How to Become an EMT or Paramedic

According to industry-sanctioned textbooks regarding the concept of Emergency Medical Services' (EMS), the modern concept of the Emergency Medical Services industry began during the 1960s. Accidental Death and Disability: The Neglected Disease of Modern Society was the academic white paper that started it all. 

Over the next ten years, it became quite noticeable that Emergency Medical Services were to be an important addition to the professional medical services delivered to the public. The primary reason that caused this new awareness was the ever-increasing number of automobile accidents on America’s highways and in communities. 

About a decade later, the United States' Emergency Medical Technician (EMT) program began. 

How An EMT Differs From A Paramedic

From the public’s perspective, the professional medical service position of an EMT is often confused with that of a Paramedic. Many people even mistakenly presume that the two jobs are the same. And, while the professional responsibilities of an EMT and a Paramedic overlap (and very often complement one another), each medical service position is fundamentally different in significant ways. 

Emergency Medical Technicians and Paramedics are similar in that the two jobs fall into the category of first responders. Emergency Medical Technicians and paramedics must be licensed and certified by the state in which they operate or, by the National Registry of Emergency Medical Technicians (NREMT). 

A Paramedic’s training begins at the more advanced EMT certification levels. Paramedics are authorized to begin an IV line, perform manual defibrillation and administer medicine – tasks that an Emergency Medical Technician is not authorized to do.  Generally speaking, paramedics are authorized to administer up to 35-40 medications; the exact allowable amount depends upon state law.

Read more about the differences between an EMT and Paramedic.

The EMT Certification Levels That Lead To Paramedic Certification

The National Registry of Emergency Medical Technicians (NREMT) is an industry organization that is dedicated to the administration of various Emergency Medical Technician (EMT) certification level awards. Each more advanced certification level requires additional skills and capabilities. 

Those who advance and complete the most elevated Emergency Medical Technician certification level has passed the requirements to become a Paramedic. 

Training requirements vary by state and/or region. Presently, 46 states use the National Registry of Emergency Medical Technicians’ suggested training directives. Therefore, it is critical to understand the requirements you need to meet by confirming your state’s standards. It is important to note that some states permit license reciprocity between each jurisdiction. 

Read more about the NREMT certification levels.

Emergency Medical Technician Education Requirements

In addition to meeting education-licensing requirements, an Emergency Medical Technician (EMT) must be 18+ years old and have a high school diploma or its equivalent. The Emergency Medical Technician course is generally completed in approximately six months, or less.

Each state-approved Emergency Medical Technician certification program offers traditional classroom lectures, hands-on training, and lab work training. 

#1 - Obtain Emergency Medical Technician (EMT) Certification. (once Known As EMT-B Certification)

The first certification level for the Emergency Medical Technician (EMT) certification is the entry-level course that provides the fundamental knowledge and practical training you will need throughout your Emergency Medical Technician/Paramedic career. 

EMT certification requires that all Emergency Medical Technician license candidates hold CPR certification in addition to completing a state-approved pre-license formal training program. The pre-license EMT Certification course generally requires the completion of 125 – 200 hours of training, which varies and depends upon the jurisdiction’s law. 

The Emergency Medical Technician examination is administered with a computer-based system that is sophisticated enough to adjust test questions, in real-time, based on the test-taker's responses. The number of questions on the exam varies as the computer adapts to the test-taker's abilities. 

The Emergency Medical Technician certification exam assesses a test-taker’s knowledge of five relevant categories. These include -

  • Medical. 
  • Trauma.
  • Airways & Breathing.
  • Cardiology.
  • Operations.

One of the smartest ways to prepare for Emergency Medical Technician exams is to practice regularly by using free online practice exams. This will allow you to gain an understanding as to the test's format and ‘feel.' Your first score can act as a baseline that can be used to monitor how your knowledge is improving, by practice.

Free EMT Practice Tests from

The EMT’s Job Responsibilities

An Emergency Medical Technician’s responsibilities are limited in scope. Emergency Medical Technicians are only authorized to perform non-evasive procedures like –

Essential lifesaving care at the scene of the emergency.

The administering of basic medication, for example, oral glucose.

Taking & Monitoring vital signs. 

Utilizing a bag valve mask. 

Assisting more advanced personnel (Emergency Medical Technicians & Paramedics)

Recently, EMTs have been chosen to complete advanced training as those first responders who work on the front line combatting the opioid crisis. This specialized training allows for an Emergency Medical Technician to administer the nasal spray naloxone, a lifesaving medicine that can reverse the effects of an opioid overdose if given in time. 

Test results for the EMT certification exam are generally available in about two days, although the EMT exam results are released sometimes sooner on the NREMT's website. If one needs to retake the Emergency Medical Technicians Certification exam, he or she must wait at least 15 days to sit for the exam. 

Once you have completed the EMT pre-license training program, you are required to pass these relevant examinations to earn an Emergency Management Technician’s certification. 

The State-Approved certification exam regarding psychomotor skills.

The National Registry of Emergency Medical Technicians (NREMT) Cognitive Certification test. 

To see how much an EMT makes, visit our EMT salaries page.

#2 - Become State Licensed & Gain Work Experience As A Certified Emergency Medical Technician Professional. 

#3 - Obtain Your EMT Intermediate/85 Certification (EMT-1)

The next professional level of Emergency Medical Technician training available is the EMT Intermediate/85 certification training. 

The professional who possesses a certified EMT-1 will have accumulated training, education and experience hours that range between 225 – 425; depending on the EMT requirements of the state or region. 

The EMT Intermediate/85 Certification examination follows a format the assesses an EMT-1 prospect's ability concerning the advanced skills that include –

  • The insertion of IV lines.
  • The use of Pulse Oximetry.
  • The placement of cervical collar splinting and traction. 
  • The use of intubation, CPAP and other airway devices that clear obstructed airways. 
  • The complex delivery of a child. 
  • The administration of medication that includes glucose oral gel, epinephrine, and albuterol.

It is important to note that certain locations revise the above-noted responsibilities and duties to meet the community's unique emergency medical technician needs. It is best to double-check with the regulatory agency overseeing the EMT program in your state. 

When the EMT Intermediate/85 Certification (EMT – 1) program is complete, you must sit for the tests that lead to certification. The EMT Intermediate/85 Certification examination is most often completed in about two hours and fifteen minutes. The testing requirements include –

  • A State-Approved Psycho-Motor Certification test.
  • The National Registry of Emergency Medical Technicians (NREMT) Cognitive Certification test. 

#4 – Obtain Your Advanced EMT Certification (AEMT)

The Advanced Emergency Management Technician (EMT) Intermediate/99 is a training level that expands an EMT's education and training. It is considered the first portion of the EMT Paramedic training program. The Intermediate/99 test requires test-takers to meet the National Standard Curriculum set forth by the NHTSA

Some states refer to this EMT professional level as an Advanced Emergency Medical Technician (AEMT) or an EMT-Intermediate level.

When the EMT Intermediate/99 training program is complete, you must sit for the tests that lead to the EMT- 1 advanced certification credential. 

A State-Approved Four-Skill Psycho-Motor Certification test.

The National Registry of Emergency Medical Technicians (NREMT) Cognitive Certification test. 

#5 - Paramedic Certification–(previously Known As An EMT-P)

Paramedic Certification Requirements

Unlike the previously mentioned qualifications, those hoping to work as paramedics generally need to complete a two-year academic degree to earn the certification. Once an individual passes the required certification exams, they know have been fully trained in both basic and advanced skills. As such, paramedics are trained and authorized to deliver extensive critical care with their additional skills. Paramedics also earn top of the scale earnings in the emergency care realm.

Paramedic Certification allows for the treatment of medical services to patients at an emergency scene. This is the highest level of medicine that is delivered before the patient reaches a medical facility or hospital. 

Paramedic training generally covers about two years of work/experience plus an internship in an ambulance or hospital setting. 

The Paramedic Certification Exam

The Paramedic Certification exam has a maximum time limit of 2 and ½ hours.  Those who complete a paramedic-training program (by completing between 1,200 and 1,800 hours – that can be completed in under 2 years) are eligible to sit for the Paramedic certification test. Certain paramedic programs issue an associate's degree for the completion of the paramedic coursework. If the degree is bestowed will depend upon the paramedic standards set forth by oversight professionals. 

Selecting a Paramedic Program or School

Selecting a quality Paramedic program is a crucial step.  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 or AEMT.  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.

If you would like to prepare for an EMT test, check out our free EMT practice tests.

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