Become a ParamedicA Paramedic certification is the highest certification awarded by the National Registry of Emergency Medical Technicians (NREMT).  Paramedics and EMTs care for sick and injured patients in a variety of situations.  Typically, paramedics will be responsible for some on-site care and then transport the patient to a hospital.  Paramedics are often sent to a scene by a 911 operator. Scenarios that a paramedic may encounter include: heart attacks, strokes, car accidents, gun shot wounds, domestic violence and other situations that require urgent medical attention.

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Once at the scene, the EMT or Paramedic will assess the patient and provide many types of emergency medical care.  Paramedics may treat patients on site if they have received the appropriate training and certifications.

Paramedics and EMTs usually are dispatched in teams.  One EMT will usually tend to a patient, while the other team member drives the vehicle to the medical facility.
Paramedics can choose to specialize their roles.  For example, some EMTs and paramedics may chose to work in a Medical Flight operation to transport critically ill patients to trauma centers.

The responsibilities and duties of EMTs have will vary based on their training and certification. A Paramedic’s experience, training, and location will also affect an EMT's salary. Typically, most EMTs are certified to one of five levels that are administered by NREMT, the National Registry of Emergency Medical Technicians.

Paramedic Programs and Paramedic Schools

Selecting a quality paramedic program is a crucial step in becoming a paramedic.  Many students will select a program based on location, reputation or word of mouth.  While these are important factors, you should also evaluate the following:

  • Entry Requirements - Paramedic Programs may require prehospital experience or years of work experience as an EMT-Basic or EMT-Intermediate.  Some programs will require an interview and recommendations.  Most programs will have an admissions exam and require certain prerequisite courses.
  • Certifications - Certification is an important aspect of the paramedic profession.  You need to understand whether the program is following the National Standard Curriculum or a state curriculum.  Insure that the program fully prepares you for the NREMT exam.  Also make sure that the program fully prepares you to be a paramedic by learning a variety of methods of performing the required skills.
  • Program Length and Schedule - The National Standard Curriculum recommends that a course be between 1000 and 1200 hours, including 500 to 600 hours in the classroom, and 250 to 300 hours each for both clinicals and field internships.  See how your prospective program matches up to the recommended length. How flexible is the program?  Does it offer both day and evening hours?  When are the clinical and field rotations?  What is the number and variety of clinical and field sites.
  • Facilities/Equipment - Does the program have dedicated classroom and lab facilities?  Does the school have enough equipment for several students to practice simultaneously?  Is the equipment relatively new and in good shape?
  • Support Services -  Depending on your needs, you should see if the program offers support services such as computer labs, tutoring/exam prep, learning centers, counseling and childcare services.
  • Accreditation - Is the program accredited?  If not, why not?  Accreditation by agencies such as the Commission on the Accreditation of EMS Programs (CoAEMSP) helps validate the quality of a program by evaluating programs on many factors and monitoring attrition/graduation rates and other key metrics.
  • Cost/Financial Aid - What is the overall cost of the program including textbooks, technology fees, and lab fees?  Is financial aid available?

For more information on paramedic schools, you should contact the regional or state agency that regulates EMS education in your area.

NREMT Certification Levels

The NREMT administers five different EMT certification levels that represent a ladder of increasing knowledge, skills, and abilities.  The five NREMT certification levels are shown below:

  • First Responder–  Entry level EMS services.  Provides basic first response first aid and patient management. If you are an employee of a police or fire agency you will most likely be required to be a first responder.
  • EMT-Basic (EMT-B) – This certification level provides basic life support.
  • Intermediate/85 (EMT-I) – NREMT certification level based on the 1985 EMT-Intermediate National Standard Curriculum.
  • Intermediate/99 – (EMT-I) - NREMT certification level based on the 1999 EMT-Intermediate National Standard Curriculum.
  • Paramedic – (EMT-P) – This is the highest level of EMT certification supported by the NREMT.  Paramedics can administer a wide range of medication, provide advanced life support, and perform advanced surgical and electrical therapies.

EMT-Paramedic Requirements

Potential EMT candidates applying for an EMT-Paramedic certification must meet certain requirements.  EMT-Paramedic candidates must be 18 years or older.  EMT-Paramedic candidates must also have an EMT-Basic certification at the national or state level.  Candidates must also have completed a state-approved EMT-Paramedic course.  The state EMT-paramedic course must meet or exceed the US Department of Transportation National Standard Curriculum for EMT-Paramedic.  This EMT-Paramedic state course must have been successfully completed within the previous two years.  Additionally, EMT-Paramedic candidates must hold a current CPR credential and have successfully demonstrated competence in Paramedic skills.

Steps to Becoming A Paramedic

  1. Become a EMT-B – Obtain your entry level training and certification.  This training will be the foundation for your Paramedic training.  You can receive EMT-Basic training at community colleges, hospitals or ambulance services.
  2. Get work experience – It is recommended (and often required) that you work as an EMT-B for at least one year before you seek your Paramedic certification
  3. Take your required courses – Your training requirements will vary based on your state.  You will probably need training in anatomy and physiology, electrocardiography (EKG), and IV Training.
  4. Study for and pass your EMT-Paramedic Exam - The EMT-Paramedic exam will cover all portions of the Paramedic curriculum, including: EMS Operations, Cardiology, Trauma, Medical, Obstetrics, Pediatrics and Airway and Breathing.  The EMT-Paramedic test is heavily focused on fundamentals and operations.


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