Short version is that if I were to train for paramedic I'd have to give up my place at my station and my crewmate - and nine tenths of the job is those two things. I sent enough time sticking cannulas in people and the like as a nurse without needing to do it on the road as well. Besides, if I do fancy doing those sorts of things my Paramedic crewmate 'supervises' me. as for doing away with EMTs... well, I'll cross that bridge when I come to it.