Smiling female paramedic

EMT to Paramedic: Career Guide for Aspiring Paramedics

How to Become a Paramedic: Duties, Requirements, Certifications, Job Outlook, and Salary

Smiling female paramedic

Working as a first responder has long been regarded as one of the noblest, most respectable, and most important careers a person can pursue. From the start of your shift to the last minute of your day (and often during off-hours as well), you are the first line of defense against injury, illness, and death. And if you ask those who do it, you’ll hear it’s a uniquely fantastic job. EMTs are portrayed as heroes in Hollywood films and television because that’s exactly what they are. The truth is, they actually make a difference in the world and in people’s lives.

But many within that first line of defense, namely Emergency Medical Technicians, strive to do even more to help people. They are looking for more responsibility, better pay, and better job opportunities. For these reasons, as well as others, many EMTs choose to become paramedics.

EMT vs. Paramedic

Difference Between an EMT and a Paramedic?

In many respects and to most people, the jobs of EMTs and Paramedics look almost identical. They work similar shifts, their jobs are about saving lives, they spend their days at an EMT headquarters or inside an ambulance, and they even wear similar uniforms. However, there are several differences between the two, primarily in trainingresponsibilities, and salary. 

EMT vs. Paramedic: TRAINING

Licensed EMTs typically complete an EMT course similar to the 14-day EMT boot camp, which encompasses 120+ hours of training in order to become certified.

On the other hand,  a paramedic builds on their initial EMT foundation by completing a full 1,200+ hours of training before certification. This higher level of training can take one to two years to complete.


EMTs and paramedics share many of the same responsibilities as first responders—providing timely emergency aid for those suffering from injuries or illnesses.

The major difference between EMTs and paramedics is that, with the exception of auto-injectors (such as the EpiPen), EMTs are not allowed to break the skin of their patients—that means no needles and no IVs.

Paramedics’ advanced training allows them to do everything an EMT does in addition to administering medication, starting IVs, and providing advanced airway management.

EMT vs. Paramedic: SALARY

Pay is another reason to consider becoming a paramedic, as they earn an average of 18% more per year than EMTs.

With the average base salary* for EMTs of around $38,000 per year, the average annual salary* for a paramedic is about $46,000 and can go as high as $57,000 per year.

Paramedic Definition

What Does a Paramedic Do?

Think of a paramedic as an EMT 2.0. A paramedic uses the vital EMT training as a foundation for learning more advanced techniques.

With the help of additional training and skills, paramedics can save lives in complicated situations where more limited EMT training might not be enough.

Paramedics at work in an ambulance

Paramedic Job Description

For individuals wanting to make as big a difference as possible as a first responder, the job of a paramedic really fits the bill. In addition to the life-saving techniques learned in EMT training, candidates also learn to provide these life-saving procedures:

  • Administering shots
  • Starting intravenous lines
  • Drawing blood
  • Advanced cardiac life support

Paramedic Work Hours

Emergencies can happen at any time of day, on weekdays, or on weekends, so like their EMT counterparts, paramedics are on call 24-hours. Paramedics most often work in 9-, 12-, or 24-hour shifts and full-time paramedics often work 40 or more hours per week, depending on staffing.

A paramedic’s exact work hours, however, will be determined by where they work—information that is typically included in the job description.

What Does a Paramedic’s Day Look Like?

There really is no such thing as a “normal” day for a paramedic. Like EMTs, paramedics start each shift having little or no idea what to expect in the hours ahead. Each day is an adventure that could take them literally anywhere.

Some days may be quiet, with nothing more than minor scrapes to tend to, while other days may be non-stop, with paramedics rushing from the scene of one disaster or accident to the next, providing emergency care as quickly as possible. Paramedics may find themselves in the difficult situation of racing against time to carry patients to the nearest hospital only to turn around and go back for more. Paramedics may encounter such extremes as performing cardiac life support for an elderly patient one minute and delivering a newborn baby the next.

Still, there are a few aspects of the paramedic’s day that are routine. Every day begins with a rig (ambulance) check and equipment inspection, and every call begins at a standby location (a hospital, ambulance center, clinic, or fire department). Where a paramedic goes after that is always an unknown, but one thing is certain – they are well trained for whatever comes their way.

Paramedic Requirements

According to the NREMT (National Registry of Emergency Medical Technicians), candidates for becoming paramedics must meet the following requirements:

  • Must be 18 or older
  • Must currently be certified as an EMT (learn how to become an EMT here)
  • Must have completed an accredited paramedic program within the last two years
  • Must be CPR certified
  • Must complete a psychomotor competency portfolio (proof that you can physically handle the job of a paramedic)
  • Must complete the NREMT paramedic cognitive and psychomotor certification exams

How to Become a Paramedic

If you have decided to advance your career from EMT to Paramedic, congratulations! You’re already on your way to an exciting career as a qualified first responder. The road ahead means a lot of study, dedication, and hard work, but at the end of the road lies a life-changing, life-saving opportunity unlike any other.

The first step towards becoming a paramedic is, of course, to become an EMT, which you can do through courses such as the 14-day EMT Boot Camp. Once you’ve completed that requirement, it’s time to begin your real training as a paramedic.

Here’s a comprehensive look at what you can expect:

How Long Does it Take to Become a Paramedic?

Of course, the time required to become a paramedic depends heavily on the educational route you choose and the work you put in. If you dedicate a full-time schedule to it, paramedic training can be completed within a year.

If you have a busier schedule and choose to study part-time while continuing to work as an EMT, your courses may take two to three years to complete.

Some programs also require aspiring paramedics to have up to six months of experience as an EMT before they can begin paramedics classes.

Paramedics also have the option of advancing their training and career prospects with a bachelor’s degree from an accredited college or university. This route is typically chosen by paramedics who hope to advance to management roles or even eventually enroll in medical school.

Aspiring paramedics training with a mannequin

Paramedic Training

During EMT training, students build a foundation in emergency medicine by studying:

  • CPR
  • Vital sign monitoring
  • Stabilization
  • Immobilization
  • Wound dressing
  • Patient transport

Paramedic students build on these EMT skills:

  • Burn treatment
  • Soft tissue shock
  • Obstetrics and Gynecology (childbirth)
  • Endocrinology (for treating diabetics and those with similar conditions)
  • Musculoskeletal trauma
  • Pharmacology (administering medicine)
  • Toxicology (treating overdoses and similar abuse)
  • IV administration

Paramedic Certification

The Cognitive Exam – Once you’ve completed training as a paramedic, the next step is to become certified. This is done by successfully passing the NREMT Paramedic Certification Exams.

You’ll begin by registering for the exam at (with a registration fee of $125 per attempt). You’ll then be emailed an ATT (authorization to test) with your exam location.

The Cognitive Exam – The cognitive portion of the exam focuses on many of the core EMT principles you learned during your paramedic training program and is graded on a pass/fail basis:

  • Airway
  • Cardiology
  • Medicine
  • Trauma patients, and
  • Operations

You may also consider downloading a practice NREMT exam for a small fee.

The exam is graded simply on a pass/fail basis. If you pass, congratulations! You’re ready to step into the paramedic uniform. If you fail, don’t panic. You can take the test up to six times before having to retake training courses (after your third attempt, you may also be required to take a 48-hour remedial course).

Fortunately, if you do fail the test, the system is designed to provide feedback on areas or questions that you missed, so you should have a good idea of where to spend your extra study hours. Students must wait 15 days between retakes, so that should provide plenty of time to brush up on any problem areas!

The Psychomotor Exam – In addition to your cognitive exam, paramedic students must also pass a psychomotor exam as well. This exam tests not only your knowledge but how you apply that knowledge under pressure, out in the field. During the exam, you’ll be asked to:

  • Size-up a scene
  • Perform initial resuscitation
  • Take a patient’s history
  • Make a secondary assessment
  • Read an ECG and manage both:
    1. A cardiac irregularity, such as arrhythmia
    2. A cardiac arrest

You’ll also be tested on your communication ability—both receiving information and giving commands.

Laptop draped with a stethoscope

Paramedic Certification Renewal

Like most other emergency medical careers, paramedics are required to recertify every two years. This can be done in one of two ways:

Continuing Education – Paramedics need to earn a total of 60 hours of continuing education in order to recertify, which they can do through courses or attending seminars. Guidelines for the allowed coursework are very specific and must meet strict standards and quotas. A full list of requirements can be found here.

Recertification Exam – Paramedics may also opt to recertify by exam. This involves most of the same steps as the initial paramedics cognitive exam—start by logging in at, pay the exam fee ($125 in most cases), and look for the ATT (authorization to test) in your email 24 – 48 hours later. However, it’s very important to remember that when recertifying by exam, you only get one attempt!

Important Note: The NREMT is required to randomly audit their certified paramedics, so always be sure to keep your certification and recertification documents in a safe place just in case you’re asked to produce them.

Paramedic Salary

According to, the average salary* of a paramedic in the United States ranges from around $42,000 to $52,000, but just like an EMT’s salary*, how much you earn depends heavily on where you work geographically and the years of experience you have under your belt.

(Check out our list of the best paying cities for EMTs here).

And, of course, you should remember to factor in overtime when calculating your final compensation. Some organizations may cap you at hours 40 per week, while others may allow for overtime shifts, which can greatly impact that final income number.

Paramedic Jobs

Paramedic Job Outlook

Once you’ve become certified as a paramedic, all that’s left is to lock down that big first job. And finding it has never been easier. According to the US Bureau of Labor Statistics (BLS), the overall employment of paramedics is expected to grow 11% by 2030, which means more open positions for hospitals and ambulance centers and more open opportunities for qualified paramedics like you.

Paramedic Resources

Some excellent job searching resources online include:


The World Will Always Need Paramedics, and in increasing numbers. You could be part of the next generation of highly-skilled, highly respected (and, of course, greatly needed) first responders. Whether your interest is in the strong career opportunities, the competitive pay, learning valuable skills, or if you’re just the type of person who wants to help others on a daily basis, a career as a paramedic career is could be just what you’re looking for.

Check out Unitek’s 14-day EMT crash courses today, and you could be on your way to saving lives in as little as two weeks.

4 replies
  1. Okan
    Okan says:

    Hi, I’m Okan Turkey, and emergency medical technician. I worked as an emergency nurse in the Acıbadem Maslak Hospital for 4 years. From now on, I want to complete my paramedic training and continue another life. Can I get training from you?
    I have a beginner level of English. What would you suggest to me if I cannot get training from you? I would be glad if you help.

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