The Difference Between EMTs and Paramedics

The Difference Between EMTs and Paramedics

Paramedics and emergency medical technicians — or more commonly known as EMTs — are both critical pillars of the emergency medical system (EMS). However, while both deal with medical emergencies and are vital to public health and safety, there are also some significant ways that these roles differ.

The main difference between EMTs and paramedics relates to the amount of education and training required for each job and the complexity of the tasks and duties each is qualified to perform. For example, paramedics are qualified to perform more advanced or specialized procedures. Keep reading to learn more about how these careers compare, some alternative careers to consider exploring, and how to become an EMT, including information about education requirements, duties and responsibilities, salary and job outlook, licensing and certification requirements, and more.

What is an EMT, and What Does an EMT Do?

An EMT, or emergency medical technician, is a medical professional trained to respond to 911 calls and other life-threatening situations, such as car accidents, in-home accidents, and natural disasters. Daily duties that an EMT might perform include:

  • Delivering oxygen to patients
  • Administering CPR
  • Providing epinephrine injections/Narcan for overdoses
  • Splinting/Bandaging fractured bones.
  • Stabilizing hospital-bound patients
  • Full Assessment of Medical and Trauma Patients

In addition to performing these types of procedures, EMTs must have the ability to rapidly assess the nature and severity of a patient’s illness or injury — and make life-or-death decisions about how to respond. They must also possess the physical strength to move and handle patients and equipment, effective communication skills, and tolerance for high-stress situations.

What is a Paramedic, and What Does a Paramedic Do?

Like EMTs, paramedics are emergency medical responders who provide patients with immediate, life-saving care after a severe injury or accident. Paramedics assess the patient’s condition at the scene and work to keep them stable while transporting them to the hospital. However, compared to EMTs, paramedics are required to complete more extensive training and are, therefore, qualified to perform more advanced procedures and offer advanced life support. Some examples of the procedures or tasks that a paramedic might perform include:

  • Monitoring and interpreting electrocardiography (EKG) readings, which help diagnose heart attacks
  • Performing intubations, which allow patients to breathe if their airways are blocked or damaged
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Key Differences Between EMTs and Paramedics

There are substantive differences between EMTs and paramedics concerning their everyday tasks and duties and many other aspects of these roles. Read on for a breakdown of how EMTs compare against paramedics regarding factors like education requirements, licensing requirements, and earning potential — all of which need to be carefully considered before applying to certificate or degree programs.

Education and Training for EMTs

At a minimum, according to the BLS, you must earn a “postsecondary nondegree award” to become an EMT. That means you’ll need a GED certificate or high school diploma. While you don’t technically need a degree to meet minimum education standards for an EMT, you can learn valuable new skills and boost your earning potential by obtaining an associate’s or bachelor’s degree, making you more competitive as a job applicant.

In addition to earning your GED or diploma (at minimum), you’ll also need to complete an EMT certificate program accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP), which you can complete at a university or community college.

Education and Training for Paramedics

Like EMTs, paramedics must earn a diploma or GED at minimum. In some cases, they may require an associate’s degree. Generally, aspiring paramedics are required to complete EMT and paramedic training via an approved program, with hour requirements ranging from 1,200 to 1,800 hours. For example, California paramedic programs require at least 1,090 hours, not including EMT training. In most cases, these programs range from about one to two years in length.

Be advised that certain paramedic programs impose EMT work experience requirements, such as requiring applicants to have a minimum of six months of EMT experience.

Required Certifications and Licenses for EMTs

After you finish your EMT program, you’ll need to pass the National Registry of Emergency Medical Technicians (NREMT) cognitive and psychomotor exams, which are discussed in detail later. You can then apply to become licensed as an EMT in your state — for instance, by submitting an In-State, Out-of-State, or Challenge application in California, a process explained in more detail below under “How Do You Become an EMT?” You’ll also need to be CPR certified and pass a criminal background check.

Required Certifications and Licenses for Paramedics

Aspiring paramedics must complete EMT training and pass NREMT exams. They are also required to become licensed at the state level, with regulations around the licensure process varying by state.

Some states use terms like “licensing” and “certification” interchangeably, which can lead to confusion. We suggest reviewing NREMT’s overview of the legal differences between licensure, which is generally a state requirement, and certification, which is usually a voluntary process handled by a private organization.

Salary and Job Outlook for EMTs

The Bureau of Labor Statistics places paramedics and EMTs into a single category. According to the BLS, both earn a median salary of just under $37,000, with the top 10% earning over $47,000. These fields are expected to grow at a rate of 7% — slightly above the 5% national average — and add nearly 18,000 jobs to the economy through 2031.

Remember that EMT salaries vary depending on the location, employer, experience level, and other factors. says the average EMT salary in the United States is approximately $36,380, close to BLS figures. According to data submitted to ZipRecruiter, state average salaries for EMTs range from $46,160 at the high end (in Washington) to $27,900 at the low end (in North Carolina).

Salary and Job Outlook for Paramedics

As the previous section covered, BLS data shows that paramedics earn median salaries of about $37,000 annually. However, that number could be higher — or lower — depending on where you are licensed to work. For example, according to ZipRecruiter data, the average paramedic salary by the state in 2023 ranges from $35,840 at the low end (in Georgia) to $54,320 at the high end (in Tennessee)

two EMTs prep a gurney

How Do I Become a Paramedic or EMT?

Starting a paramedic or EMT career requires you to take specific steps, like ensuring you receive the appropriate type and amount of training. The sections below provide step-by-step guidance on how to become an EMT or paramedic.

How Do You Become an EMT?

Is your goal to become an EMT? Then be prepared to take the following steps, which are essential to help prepare and qualify you for an EMT role.

  1. Complete an EMT training program approved by your state. For example, California’s list of approved programs includes National University.
  2. Pass exams administered by the National Registry of Emergency Medical Technicians. Exams include a psychomotor exam, which tests your ability to perform specific EMT tasks, and a cognitive exam, which tests your understanding of the training. You must pass the NREMT exams to earn your EMT National Registry certificate, at which point you can obtain state certification.
  3. Find a local EMS agency where you can apply to get certified by the state. Be advised that you’ll have to pay a fee and meet any other requirements from your local agency.

It’s important to note that the specific steps for becoming an EMT will vary depending on your location. Therefore, it’s a good idea to check out the policies and regulations in your state, such as these California-specific requirements for EMTs.

Learn more about the process for becoming an EMT in California, or get in touch with the California Emergency Medical Services Authority (EMSA) for more information about EMT certification, reinstatement, and renewal.

How Do You Become a Paramedic?

The steps to becoming a paramedic vary by state. Generally, they include completing paramedic training, passing national exams, and applying to a state licensing board (such as EMSA in California) for certification. Here are some critical steps to becoming a paramedic in California.

  • Complete paramedic training. Many paramedic programs prefer candidates with prior EMT experience, as paramedic training builds on the skills and knowledge you learn as an EMT. You must receive your training from an approved program. California generally requires you to complete a minimum of 1,090 training hours, which can be broken down as follows:
    • 480 hours on a field internship
    • 450 hours on skills and didactic training
    • 160 hours of hospital and clinical training
  • Pass the NREMT exams and earn NREMT certification. These exams are covered in the section above (“How Do You Become an EMT?”). You can also learn more at the NREMT website, which features a section devoted to paramedic certification.
  • Submit the appropriate application to EMSA. Depending on whether you received your paramedic training inside or outside of California, you will need to submit either an In-State, Out-of-State, or Challenge application. As EMSA’s website explains, the Challenge application is meant for “applicants who are currently licensed as a Physician, Physician Assistant’s, Registered Nurse, or Mobile Intensive Care Nurse.” According to EMSA, “Applications are reviewed within 30 days of their submission date and processed in the order in which they are received.”

In addition to meeting these requirements, be advised that you’ll also need to obtain cardiopulmonary resuscitation (CPR) certification, which is generally awarded by either the American Red Cross or the American Heart Association (AHA). You’ll also need to pass a criminal background check to become an EMT or paramedic.

EMT and paramedic are only two examples of EMS careers you can explore. Here are three examples of EMS-related career paths: a firefighter, a private medical transport, or a volunteer EMS.

Volunteer EMS

As a volunteer EMS, such as a volunteer EMT or paramedic, you’ll have job duties like communicating with patients, family members, and bystanders; assessing illnesses and injuries; completing patient care reports; and providing support to other EMS personnel.

Private Ambulance Services

Private ambulance services provide swift emergency transportation to and from hospitals and other healthcare facilities. Since they are regulated differently than public services, private ambulance services offer patients more choice and flexibility when selecting a healthcare destination. According to ZipRecruiter, the average salary for private ambulance services is approximately $56,660.


Save lives and make your community safer by becoming a firefighter. You’ll generally need to pass a background check and drug test, earn a high school diploma (at minimum), earn your EMT certification, and pass an exam called the Firefighter Candidate Assessment (FCA). According to the BLS, firefighters earn a median salary of $50,700 annually, with federal organizations paying more on average than state or local fire departments.

Flight Paramedic

A flight paramedic is a highly trained emergency medical professional who provides critical care to patients during air transport, typically on helicopters or fixed-wing aircraft. They have advanced skills and knowledge to handle complex medical situations in the air, working alongside flight nurses and pilots to ensure patient safety and care. The median salary for a flight paramedic was approximately $54,000 per year, according to BLS data. Please note that salaries may vary due to factors such as experience and location.

EMS Instructor

An EMS Instructor is responsible for training and educating aspiring emergency medical professionals, such as EMTs and paramedics. They develop course materials, teach practical skills, evaluate student performance, and ensure that students meet state and national certification requirements. EMS Instructors typically have significant field experience and may work at educational institutions or EMS agencies. The median salary for an EMS Instructor, according to BLS data, was approximately $54,000 per year. Salaries may vary based on experience, location, and institution.

SWAT Medic

A SWAT Medic is a specialized paramedic who provides emergency medical care to SWAT team members and other individuals during high-risk law enforcement operations. They are trained in tactical medicine and have the skills to work in high-pressure, dangerous situations. SWAT Medics often have prior experience as EMTs or paramedics and may receive additional training in law enforcement tactics. The median salary for a SWAT Medic was approximately $54,000 per year. However, this figure may vary depending on factors such as experience, location, and the specific agency.

Rescue EMT

A Rescue EMT (Emergency Medical Technician) is a first responder trained to provide basic life support and emergency medical care during rescue operations. They often work in challenging environments, such as natural disasters, vehicle accidents, or other incidents requiring specialized rescue skills. Rescue EMTs collaborate with other emergency responders, such as firefighters and police, to save lives and minimize harm. The median salary for a Rescue EMT, according to BLS data, was approximately $36,000 per year. Salaries may vary based on experience, location, and the specific rescue organization.

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Complete Your Education at National University

National University offers a range of degree and certificate programs for students looking to launch or advance their careers in healthcare. Many of our regionally accredited programs are available in online or hybrid formats, making it flexible and convenient for you to learn at your pace and schedule.

Explore programs like the Family Nurse Practitioner (FNP) Certificate or Bachelor of Science in Nursing (RN to BSN). Contact our admissions counselors for more program information, or apply to National University online.

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