The EMS (Emergency Medical Service) system in France is a centrally based, two-tiered, physician-manned system. The first level is composed of BLS (Basic Life Support) fire department ambulances (called "VSAB") based at fire stations. The second level is composed of ALS (Advanced Life Support) physician staffed-ambulances. In France, there are two different levels of emergency department (ED). The first level is called "SAU" and has continuous coverage by surgeons, in Level 2 certain specialities may be available only on an "on-call" basis. Staffing patterns in the ED vary from one hospital to another. In general, EDs in university and major teaching hospitals are staffed by emergency physicians and residents from different specialties. In France medical schools are part of free public universities. The length of medical training varies from 8 to 11 years according to speciality. Emergency Medicine is not recognised as a stand alone specialty.