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Advancing from EMT to paramedic

Learn more skills and open up new career opportunities by becoming a paramedic


Two Orlando-based paramedics stand by their emergency vehicle.

AP Photo

If you’re thinking about advancing from an EMT to a paramedic, there are a few important components to consider. Becoming a paramedic is a much bigger commitment than becoming an EMT, but you’ll expand your patient care skillset, open up several career opportunities, and grow as a medical professional.

What’s the difference between an EMT and a paramedic?

When an EMT becomes a paramedic, their scope of practice is expanded and they take on a greater leadership role at the scene of an emergency.

Paramedics are the most highly-skilled prehospital care providers. They perform advanced life support for patients in urgent medical emergencies, invasive procedures like IV insertions, advanced airway management, and the administration of several drugs.

In addition to helping patients in possibly dire conditions, paramedics are expected to manage the scene. This might mean being a steady, calming presence for a patient’s emotional family members or any nearby bystanders. It’s not an easy job by any means, especially not when all eyes are on the paramedic at the scene of an emergency.

Career opportunities for paramedics

A career-minded EMT who becomes a paramedic will have several more job opportunities beyond working in an ambulance. Because paramedics have a much wider scope of practice and are more self-sufficient than EMTs, they are attractive candidates for:

  • Fire departments
  • Police departments
  • Hospitals
  • Oil rigs
  • Medical helicopters
  • Event staffing
  • International EMS providers

Earning a paramedic certification opens up doors that an EMT might not have access to. Since paramedic training is much more rigorous than EMT school, those who earn their cert are held in high regard by potential employers.

Registering for paramedic school

To become a paramedic, you’ll first have to be an EMT. You’ll also need some of the same documents that were required to get your EMT, including:

  • Driver’s license

  • CPR certification
  • Health insurance
  • Immunization records
  • Consent to a criminal background check and drug screen

Many EMS professionals will suggest you spend six months to a year as an EMT before signing up for paramedic school, but it’s possible to go “zero to hero” and enroll right away. This is a topic of debate for EMS professionals. Some believe that spending some time as an EMT will refine the BLS and scene management skills for prospective paramedics, while others believe it’s possible to learn on the job. Others choose to work as an EMT while going to paramedic school.

The final decision is up to you, but ultimately, your worth as a medic hinges on your desire to keep up with the profession and grow your skills.

Paramedic program overview

Paramedic programs can range from six to eighteen months in length. They are typically broken up into didactic, clinical, and field internship sections.

Though each paramedic program in your area may have different schedules, instructors, and clinical opportunities available, all of them (even the online programs) must meet the paramedic education standards outlined by the NREMT.

In the didactic section, students will attend labs and lectures delivered by experienced paramedics. They’ll learn the theory behind emergency medicine and practice new skills on dummies, mannequins, and even other students.


EMS students working on a skills lab.

Photo/Paul Long

Depending on their program’s requirements, paramedic students must also log 600 to 1200 clinical hours on sites like the hospital’s emergency department, pediatric ED or NICU, nearby fire stations, cath labs, and behavioral/psych units.

In addition, students may have to perform several repetitions of specific skills (such as intubation) while under the supervision of a health care professional in order to pass. Many paramedic programs use Fisdap to track the clinical hours and skills of their students.

Finally, the field internship will have you working in the back of an ambulance with paramedic (or firefighter-paramedic) preceptors. At this point, you’re not really expected to be a full-blown paramedic, but you should be a useful set of hands and have the theory component of the course down pat.

After you’ve passed all sections of your course, you’ll be eligible to take the NREMT and become officially certified as a paramedic.

What are the challenges you may face while in paramedic school?

Paramedic school isn’t easy. In addition to learning material that’s much more advanced than the EMT curriculum, time management becomes a huge priority for students.

If you choose an in-class program, you’ll have up to 16 hours of classes per week, grueling study sessions with your peers, and about 8 - 36 hours of clinical rotations to meet your hours. This gets more complicated when work and family are thrown into the mix. You may have to give up your social life for a while and cut out the nonessentials while getting your certification. Paramedic school is also a poor time to make big life decisions like moving or getting married.

Many paramedic students also struggle with learning the material, in particular the cardiology and pharmacology sections of the course. Though you’re not expected to perform at the level of a senior paramedic during your clinical rotations and field internships, you should absolutely have a solid base of knowledge under your belt.

Finally, younger paramedic students with little to no EMS experience may struggle with being assertive around patients and hospital personnel. This is something you have to get over. The people around you will help you out if you ask, but you must ask.

Paramedic school will test the limits as an EMS student. It’s important to know what you’re getting into before you make that commitment, but many of the paramedics who made it can’t see themselves doing anything else.

This article, originally published on Nov. 30, 2016, has been updated

Rachel Engel is an award-winning journalist and the senior editor of and In addition to her regular editing duties, Engel seeks to tell the heroic, human stories of first responders and the importance of their work. She earned her bachelor’s degree in communications from Cameron University in Lawton, Oklahoma, and began her career as a freelance writer, focusing on government and military issues. Engel joined Lexipol in 2015 and has since reported on issues related to public safety. Engel lives in Wichita, Kansas. She can be reached via email.