Paramedic How to become, career path, income potential

What is a paramedic?

A paramedic is a medical professional who is specially trained to perform emergency medical treatment. They may be the first medical professionals to arrive at the scene of an emergency and treat victims on site while they transport them to a hospital to be treated by a doctor. They often perform life-saving treatment on patients.

Paramedics are similar to emergency medical technicians (EMTs). An EMT is trained to stabilize and transport people who have been injured in an accident and need emergency medical care. A paramedic has more training and can provide more advanced emergency medical care, such as starting intravenous lines (IVs) and managing compromised airways. They may supervise EMTs as part of their job function.

Paramedics most often work in emergency rooms and ambulances, where they treat people with urgent and sometimes critical problems. They may also work for fire departments, S.W.A.T. teams, on airplanes, cruise ships, or as part of medical flight crews. They work under the direction of a doctor, which may be via phone, radio, or another form of communication when the doctor is not on site. 

A paramedic performs typical procedures on-site at an accident, a medical emergency, or during transport to a hospital, include performing CPR, using a defibrillator, administering IV medication, clearing airways, and performing basic medical tests. They monitor sick and injured patients during transport until they can turn them over to a doctor.

Qualifications and eligibility

To become a paramedic, you must be at least 18 years old and have a high school diploma or equivalent. You’ll also need CPR certification. Other requirements can vary by state. You need an associate’s degree to start paramedic training in some states. You may also need to have an EMT certification and may have to have at least a year of experience working as an EMT before you can train as a paramedic.

You can find paramedic programs at technical, vocational, and community colleges. The amount of training needed can vary. Some programs require at least 1,200 hours of training while others require as much as 1,800 hours. Training involves classroom work, clinical practice, and field experience. Make sure the program you choose is accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP). 

After you’ve completed your training, you are required to pass an exam to become licensed. Requirements for licensure can vary by state. Most states use the National Registry of Emergency Medical Technicians (NREMT) Paramedic exam, but some states have their own exam. You have up to 2 years to apply for certification after passing the exam.    

Professionals in this role should be in good physical condition as they need to move quickly and may need to lift people onto stretchers. Other essential skills include compassion and a passion for helping others in need. You’ll need to have the ability to work well under pressure and make quick decisions that could mean the difference between life and death. 

Communication is vital as you typically work with a team that can include other paramedics, EMTs, and firefighters. You’ll also need to communicate with police officers and other first responders at emergency scenes. When transporting patients, you will need to be in contact with doctors and nurses, giving them clear updates on the patient’s condition. You may also need to talk to family members and loved ones.

Those in this position should have exceptional observation and problem-solving skills to assess a patient’s condition quickly and take necessary action.   

Some of the best programs for paramedics include:

The top certifications for paramedics are:

Work environment

Those in this profession may work indoors or outdoors in all types of weather. They often have to kneel, bend, and perform heavy lifting while caring for patients. They are often exposed to loud sirens and may be exposed to a variety of diseases such as hepatitis B and AIDS.

They wear protective gloves and masks to reduce the risk of disease. They may encounter violent patients who are mentally unstable or under the influence of drugs. As such, they are more susceptible to injury and sickness than the average worker. The work is physically demanding and stressful, as they may encounter a number of life-or-death situations in the course of a day.

Typical work hours

Paramedics working for fire departments can often work up to 50 hours a week. Those employed by hospitals or ambulance services may work as many as 45 to 60 hours a week. They may also be on call for extended periods when not at work. The hours can be irregular, and they may work a variety of shifts as emergency services is a 24-hour, 365-day-a-year operation.  

Types of paramedics

Paramedics are defined by where they work more than their job type. All paramedics perform emergency medical care to patients either before, during, or after transport to a hospital. Some different types of paramedics as defined by where they work include:

Emergency Medical Technician-Paramedic

EMT paramedics typically work as part of an emergency-response unit where they encounter all kinds of emergencies from minor incidents to serious casualties. They treat victims and stabilize them before they can be transported to a hospital or another healthcare facility. An EMT paramedic is also known as an EMT-4, which is an advanced EMT license and the only EMT worker qualified as a paramedic.

Flight Paramedic

Flight paramedics travel with emergency crews to remote locations such as forests or mountains to find and treat accident victims while they transport them to the hospital. Flight paramedics typically work with flight nurses to assess injuries and determine the necessary action to take. Flight paramedics may also be part of a team that transports severely injured patients from the scene of vehicle accidents or other similar accidents.

Firefighter Paramedic

Firefighter paramedics are part of a fire rescue team that responds to emergency fires and rescues people trapped in burning buildings, wrecked vehicles, or other places where they need medical attention. A firefighter paramedic is typically skilled in fighting fires as well as assessing and treating injuries at the scene. 

Ambulance Paramedic

An ambulance paramedic travels to the scene of an emergency with the ambulance crew to perform emergency medical care to victims at the scene and while transporting patients to the hospital or other emergency care facility.  

Shipboard Paramedic

Shipboard paramedics are typically employed by cruise ships, providing emergency care for vacationers and crewmembers injured during the cruise. They are typically employed by cruise ship companies and work with shipboard doctors and nurses. 

Ocean Rescue Paramedic

A paramedic who works as part of a search and rescue team at sea is known as an ocean rescue paramedic. They often have to locate boats, aircraft, or ships, rescue victims, and treat them during transport to the hospital. They generally work on helicopter rescue teams but also may be found on boats. 

Paramedic Supervisor

Paramedic supervisors provide advanced emergency medical care to patients and also typically plan and implement clinical programs and patient care procedures to ensure consistent, effective, and efficient medical service. They may train EMTs and paramedics and evaluate performance, stock vehicles, and maintain records. 

Paramedic Teacher

A paramedic teacher works at a vocational or technical school or a community college where they teach paramedic programs to students. 

Military Paramedic

Military paramedics work in the military where they provide immediate medical care in the field. They may treat military personnel or the enemy in the course of their duties. 

S.W.A.T Paramedic

These paramedics work for police departments as part of the S.W.A.T. team. They may have to respond to riots or other violent confrontations with criminals. They provide emergency care to criminals, the public, or police officers who are injured during a confrontation.

Emergency Room Paramedics

An emergency room paramedic is part of the emergency room staff and provides immediate care and treatment for incoming patients. They typically work alongside nurses and doctors.

Income potential

The earning potential for a paramedic can vary greatly depending on geographic location, education, experience, and acquired skills.  

  • According to the U.S. Bureau of Labor Statistics, the median annual wage for paramedics was $46,770 in May 2021. The lowest 10 percent earned less than $34,420, and the highest 10% earned more than $74,200. The average pay for paramedics in the top industries was: 
    • General medical and surgical hospitals (private) – $47,000
    • Local government – $46,950
    • Ambulance services – $46,660
    • General medical and surgical hospitals (local) – $46,460
    • Administrative and support and waste management and remediation services – $37,230
  • As of Sep 2022, the range of salaries is as high as $70,000 and as low as $26,000, while the majority of paramedic salaries fall between $39,500 and $53,500. The 5 states with the highest annual pay for paramedics are:
    • Tennessee – $51,563
    • Massachusetts – $50,619
    • Hawaii – $50,461
    • Minnesota – $50,250
    • Connecticut – $49,828
  • The bottom 3 states are:
    • Florida – $36,385
    • North Carolina – $36,208
    • Georgia – $33,924
  • The best-paying cities for paramedics were:
    • Indianapolis, IN – $61,943
    • Philadelphia, PA – $55,213 
    • Miami, FL – $53,733
    • Austin, TX – $45,939
    • Cleveland, OH – $45,330 

Position trends

The U.S. Bureau of Labor Statistics projects that the overall employment of EMTs and paramedics is projected to grow 7% from 2021 to 2031, about as fast as the average for all occupations. Approximately 20,000 jobs will be open each year over the decade.

This role will continue to be in demand due to accidents, natural disasters, drug abuse incidents, acts of violence, and other emergencies. Also, as the population of middle-aged and older people continues to grow, more paramedics will be needed for age-related health emergencies, such as falls, heart attacks, and strokes.   

Career path

As a paramedic, you can develop essential skills that can take you to exciting and challenging advanced positions in the medical field. Building on your knowledge and experience, you can gain the education and training you need to advance your career. Here are some career advancement options available for paramedics:

  • Emergency Room Technician
  • Licensed Practical Nurse
  • Registered Nurse
  • Physician Assistant
  • Emergency Medical Services Educator
  • Emergency Medical Services Manager
  • Physician

Steps to becoming a paramedic

1. Get your high school diploma

You must have a high school diploma or equivalent and be at least 18 years old to train as a paramedic.

2. Get your CPR certification

To become a paramedic, you must be CPR certified. Organizations such as the American Red Cross and the American Heart Association provide CPR training certification courses. 

3. Earn an EMT certificate

Certification as an EMT is required in some states but not in others. However, getting an EMT certificate is advantageous for anyone who wants to become a paramedic. Students learn to assess patients’ conditions, control bleeding, manage airways, and respond to cardiac emergencies. The basic certificate program is typically 1 semester or 12 credit hours.

4. Pass the EMT licensing exam

Some states require that you be a licensed EMT before applying to a paramedic program. The exam is administered by the state or the National Registry of Emergency Medical Technicians. You will have to pass a cognitive and psychomotor skills exam to get your license.

5. Gain EMT experience

Some paramedic programs only admit applicants who have had 6 months to 1 year of experience as an EMT. Gaining EMT experience gives you skills and knowledge that will help in your pursuit to become a paramedic. 

6. Complete your paramedic training program

You are required to complete a paramedic program before you can sit for the certification exam. You can study at a community college, technical college, or vocational school that offers an accredited paramedic training program.

Some 4-years schools also offer paramedic certificates or associate degree programs. The program typically takes 1 to 2 years to complete and often earns you an associate’s degree in emergency medical services. The program includes classroom, practical, and hands-on training in the field.  

7. Get your state license

Every state requires that paramedics are licensed before they can work. To get your license, you must pass a state exam or the exam offered by the NREMT. The exam consists of written and practical sections that test medication skills, patient assessment, cardiac management, and more.  

8. Keep your license current

Paramedics are typically required to renew their credentials every 2-3 years by earning continuing education credits and attending refresher courses.    

9. Join associations

Joining an organization can open up a wealth of resources, networking opportunities, and job opportunities for you. Here are some of the top organizations:

Tips for becoming a paramedic

If you are planning to become a paramedic, a few things can give you the edge you need. Here are some tips:

  • Find volunteer work helping to care for patients. You can volunteer in a nursing home, hospital, the Red Cross, or other healthcare organization. Find out if caring for sick and injured patients is right for you.
  • Understand that the job is stressful and you’ll have to be able to work well under pressure. It can also be hazardous at times. 
  • Get your EMT and CPR certifications. You’ll typically need these before you can apply for paramedic training. 
  • Consider whether you want to apply to a paramedic certificate or associate’s degree program. A certificate program will typically take less time, but you’ll generally get more training and practical experience in a 2-year degree program.  
  • Research what specific qualifications, education, certifications, etc, are needed in the state where you want to work as requirements vary by state. 
  • Practice taking the paramedics’ exam to prepare yourself for the actual test. You can find online resources for practice tests.
  • Visit local fire stations and talk to paramedics about the job. Get advice on career paths, different departments, programs, and more from those who’ve been through it.

Paramedic interview questions to expect

  • You get called out to someone who complains of severe bleeding, but when you show up, the patient is physically okay. What steps would you take to help?
  • Have you ever been called out to a mentally precarious situation? How did you handle it?
  • A three-car car crash just occurred. One of the cars is smoking and another is leaking fluid. People are trapped inside, and one is bleeding. What do you do?
  • How do you handle incidents when there are minors involved?
  • How do you administer an IV en route to the hospital?
  • Someone is passed out, and you can’t wake them up. You notice some marks on their arms and legs. Do you proceed with Narcan?

Paramedic FAQs