On Friday, September 22 first-year medical students at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell responded elbow-to-elbow with Homeland Security forces straight into an active shooter simulation to test their newly acquired emergency medical skills.

The all-day disaster drill, which included other mass casualty incident scenarios, was orchestrated by Nassau County Fire Service Academy instructors and held on their multi-acre campus in Old Bethpage, NY. For the first time, the Nassau County Police Department’s special forces assisted with the active shooter portion of the exercise.

Mass Casualty Incident training day is part of the Zucker School of Medicine’s innovative curriculum that includes Emergency Medical Technician instruction and, ultimately, state certification for all students beginning their first day of medical school.

The annual exercise culminates nine weeks of EMT training for the students.

“Our EMT curriculum and the Mass Casualty Incident training day is an example of how our students put their knowledge into action,” said Dr. David Battinelli, dean of the Zucker School of Medicine and executive vice president and physician-in-chief of Northwell Health. “The EMT program is an innovative early clinical immersion that helps students contextualize the basic sciences within clinical practice and builds skills, confidence and critical thinking.”

With EMT training under their belts, the 101 students who make up the Class of 2027 were immersed in near-realistic catastrophic events, including a terrorist bus bombing, train derailment, car crash, chemical disaster, and the active shooter scenario, which enlisted the expertise of the NCPD’s Homeland Security team.

The EMTs, and future doctors, were under police force protection as they aggressively entered the simulated building attack, located shooting victims, secured their safety, triaged, and administered life-saving care.

The collaboration between law enforcement, paramedics, EMTs, and other first responders became a critical aspect of disaster training following the attack by two active shooters at Columbine High School in Colorado on April 20, 1999.

Since then, law enforcement and other first responders have dramatically changed their training protocols to focus on more rapid response in an active shooter event. Part of that is having law enforcement and emergency medical services personnel working and training together to better respond to these incidents.

“We wanted the medical students to see what it’s like to be embedded into a Rescue Task Force and feel some of the stresses that a police medic would feel because as medical professionals they might find themselves in a scenario where it erupts around them,” explained Lt. Robert Connolly, NCPD Homeland Security. “We incorporated Nassau County Police officers using rapid deployment equipment, and the students had the opportunity to manipulate some of the stretchers and tourniquets that we would realistically provide in an active assailant situation. So, it’s a real practical application of skills and equipment.”

This important exercise, made possible through a unique partnership between the Zucker School of Medicine, Northwell Health’s Emergency Medical Institute, the NCFSA, and the NCPD, highlights the many disciplines that must work in lockstep to rapidly neutralize a threat and save lives. Each scenario is played out with accurate details, complete with the chaotic sights and sounds of an actual disaster, including fire, smoke, darkness, sirens, noises, and the screams of first responders and the injured.

“The day was high stress and anxiety because you don’t deal with real-life emergencies on a normal basis,” said first-year medical student Ivory Jean-Paul. “Reading a textbook is so different than being put into the actual experience. The number one thing that we did today was to think and act quickly. We also learned that in a real-life emergency, it’s also important to have a certain level of empathy for everyone’s situation.”

When it opened its doors in 2011, the Zucker School of Medicine became one of the first institutions nationwide to devote part of its curriculum to EMT training – today, the program is a model for other medical schools nationwide. Because of the partnership between Hofstra University and Northwell Health, the Zucker School of Medicine can provide students with the unique opportunity to complete clinical rotations in one of the most extensive hospital-based ambulance services in the United States.

During their EMT training, students ride alongside and learn from the more than 100 ambulance crews in the Northwell Health system while providing care to a widely diverse population. Dr. William Rennie is one of the medical school’s founding faculty members who helped create the popular EMT curriculum.

“We designed the course to include community interactions with the students not as observers, but as participants in community health care by riding on ambulances and visiting people in their homes and stores and laundromats, on highways and wherever they are needed,” explained Dr. Rennie, associate professor of emergency medicine and science education. “The ambulance rotations allow students to work with emergency medical care professionals who can give them insight into what it takes to do the job every day and how to interact with every patient effectively, both interpersonally and medically; both are equally important.”

First-year medical student Brandon Smith described EMT training as an intensive two months that exposed him to a broad spectrum of life-and-death situations, from transporting a week-old premature baby to the hospital to performing CPR on an elderly patient. “As an EMT about to enter someone’s home, you have absolutely no idea what will be behind the door,” explained Smith. “Having that experience and getting that extra knowledge of a patient’s living conditions can help provide the extra care they may need.” Smith, who hails from Levittown, is the first in his family to attend medical school. He admits that caring for patients as a first responder was an eye-opening experience that will help him become a better doctor.

“When you do the ambulance rotations and see how people live and work, you start to appreciate the fact that everyone has a different situation, so as a doctor, I’m going to have better questions for EMTs, paramedics, and patients coming into the hospital,” said Smith, who holds a bachelor’s degree in Biological Sciences from SUNY Binghamton. “There’s been much research about how the social determinants of health impact health outcomes, so it’s important to ask questions – a patient is a person, not just a list of symptoms.”

Zucker School of Medicine’s newly certified EMTs will celebrate their transformation to active participants in meaningful patient encounters during a White Coat Ceremony on October 13, officially marking their transition from students to colleagues in medicine. To learn more about the Zucker School of Medicine’s EMT curriculum, visit the website.