Fifteen new Boston EMTs were sworn in last week as they graduated from the city's paramedic academy — and their help will be sorely needed in a department that is both understaffed and overworked.

So far this year, Boston EMS has responded to more than 109,000 calls and is struggling with not having enough paramedics to handle all of that work. On several occasions in August alone, the staffing limitations meant ambulances in some neighborhoods couldn't operate, increasing response times for patients in those areas who needed help.

In an effort to boost the ranks, Boston Mayor Michelle Wu announced at the graduation that the city is launching a new cadet program to start the training process for new EMTs. Before people can apply to Boston's paramedic academy, they need to have completed an EMT training course, which can cost several thousand dollars and require around six weeks of full-time classwork. Wu said the new cadet program will pay people to get that initial training and certification.

“So now we have a program where anyone who just has a heart to serve and an interest in the role can be paid as they get that training,” Wu said after the graduation event. “And it's opened up lots of doors in terms of residents who now feel that this is an accessible job pathway.”

The union that represents Boston's EMTs says increasing the pipeline of cadets will help, but that doesn't address the fundamental problems of burnout and insufficient retention.

“People are being forced into overtime to fill open shifts because of various reasons ... you know, injuries, vacations, whatnot,” said Matt Anderson, president of the Boston Police Patrol Association EMS Division. “But, people leaving as well. You know, as we graduate a class of 15, we this year have lost 23 to 25 [EMTs].”

“As we graduate a class of 15, we this year have lost 23 to 25 [EMTs].”
Matt Anderson, president of the Boston Police Patrol Association EMS Division

So far this year, Anderson said, the department has seen over 1,200 overtime shifts. Each shift is 8 hours, and then they are being told they have to work another 8-hour shift immediately after that.

The Boston EMTs' collective bargaining agreement says they can't do more than two of those overtime shifts a month. The union said that becomes a problem when everybody's already run through their two allotted overtime shifts, leaving some ambulances no longer available to respond to calls.

“On several occasions within the calendar month of August, we had to shut down Paramedic 16, which covers the Back Bay, Longwood, Allston-Brighton area of the city, because we had no paramedics available,” said Nicholas Mutter, who's also a Boston EMT and a secretary with the union. “That then turns around and increases response times to those districts where we don't have the ambulance coverage.”

And increased response times can have a real impact on safety.

The city reports that the median response time currently is 7.4 minutes for the most urgent calls, which are called "priority 1 incidents." Mutter said the target time for those calls is 6 minutes.

While that discrepancy might not appear too bad, response times can take significantly longer. At a Boston City Council hearing on the issue of paramedic staffing earlier this month, Boston resident Kelli Gillen Forbes called in to describe pulling a fire box in Charlestown when her aunt was having a stroke in May. She told the City Council the fire department managed to get there within about 3 minutes. They provided her with oxygen, and called for an ambulance to transport her to more advanced care.

“They immediately contacted EMS to get an ambulance out there to us,” Gillen Forbes said. “It was anywhere from 45 minutes to an hour before it got there. I actually had my aunt's son-in-law walk from the Garden to get over there, and he got there before we got any ambulance there to help her.”

The city disputes Gillen Forbes’ timeline and says an ambulance arrived within 17 minutes.

Gillen Forbes said her aunt is doing OK, but she asked the council to do what they can to make sure those kinds of delays don't happen.

Paramedics say there are several ways to improve those call times. They want a strategic plan for how the department is going to grow as the city's population continues to increase. They want more stations opened up in neighborhoods where they are needed, especially in Dorchester and Roslindale, and in the Seaport District, where there's currently no EMT station, but one is under construction.

Also, there's a requirement that Boston paramedics live in the city, and they note that Boston is an expensive place to live. There's currently a three-year moratorium on that requirement, but once that expires, EMTs living outside the city would have to move into Boston. The union wants to see that mandate go away altogether.

After Friday’s EMT graduation, the mayor did acknowledge that retention is an issue. She pointed out that paramedics got a new contract with a pay raise over the summer, and she's hoping that helps keep more of them sticking around.