EMT vs. Paramedic: What’s the Difference?

EMTs and paramedics both work for emergency medical services. Find out which career might be right for you.

Emergency medical technicians (EMTs) and paramedics both work together as part of emergency medical services (EMS). Although EMTs and paramedics work in many of the same settings and perform many of the same responsibilities, the roles have some key differences.

Find out which role is right for you when you compare the education and certification requirements, the responsibilities, and the salary information for an EMT vs. paramedic.

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EMT and Paramedic Key Similarities and Differences

EMTs and paramedics both work for EMS to provide urgent and emergency care for patients. Both careers require a high school diploma, cardiopulmonary resuscitation (CPR) – basic life support (BLS) certification for healthcare providers, a license to practice in their state, and certification through the National Registry of Emergency Medical Technicians (NREMT). To become a paramedic, one must already hold EMT certification.

Paramedics must receive an additional 1,200 hours of training, so they can lead their team on the field, make decisions about where to take the patient for the best care, give oral and intravenous (IV) medication, and use advanced airway management techniques. Paramedics often earn higher pay because they receive additional education and learn more skills.

What is an EMT?

An EMT is a member of EMS who evaluates the patient’s condition, provides them basic medical care, and transports them to the hospital.

What is a Paramedic?

A paramedic is a healthcare professional within EMS who has earned EMT certification and learned additional skills, such as stitching wounds, giving oral and IV medications, and reading electrocardiograms (EKG) for patients who need urgent medical care.

Major Comparisons
Points to ConsiderEMTParamedic

Admission Requirements

  • High school diploma or equivalent
  • CPR certification
  • High school diploma or equivalent
  • CPR certification
  • EMT certification from NREMT

Degree Required

  • None
  • Associate degree or bachelor’s degree could be required

Certification Options

  • CPR-BLS certification for healthcare providers
  • EMT certification from the National Registry of Emergency Medical Technicians (NREMT)
  • An EMT license issued by the state
  • CPR-BLS certification for healthcare providers
  • Paramedic certification from the National Registry of Emergency Medical Technicians (NREMT)
  • A paramedic license issued by the state

Recertification Options

  • Schedule and pass the recertification exam for EMTs

OR

  • Complete 40 hours of continuing education that meets the requirements the National Continued Competency Program
  • Schedule and pass the recertification exam for paramedics

OR

  • Complete 60 hours of continuing education that meets the requirements the National Continued Competency Program

Duties and Responsibilities

  • Responding to 911 calls
  • Asses patients’ medical condition
  • Driving the ambulance
  • Providing first aid
  • Providing life-support
  • Leading the EMS team in the field
  • Deciding where to take the patient for the best care
  • Stitching wounds
  • Reading EKGs
  • Giving oral and IV medication

Average Annual Salary

$36,690$49,500

Duties and Responsibilities

Paramedics earn higher pay, have skills in advanced emergency medical procedures, and hold more responsibility to make decisions about medical care and patient transport. However, EMTs and paramedics share many of the same duties, including:

  • Driving the ambulance
  • Providing first aid
  • Providing basic life-support
  • Reporting their observations to physicians, nurses, and other healthcare staff
  • Documenting medical care they give to patients
  • Transferring patients to the emergency department in a hospital or other healthcare space
  • Replacing, cleaning, and taking inventory of supplies

Additional Paramedic Duties

Most paramedics work in other ambulatory care services; local government, excluding schools and hospitals; general medical and surgical hospitals; other support services; and physicians’ offices.

Paramedics hold all the responsibilities of an EMT and additional responsibilities, including:

  • Deciding which healthcare space to take the patient to
  • Leading the team in the field
  • Giving oral and IV medication
  • Stitching wounds
  • Providing advanced airway management
  • Reading EKGs
  • Providing advanced cardiac life support

Education and Certification

Whether you want to become an EMT or a paramedic, you need a high school diploma or a GED diploma and CPR certification. EMTs and paramedics also have to pass three exams: a state licensure exam, a knowledge and skills test, and a NREMT certification exam. After that, deciding which career path to choose depends on how much time you want to spend in training before you can apply for employment.

When applying for NREMT certification, you can create an account with the NREMT. After that, fill out an application for certification and pay the non-refundable application fee of $98 for EMTs and $152 for paramedics.

How to Become an EMT

If you want to apply to an EMT program, you need a high school or GED diploma and CPR certification. EMT programs take 4-5 months to complete. They comprise between 150 and 190 hours of classroom learning and supervised field experience.

After you complete your state-approved EMT program, you must pass the EMT licensing exam in your state. Then, you need a passing score on the NREMT knowledge and skills test. You must also have a current CPR-BLS certification for healthcare providers. Some states may require you to pass a background check.

Upon completion of these steps, you are ready to apply for NREMT certification and become a nationally certified EMT.

How to Become a Paramedic

When applying to a paramedic program, you need a high school or GED diploma, CPR certification, and current EMT certification. Paramedic programs take 16-18 months to complete and comprise about 1,200 hours of classroom learning and supervised field experience.

After you complete a program accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP), you must pass the paramedic licensing exam in your state. You also need to show proof of your EMT license and CPR-BLS certification for healthcare providers.

You need to then pass the NREMT knowledge and skills test. Paramedics must complete a psychomotor competency portfolio that shows you can properly do certain lab skills, such as obtain a patient history or give medication. Some states require you to pass a background check. After you prepare all those items, you can apply for NREMT certification and become a nationally certified paramedic.

Salary and Career Outlook

U.S. Bureau of Labor Statistics (BLS) data from July 2022 projects 11% job growth for EMTs and paramedics between 2020 and 2030, resulting in the addition of 20,700 open positions.

Many factors contribute to the need for more EMTs and paramedics, such as retirement and transfer of current EMTs and paramedics, new specialized care facilities, and a growing population of middle-aged and older adults who have age-related health issues.

Pay for EMTs and paramedics varies by location and work setting. EMTs may also earn more if they increase their certification and become an Advanced EMT (AEMT).

$36,690
Average Annual EMT Salary
Source:BLS, 2021

$49,500
Average Annual Paramedic Salary
Source:BLS, 2021

EMT Salary

EMTs earn an average annual salary of $36,690, or $17.64 an hour, according to BLS data from July 2022.

Advanced EMTs (AEMT), also called Intermediate EMTs, earn more money and carry out more responsibilities than basic EMTs. Work setting and location affect EMT salary the most.

EMTs earn higher-than-average pay if they work in medical and diagnostic labs ($58,200); state government, excluding schools and hospitals ($54,090); outpatient care ($49,820); local government, excluding schools and hospitals, ($41,500); and general medical and surgical hospitals ($37,980).

States that offer EMTs higher-than-average pay:

  • Hawaii ($55,600)
  • Alaska ($51,330)
  • Maryland ($50,770)
  • Washington, D.C. ($48,500)
  • Illinois ($44,460)

Paramedic Salary

Paramedics earn an average annual salary of $49,500, according to BLS data from July 2022. They make an average of $23.80 an hour.

Paramedics earn higher-than-average pay if they work in non-scheduled air transportation ($79,580), medical and diagnostic labs ($54,760), physicians’ offices ($54,690), chemical manufacturing ($53,310), and local government, excluding schools and hospitals ($53,090).

States that offer paramedics higher-than-average salaries:

  • Washington ($82,810)
  • New Jersey ($71,180)
  • Washington, D.C ($64,940)
  • Connecticut ($62,210)
  • Maryland ($59,520)

EMT vs. Paramedic: Which Career Is Right For Me?

Paramedics have more responsibilities and earn higher salaries in all work settings, but it takes at least 3-4 times longer to become a paramedic. You can become an EMT in as little as four months, but the average annual EMT salary is about $13,000 less than the average annual paramedic salary.

All paramedics must start out as EMTs. If you’re an EMT thinking about becoming a paramedic, consider the time it takes to complete the education and certification requirements, the higher pay, and the greater responsibilities before you make your decision.


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