Pitt-Bradford’s new emergency medicine program is meeting a crucial community need
EMS bag: check. Two-way radio: check. Defibrillator: check. It’s a Tuesday afternoon, and Jay Mckenzie is on his way to save a life.
Just moments earlier, a 911 dispatcher blared over the City of Bradford Fire Department’s public address system: McKean County Ambulance 1, ALS response in Bradford City, cross streets of Mill Street and York Street, unresponsive.
Mckenzie is an emergency medical technician (EMT) and firefighter. He’s also a history and political science major at the University of Pittsburgh at Bradford — the first City of Bradford Fire Department employee to also juggle a full-time college workload.
In 2022, when Mckenzie was a beginning student, Pitt-Bradford’s Division of Biological and Health Sciences began offering an EMT course; taking that class jump-started Mckenzie’s own EMT path.
His training couldn’t have been more timely. Emergency services have long had trouble recruiting and retaining workers. According to the federal Health Resources and Services Administration, an additional 40,000 full-time emergency medical personnel are needed across the country by 2030 to keep up with demand.
To address this shortage, Pitt’s Bradford campus, in partnership with the School of Health and Rehabilitation Sciences, launched a bachelor’s degree program in emergency medicine this school year. Students in the program, which will see its first graduates by 2028, gain the expertise and skills to become certified paramedics, fluent in critical care medicine.
The introduction of the EMT course and emergency medicine major upholds Pitt-Bradford’s legacy of responding to the challenges faced by its surrounding communities, says Rick Esch (UPB ’81, ’83, BUS ’98G), president of both Pitt-Bradford and Pitt-Titusville. The new major is also yet another example of the University’s impact throughout the entire commonwealth.
“Over time, we’ve oriented our curriculum to address the region’s needs; we established our nursing program in the late ’70s because, at the time, there was a shortage of nurses, and today we are addressing the deficiency of EMTs and paramedics,” he says.
More than 99% of the land in McKean County, where Pitt-Bradford resides, is classified as rural by the U.S. Census Bureau. For Esch, who has lived in Bradford since kindergarten, supporting his neighbors’ access to essential health care services, including emergency medical services (EMS), is a personal mission.
“We can’t sustain ourselves without investing in emergency services in the region,” says Esch. “It’s essential we train professionals and add them to the workforce because the need here is so large.”
A fragile rural health system
According to a report by the Pennsylvania Office of Rural Health, almost a third of Pennsylvania’s population lives in rural areas, and that isolated geography impacts health outcomes. Furthermore, 22% of Pennsylvania’s population lives in federally designated Health Professional Shortage Areas, which include more than a quarter of Pennsylvania’s rural residents, as opposed to less than 2% of Pennsylvania’s urban residents.
This is “beyond crisis,” says Pennsylvania State Representative Martin Causer (UPB ’96).
Existing staffing and funding crises in many rural Pennsylvania EMS agencies are exacerbated by factors like low volunteer numbers and the demographic shift toward an older, sicker population. These are all factors that are leading to critical issues in providing timely EMT and paramedic services.
“We need additional EMS personnel in nearly every community; getting more personnel trained is a top priority,” Causer says. “The Pitt-Bradford emergency medicine program can make a real difference toward meeting that goal and, ultimately, saving lives.”
Causer, whose legislative district includes Cameron, McKean and Potter counties, is not only a leading EMS advocate in the state legislature, but he also volunteers as an EMT for an ambulance service in eastern McKean County, giving him a direct perspective of the challenges playing out in his legislative district and rural communities across Pennsylvania.
Causer gives one example of an area that is contributing to the dire situation for his rural constituents.
“EMS has been trained to deliver babies, but if you’re having a complicated childbirth, you do not want to be in the back of an ambulance,” Causer says. “The lack of access to labor and delivery hospital units is putting more of a burden on emergency medical services. It’s caused a situation where the ambulance service I run with had done extra training on childbirth in anticipation of needing to utilize those skills.
“I wish people knew how fragile our emergency medical system is. Many people don’t think about it until they need it. They expect that they’ll dial 911 and someone’s going to come, but it may take a long time,” he adds. “We have to continue to strengthen the system.”
Addressing the gaps
Esch describes his campus’ efforts to address the gaps in the region’s health care system as a “homegrown strategy.”
“We’ve learned that if we educate people from Western Pennsylvania, they are more likely to get placed locally, and even postgraduation, they’re likely to stay in the community. The EMT course and emergency medicine major are our opportunity to make a big difference in the region and provide great career paths for our students.”
Case in point: At 33 years old, in April 2024, Brett Butler became the youngest person to hold the rank of fire chief in the City of Bradford Fire Department. A City of Bradford native, Butler (UPB ’13) is also one of four Pitt-Bradford alums currently serving in the fire department. The campus’s emergency medicine program wasn’t yet established during his undergraduate years, but he did serve within the region as a volunteer firefighter while he was a student.
He notes the reciprocal benefit of having Pitt-Bradford in his town.
“There are a lot of people around here who want to see the Bradford area succeed, and a large part of that is investing in Pitt-Bradford because it will bring more people here,” Butler says.
Butler’s fire department is on pace this year to break its record for the most ambulance calls. He’s hopeful about Pitt-Bradford’s emergency medicine major being a wellspring of support.
“It’s difficult right now to get people into the fire and EMS field; the number of people we need just isn’t there. If Pitt-Bradford can become a hub for EMS training and a pipeline to the region, it would help the current strain on EMS services,” says Butler.
The road to care
To give Pitt-Bradford’s EMT students and the larger Bradford community a feel for what it would be like to work on an EMS crew, Butler’s fire department offers observational ride-alongs in its ambulances. For Mckenzie, once wasn’t enough. After his first experience with the City of Bradford Fire Department, he signed up for every ride-along offered that year.
“With Jay, it was as if he started riding along and never left,” says Butler.
Since earning his EMT license at Pitt-Bradford, Mckenzie also has completed multiple training programs, including interior firefighting through the Allegheny County Fire Academy.
He credits his strong support system, including his relationships with colleagues at the fire department, with motivating his training as well as his love of learning, especially when it means gaining knowledge to help more people.
“No matter how long you’ve worked in emergency services, there is always something new and interesting to learn. Training doesn’t feel like a chore,” he says.
Bradford City Fire Department paramedic Cathy Mealy, one of Mckenzie’s supervisors, oversees the fire department’s emergency medical services and has taught in Pitt-Bradford’s EMT class since its inception.
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Learning how to help is transformative, says Mealy, who has watched students’ self-confidence and sense of purpose grow.
“It’s incredibly rewarding to do service for others when the focus is off you,” she says. “It’s like love: The more you give away, the more you have.”
While not all students in Pitt-Bradford’s EMT class and emergency medicine major will go on to practice in a professional capacity, they are learning skills that will benefit them throughout their lives, Mealy adds.
“Besides understanding the basic EMT principles, students learn how to think, how to observe and how to process information. We teach them to make rapid, good decisions in a crisis,” she says.
She’s had a front-row seat watching Mckenzie’s skills and maturity develop since he joined the fire department crew.
“Jay is successful because he’s constantly willing to learn and push himself out of his comfort zone; that’s the definition of working in emergency medical services and fire. He’s brave enough to challenge himself,” says Mealy.
“EMS students are held to a higher standard because they will encounter people at their most vulnerable moments,” she says. “People have to be able to trust and rely on you.”
Witnessing the pain of others is part of the job, Mealy says, but there are ways to cope. She tells students to know what their “why” is.
“You’re going to have hard calls, and you’re going to see things you need to talk to somebody about, but knowing your ‘why’ will get you through the hard times and will help you stay grounded in the good times, too,” says Mealy.
Mckenzie’s “why” is his drive to help people in need. He says that working in emergency services has led to greater empathy — a trait that will serve him in his future aspiration of going to law school and becoming a prosecutor. He also plans to continue working part-time in EMS while earning his law degree.
While going from working as an EMT and firefighter to law school may not seem like an intuitive path, Mckenzie says it’s all about being where he’s needed.
“In being an EMT, you’re an advocate for your patient,” says Mckenzie. “They could be someone experiencing domestic violence or even sexual assault. You’re more than a medical provider; you play multiple roles, especially in an area like Bradford.”
Researching rural hospital health
In Pittsburgh, med student Donald Bourne (SPH ’24G) is researching another big problem specific to Pennsylvania’s rural health care providers — payment models.
“Traditionally, health care has been financed through a fee-for-service model, where a medical provider performs a service and is then reimbursed by an insurer, and that model relies on a large volume of patients to produce revenue. As rural populations have declined, hospitals are seeing fewer patients and bringing in less money,” says Bourne, a fourth-year student in the joint Pitt/Carnegie Mellon University Medical Scientist Training Program.
Despite a downturn in revenue, the cost of maintaining a hospital has remained the same or even increased because of rising labor costs, supply chain inflation and increased capital expenditures. The financial stresses of running a hospital are passed on to the community.
“Often what happens is hospitals pare down the services they provide that have the lowest profit margins. Obstetrics, psychiatric care and substance use treatment are usually the first to go,” Bourne says.
That leaves patients needing to be transported greater distances to access care, increasing pressure on EMS providers, he says.
Bourne’s dissertation explores a potential solution — the Pennsylvania Rural Health Model, a project of the U.S. Centers for Medicare and Medicaid Services that ran from 2019 to 2024. It was an initiative to supply rural hospitals with stable, sustainable funding, eliminating the ups and downs inherent in a fee-for-service model.
It’s relaunching in 2026 — the new version adapting some of its practices based on Bourne’s research findings.
Bourne describes the Pennsylvania Rural Health Model as an alternative payment arrangement system.
“Basically, it estimated historical patient revenue for the hospital and then set its prospective budget for the next year. The Pennsylvania Rural Health Model issued payments, regardless of how many services the hospital provided or didn’t provide,” he says.
The goal of the program, as Bourne explains, was to determine whether improving the financial health of rural hospitals would, in turn, improve patients’ health.
“Hopefully, [a participating hospital] could better adapt its services to the community, avoiding potentially avoidable hospitalizations, retaining savings they then invest in hospital improvements or community health plans,” he says.