In this EAST Careercast, Dr. Zaffer Qasim and Dr. Laszlo Kiraly discuss the role of Emergency Medicine-Critical Care specialists involved in the operational and directorial aspects of prehospital and critical care transport medicine.  Dr. Qasim interviews Dr. Jason Cohen (EM-Intensivist at Brigham and Women's Hospital and Medical Director of Boston Medflight), Dr. Jacob Keeperman (triple board-certified in EM, Critical Care, and Emergency Medical Services, attending physician at the Washington University School of Medicine in St Louis, and Medical Director of Air Evac Lifeteam), and Dr. Jonathan Trager (EM and Critical Care Physician at St Luke's University Hospital, Bethlehem, and Medical Director for St. Luke’s Emergency & Transport Services and Critical Care Transport). They provide an insight into their role providing critical care both in and out of the hospital, key considerations of choosing this path as a career option, and the challenges and opportunities of this area of medicine in the United States.