Under the terms of the agreement, a city firefighter would be assigned to a county ambulance in the city and in exchange a county paramedic would ride on a city fire truck. Dr. Robert Tober, the EMS medical director, has allowed city firefighters to engage in advanced life support procedures in part because of the experience they gained through SWAP. That ALS certification for city firefighters could be endangered if the city and county can’t find some other way to satisfy Tober that the firefighters are up to the job medically.