The first model, arguably the oldest, is generally described as the Franco-German model. This model is physician-led, and those personnel who serve emergencies from ambulances are often place in minor, supporting roles. There is ample evidence indicating that at the turn of the 20th century, many North American hospital-based ambulances in larger centres were staffed by ambulance surgeons; physicians who responded in the ambulance and provided care in a manner which very much resembles the current Franco-German model. In the French version of the model, only physicians and nurses perform advanced care, and ambulance drivers have only minimal medical training.