This week, Aebhric O’Kelly is joined by Rob Schembri, a Canadian critical care paramedic with Ornge, Ontario’s air ambulance service, and a student on CoROM’s MSc in Austere Critical Care.
Rob discusses his journey through critical care paramedicine, his recent move onto a special operations team and why, after decades in the profession, he decided to pursue postgraduate education in austere medicine. His new role includes supporting the transport of patients with high-risk pathogens and mechanical cardiac support, as well as USAR and other specialist operations.
The conversation explores the Canadian paramedic system, including the progression from Primary Care Paramedic to Advanced Care Paramedic and ultimately Critical Care Paramedic. Rob explains the extensive training required at the critical care level and how international paramedics can enter the Ontario system.
Rob also talks candidly about undertaking his first research project, navigating ethics approval and discovering that the thesis he initially dreaded has become one of the most interesting parts of his MSc.
The episode finishes with a discussion about lifelong learning, career development and Rob’s advice to clinicians beginning a career in austere medicine: learn as much as you can, experience as much as you can—and enjoy what you do.
Chapters
00:00 – Meet Rob Schembri: Critical care paramedicine, Ornge and joining the special operations team.
01:18 – The Malta Connection: Rob's Maltese heritage and his family's move to Canada.
03:03 – Returning to Malta for a Master's Degree: The irony of pursuing postgraduate education in the country his parents left.
03:25 – Why the MSc in Austere Critical Care?: Preparing for specialist critical care and special operations.
05:02 – High-Risk and Special Operations Medicine: High-risk pathogens, mechanical cardiac support, USAR and specialist transport.
06:50 – Why Study Austere Critical Care in Malta?: Choosing CoROM rather than a conventional Canadian critical care programme.
08:18 – POCUS and Future Training: Bringing austere prehospital ultrasound into specialist practice.
11:05 – Reaching the MSc Thesis: Rob's progress through the programme.
11:36 – Researching Cognitive Load in Austere Conditions: Identifying a gap in conventional critical care paramedic training.
13:32 – Designing the Research: Comparing conventional scenarios with scenarios incorporating austere stressors.
15:02 – From Dreading Research to Enjoying It: Becoming a first-time clinical researcher.
16:01 – Research Ethics: The challenges of preparing an ethics submission.
17:42 – Why an MSc Should Include Research: Thesis versus coursework and what it means to earn a Master of Science.
19:42 – What Comes After the MSc?: PhDs, lifelong education and knowing when to give the family a break.
20:32 – Taking a Maltese MSc Back to Canada: Recognition, professional development and teaching opportunities.
22:31 – How Canadian Paramedicine Works: PCP, ACP and Critical Care Paramedic pathways.
24:43 – Moving Between Canadian Provinces: Reciprocity and employment across provincial systems.
25:40 – Is There a Canadian Paramedic Registry?: How Ontario regulates and identifies paramedics.
26:59 – International Paramedics Coming to Ontario: Where UK, Australian, South African and other clinicians may fit.
28:09 – Comparing US and Canadian Paramedic Education: Training pathways and entry into critical care practice.
30:06 – Becoming a Critical Care Paramedic in Ontario: The 16–18-month training process and clinical placements.
31:17 – “It's Never Too Late”: Rob became a critical care paramedic in his fifties.
32:04 – What Would Rob Do Differently?: Looking back on the MSc and a 36-year career.
32:54 – Advice for the Next Generation: Learn, experience, enjoy your work and value the people around you.
33:53 – Coming Home to Malta: Pastizzi, cannoli and plans to finally meet in person.
