Version 1: This course is designed for individuals employed by FDNY-EMS Academy as EMTs who have completed paramedic training outside the Department and are about to begin working as paramedics. The course covers Advanced Life Support (ALS) equipment inventory, ALS assessment principles, ALS documentation, introduction to FDNY-EMS ALS operations, issues of quality assurance, paramedic roles and responsibilities in FDNY-EMS as presented by the Medical Director of Training and Telemetry Rotation. The course includes lecture; scenario testing, involving medical, trauma, and cardiac arrest scenarios in a simulated clinical setting before and following the field component; a field component involving the course participant as a member of a paramedic unit in the field; a field diary, including properly formatted patient assessment, histories, presumptive diagnoses, treatments, and follow-up at the emergency department; and case study presentations, for which course participants prepare a research paper on an advanced level medical condition or treatment modality for peer presentation and critique. Prerequisite: New York State certification as a Paramedic. Version 2, 3, 4, and 5: This course covers Advanced Life Support (ALS) equipment inventory, ALS assessment principles, ALS documentation, introduction to FDNY-EMS ALS operations, issues of quality assurance, paramedic roles and responsibilities in FDNY-EMS. The course includes lecture; scenario testing, involving medical, trauma, and cardiac arrest scenarios in a simulated clinical setting before and following the field component; a field component involving the course participant as a member of a paramedic unit in the field; a field diary, including properly formatted patient assessment, histories, presumptive diagnoses, treatments, and follow-up at the emergency department; and case study presentations, for which course participants prepare a research paper on an advanced level medical condition or treatment modality for peer presentation and critique. Prerequisite: New York State Paramedic certification.