The commentary by Reaburn and colleagues in this issue of the Australasian Journal of Paramedicine suggests another type of paramedic for rural areas of Australia – the rural paramedic – a combination of a paramedic and a physician assistant (1). This view is in line with other international studies, which have proposed and trialled extended care paramedics (2), emergency care practitioners (3), and community paramedics (4). Australian university-based paramedic education programs were derived from the old state ambulance service-run vocational education and training sector paramedic programs. The university-based paramedic programs added a tertiary perspective to the upgraded paramedic education. What these tertiary education programs have not necessarily done is provide graduates with the education to meet the current and prospective ambulance workload and case type. As an example, the total trauma workload for the state of Victoria in 2002 was about 15 percent, the remaining workload was made up of medical and other conditions (5). Of the total trauma workload nearly 50 percent of cases were falls (5), a condition that does not receive the educational time it should in Australian paramedic programs. Therefore, should universities combine in an effort to analyse Australian ambulance data to establish what the caseload and case types are in a bid to guide the refinement of paramedic education programs in Australia, based on current and predicted ambulance caseload and case type?