Joe, another interesting idea (For myself anyway-maybe Josh, too) was the flight medic. I'm lucky enough to live in an area where Lifeflight/Lifenet helicopters operate and have been able to ride in them a couple times. It's pretty fantastic and if Josh is able, he may want to explore that route too-like he doesn't have enough on his plate already . He should feel lucky being able to drive at 21 (I know he's only 19), some of my locales require the driver to be 25 because of insurance requirements.