What's the Difference Between an EMT and a Paramedic?

Just turn on your television and you'll see them.

Whether it's on the breaking news story of the day or on a TV drama, you'll see them. Hollywood loves them. Remember the show that started it all, Emergency!? They are the uniformed men and women rescuing the victims of an accident or a disaster. Sometimes you'll see them in ambulances, sometimes they are in fire trucks, hospitals or in helicopters. They are everywhere that help is needed. They are EMTs and Paramedics. Both work in a variety of roles and are often the first on the scene of accidents, medical emergencies, and natural disasters. They both wear uniforms and they both help patients - so what's the difference?

In the field of emergency medical services (EMS), there are different levels of certifications for provider of care. Emergency Medical Technicians (EMTs) are the most common type of providers in all of EMS. They are the entry-level patient care provider followed by EMT-Intermediates (in some states) and then paramedics. EMTs are sometimes referred to as EMT-Basics or EMT-1s. However, do not be fooled by the term "entry-level." EMTs learn the essential skills to help in life-threatening situations and their education is the foundation for all other levels of provider. As one EMS instructor recently put it, "You can't learn and be good at advanced skills without having a solid foundation of basic skills." Many paramedics, doctors, nurses, and firefighters have used their EMT education and work experience as a stepping stone to their new career.

Both EMTs and paramedics have the knowledge and skills to transport patients and provide them with emergency care. The biggest difference between them is the amount of education they receive and what they are allowed to do for patients (scope of practice).

EMTs usually complete a course that is about 120-150 hours in length. Paramedic courses can be between 1,200 to 1,800 hours. EMT and paramedic courses consist of lectures, hands-on skills training, and clinical and/or field internships. EMTs are educated in many skills including CPR, giving patients oxygen, administering glucose for diabetics, and helping others with treatments for asthma attacks or allergic reactions. With very few exceptions, such as in the case of auto-injectors for allergic reactions, EMTs are not allowed to provide treatments that requiring breaking the skin: that means no needles. Paramedics are advanced providers of emergency medical care and are highly educated in topics such as anatomy and physiology, cardiology, medications, and medical procedures. They build on their EMT education and learn more skills such as administering medications, starting intravenous lines, providing advanced airway management for patients, and learning to resuscitate and support patients with significant problems such as heart attacks and traumas.

So How Do You Become an EMT or a paramedic?

In order to become an EMT or a paramedic, there are four (4) major steps that you will need to complete, which may vary from state to state. Be sure to view our career pathways for EMTs and paramedics. In California you must:

  1. Meet the eligibility requirements and prerequisites for attending an EMT or paramedic course.
  2. Attend and successfully complete an approved EMT or paramedic education course.
  3. Take and pass the National Registry of Emergency Medical Technicians (NREMT) EMT or Paramedic computer based exam.
  4. Apply and obtain for certification within two years of being issued a course completion certificate.

The eligibility requirements and prerequisites for EMT and paramedic courses may vary from school to school. So be sure to check with the schools you are interested in before you enroll for a course. In general, to be eligible for enrollment into an EMT course you do not need to have any previous medical experience. You must be at least 18 years of age to be eligible to certify as an EMT in California. Becoming an EMT is the first crucial step to becoming a paramedic. To be eligible for a paramedic course, you must be an EMT and generally have at least 6 months of work experience as an EMT.

In addition to these eligibility requirements, some courses have other prerequisites including academic and medical requirements. Again, be sure to check with the course you are interested in to find out what they require from you. Some courses may require you to submit proof of a current basic physical and proof of immunizations. Remember, this is about protecting your health and that of your patients!

Finding an EMT or Paramedic Course

To find an approved EMT or paramedic course, you should check with your local county and/or state Emergency Medical Services Agency (EMSA) for a list of approved courses. For the State of California, you can find this information on the state EMSA web site and for Los Angeles County you can check the Department of Health Services EMSA web site.

Determining the right course for you is a personal decision. Some factors that you might consider are:

  • reputation of organization providing course
  • quality and experience of educators
  • quality of clinical and/or field ride-along opportunities
  • course's student completion rate
  • course's overall student National Registry test passing rate
  • how much time you will need outside of the course to study
  • course start date availability
  • course scheduling options, e.g., short full-time courses, semester long courses, etc.
  • available student resources, such as tutoring, office hours, etc.

If you are not sure about which is the right place for you to take a course, talk to current prehospital care providers such as EMTs and paramedics and find out what courses they recommend and why. You can also check with the school you are interested in if you can visit their course or meet with the staff/faculty to learn more about their courses. Take the time to find out all you can before investing your time and money. By finding the right course, you will find your educational experience a much more rewarding one.

Suggested Preparation

EMT and paramedic courses are fast-paced and demanding. To get the most out of your education and to help you succeed, you might help prepare yourself by completing any of the courses listed below. While the courses below may not be required for you to enroll into the EMT or paramedic course of your choice they can help you in your EMT or paramedic course and in future possibilities such as going on to become a paramedic, nurse, or physician.

  • Completion of a college-level English course (English A or English 1)
  • Completion of a college-level Math course
  • Completion of a college-level Anatomy and Physiology course
  • Completion of an EMT Preparation Course
  • Completion of a Medical Terminology Course
  • Completion of a Paramedic Preparation Course
So How Much Does an EMT or a Paramedic Make?

The income for EMTs and paramedics varies by region, state, position, number of hours worked (e.g., over time), employer (government/federal versus private), and other variables. For example, in Los Angeles, EMTs earnings may range from $25,000 to over $40,000 per year; paramedic earnings may range from $32,000 to over %54,000 per year. 

For information in your area, you can check web sites such as the US Bureau of Labor and Statistics (http://www.bls.gov/oes/current/oes292041.htm) or commercial sites such as www.salary.com.

Finding Work

EMTs and paramedics can work for a variety of employers including private ambulance companies, hospitals, fire departments, military organizations, entertainment and sporting event venues, and many more. They can work in cities and towns, on mountain tops, in the desert, in the sky, on movie sets, on beaches, etc. 

To find open positions, you can check with recruiters and/or the Human Resources departments of employers in your area. Internet searches are another very popular way to find open positions. You can look for positions on government web sites such as the State of California EMSA (http://www.emsa.ca.gov/jobs/default.asp) and your local Emergency Services Agency site. (http://ems.dhs.lacounty.gov/Home/Links.htm) You can also search commercial web sites such as www.firecareers.com, www.emsmagazine.com, and www.jems.com and membership organizations such as the National Association of EMS Educations (www.naemse.org) and the National Association of EMTs (www.naemt.org). 

While it is not required for completing the EMT course or passing the NREMT exams, the local certifying agency and most employers hiring EMTs and paramedics will require a background investigation to determine if an applicant has a criminal history. In addition to background checks, employers generally seek applicants that successfully complete a Department of Transportation (DOT) physical to be an ambulance driver, have a clean drug test before being hired, and have a good driving record. If you have any questions about the certification and background check process please contact your local Emergency Services Agency. For Los Angeles County contact them at http://ems.dhs.lacounty.gov/

What Other Opportunities Exist for an EMT or a Paramedic?

EMTs can advance to become EMT-Intermediates (in certain states), field training officers, EMT skills instructors, program coordinators, managers, paramedics, educators, researchers, and more. Additionally, many doctors, nurses, firefighters, and fire captains and chiefs have used their EMT and paramedic education and experience as a stepping stone to their new careers.

So why become an EMT or a Paramedic?

The reasons for becoming an EMT or paramedic are as varied as the people that come into this field. Some become EMTs to learn the skills to help their families and neighborhoods in the event of a disaster. Some use their EMT and paramedic education as stepping stones to other careers in medicine and emergency medical services. Some do it just because they want to help people. Whatever your reasons know that these are dynamic, challenging, and demanding professions. They require passion, dedication, and the ability to care for patients with compassion. Being an EMT or paramedic is not for everyone, but for those that answer the call it can be a life-long passion.