Before the Hospital Transistor (https://transistor.fm) https://feeds.transistor.fm/before-the-hospital Before the Hospital is a podcast for the people building emergency medical systems where they are needed most. Each episode brings together practitioners, researchers, and health system leaders working on the frontline of prehospital care in resource-constrained settings — sharing what works, what does not, and what it takes to build systems that save lives. Produced by EMS Global Foundation. (c) 2026 EMS Global 301b9475-accb-530c-bffc-bb1b28ce0484 yes en Wed, 27 May 2026 00:49:07 +1000 Wed, 27 May 2026 00:49:38 +1000 http://ems-global.org https://img.transistorcdn.com/ncy0-KOwEhuLoTiN-JNK75dHBqFcdMbqSEuSK9tNNgQ/rs:fill:0:0:1/w:1400/h:1400/q:60/mb:500000/aHR0cHM6Ly9pbWct/dXBsb2FkLXByb2R1/Y3Rpb24udHJhbnNp/c3Rvci5mbS9kOTQ1/NGRiMDJjZTNjZjE1/NDk1MDZmYzIzNzFi/NDIwOC5wbmc.jpg Before the Hospital http://ems-global.org episodic EMS Global Foundation Before the Hospital is a podcast for the people building emergency medical systems where they are needed most. Each episode brings together practitioners, researchers, and health system leaders working on the frontline of prehospital care in resource-constrained settings — sharing what works, what does not, and what it takes to build systems that save lives. Produced by EMS Global Foundation. Before the Hospital is a podcast for the people building emergency medical systems where they are needed most. paramedicine, prehospital care, emergency medical services, global health, Mongolia EMS Global Foundation hamish@ems-global.org No No When less teaches more: What Mongolia's EMS reveals about Western systems 5 5 When less teaches more: What Mongolia's EMS reveals about Western systems full e47467ff-35fb-4c0e-98f6-fd1d80ac1d19 https://emsglobalfoundation.substack.com/p/when-less-teaches-more-what-mongolias Canadian paramedic Joe Acker watched a Mongolian ambulance doctor suture a head laceration on the roadside in the capital Ulaanbaatar, write a prescription and send the patient home. In Canada, the UK or Australia, that patient goes to hospital. No question.

]]> Canadian paramedic Joe Acker watched a Mongolian ambulance doctor suture a head laceration on the roadside in the capital Ulaanbaatar, write a prescription and send the patient home. In Canada, the UK or Australia, that patient goes to hospital. No question.

]]> Tue, 26 May 2026 10:00:33 +1000 EMS Global Foundation EMS Global Foundation 1237 Canadian paramedic Joe Acker watched a Mongolian ambulance doctor suture a head laceration on the roadside in the capital Ulaanbaatar, write a prescription and send the patient home. In Canada, the UK or Australia, that patient goes to hospital. No question.

]]> paramedicine, prehospital care, emergency medical services, global health, Mongolia No Mongolia's doctors know medicine. This is what they're missing. 4 4 Mongolia's doctors know medicine. This is what they're missing. full ff7581b2-26c5-44a8-9c51-cdd2c718012f https://emsglobalfoundation.substack.com/p/mongolias-doctors-know-medicine-this Mongolia’s ambulance doctors are qualified physicians. They know the medicine. What most of them have never been taught is what to do with that knowledge before the patient reaches hospital.

That is the problem international paramedic Leon Baranowski flew to Ulaanbaatar to help solve - for the third time.

This conversation was recorded mid-programme at the 103 Ambulance Service, while the training was still running. Leon is Operations Director for EMS Global and Senior Lecturer in Paramedicine at Monash University, and he has spent close to two decades working across paramedic systems in the UK, Canada, and Australia. But what he talks about in this episode is not his career. It is what happens when you try to build prehospital capability inside a system that was never designed around it.

The gap he describes - between clinical knowledge and prehospital application - is not unique to Mongolia. It recurs across health systems that rely on doctors and drivers rather than a paramedic workforce. Teamwork under pressure, communication on scene, decision-making before the hospital rather than inside it: these are not things medical school teaches, and they are not things that transfer automatically from hospital to ambulance.

What EMS Global is attempting in Ulaanbaatar is also not a short-term training visit. The harder question this episode sits with is whether you can build something that lasts after the instructors get on the plane home.

]]> Mongolia’s ambulance doctors are qualified physicians. They know the medicine. What most of them have never been taught is what to do with that knowledge before the patient reaches hospital.

That is the problem international paramedic Leon Baranowski flew to Ulaanbaatar to help solve - for the third time.

This conversation was recorded mid-programme at the 103 Ambulance Service, while the training was still running. Leon is Operations Director for EMS Global and Senior Lecturer in Paramedicine at Monash University, and he has spent close to two decades working across paramedic systems in the UK, Canada, and Australia. But what he talks about in this episode is not his career. It is what happens when you try to build prehospital capability inside a system that was never designed around it.

The gap he describes - between clinical knowledge and prehospital application - is not unique to Mongolia. It recurs across health systems that rely on doctors and drivers rather than a paramedic workforce. Teamwork under pressure, communication on scene, decision-making before the hospital rather than inside it: these are not things medical school teaches, and they are not things that transfer automatically from hospital to ambulance.

What EMS Global is attempting in Ulaanbaatar is also not a short-term training visit. The harder question this episode sits with is whether you can build something that lasts after the instructors get on the plane home.

]]> Tue, 26 May 2026 09:58:01 +1000 EMS Global Foundation EMS Global Foundation 1246 Mongolia’s ambulance doctors are qualified physicians. They know the medicine. What most of them have never been taught is what to do with that knowledge before the patient reaches hospital.

That is the problem international paramedic Leon Baranowski flew to Ulaanbaatar to help solve - for the third time.

This conversation was recorded mid-programme at the 103 Ambulance Service, while the training was still running. Leon is Operations Director for EMS Global and Senior Lecturer in Paramedicine at Monash University, and he has spent close to two decades working across paramedic systems in the UK, Canada, and Australia. But what he talks about in this episode is not his career. It is what happens when you try to build prehospital capability inside a system that was never designed around it.

The gap he describes - between clinical knowledge and prehospital application - is not unique to Mongolia. It recurs across health systems that rely on doctors and drivers rather than a paramedic workforce. Teamwork under pressure, communication on scene, decision-making before the hospital rather than inside it: these are not things medical school teaches, and they are not things that transfer automatically from hospital to ambulance.

What EMS Global is attempting in Ulaanbaatar is also not a short-term training visit. The harder question this episode sits with is whether you can build something that lasts after the instructors get on the plane home.

]]> paramedicine, prehospital care, emergency medical services, global health, Mongolia No What a genuine thank you means when you're running forty calls a shift 3 3 What a genuine thank you means when you're running forty calls a shift full 7458ec80-a31f-4af8-acd8-67698fc79b65 https://emsglobalfoundation.substack.com/p/what-a-genuine-thank-you-means-when Dr Judy is an ambulance doctor with the Ulaanbaatar Ambulance Centre, one of the frontline clinicians EMS Global Foundation has been working alongside since 2017. During the 2025 mission, she did something that captures the programme’s direction exactly: she participated as a trainee, contributed as a translator for the international instructor team, and helped bridge the gap between what was being taught and what her colleagues needed to understand.

She also agreed to sit down with us and talk about her work.

The conversation is short, unscripted and worth your time. Dr Judy describes what it is like to run forty calls in a single shift, the difference between the critical patient and the patient who simply has to wait.

]]> Dr Judy is an ambulance doctor with the Ulaanbaatar Ambulance Centre, one of the frontline clinicians EMS Global Foundation has been working alongside since 2017. During the 2025 mission, she did something that captures the programme’s direction exactly: she participated as a trainee, contributed as a translator for the international instructor team, and helped bridge the gap between what was being taught and what her colleagues needed to understand.

She also agreed to sit down with us and talk about her work.

The conversation is short, unscripted and worth your time. Dr Judy describes what it is like to run forty calls in a single shift, the difference between the critical patient and the patient who simply has to wait.

]]> Tue, 26 May 2026 09:56:45 +1000 EMS Global Foundation EMS Global Foundation 416 Dr Judy is an ambulance doctor with the Ulaanbaatar Ambulance Centre, one of the frontline clinicians EMS Global Foundation has been working alongside since 2017. During the 2025 mission, she did something that captures the programme’s direction exactly: she participated as a trainee, contributed as a translator for the international instructor team, and helped bridge the gap between what was being taught and what her colleagues needed to understand.

She also agreed to sit down with us and talk about her work.

The conversation is short, unscripted and worth your time. Dr Judy describes what it is like to run forty calls in a single shift, the difference between the critical patient and the patient who simply has to wait.

]]> paramedicine, prehospital care, emergency medical services, global health, Mongolia No What minus 40 teaches you about priorities 2 2 What minus 40 teaches you about priorities full e6807979-2824-45f4-a096-2056fa9a8ea4 https://emsglobalfoundation.substack.com/p/what-minus-40-teaches-you-about-priorities Jarrod Bell is a wilderness intensive care paramedic from Tasmania (Australia) - and a two-year EMS Global Foundation volunteer instructor in Ulaanbaatar. In this episode, Jarrod reflects on what draws a Tasmanian paramedic back to Mongolia for a second year: the adaptability and workload of Mongolia's ambulance doctors, the overlooked importance of environmental control in extreme cold and what a negative 40 degrees car rollover scenario teaches you about prehospital priorities. He also shares how working here has changed his sense of what paramedicine can achieve.

]]> Jarrod Bell is a wilderness intensive care paramedic from Tasmania (Australia) - and a two-year EMS Global Foundation volunteer instructor in Ulaanbaatar. In this episode, Jarrod reflects on what draws a Tasmanian paramedic back to Mongolia for a second year: the adaptability and workload of Mongolia's ambulance doctors, the overlooked importance of environmental control in extreme cold and what a negative 40 degrees car rollover scenario teaches you about prehospital priorities. He also shares how working here has changed his sense of what paramedicine can achieve.

]]> Tue, 26 May 2026 09:54:54 +1000 EMS Global Foundation EMS Global Foundation 761 Jarrod Bell is a wilderness intensive care paramedic from Tasmania (Australia) - and a two-year EMS Global Foundation volunteer instructor in Ulaanbaatar. In this episode, Jarrod reflects on what draws a Tasmanian paramedic back to Mongolia for a second year: the adaptability and workload of Mongolia's ambulance doctors, the overlooked importance of environmental control in extreme cold and what a negative 40 degrees car rollover scenario teaches you about prehospital priorities. He also shares how working here has changed his sense of what paramedicine can achieve.

]]> paramedicine, prehospital care, emergency medical services, global health, Mongolia No Why paramedic Tania came back to Mongolia 1 1 Why paramedic Tania came back to Mongolia full ec8508e3-3b0d-45cc-88d6-e93280bcaf3a https://emsglobalfoundation.substack.com/p/what-a-canadian-paramedic-sees-in Tania Johnston is an intensive care flight paramedic, emergency nurse, and academic based in Canada - and a two-year EMS Global Foundation volunteer in Ulaanbaatar. In this episode, Tania reflects on what she observed between her first and second mission: the strengths of Mongolia’s ambulance doctors, the opportunity to bridge contemporary prehospital practice with operational reality, and why teaching doctors when you are a paramedic works better than you might expect. She also shares the memory that brought her back for year two.

]]> Tania Johnston is an intensive care flight paramedic, emergency nurse, and academic based in Canada - and a two-year EMS Global Foundation volunteer in Ulaanbaatar. In this episode, Tania reflects on what she observed between her first and second mission: the strengths of Mongolia’s ambulance doctors, the opportunity to bridge contemporary prehospital practice with operational reality, and why teaching doctors when you are a paramedic works better than you might expect. She also shares the memory that brought her back for year two.

]]> Tue, 26 May 2026 09:38:51 +1000 EMS Global Foundation EMS Global Foundation 894 Tania Johnston is an intensive care flight paramedic, emergency nurse, and academic based in Canada - and a two-year EMS Global Foundation volunteer in Ulaanbaatar. In this episode, Tania reflects on what she observed between her first and second mission: the strengths of Mongolia’s ambulance doctors, the opportunity to bridge contemporary prehospital practice with operational reality, and why teaching doctors when you are a paramedic works better than you might expect. She also shares the memory that brought her back for year two.

]]> paramedicine, prehospital care, emergency medical services, global health, Mongolia No