EMTs and paramedics held about 262,100 jobs in 2018. The largest employers of EMTs and paramedics were as follows:
| Ambulance services | 47% |
| Local government, excluding education and hospitals | 27 |
| Hospitals; state, local, and private | 19 |
The above percentages exclude volunteer EMTs and paramedics who do not receive pay.
EMTs and paramedics work both indoors and outdoors, in all types of weather. Their work is physically strenuous and can be stressful, sometimes involving life-or-death situations.
Volunteer EMTs and paramedics share many of the same duties as paid EMTs and paramedics. They volunteer for fire departments, providers of emergency medical services, or hospitals. They may respond to only a few calls per month.
Injuries and Illnesses
EMTs and paramedics have one of the highest rates of injuries and illnesses of all occupations. They are required to do considerable kneeling, bending, and lifting while caring for and moving patients. They may be exposed to contagious diseases and viruses, such as hepatitis B and HIV. Sometimes they can be injured by combative patients. These risks can be reduced by following proper safety procedures, such as waiting for police to clear an area in violent situations or wearing gloves while working with a patient.
Work Schedules
Most paid EMTs and paramedics work full time. Some work more than 40 hours per week. Because EMTs and paramedics must be available to work in emergencies, they may work overnight and on weekends. Some EMTs and paramedics work shifts in 12- or 24-hour increments. Volunteer EMTs and paramedics have variable work schedules. For example, they may work only a few days per week.
Emergency medical technicians (EMTs) and paramedics typically complete a postsecondary educational program. All states require EMTs and paramedics to be licensed; requirements vary by state.
Education
Both a high school diploma or equivalent and cardiopulmonary resuscitation (CPR) certification typically are required for entry into postsecondary educational programs in emergency medical technology. Most of these programs are nondegree award programs that can be completed in less than 1 year; others last up to 2 years. Paramedics, however, may need an associate’s degree. Programs in emergency medical technology are offered by technical institutes, community colleges, universities, and facilities that specialize in emergency care training. Some states have EMR positions that do not require national certification. These positions typically require state certification.
The Commission on Accreditation of Allied Health Education Programs offers a list of accredited programs for EMTs and paramedics, by state.
Programs at the EMT level include instruction in assessing patients’ conditions, dealing with trauma and cardiac emergencies, clearing obstructed airways, using field equipment, and handling emergencies. Formal courses include about 150 hours of specialized instruction, and some instruction may take place in a hospital or ambulance setting.
Programs at the Advanced EMT level typically require about 400 hours of instruction. At this level, candidates learn EMT-level skills as well as more advanced ones, such as using complex airway devices, intravenous fluids, and some medications.
Paramedics have the most advanced level of education. To enter specific paramedical training programs, they must already be EMT certified. Community colleges and universities may offer these programs, which require about 1,200 hours of instruction and may lead to an associate’s or bachelor’s degree. Paramedics’ broader scope of practice may include stitching wounds or administering intravenous medications.
High school students interested in becoming EMTs or paramedics should take courses in anatomy and physiology and consider becoming certified in CPR.
Licenses, Certifications, and Registrations
The National Registry of Emergency Medical Technicians (NREMT) certifies EMTs and paramedics at the national level. All levels of NREMT certification require completing a certified education program and passing the national exam. The national exam has both written and practical parts. Some states have first-level state certifications that do not require national certification.
All states require EMTs and paramedics to be licensed; requirements vary by state. In most states, an individual who has NREMT certification qualifies for licensure; in others, passing an equivalent state exam is required. Usually, an applicant must be over the age of 18. Many states require background checks and may not give a license to an applicant who has a criminal history.
Although some emergency medical services hire separate drivers, most EMTs and paramedics take a course requiring about 8 hours of instruction before they can drive an ambulance.
Advancement
EMTs and paramedics may advance into other related healthcare occupations, such as physician assistants and medical assistants, as well as administrative positions in various healthcare settings, such as ambulatory care companies or hospitals.
Emergency medical technicians (EMTs) and paramedics typically have an interest in the Building, Thinking and Helping interest areas, according to the Holland Code framework. The Building interest area indicates a focus on working with tools and machines, and making or fixing practical things. The Thinking interest area indicates a focus on researching, investigating, and increasing the understanding of natural laws. The Helping interest area indicates a focus on assisting, serving, counseling, or teaching other people.
If you are not sure whether you have a Building or Thinking or Helping interest which might fit with a career as an emergency medical technician (EMT) and paramedic, you can take a career test to measure your interests.
Emergency medical technicians (EMTs) and paramedics should also possess the following specific qualities:
Compassion. EMTs and paramedics must be able to provide emotional support to patients in an emergency, especially patients who are in life-threatening situations or extreme mental distress.
Interpersonal skills. EMTs and paramedics usually work on teams and must be able to coordinate their activities closely with others in stressful situations.
Listening skills. EMTs and paramedics need to listen to patients to determine the extent of their injuries or illnesses.
Physical strength. EMTs and paramedics need to be physically fit. Their job requires a lot of bending, lifting, and kneeling.
Problem-solving skills. EMTs and paramedics need strong problem-solving skills. They must be able to evaluate patients’ symptoms and administer the appropriate treatments.
Speaking skills. EMTs and paramedics need to be able explain procedures to patients, give orders, and relay information to others.
The median annual wage for EMTs and paramedics was $35,400 in May 2019. The median wage is the wage at which half the workers in an occupation earned more than that amount and half earned less. The lowest 10 percent earned less than $23,490, and the highest 10 percent earned more than $59,860.
In May 2019, the median annual wages for EMTs and paramedics in the top industries in which they worked were as follows:
| Local government, excluding education and hospitals | $37,570 |
| Hospitals; state, local, and private | 37,570 |
| Ambulance services | 32,730 |
Most paid EMTs and paramedics work full time. Some work more than 40 hours per week. Because EMTs and paramedics must be available to work in emergencies, they may work overnight and on weekends. Some EMTs and paramedics work shifts in 12- or 24-hour increments. Volunteer EMTs and paramedics have variable work schedules. For example, they may work only a few days per week.
Employment of emergency medical technicians (EMTs) and paramedics is projected to grow 7 percent from 2018 to 2028, faster than the average for all occupations. Emergencies, such as car crashes, natural disasters, and acts of violence, will continue to require the skills of EMTs and paramedics. The need for volunteer EMTs and paramedics in rural areas and smaller metropolitan areas will also continue.
Growth in the middle-aged and older population will lead to an increase in age-related health emergencies, such as heart attacks and strokes. This increase, in turn, will create greater demand for EMT and paramedic services. An increase in the number of specialized medical facilities will require more EMTs and paramedics to transfer patients with specific conditions to these facilities for treatment.
Job Prospects
Job opportunities should be good because the growing population will require more emergency services generally. There will also be a need to replace workers who leave the occupation due to the high stress nature of the job or to seek job opportunities in other healthcare occupations.
For more information about emergency medical technicians and paramedics, visit
National Association of Emergency Medical Technicians
National Association of State EMS Officials
National Highway Traffic Safety Administration, Office of Emergency Medical Services
National Registry of Emergency Medical Technicians
For information about educational programs, visit
Commission on Accreditation of Allied Health Education Programs