Now I know why I am glad I don't work in a city like London. Yes we get out fair share of innapropriate jobs etc but nothing like your 80%. Take today for instance out of 11 999 calls inc symtomatic bradycardia requiring atropine from me, acute asthma, cva etc only one call we weren't required_ECP dealing. We had one stand down as well. All genuine stuff. For me most shifts are like that. I think the education thing is the same all over but as a Paramedic I am responsible for my own education according to the HPC. I must say I have learned far more through my own self directed study than I ever did at training school. What makes me laugh is going to training school for a training officer to go over the quicktrach surgical airway device (who has never used one in anger) yet I have and so had 2 of the other guys! Same as needle decompression. Same as paeds cannulation and drugs administration, I have had quite a bit of experience. If you get the exposure then up goes your confidence. But if you don't get the exposure and/or decent/regular updates/refreshers then how is your confidence going to grow? I must be one of the lucky ones.