is a picture of you on facebook wearing a lamp shade.

But if your background includes two, 10 or 20 separate instances like these, it’s time for corrective action. Why? Because too many screw ups shows a pattern of poor judgement, and the result is your reputation is questioned.

Worse yet, your company’s reputation could be questioned.

Remember that EMS and air medical company success is as much about perception as reality. Lifesavers are God-like in the public’s eye. Lifesavers can do no wrong.

As operators, we all know this is total BS. We know professionals make mistakes all the time. But in this case it doesn’t matter what we know.

The public thinks what it thinks. The public is our customer. And like it or not, it’s important for EMS and Air medical to meet the perceptions of the public. Guarding EMS and air medical reputations is part of this process.

This is the reason your personal EMS reputation matters.

#5 Rockstar Status (locally)

I can hear the moans through the monitor.

Really? I have to be a rockstar or I have no chance of flying air medical?

The answer is yes.

But, it’s a different kind of rockstar than you’re probably thinking.

You need to be an authority or expert in your field. This sounds really difficult. It’s not.

I teach a whole course on how to do this. And everyone who takes it succeeds at positioning themselves as an expert.

Here’s my best tip on positioning yourself as an authority:

Get really specific. The more specific the better. Don’t try to be the guy or gal who is an expert at EMS. Be the guy or gal who is an expert at intubations. Or better yet, the guy or gal who is an expert at child intubations from unstable positions.

See how getting really specific even sounds more expert? That’s one of the secrets. It’s also one of the benefits. You don’t need to be expert at everything.

One very specific topic in your field will do.

Are You Depressed Yet?

Chances are, you fail at least one of these tests.

And you know what that means, right?

It’s curtains. Goodbye, dear one, we’ll remember you fondly forever.

At least as far as flying today is concerned.

You can absolutely continue applying for flight jobs, but it’s not going to be an easy road until you pass the tests and remove all doubts.

The Good News…

You can always improve your situation. All is not lost.

If you’re currently failing one, or two, or all of the tests . . . it’s fixable.

It’s about changing habits and making you better until you pass.

If you’ve made it far enough in the “get a flight job” process to find this article . . . you absolutely can make it the rest of the way.

What’s the easiest, fastest and best way to do it?

Start with a like-minded group of professionals who will give you real advice and support. Where can you find a group like this?

Here you go:


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Troy Shaffer
Troy Shaffer

About the Author: Troy is an Air Medical Career Expert passionate about a team approach to improving air medical safety from the ground up. Troy is a former Army medic, Army pilot, Coast Guard pilot and EMS pilot. Troy has taught hundreds of wannabe flight medics, flight nurses and EMS pilots the exact steps needed to launch air medical careers.

    12 replies to "An Open Letter To EMS Who Want To Fly"

    • Craig Bowman, Garth Fitzgerald, and Rhys Antony Lilley we know a few that don’t pass these tests or try to answer these questions, no?

      • Troy Shaffer


        No big surprise that applicant motivation (or lack of) directly affects air medical job success.

        If you want to fly, you have to do the work.

        Clear Skies & Tailwinds

    • Betty Smith

      I am not an employee of BCAS, however I would like to be on your mailing list.
      I am a retired RCMP Dispatcher and have been involved with Ambulance personnel for many years; had 2 brothers, husband who were with BCAS and currently have 1 son who has been a Paramedic for many years..and I am acquainted with a number of the old timers, some still working, most retired.

      • Troy Shaffer


        Thanks for the question.

        You’re absolutely welcome to join the EMS Flight Safety Network mailing list. We’re all about team, and that team includes all the family who support EMS, air medical, fire and dispatch professionals.

        Just drop your name into the email sign-up box and we’ll take care of the rest.

        We’re honored to have you join us.

        Clear Skies & Tailwinds.

    • Stephanie Lowe

      Megan Elizabeth Lowe you need to read this! This guy rocks when it comes to getting flight jobs.

    • Charles Van

      An easier way to get a flight job is to be a regular so-so medic who happens to work for the local fire department in an area that is getting another stand alone communty based helicopter and they’ll hire the locals in an effort to get the calls over the competition.

      • Troy Shaffer


        I can tell by your tone the scenario you describe has happened to you.

        That stinks and I won’t try and sugar-coat it as anything it’s not.

        Do some EMS and air medical companies intentionally hire locals to increase their call and case numbers? Yes, without a doubt. Do some highly qualified candidates get passed over because of it? Yes, again without a doubt.

        But here’s the thing:

        Any time you spend being upset about it is wasted time.

        My advice is to focus on making you better. Focus on things in your control. Let the rest go. I know from experience it’s easier said than done.

        Thanks for commenting. Good luck to you.

        Clear Skies & Tailwinds

    • Valery M Burkholder

      Great write up; it will definitely help me in the future.

      Kinds regards!

      • Troy Shaffer


        Thanks for the kind words and feedback. I sincerely appreciate it.

        Stay focused. Air medical needs good folks like yourself.

        Clear Skies & Tailwinds

    • Patrick Jackson

      Very well thought out and written.

      • Troy Shaffer


        Thanks for the kind words and feedback. I hope the article helps you.

        Clear Skies & Tailwinds

    • Clark Hickingbottom

      Hey Troy,

      I’m a current active duty Navy helo pilot looking to get into EMS / HAA – and the thing we’re being told (at HeliExpo, et al venues) is that EMS companies do not like military helo pilots because we lack Single-Pilot IFR (SPIFR) experience. Though they are correct in the presumption that we “never fly alone”, I think they miss the point that most military regulations require that we accept IFR clearances whenever available (for weather avoidance) and consequently, accumulate a lot more time in “the goo” than our civilian counterparts. How do I ‘spin’ all of my multi-pilot, military IFR into a positive benefit for EMS/HAA employers who are seeking SPIFR applicants?

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