Acting over the objection of the director of the Martha’s Vineyard Hospital emergency room, Chilmark selectmen voted to appoint Paul (Zeke) Wilkins as permanent chief of the tri-town ambulance service on Tuesday night.

Dr. Jeffrey Zack expressed frank concerns about whether the new chief has enough experience to lead the rural ambulance squad that serves Chilmark, Aquinnah and West Tisbury.

“I’ve had time to reflect over the last week or two . . . whether I agree or not with the decision and I do not,” Dr. Zack told the selectmen. “While he [Mr. Wilkins] may meet the requirements of position, he is not qualified to fill the role for quality assurance and do the training part of the job. Zeke can’t provide that yet, not to the level of my expectations. This is about providing quality care.”

Mr. Wilkins has served as interim tri-town chief since February. He has 10 years of experience as an EMT but has only been a paramedic for the past year and does not satisfy the hospital’s two-year requirement to be able to train subordinates.

Chilmark police chief Brian Cioffi said he originally agreed with Dr. Zack but said he had changed his position and backed Mr. Wilkins as chief, citing his leadership of the squad.

“He may just be a new paramedic and not meet Dr. Zack’s criteria, but the reality is the service has come around,” the chief said.

The tri-town ambulance committee recommended the appointment, which is made by the selectmen.

Mr. Wilkins said he would strive to meet Dr. Zack’s standards.

“I agree, we need to be the best we can and whatever we need to do I’m more than willing to do it,” he said.