How to Become an EMT – Certification and Training Requirements

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How to Become an EMT

Emergency Medical Technicians provide immediate, on-the-scene treatment and care to patients in situations of emergency. These professionals have a very hectic work schedule, and during emergencies, they are required to work on holidays, nights, and weekends. Their scope of duties depends on their certification levels and experience.

How Long does it Take to Become an EMT?

The duration to become an EMT depends on the certification level that a candidate prefers to pursue. The EMT-Basic or First Responder training gets completed in 8-11 weeks, EMT-Intermediate training takes 30-350 hours to complete, and EMT-Paramedic training usually lasts from 6 to 24 months.

How Much does it Cost to Become an EMT?

The cost to become an EMT depends on the location/state and the college/school that you choose for your EMT training. Full-time courses are costlier than part-time EMT courses. Besides training cost, you will have to pay the certification exam fee. The NREMT examination may cost you $70.

The EMT Basic Training Cost:

  • University – $800 to $1,000
  • Technical Colleges – $750 to $1,800
  • Community College – $200 to $1,000

Additional Costs:

  • Books – up to $200 (some colleges include book cost in tuition fee)
  • Health testing – Hepatitis B vaccination: up to $50 a dose, TB test: less than $20
  • CPR Certification – Classes offered by the Red Cross and the American Heart Association may cost you under $100.
  • EMT Recertification Cost – varies from state to state

Financial Aid:

Some universities/colleges provide financial aid to the deserving students who can’t pay their EMT fee. However, students need to fulfill some requirements such as they must be citizens of the U.S. and currently enrolled in an accredited EMT program.

EMT Skills

Aspirants with the following skills may consider pursuing a career as an Emergency Medical Technician:

  • Emotional stability
  • Strong physical fitness
  • Perfect color vision and eyesight
  • Alertness and manual dexterity
  • Communication skills
  • Interpersonal skills
  • Analytical and problem-solving skills

EMT Job Description

EMTs perform the following duties and responsibilities:

  • Transporting patients to hospitals or emergency room
  • Assessing the condition and administering the treatment accordingly to the patient
  • Assessing the accident scene and severity of injuries of the victims
  • Providing life support care or first-aid treatment to injured or sick patients
  • Documentation of patient care reports
  • Inserting IVs and administering essential medication
  • Administering CPR for managing cardiac arrest situations
  • Administering oxygen and clearing the obstructed airways of patients

How Much do EMTs Make?

The average annual salary of EMTs and Paramedics, according to the Bureau of Labor Statistics, as of May 2017, was $33,380 whereas per hour wages were $16.05. Emergency Medical Technicians who were employed in the state, local and private hospitals earned $35,990 per year; those who worked in local government (excluding hospitals and education) made $35,620 per annum, and those employed in ambulance services were paid an average annual salary of $30,800.

As per (as of October 31, 2018), the salary of these professionals ranged between $31,898 and $39,579 per annum while their average annual salary was $35,340. The entry-level EMTs took home between $10,000 and $30,000.

As of 12 November 2018, the average hourly salary of EMTs/Paramedics was reported to be $13.31 per year while the annual salary was $38,666 (according to

How to Get an EMT Certification?

To obtain an EMT certification, aspirants must fulfill the below-given requirements:

  • Obtain a GED or diploma in high school
  • Possess a valid driver’s license
  • Pass a drug test and criminal background check
  • Acquire a CPR certification

Steps to Become an EMT

Follow these steps to become an EMT:

Step 1 – Complete the EMT Basic (EMT-B) Training

Depending on the school/institution, EMT-B training may complete in 6 months to 2 years (120-150 hours). The programs are divided into two components – hands-on learning that imparts knowledge about how to use field equipment, and classroom studies that cover interesting topics like patient assessment, medical emergencies, trauma care, etc. Some institutes require aspirants to possess CPR certification before enrolling in the EMT program. These programs can be availed at community colleges, technical schools, etc.

Step 2 – Gain Certification

After completing the training, appear for and qualify the national or state licensing examination. The national exam is administered by the NREMT (National Registry of Emergency Medical Technicians). Once you pass the exam, apply for your EMT certification.

Step 3 – Find a Job

EMTs may work in hospital emergency rooms, recreation centers, wilderness teaching programs, fire departments, etc. You may find jobs via placement agencies, online job listing sites, etc.

Step 4 – Take Advanced Education

If you want to get promoted to higher levels, you must pursue advanced certifications (EMT-Intermediate or EMT-Paramedics) or degree programs.

EMT Certification

EMT certification is awarded by the NREMT (National Registry of Emergency Medical Technicians), which is the Nation’s EMS (Emergency Medical Services) Certification organization. The mission of the NREMT is to advance the EMS profession and protect the public.

For obtaining an EMT certification, candidates need to pass a certification exam which is divided into two parts – the cognitive exam and the psychomotor exam. The National Registry administers the exam via Pearson VUE, one of the most extensive testing and assessment organizations in the world.

1. The Cognitive Exam

The cognitive examination is a Computer Adaptive Test which comprises of 70-120 questions and must be completed in 2 hours. The test also has 10 pilot questions that do not impact the final score. The questions are focused on pediatric (15%) and geriatric (85%) patients, including EMS operations, gynecology/obstetrics, trauma, cardiology and resuscitation, respiration and ventilation, and airway. The National Registry Board of Directors sets the minimum passing standard which is reviewed every 3 years.

If candidates fail to qualify the cognitive exam, they can submit an application to retest 15 days after the last test. Candidates are provided with 6 opportunities to clear the cognitive test. After 3 attempts, aspirants are supposed to undertake remedial training from an approved CAPCE course or a state-approved instructor. Aspirants must submit official documents which verify that they have completed the remedial training to get 3 additional attempts. If candidates fail to qualify the exam in 6 tries, they need to retake the entire EMT training.

2. The Psychomotor Exam

EMT psychomotor tests are not conducted by the National Registry; they are administered by the training institution (on approval by the State EMS Office) or the State EMS Office. You can contact the State EMS Office or your instructor to know about the format and gain other information related to the psychomotor examination. The primary objective of this exam is to check your competence in the following emergency care skills:

  • Administration of supplemental oxygen to a breathing patient;
  • Management/assessment of a medical patient;
  • Traction splinting;
  • Upper airway adjuncts and suction;
  • Long bone fracture immobilization;
  • Spinal immobilization (both supine and seated patients);
  • Management/assessment of a trauma patient;
  • Shock management/bleeding control;
  • Joint dislocation immobilization; etc.


EMTs are required to renew their NREMT certificate every 2 years. Recertification can be done either by completing continuing education or taking the cognitive test.

Note: Candidates need to fulfill the renewal requirements of the state where they are licensed to practice.

Recertification by Examination

For recertification by exam:

  • Candidates need to login to their National Registry account.
  • Complete the application and the requisite examination fee.
  • Login to your National Registry account after 24-48 hours to print your ATT (Authorization to Test) letter.
  • Schedule the exam following the directions in the letter.

Recertification by Continuing Education

For recertification, the EMT NCCP (National Continued Competency Program) requires the Emergency Medical Technicians to undertake 40 hours of Continuing Education which includes the following 3 components:

1. National Component – 20 Hours

The National Component needs EMTs to undergo approved continuing education of 20 hours, out of which, 7 hours must be dedicated to distributive education.

  • Medical – 6 hours
  • Trauma – 1.5 hours
  • Operations – 5 hours
  • Cardiovascular – 6 hours
  • Ventilation/Respiration/Airway – 1.5 hours

2. Individual Component, and 3. Local or State Component – 10 Hours

You need to take the CAPCE (Commission on Accreditation for Pre-Hospital Continuing Education) or state-approved Emergency Medical Services related education of 10 hours, out of which, 7 hours must be dedicated to distributive education.

Lapsed Certification

The EMT certification is deemed lapsed if the recertification requirements are not fulfilled before the expiration date.

Certification Lapsed (0-2 Years)

If you currently possess state EMT license or it has been less than 2 years since your certification is lapsed, you need to pass the cognitive and psychomotor tests to regain the certification from the NREMT.

Emergency Medical Technicians with lapsed certification need to meet education requirements to acquire authorization to test:

  • EMT refresher course approved by the state
  • Continuing education equivalent to the EMT refresher approved by the state
  • Complete the National Component if the EMT obtained the license in a NCCP state

Certification Lapsed (More Than 24 Months)

If it has been more than 24 months since your certification has lapsed, you need to meet the following criteria to get recertified:

  • Complete the National Component of the NCCP program or a refresher course approved by the state
  • Possess current BLS CPR certificate
  • The cognitive exam
  • Practical exam administered by the state

Active or Inactive Status

EMTs can declare their status as either “Inactive” or “Active” when renewing their National Registry certification. Active state implies that the EMT is actively rendering patient care services.

On the other hand, an inactive status implies:

  • The EMT is not actively involved in patient care/healthcare activity or an EMS service.
  • The EMT is working as a regulator, administrator or educator and is not actively providing patient care at the certification level.
  • The EMT is not able to actively carry out patient care activities due to family responsibilities, illness or any other reason.

EMTs who want to declare inactive status are supposed to continue to meet the continuing education recertification requirements of the National Registry.

Note: Those who have had revocation of a health care license or not able to fulfill the educational requirements are not eligible for applying for inactive status.

Return to Active Status

Nationally certified Emergency Medical Technicians can request to turn their inactive status to active by gaining an active affiliation with an Emergency Medical Service and submitting a filled Inactive to Active Registration Form that can be downloaded from the following link:

How Long is an EMT Course?

The duration extensively depends on the level of EMT training that you choose to pursue. However, training programs take 2-6 months to 2 years to complete and are conducted at universities, technical schools, community colleges, EMS academies, etc. All these programs prepare candidates for the NREMT (National Registry of Emergency Medical Technicians) certification examination.

The EMT training is available at the following 3 levels:

1. EMT-Basic Training

It is the minimum level of training for becoming an EMT. Some training programs require candidates to have CPR certification before enrollment in the program while some programs provide CPR training in their curriculum. The curriculum comprises 100 hours (3-11 weeks) of training in major disasters, childbirth, respiratory and cardiac emergencies, and other urgent situations. Topics covered in training include patient assessment, trauma management, airway management, human anatomy, etc.

2. EMT-Intermediate Training

This level is divided into EMT-Intermediate 1985 and EMT-Intermediate 1999 and provides 30-350 hours of clinical and classroom instructions. Students gain in-depth knowledge of medication administration, trauma management, life support, intravenous treatment, etc.

3. EMT-Paramedic Training

It is the highest level of training that may take up to 6 months to 2 years to complete. This training leads to associate’s degree or certificate in EMT-Paramedic. These programs provide clinical and field practice and focus on a wide range of topics including psychology, emergency service management, medical terminology, etc.

EMT Program

Aspirants may take any of the following educational programs:

1. Diploma Programs

These programs are provided at the EMT-Basic level and equip students with patient assessment and basic emergency skills. Candidates also learn to operate and maintain emergency equipment. The internship also includes clinical practice.

2. Certificate Programs

Certificate programs are offered at basic, intermediate, and paramedic levels. The coursework is divided into clinical practice and classroom study. The topics covered in the program include physiology, human anatomy, medical terminology, life support systems, etc. Students gain advanced knowledge in emergency practices such as administering medications and intravenous fluids, use of airway devices, etc. The credits offered by many certificate programs can be transferred to associate’s degree programs.

3. Associate’s Degree

The curriculum covers biology, physiology, anatomy, etc., and students are supposed to complete a long internship. The extensive coursework is divided into clinical practice, field experience, and classroom studies. Candidates acquire advanced knowledge in patient management, shock treatments, pharmacology, etc.

Job Outlook for EMTs

From 2016 to 2026, the employment of EMTs/paramedics is expected to grow 15%, which is faster than the average of employment for all occupations. The projected jobs for EMTs by the year 2026 are 285,400.

There are many reasons for the job vacancies of these professionals, some of them are –

  • increase in emergencies like natural disasters and car crashes;
  • increase in the older and middle-aged population, growth in strokes, heart attack and other age-related health emergencies;
  • improvement in specialized medical facilities will create demand for emergency medical services;
  • workers who leave this profession to seek job opportunities in other healthcare streams or due to the stressful nature of the job.

Future Career Scope

EMTs have a bright future and advanced career opportunities. They can work in various settings – either rural or urban, including rescue services, hospitals, fire departments, ambulance services, etc. They may also get career opportunities in quality management, industrial safety, hazardous materials, special operations, wilderness EMS, etc. They work with firefighters, physicians, registered nurses, medical assistants, and police officers. After completing further education and acquiring advanced certifications, Emergency Medical Technicians can work as a paramedic.

EMT Online

Aspirants can pursue an online EMT course to obtain the NREMT certification. The online EMT training program is a distance learning, interactive, and self-directed course that students can pursue at their convenience and pace. EMT online courses are the best option for goal-oriented and self-motivated students who can’t attend regular classes due to family commitments or other reasons. These programs can also be continued simultaneously with the job.

Online EMT programs require students to complete the clinical component on their own as these courses cover only the theoretical part. You need the internet connection and laptop or desktop to pursue online programs. These programs save you money and time of traveling to the campus.