EMS Pathways

"EMS" is a few different jobs that share a starting line. This page maps the main routes so you can see where each one goes before you commit to a class.

The three levels

In California, people who respond to medical emergencies are certified or licensed at three levels. Each one builds on the one before it.

• EMT is the entry level. You learn assessment, CPR, oxygen, bleeding control, splinting, and a short list of medications.
• Advanced EMT (AEMT) adds a limited set of skills such as starting IVs. Not every agency uses this level.
• Paramedic is the advanced level, with a much larger scope: cardiac monitoring, a wide set of medications, airway management, and more. The training is far longer than an EMT course.

Which skills each level can use is set by the state and your local EMS agency, so the details change from county to county. Always confirm with the agency where you want to work.

The common routes

1. EMT first, then work. Most people start by getting an EMT certification and then work on an ambulance (private, 9-1-1 or interfacility), in a hospital, or at events.
2. EMT first, then paramedic school. Paramedic programs usually expect you to be an EMT already, and many programs also look for work experience. Some require a large number of hours, so read each program's page carefully.
3. EMT first, then fire. Many fire departments in California want a current EMT certification at the time you apply, so EMT often comes before the fire hiring process begins.
4. Paramedic, then fire. Some departments hire firefighter-paramedics directly, and a paramedic license plus 9-1-1 experience can be a strong qualification there.

Which one is for you?

Think about what you want your day to look like:

• Ambulance work is about patient care: you meet people on their worst day and take them to the hospital.
• Fire department work is broader. Medical calls are a large part of it, but you also train for fires, rescues, hazardous materials and wildland response.
• Hospital and other roles (emergency department technician, event medical, critical care transport) use EMT or paramedic skills in other settings. See the next page.

Practice while you study

If you are working toward your EMT, the EMT Call Lab lets you practice calls one scenario at a time.

Scopes of practice and agency rules vary by county, so confirm details with your local EMS agency.