Becoming a paramedic starts with EMT training, usually a course of one semester or less, followed by passing the NREMT exam and getting a state EMT license. After gaining field experience, you complete an accredited paramedic program, often one to two years, pass the NREMT paramedic exam and get licensed by your state. You generally must be at least 18.
Life on an ambulance
Paramedics provide advanced emergency care before a patient reaches the hospital. That means making real medical decisions in the back of a moving vehicle, in someone’s living room or on the side of a highway.
- The skills: cardiac monitoring and reading ECGs, giving medications, starting IVs, managing airways, and treating trauma, strokes, overdoses and breathing emergencies.
- The calls: some are true emergencies, and many are falls, chronic illness and people with nowhere else to turn. Paperwork follows every call.
- The schedule: 12 or 24-hour shifts are common, plus nights, weekends and holidays.
- Employers: private ambulance services, fire departments (many hire paramedics who are also firefighters), hospitals, air medical programs and event medical teams.
The levels of EMS
- EMT: basic life support, including CPR, bleeding control, splinting, oxygen and a short list of medications.
- Advanced EMT (AEMT): adds IV access and more medications. Not every area uses this level.
- Paramedic: the highest level of prehospital care, with advanced assessment, cardiac care, airway management and a wide range of medications.
Training routes
- EMT course: offered by community colleges, technical schools, hospitals and some fire academies, with classroom, skills labs and supervised ambulance time.
- Paramedic program: a certificate or associate degree with classroom work, hospital clinical rotations and a field internship. To be eligible for the NREMT paramedic exam, the program must be nationally accredited.
- Fire service route: some departments hire EMTs and pay for paramedic school later; others require it at hiring.
- Military route: military medics can often transition into civilian EMS credentials.
Many paramedic programs want applicants to have worked as an EMT first, and that time on the truck makes paramedic school far easier.
Exams and licensing
The National Registry of Emergency Medical Technicians (NREMT) offers national exams at each level, with a written exam and a skills assessment. Most states use NREMT results for licensing, and some add their own requirements. Licensing rules vary by state, so check your state EMS office before you enroll.
Steps from high school
- Take biology, health science and anatomy if offered, and get CPR training.
- Look into a high school EMT program or a youth EMS or fire cadet program, if your area has one.
- At 18, or as your state allows, complete an EMT course and pass the NREMT EMT exam.
- Work as an EMT for a year or more to build assessment skills.
- Complete an accredited paramedic program and pass the NREMT paramedic exam.
- Get your state paramedic license and keep up with continuing education.
Testing whether EMS fits
- Ask a local ambulance service or fire department about ride-along opportunities.
- Take a CPR or first aid class, then an EMT course. EMT alone is a useful skill and a solid job.
- Hold informational interviews with paramedics in private, fire and hospital settings.
Who lasts in EMS
Paramedics who do well stay calm in chaos, communicate clearly, like solving problems fast and can handle unpredictable days. People leave because of physical strain, disrupted sleep, pay in some areas and the cumulative stress of hard calls. Peer support helps, and talking with a licensed mental health professional is the right step when the weight builds. In a crisis, call or text 988. Many paramedics later move into nursing, physician assistant programs, firefighting, teaching or EMS leadership.
Coming to EMS later
Many people enter EMS in their twenties, thirties or later. EMT courses often run evenings and weekends, so you can test the field while keeping a job. Our guides on career change and building a career without a degree help with the planning. For pay and outlook, check the Bureau of Labor Statistics Occupational Outlook Handbook.
Where a mentor helps
A mentor helps a young adult explore emergency medicine and related paths, plan training, stay accountable through a demanding program and prepare for hiring processes and the first job. Mentors are not credentialed career counselors or licensing experts. Learn about our career and education mentoring and young adult mentoring.
Related
- Career paths: guides to dozens of careers
- How to become a firefighter
- How to become a nurse
- How to become a police officer
- Paramedic vs Firefighter: How the Jobs and Training Compare
Common questions
How long does it take to become a paramedic?
An EMT course is often a semester or less. Add field experience and a paramedic program of one to two years, so the full path commonly takes two to three years.
Do you have to be an EMT before becoming a paramedic?
Yes. Paramedic programs generally require an EMT credential, and many prefer that you have worked as an EMT.
What is the difference between an EMT and a paramedic?
EMTs provide basic life support. Paramedics have much longer training and provide advanced care such as medications, cardiac monitoring and advanced airway management.
Is the NREMT required everywhere?
Most states use NREMT exams for licensing, but not every state does in the same way. Check your state EMS office.
Get started
Drawn to emergency work and want a plan from EMT to paramedic? Call (888) 305 5422, email contact@blackburnmentoring.com or start with a short assessment. A member of our team reviews every assessment personally and sets up a free intro call.