Become an EMS Clinician
Emergency medical services (EMS) clinicians are an essential part of our healthcare system—and often provide the first care someone receives following a crash or injury. They also do much more, and have proven to be an integral part of our nation’s healthcare, public health and emergency management and public safety infrastructure.
If you decide to work or volunteer in EMS, you’ll be joining more than one million licensed EMS clinicians across the U.S. Not surprisingly, most are drawn to the field by a desire to serve their communities in this critical and extremely rewarding role.
EMS clinicians generally maintain one of the following levels of certification, though you might see other terms used in some states or organizations:
Emergency Medical Responder (EMR)
Emergency Medical Technician (EMT)
Advanced Emergency Medical Technician (AEMT)
Education and Training
The National EMS Education Standards address the minimum competencies and knowledge required for the four most common types of EMS clinicians—EMR, EMT, AEMT and paramedic.
Of these, becoming a paramedic requires the most schooling in prehospital care, while EMR certification requires the least training. The majority of EMS clinicians serving their communities as first responders and on ambulances are certified as EMTs. EMTs are trained to assess and treat patients for life-threatening conditions, while AEMTs can provide basic as well as limited advanced emergency medical care.
Paramedic is a more advanced level of certification, allowing these clinicians to more thoroughly assess patients and make clinical decisions related to their care, often involving complex treatment protocols. Many paramedics gain experience as EMTs first before their paramedic course, which requires many more hours of classroom, practical and clinical training.
EMS clinicians at all levels often pursue other educational opportunities and certifications, including critical care, community paramedicine, tactical EMS and many others. In addition, EMS clinicians have continuing education requirements to maintain their certifications. It is truly a field dedicated to continuous learning and improvement.
A number of different types of institutions offer EMS educational programs. Some agencies will hire you or let you sign up to volunteer with no previous training and will provide the education you need to serve. Others require you to become an EMT or paramedic first; you can often find training through local first responder agencies, community colleges or universities, or private companies. Check with your local EMS organizations to find out more about EMS education and employment and volunteer opportunities in your community.
Types of EMS Agencies
EMS clinicians serve in a number of settings: They might work for ambulance companies that perform interfacility transports, agencies that respond to 911 calls or some that do both. Depending on the community, EMS service could be provided by:
Government EMS Agencies
Local Volunteer Squads
Other Service Models
Some EMTs and paramedics even work in other settings, including hospitals and medical clinics.
Licensing and Certification
There’s a lot of variation in certification and licensing of EMTs and paramedics across the country (sometimes, in fact, they are the same, though there are legal differences). Check your state’s requirements to determine the training, education and other qualifications you’ll need to work where you live.
Many states require national certification for EMTs and paramedics, which is offered through the National Registry of Emergency Medical Technicians (NREMT). Check the NREMT’s State EMS Agency Map to see if NREMT certification is a requirement in your state.
The following descriptions of the four levels of EMS clinician are taken from the National EMS Scope of Practice Model and will give you a sense of what’s required for each of the four most common roles in EMS:
Emergency Medical Responder
The emergency medical responder (EMR) is an out-of-hospital practitioner whose primary focus is to initiate immediate lifesaving care to patients while ensuring patient access to the emergency medical services system. EMRs possess the basic knowledge and skills necessary to provide lifesaving interventions while awaiting additional EMS response and rely on an EMS or public safety agency or larger scene response that includes other higher-level medical personnel. When practicing in less populated areas, EMRs may have a low call volume coupled with being the only care personnel for prolonged periods awaiting arrival of higher levels of care. EMRs may assist, but should not be the highest-level person caring for a patient during ambulance transport. EMRs are often the first to arrive on scene. They must quickly assess patient needs, initiate treatment and request additional resources.
Emergency Medical Technician
An emergency medical technician (EMT) is a health professional whose primary focus is to respond to, assess and triage emergent, urgent and non-urgent requests for medical care, and to apply basic knowledge and skills necessary to provide patient care and medical transportation to/from an emergency or healthcare facility. Depending on a patient’s needs and/or system resources, EMTs are sometimes the highest level of care a patient will receive during an ambulance transport. EMTs often are paired with higher levels of personnel as part of an ambulance crew or other responding group. With proper supervision, EMTs may serve as a patient care team member in a hospital or healthcare setting to the full extent of their education, certification, licensure and credentialing. In a community setting, an EMT might visit patients at home and make observations that are reported to a higher-level authority to help manage a patient’s care. When practicing in less populated areas, EMTs may have low call volume coupled with being the only care personnel during prolonged transports. EMTs may provide minimal supervision of lower-level personnel. EMTs can be the first to arrive on scene; they are expected to quickly assess patient conditions, provide stabilizing measures and request additional resources as needed.
Advanced Emergency Medical Technician
The advanced emergency medical technician (AEMT) is a health professional whose primary focus is to respond to, assess and triage non-urgent, urgent and emergent requests for medical care; apply basic and focused advanced knowledge and skills necessary to provide patient care and/or medical transportation; and facilitate access to a higher level of care when the needs of the patient exceed the capability level of the AEMT. The additional preparation beyond EMT prepares an AEMT to improve patient care in common emergency conditions for which reasonably safe, targeted and evidence-based interventions exist. Interventions within the AEMT scope of practice may carry more risk if not performed properly than interventions authorized for the EMR/ EMT levels. With proper supervision, AEMTs may serve as a patient care team member in a hospital or healthcare setting to the full extent of their education, certification, licensure and credentialing. In a community setting, an AEMT might visit patients at home and make observations that are reported to a higher-level authority to help manage a patient’s care.
The paramedic is a health professional whose primary focus is to respond to, assess and triage emergent, urgent and non-urgent requests for medical care; apply basic and advanced knowledge and skills necessary to determine patient physiologic, psychological, and psychosocial needs; administer medications, interpret and use diagnostic findings to implement treatment; provide complex patient care; and facilitate referrals and/or access to a higher level of care when the needs of the patient exceed the capability level of the paramedic. Paramedics often serve as a patient care team member in a hospital or other healthcare setting to the full extent of their education, certification, licensure and credentialing. Paramedics may work in community settings where they take on additional responsibilities monitoring and evaluating the needs of at-risk patients, as well as intervening to mitigate conditions that could lead to poor outcomes. Paramedics help educate patients and the public in the prevention and/or management of medical, health, psychological and safety issues.