National EMS Museum People Files, NEMSM-0003 [Please include Folder/Person’s Name]

Dr. Sheldon Jacobson


Sheldon Jacobson, MD: Father of the New York City EMS Paramedic Program

In 1973, the New York City Emergency Medical Service, like most of the ambulance services around the country, provided little more than basic first aid and a fast ride to the critically injured patient. The ambulances were affectionately know as “Bread Boxes” because they were built on the step van chassis favored by the bread and bakery delivery services. While the “arsenal of medical equipment” consisted of splints, bandages, OB kit, a foam filled BVM, a useless foot operated suction pump, a RevivaLife resuscitator incapable of free flow oxygen, stair chair, and a scoop stretcher.

The TV show Emergency! went on the air in January 1972, depicting a totally new concept: non-physician Paramedics trained to interpret EKG’s, start IVs, administer fluids and medications, control the airway, and defibrillate at the scene of the emergency. The nation was fascinated with the show and pilot programs were starting in many major US cities.

The world of EMS in New York City changed radically because of Dr. Sheldon Jacobson. Then-Chief of Emergency Services at Jacobi Hospital in the Bronx, he recognized that both ED Physicians and Emergency Medical Technicians needed better training in order to have any meaningful impact on patient outcomes. He formed the Institute of Emergency Medicine at Albert Einstein College of Medicine where the first Emergency Residency program in NYC was conducted. The first class of Paramedics, “Jacobi 1”, hit the streets of the Bronx in July 1974 with two medic units out of Jacobi Hospital.

Funding for the next class and expansion would not come until June 1977. It was clear from the outset, that there was a very close relationship between Dr. Jacobson and the Jacobi 1 medics. He took a very hands on approach with the class, as he had done with the first, delivering many of the major lectures himself. His students often wondered how he could give an entire day’s presentation, without any notes or aids.

He surrounded his students with expert lecturers: nurses, physicians, respiratory therapists, and many of the class 1 paramedics filled in the gaps and made the material relevant for the prehospital environment. There were no paramedic textbooks in print, but he managed to obtain pre-publication photocopies of the nation’s first textbook authored by Dr. Nancy Caroline.

But it was the values he taught his students that have served his medics best. They were to be trained to be thinking practitioners who must understand the mechanism of the disease process in order to make correct decisions. They were NOT going to be trained like LA’s early paramedics, routinely asking for direction and permission over the radio. They would operate primarily under standing orders and were ultimately responsible for any treatment decisions or drugs administered, not the physician on the radio.

They had a responsibility to continue their education, and to pass their knowledge and experience on to others. At graduation he asked that they take the Oath of Geneva, affirming our responsibility to practice our profession with honor, to make the patient their first consideration, to respect their teachers, treat their patients without prejudice, and respect life.

He served as the first Chairman of the Regional Medical Advisory Committee, responsible for the development of the first regional protocols, and the first testing and certification process for paramedics and medical control physicians. His greatest influence was firmly establishing that it would be the MAC physicians making the major medical decisions in the system.

Dr. Jacobson left NYC for a position as ED Director at the University of Pennsylvania in 1979, but continued to maintain close relationships with many of the Jacobi medics for the next 30 years. Many of those medics went on to become influential Emergency Physicians, and the next generation of leaders in EMS.

Dr. Jacobson returned to New York in 1994, as Professor and Chair of the Department of Emergency Medicine at Mount Sinai Medical Center. Here too, he established a residency program in Emergency Medicine,

Among his lifetime of contributions to emergency medicine- teacher, professor, Chief of Service, author, lecturer and mentor, it is as Father of the New York City Paramedic program that all the Jacobi Medics will remember him.     

Submitted to NEMSM August 2009 by Mark Peck, EMT-P

National EMS Museum Resources

Additional Resources