Emergency Medical Technicians (EMTs) serve 25 to 30 million Americans in the course of just one year. EMTs are often the first responders on a scene, trained to directly provide medical care to people suffering a health episode and those who are injured. They work with other first responders to provide on-the-scene lifesaving care and transport individuals to a hospital emergency department. 

EMTs go through a series of training sessions to pass a state-approved EMT course. They must also take and pass the National Registry of Emergency Medical Technicians (NREMT) EMT computer exam, and take and pass the National Registry of Emergency Medical Technicians (NREMT) EMT skills exam. Within two years of completing these tasks, prospective EMTs can use their course completion certificate to apply for EMT certification in their state.¹

While an EMT doesn't have to attend a four-year university or get a bachelor's degree to become a certified EMT, there are strict state and federal education and hands-on experience requirements before an individual can become employed as an EMT. 

• Basic Education Requirements: EMTs must complete a high school program or get a GED. 

• CPR Certification: EMT training programs may require applicants to complete their CPR certification as a condition of acceptance. 

• EMT Program: EMTs must complete an education program approved by their state to receive certification. A database of EMT programs for each state is on the Commission on Accreditation of Allied Health Educations Programs website. 

• Cognitive Exam: EMT students taking the National Registry Emergency Medical Technician cognitive exam must achieve a "standard level of competency" according to the National Registry of Emergency Medical Technicians. The exam takes about two hours and has 60 to 110 questions. 

• Psychomotor Exam: Prospective EMTs must demonstrate their ability to perform emergency services. The exam is administered by the state's emergency management services office or a local training institution. 

   

Different Types of EMS and EMT Certifications

There are a few different types of EMTs. The National Highway Traffic Safety Administration (NHTSA) recognizes four levels of EMT certification². EMS professionals must also meet their state's standards of certification. 

To advance through each of the four levels, emergency medical services (EMS) personnel build on the knowledge and skills gained in lower levels. 

• EMR (Emergency Medical Responder): Basic medical emergency response training ideal for volunteers living in rural communities, search and rescue personnel and firefighters. 

• EMT (Emergency Medical Technician): The most common level of medical emergency response training. Suitable for full-time licensed EMTs responsible for responding to emergency calls and safely transporting medical patients to facilities where they can receive appropriate and life-saving care.³

• AEMT (Advanced Emergency Medical Technician): Builds on EMT training, allowing certified individuals to provide intermediate life support (ILS) care. 

• Paramedic: Highest certification level for pre-hospital medical providers. 

In some states, paramedics can attend additional classes to achieve a higher certification. These state-specific licenses may include the Advanced Practice Paramedic or Critical Care Paramedic. 

EMT Specialty Certifications

EMTs can seek out additional education to receive one or more of the following EMT specialty certifications:

• Wilderness EMT

• Tactical EMT

• Flight Paramedic

• Wilderness Paramedic

   

Difference Between an EMT and a Paramedic

Paramedic (PM) courses build on EMT skills and education. While an EMT completes a minimum of 170 hours of educational instruction, a PM may go through a program that includes between 1,200 and 1,800 hours of instruction. 

In general, students in a PM program have already completed their EMT education. They may also have a few months of field experience as EMTs. 

PM programs last six to 12 months and teach students how to start intravenous lines, interpret EKG results, provide advanced airway management, administer medication and provide care to patients experiencing an emergency. 

Some PM programs require students to take college-level Physiology or Anatomy classes as a condition of admission. PM students may have to pass a background check, provide proof of current immunizations, pass a physical and fulfill personal health requirements.⁴

Education Requirements to Become an EMT

Each state and some larger cities have specific requirements for EMT certification. If you want to know how to become an EMT in Boston, you can contact the City of Boston and inquire about their EMS EMT Basic Course. Boston offers this six-month program twice each year. Evening and weekend classes make getting an EMT certification easy for people who have full time jobs.⁵

What Are the National EMS Education Standards?

Standards are comprised of four components:

• Competencies

• Knowledge

• Clinical behaviors and judgments

• Educational infrastructure

This framework supports individual programs so that students can develop the skills they need to successfully perform duties expected of them during the course of a workday.⁶ 

EMT Training Requirements

An EMT course must meet both local and national requirements. EMTs must complete 120 to 300 hours of classroom training, depending on their state's requirements. AEMTs must complete an additional 100 to 300 hours of classroom training after receiving their EMT certification. Paramedics build on that education by completing another 1,500 to 2,500 hours of training.⁷

EMT students must also spend a minimum amount of time in clinical rotations in a hospital environment. Their clinical rotations may include emergency medicine, psychiatry, intensive care and obstetrics. They may also be required to spend a minimum amount of time working in an ambulance setting. The amount of time spent in clinical rotations and in an ambulance depends on how long it takes the student to prove competency and meet state requirements. 

Skills Required to Become an EMT

EMTs often work long hours with few days off. The job requires a unique set of skills and personality traits. 

Problem Solving: EMTs must be able to think quickly and make decisions with limited information. It's crucial to be decisive and confident when providing emergency care to patients. 

Communication: An EMT interacts with a variety of different people in the course of a normal day on the job. Many people aren't at their best in stressful situations, and an EMT must be able to give clear instructions, communicate with team members about a patient's condition, and provide hospital personnel with the information they need to continue caring for a patient. 

Physical Endurance: EMTs work long hours and have physically demanding jobs. It's necessary to be able to lift another human, spend time kneeling and contort to provide life-saving services to people trapped in cars, or reach wounded individuals who can't move their bodies. 

Frequently Asked Questions About Becoming an EMT

How Much Money Does an EMT Make?

According to the Bureau of Labor Statistics, the EMT technicians in the lowest 10% of earners made less than $24,650. The median annual salary for an EMT technician in the United States was $36,650. The highest 10% of EMT workers make at least $62,150 per year.⁸

States that pay EMTs the highest annual salaries are:

• Maryland: $47,830

• Connecticut: $43,95

• Alaska: $50,110

• Washington: $76,040⁹

States that pay EMTs the lowest annual salaries are:

• Kansas: $27,470

• West Virginia: $28,600

• Alabama: $28,790

• Mississippi: $31,010

• Arkansas: $31,870

• Michigan: $32,280

• South Dakota: $32,280

• Montana: $32,050

• Kentucky: $33,550¹⁰

   

How Long Does It Take to Become a Paramedic?

The length of time it takes to become a paramedic depends on your current education level and whether you have an EMR, EMT or AEMT certification. If you attend school full time, you may be able to complete paramedic training (if you are already a certified EMT) in just 12 months. Many students take up to three years to go from EMT status to a paramedic certification.¹¹

How Do Paramedics and EMTs Pay for School?

Paramedics and EMTs have access to the same financial aid as any other high school or college student. Many people with EMT and paramedic certifications paid for school with a combination of grants, scholarships, and tuition loans or education loans. 

What Can I Do With EMT Training?

EMTs may be employed as firefighters, emergency dispatchers, contract medics or offshore medics. With additional training, an EMT could also transition into a job as a crime lab technician, biological technician or health information technician. 

An EMT or paramedic who wants to use their certification and education to switch careers may be able to move into an ER technician position in an emergency room. ER techs work inside the hospital, so there's no on-scene work. On average, an EMT tech's annual salary in the United States is $63,507. 

A surgical technologist assists a medical team with before and after surgery patient care, as well as sterilizing equipment. This position may require additional training. Surgical technicians make about $50,110 per year in the U.S.¹² 

Becoming a certified EMT or EMS technician is a great career choice for those who crave a fast-paced work environment. Jobs are plentiful, even in rural areas. Growth opportunities in the field are abundant; many EMTs use their education and experience as a stepping stone into adjacent careers. 

Ready to become an EMT? Start by contacting an institution near you with an accredited EMT program. Check out the Commission on Accreditation of Allied Health Educations Programs website to find a program in your area. They can assess your situation and help you move forward toward an EMT certification.

¹  UCLA, 2021, What's the Difference Between an EMT and a Paramedic?, Accessed August 4, 2021, [UCLA.edu]
²  Mike Touchstone, 2009, National EMS Education Standards a Big Step Forward, Accessed August 4, 2021, [EMS1.com]
³ U.S. Bureau of Labor Statistics, Occupational Outlook Handbook EMTs and Paramedics, Accessed August 4, 2021, [BLS.gov]
⁴ UCLA, 2021, What's the Difference Between an EMT and a Paramedic?, Accessed August 4, 2021, [UCLA.edu]
⁵ City of Boston, 2021, How to Become a Boston EMS EMT, Accessed August 4, 2021, [Boston.gov] 
⁶ Mike Touchstone, 2009, National EMS Education Standards a Big Step Forward, Accessed August 4, 2021, [EMS1.com]
⁷ Katy McWhirter, 2020, Emergency Medical Technicians 101, Accessed August 4, 2021, [FireScience.org]
⁸ Careeronestop, 2020, Yearly Wages for Emergency Medical Technicians and Paramedics in UNITED STATES, Accessed August 4, 2021, [Careeronestop.com]
⁹ Careeronestop, 2020, Salary Finder, Accessed August 4, 2021, [Careeronestop.com]
¹⁰ Careeronestop, 2020, Salary Finder, Accessed August 4, 2021, [Careeronestop.com]
¹¹ Firefighter Insider, 2020, How Long Does It Take To Become a Paramedic? Expert Advice, Accessed August 4, 2021, [Firefighterinsider.com]
¹² Alyssa Jordan, 2019, 15 Alternative Jobs for EMTs & Paramedics in 2021, Accessed August 4, 2021, [UnitekEMT.com]