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EMT vs. Paramedic: Get to Know the Difference

From training and certification requirements to scope of practice, job responsibilities, salary, and career growth, discover which emergency medical services career path is right for you and collect the resources you need to get started

A female paramedic smiling at the camera with a stethoscope around her neck, standing in front of an ambulance with colleagues in the background.

Whether you’ve seen them on TV or you’ve come face-to-face with them during a crisis situation, you probably recognize the importance of EMTs and paramedics. These first responders provide on-site emergency care, bravely reassure patients, and prepare them for quick transport to a medical facility for further treatment. Both professions are crucial when it comes to saving lives and mitigating risk in emergency scenarios, but what sets them apart? Though equally important, factors like training level and approved scope of practice make these two professions unique from one another, and students should understand the differences before applying to a training program.

This guide provides a clear comparison of EMTs and paramedics, the training it takes for each career path, information on earning potential and career growth, and the resources you need to choose which path is right for you.

EMT vs. Paramedic: Education & Training Breakdown

Although these professions overlap to a certain extent when it comes to job duties, there are significant differences between the two when it comes to education and training. Here’s how they differ.

EMT Paramedic
Program Eligibility & Prerequisites No previous experience is required to start an EMT program. Some prerequisites might be necessary, such as a class in statistics or anatomy, as well as CPR certification. Paramedic programs include more in-depth classes, as they do more invasive work with patients. EMT certification is a requirement for most paramedic programs.
Program Details Classes for EMTs might include anatomy and physiology, assessing patient condition, dealing with specialized emergencies (such as heart attacks or specific injuries), and clearing airway obstructions. Though some courses can be taken online, the majority of the work will be hands-on with a local technical institute, community college, or medical facility. In addition to the classes required for EMTs, paramedics will take courses that teach them more advanced techniques, such as pharmacology, advanced phlebotomy, the use of complex medical devices, and further training on how to handle large-scale emergencies. Again, hands-on work is the primary means of learning, though some courses can be taken online.
Length of Program Typical EMT training is between 120 and 150 hours, which can take up to one year to complete. Those who choose Advanced EMT training usually requires 400 hours, so students might be looking at two years to completion. In addition to the time it takes to earn EMT certification, paramedics can expect to complete about 1,200 to 1,800 hours of instruction; in some cases, this takes two years and culminates in an associate degree.
Program Requirements In addition to classroom instruction, students will complete ride-alongs with current EMTs and paramedics to learn what the job is like on the ground. They will also complete skills assessments that happen both in a classroom and in the field, where they will receive training during a real-life emergency. The number of training hours necessary depends upon the state you’re in. In addition to the requirements of the EMT programs, paramedics will be required to complete more field and clinical rotations to hone their skills. They will work with registered nurses, as well as seasoned paramedics, on important field procedures, such as starting IV lines. The number of field hours, ride-alongs, and more will be determined by state guidelines.
Degree or Credential Earned There are different levels of EMT credentials, including Advanced EMT (AEMT) or Emergency Medical Responder (EMR). Most paramedics graduate their program with an associate degree.
Certification and Licensing Requirements Those who want to become an EMT must graduate from an approved EMT program, have their CPR certification, and pass both the National Registry exam and the state-approved psychomotor skills exam. The national exam can be taken at Pearson VUE Testing Centers; the state exam location depends upon the state. Visit the National Registry of Emergency Medical Technicians for more details. Testing for paramedics includes holding a valid EMT certification, completing an accredited paramedic program, complete a psychomotor competency portfolio, have current CPR certification, and pass both the cognitive and psychomotor exams. Testing is conducted at Pearson VUE locations, but the psychomotor testing location is dependent upon the state. The National Registry of Emergency Medical Technicians has more information.
Further Training Recertification for EMTs happens every two years. There is a 40 hour requirement; 20 hours are on the national level, 10 on the state/local level, and 10 on the individual level. Recertification by examination is also possible. Paramedics must complete 60 hours of continuing education for renewal of their certification every two years. This includes 30 hours on the national level, 15 hours on local or state, and 15 hours on the individual level. Recertification by exam is also possible.

EMT vs. Paramedic: Career Comparison

When the call for help comes in, EMTs and paramedics are often the first to arrive. These first responders might handle any number of emergencies, but even within that response they have certain responsibilities and roles to fulfill. Their daily tasks, not just in emergencies but in day-to-day administrative and general work, can vary widely. Both EMTs and paramedics are trained with the ultimate goal of helping those in times of dire need, some of their responsibilities and tasks will overlap, but there are important distinctions to be aware of. Here’s what each profession can do.

EMT Job Responsibilities

EMTs are often the first on the scene, ready to assess and stabilize patients. Here’s some of what they do.

  • Administer first aid treatment to those who are ill or injured
  • Assess the nature of the injuries or illness to prioritize medical procedures
  • Perform emergency procedures, such as stemming bleeding or clearing an airway
  • Operate basic equipment, such as external defibrillators, to help ensure best patient outcomes
  • Observe and record patient condition and responses to interventions
  • Prepare patients for transfer to a medical facility
  • Coordinate with other first responders on how to best move the patient
  • Drive the emergency vehicle to and from the scene
  • Maintain vehicles with the appropriate supplies for patient care
  • Report to receiving physicians or nurses the situation, including what the emergency was, the condition of the patient, the extent of their injuries, and interventions performed thus far

Paramedic Job Responsibilities

As first responders, paramedics come prepared to jump into any scenario and assess, stabilize, treat, and prepare the patient for transport. Here’s what they handle in any given day.

  • Respond to medical emergencies; this can include anything from trauma caused by accidents to natural causes, such as heart attacks
  • Perform emergency procedures as necessary, such as stomach suction or airway management
  • Operate equipment, such as bag valve mask resuscitators, to keep critical patients alive during transport
  • Instruct EMTs and other medical personnel on the next steps for patient care
  • Administer drugs as necessary, including starting intravenous lines
  • Communicate closely with dispatchers and similar personnel on where to transport patients and arrange for the reception of the patient
  • Coordinate treatment with other medical personnel
  • Report to receiving medical professionals the vitals, status, and interventions of patient care, including information on the emergency that led to the transport, if possible
  • Coordinate with EMTs and other first responders on stocking supplies, decontaminating the transport vehicles, and preparing for the next call

EMT vs. Paramedic: A Day in the Life

It’s important to note that the chart below features a day in the life of the typical EMT or paramedic, but that the scope of practice and other points might vary depending upon state guidelines. Here are the basics.

EMT Paramedic
Crucial Skills & Knowledge EMTs must have a working knowledge of the human body, anatomy, physiology, and the typical illnesses and injuries they might encounter. They should have training to recognize psychiatric symptoms as well, and take those into account when treating patients. They should know how to use all equipment in the transport vehicle, move a patient in a safe and secure manner, know how to handle combative individuals or bystanders, and understand drug interactions, proper uses of medications, stabilization and immobilization procedures, and the like. In addition the skills and knowledge EMTs must have, paramedics must also have knowledge and experience with advanced medical equipment and procedures, such as how to use certain devices or how to start IV lines. They must also have a strong working knowledge of drugs and their interactions, how to handle administering medications in the presence of illicit drugs already in the patient’s system, and deal with triaging in the event of large-scale emergencies.
Scope of Practice EMTs do the vital work of keeping patients alive, stable, and prepared for transport to a facility that can support their needs. They can assess patient conditions for report to other personnel, start lifesaving interventions such as opening up an airway obstruction or performing chest compressions, making use of supplies in the transport vehicle to treat wounds and injuries, and in some states, administer some drugs for illnesses and pain. Paramedics have more autonomy than EMTs when it comes to what they can do in the field. They can start IV lines, use lifesaving or diagnostic equipment such as defibrillators and EKGs, work closely with or supervise other first responders in caring for the patient, preparing the patient for transport, and more. They might have the ability to administer medications EMTs are not allowed to in some states, such as narcotics for pain relief.
Patient Interaction Patient interaction is essential to the job; EMTs are called to the scene of emergencies and are often among the first people to provide any sort of intervention. They will stay with the patient throughout the treatment and transport. Just like EMTs, paramedics work with a patient from the moment they arrive on the scene to the moment they turn that patient over to a medical facility for more advanced treatment. This can include not only assessment and treatment, but also providing reassurance and comfort.
Job Autonomy & Decision Making Though EMTs are trained to stabilize a patient, keep them alive, and get them through transport for further medical care, in most states they do work under the supervision of paramedics. In some states they are allowed to give medications, start IVs, and handle certain medical equipment; in others, they are prohibited from doing this. They work closely with law enforcement and other first responders to coordinate responses and follow instruction as given by superiors or dispatchers. Paramedics have a great deal of latitude when it comes to making decisions that will save a life. They often supervise EMTs, though a team quickly learns to work well together and perform their duties seamlessly in an emergency situation. Paramedics report to the doctors and nurses at the receiving facility, where they explain what they did for the patient and why.

Choosing Your Career: Questions to Ask Yourself

The question of whether you should work as an EMT or a paramedic is a crucial one. How much responsibility do you want to take on? How much training do you want to undergo? These questions can help you decide which path to take.

Q: Do I want a great deal of freedom to treat patients in the field?

If you’re looking for autonomy to make split-second decisions with a wide range of options available to you, becoming a paramedic is probably right for you.

Q: Do I want to make a higher salary even if it requires more training to get it?

If you’re looking to bring home a larger paycheck, look to get more training and become a paramedic.

Q: Do I have the emotional resiliency to handle difficult situations?

This goes to the heart of the job, and whether you can handle what you might encounter. If you feel you have a strong ability to weather whatever emergencies you might see, then working as either an EMT or a paramedic might be right for you.

Q: Do I want to begin working as soon as possible?

If you’re looking to start earning a paycheck faster, the EMT route is the one for you, with programs that last less than one year. This page has more information on EMT programs.

Q: Do I want to move up the ladder as an emergency responder?

It is entirely possible to move up through the ranks of EMT, become a paramedic, and then move into similar positions, such as that of firefighter or nurse. This page discusses those options and more.

EMT vs. Paramedic: Salary & Job Growth

Job Growth

According to the Bureau of Labor Statistics, job growth for EMTs is expected to be strong at 7% from 2018 to 2028, which is faster than the average for all occupations. That growth might be driven by an aging population, as well as emergencies that will always happen in today’s society, from car crashes to natural or manmade disasters

Just as with EMTs, growth of jobs for paramedics is expected to reach 7% from 2018 to 2028. This growth arises from a variety of factors, including an aging population, natural disasters, acts of violence, car accidents, and other emergencies. Paramedics can expect higher job growth prospects in urban areas, simply because a higher population correlates with a higher number of emergencies occurring in a given area.

Salary Potential

EMTs have less training and fewer responsibilities than paramedics, and their pay reflects that. According to Indeed surveys, EMTs average $14.81 per hour, with a range from $7.25 to $38.55 per hour. Those with higher salaries tend to have more experience, and their location also makes a difference in pay; an EMT in a smaller city might be paid less than an EMT in a larger urban area.

When it comes to salary, paramedics make an average of $19.58 per hour, which is substantially higher than that of EMTs. The range of pay runs from $8.00 to $36.15 per hour. It is important to note that the Bureau of Labor Statistics reports rather close to the same average number at a median of $18.67 per hour

EMT Career Resources

Bureau of Labor Statistics: Occupational Outlook Handbook: EMTs and Paramedics.

This site provides information on job outlook, what to expect from the work, and further resources.

Bureau of Labor Statistics: Occupational Employment Statistics.

This government site offers information on many careers, including the wages for those who work as EMTs or paramedics.

National Association of Emergency Medical Technicians.

NAEMT is the home for information on EMTs, updates on the profession, advocacy, and further education.

National Registry of Emergency Medical Technicians.

This is the place to be for certification, recertification, and further information on the career.

O*NET Online.

This is a fantastic place to find in-depth information about what a career entails, salary information, knowledge and skills needed, and more.

Paramedic Career Resources

Commission on Accreditation of Allied Health Education Programs.

Earning certification requires completing and accredited program; this is a great place to start to find one.

Differences Between EMTs and Paramedics.

Always wondered what the differences were in the two careers? This article can help.

International Association of EMTs and Paramedics.

Go global with this site that offers a look into the work of first responders around the world.

International Association of Flight and Critical Care Paramedics.

Those who choose to take their career to new heights will enjoy this site, which provides information on flight, critical care, and other unique jobs in the field.

Madigan Library at Penn College.

The “Paramedics” section of this website offers a wealth of information on journals, organizations, textbooks, and so much more that is of importance to those working as paramedics.