EMT-Paramedic TestThe Paramedic exam requires applicants to pass both a state approved psychomotor exam, as well as a national NREMT certification exam. Under the 2014 NHTSA guidelines, the EMT-Paramedic certification level will be referred to as simply the Paramedic certification. Potential EMT candidates applying for an Paramedic certification must meet certain requirements.  Candidates must be 18 years or older.  Paramedic candidates must also have an EMT certification at the national or state level.  Candidates must also have completed a state-approved Paramedic course.  The state Paramedic course must meet or exceed the US Department of Transportation National Standard Curriculum for Paramedic.  This state course must have been successfully completed within the previous two years.  Additionally, Paramedic candidates must hold a current CPR credential and have successfully demonstrated competence in Paramedic skills.

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NREMT Paramedic Application Steps

To apply for the Paramedic test, please follow the following steps:

  • Go to NREMT.org and register for an account.
  • Complete an online National Registry Application. Please note that the application includes a statement on Licensing Action and Felonies - dealing with felony convictions. If you have an existing felony conviction on your record, your application will be denied.  You are, however, allowed to appeal your application denial. 
  • Pay an application fee of $110.  The applicaon fee applies to each attempt at the cognitive exam.  The application fee can not be transferred or refunded.
  • You will receive an Authorization to Test (ATT) document, after you submit your application.  The ATT will contain complete test information and logistics, such as required identification, scheduling instructions and test center locations.

NREMT Paramedic Exam

Candidates for the Paramedic certification must pass the NREMT cognitive test.  The test is given via a computer and is a Computer Adaptive Test (i.e., which adapts the test based on the student’s aptitude).  The number of questions on the Paramedic exam will range from 80 to 150 based on the EMT student’s aptitude.  You will be given a maximum of 2.5 hours to complete the Paramedic exam.

The EMT-Paramedic exam will cover all portions of the curriculum, including: EMS Operations, Cardiology, Trauma, Medical, Obstetrics, Pediatrics and Airway and Breathing.  The EMT-Paramedic test is heavily focused on fundamentals and operations.

The following requirements apply to Paramedic certification candidates:
 - You must be at least 18 years of age.

 - You must currently be certified at the EMT level (at either a state or national level).

 - You must have successfully completed a state certificed Paramedic course.  The Paramedic course must, at a minimum, meet the U.S. Department of Transportation (DOT) Paramedic National Standard Curriculum requirements. The course must have been completed within the past two years and verified by the Course Program Director on the NREMT web site.


EMT-Paramedic Test Outline

An applicant can expect to see 80 to 150 items. Of the 80 to 150 items, 60 to 130 of them will be counted towards the final score, while the other 20 "pilot" questions will not be counted towards an applicants final score. Applicants will have a maximum time of 2 hours and 30 minutes to complete the test. The test is a computer adaptive test (CAT).

The Paramedic cognitive exam includes information on the following topics:

Topic  Exam Percentage Adult/Pediatric Mix
 Airway, Respiration & Ventilation 18-22% 85% Adult/15% Pediatric
Cardiology & Resuscitation 22-26% 85% Adult/15% Pediatric 
Trauma  13-17% 85% Adult/15% Pediatric 
Medical; Obstetrics & Gynecology 25-29% 85% Adult/15% Pediatric 
EMS Operations 10-14% n/a 

Paramedic Psychomotor Assessment Exam

Twelve skills will be assessed in the psychomotor examination.  The skills are based on scenarios and will evaluate your abilities to perform in an out of hospital environment. The covered skills include: patient assessment-trauma, ventilatory management, cardiac management, IV and medication skills, oral station, pediatrics and basic skills such as spinal immobilization and bleeding control/shock management.

EMTs have different duties and responsibilities based on their training and certification.  An EMT's salary is often different based on their experience, training, and location. Typically, most EMTs are certified to one of four levels that are administered by NREMT, the National Registry of Emergency Medical Technicians.  The four NREMT certifications are: Emergency Medical Responder, EMT, AEMT and Paramedic.  An effective way to pass your NREMT certification exam is to use free EMT practice tests.