The people in this group provide direct patient care in particular settings or areas of medicine. Some function as physician extenders (Nurse Practitioners, Physician Assistants) and practice in settings and areas of medicine as diverse as physicians do. Within variable constraints of physician supervision and protocols, their practice is based on their own clinical judgment and is relatively independent. Others practice within specialized areas of medicine (Certified Nurse-Midwives, Certified Registered Nurse Anesthetists) or in prehospital settings (Emergency Medical Technicians/Paramedics). Education and training varies by discipline but often requires professional medical or nursing degrees.