Steps to Becoming an EMT The Skills & Training You Need to Make a Difference

According to the National Highway Traffic Safety Administration’s Office of EMS, individuals working within emergency medical services serve approximately 25 to 30 million Americans each year, with EMTs often at the forefront when it comes to providing care. Although these medical professionals aren’t required to hold a college degree, they have the opportunity to make a significant difference in the lives of individuals and communities. The following guide highlights the path to becoming an EMT, discusses related careers and provides expert advice from a former EMT. Keep reading to find out all you need to know about the path to becoming an EMT.

Meet The Expert

Stephen Richey Former EMT

Written By

Katy McWhirter

Emergency Medical Technicians 101

Working on the front lines of emergency medical response, EMTs usually serve as the first point of contact when someone has experienced injury, trauma or issues brought about by illness or age. Working alongside other first responders, EMTs are responsible for providing life-saving care and transporting individuals to hospitals for more in-depth services.

During the course of a standard day, EMTs may provide CPR, administer medications, wrap wounds, stabilize head/neck injuries or broken bones, administer oxygen, deal with issues related to shock and drive the ambulance. Often the care they administer can make the difference in whether a patient survives until they reach a hospital, making it an important role.

EMTs must also understand how to provide basic emergency services across the lifespan. While one call may deal with a toddler facing a choking issue, the next might require them to provide emergency delivery care for an expectant mother. The next call might relate to a senior citizen experiencing an issue related to cardiac arrest. EMTs must feel prepared and confident enough to walk into any situation and help the patient.

What’s the Job Outlook for EMTs?

Like several other roles within the medical and healthcare arenas, the Bureau of Labor Statistics projects that roles for EMTs will grow significantly between 2016 and 2026. While job growth statistics for all careers in the U.S. collectively hovers around seven percent, roles for EMTs are predicted to grow by 15 percent – or approximately 37,400 jobs.

Growth from this role stems from several sources. While unfortunate events such as violence, vehicular crashes and natural disasters will continue to demand the skills of these professionals, a growing elderly population means that more EMTs are needed to respond to health emergencies stemming from advanced age. The BLS also projects that more EMTs will be needed in the coming years to provide services to rural populations.

How Much Do EMTs Make?

EMTs save lives each and every day, but many individuals considering this path cannot pursue it solely based on their desire to help people – they need to know their salaries will cover life expenses. The following section takes a look at a few salary statistics to help those on the fence decide if this career suits their financial needs.


Lowest 10% of earners:
Less than $21,880

Median annual salary: $33,380

Highest 10% of earners:
More than $56,990

Source: Bureau of Labor Statistics, 2018


  1. 1.Washington: $76,040
  2. 2.Washington D.C: $60,100
  3. 3.Alaska: $50,500
  4. 4.Connecticut: $47,360
  5. 5.Maryland: $41,940

Median annual salaries.
Source: CareerOneStop, 2018


  • Hospitals: $35,990 per year
  • Local government: $35,620 per year
  • Ambulance services: $30,800 per year

Source: Bureau of Labor Statistics, 2018

What are the Different Levels of EMT?

Within the world of emergency medical technicians, three different levels of certification exist to help workers continue gaining skills, responsibilities and higher pay. The following section highlights the main differences at each level.

  • Emergency Medical Responder (EMR)

    After completing an EMR course approved by their state and passing the cognitive and psychomotor examinations, newly minted EMRs possess the skills and knowledge necessary to provide immediate, first-responder services to the individuals they serve. They can provide life-saving care with little support while waiting for other responders, but don’t possess the training to offer advanced care.

  • Emergency Medical Technician (EMT)

    Individuals pursuing this path meet requirements in addition to those mandated for EMRs before moving into day-to-day work. In a typical shift, these medical professionals provide emergency medical care, stabilize patients, provide transportation, and use the tools and devices provided on an ambulance to care for patients en route to hospitals.

  • Advanced EMT

    After completing additional education and certification requirements, Advanced EMTs can provide all the services administered by EMTs but also possess the medical knowledge needed to offer a few advanced services while transporting patients to a hospital. These professionals often go out on calls when it’s clear that EMRs or EMTs will be out of their depths.

  • Paramedic

    Unlike earlier qualifications, individuals hoping to work as paramedics typically need to complete a two-year degree to qualify. Once they pass certification exams, paramedics possess both basic and advanced skills and can provide extensive critical care to emergency patients. Aside from making higher salaries, they also take on more responsibilities.

A Day in the Life of an EMT

After reading many different articles and guides about what it takes to become an EMT and the likelihood of finding a job after finishing certification requirements, many interested students still find themselves wondering what it really means to be an EMT. Stephen Richey, a former clinical instructor and EMT-Intermediate, answers some of the most common queries.

Q: What are typical hours like for an EMT?

Hours will depend on where you’re working. Mostly it’s 12-hour shifts (one during the day and one at night) although it’s not uncommon to have to stay late because of a call that comes in at the end of your shift. The number of calls will depend upon where you work. An urban setting usually means more calls although that isn’t always the case. A city of a million people with a ton of ambulances may result in fewer calls per truck than a county ambulance service with two or three trucks covering 10,000 people. 

Q: What does it look like when an EMT takes a call?

Most EMTs do not run emergency calls as people think of them. The majority start out working on private service trucks handling nursing home and dialysis patients mostly. A lot of EMS providers look down on this but it’s a good way to learn the stuff they don’t teach you in class. Even if you do get a spot on a service handling 911 calls, you’re more than likely going to drive the truck while your medic partner handles the critical patients. This is especially the case if the local fire department has paramedics on their engines. 

Q: What are the most common types of calls an EMT takes on a given day?

A lot of people come in expecting lights and sirens, gunshot wounds, car crashes and excitement only to find out that those are the minority of calls. I used to tell students that 95% of people are attracted by 5% of calls. A good way to tell a veteran EMT or medic from a rookie (or someone who hasn’t really done much despite being around for years) is the rookie goes “Give me something interesting! Give me something cool!” while the veteran is going “Give me something I can fix”. This is where you’ll get different answers between “most rewarding” and “most frustrating”. 

To me, the most rewarding are the ones where you can make someone’s day better. You seldom if ever “save a life” in a strict sense. My most rewarding call ended up being where I got to share a peanut butter and jelly sandwich with one of the last surviving veterans of World War I. 

Q: What are the worst parts of being an EMT? What are the best parts of being an EMT?

To me, the most frustrating calls are the ones where people use us as a taxi service to get to the hospital. We call them “frequent flyers.” EMTs are, like it or not, not really doing “procedures” for the most part. It’s basically first aid on steroids in a lot of ways. The procedures in the field are, for the most part, left to paramedics and EMT-Intermediates (in the few places that still have the later [also called Advanced EMTs in some places]). 

All in all, I recommend it as a job for those who want to give something back to their community. On the other hand, if you’re looking to be a hero or make a lot of money, it’s not the field for you.  

How to Become an EMT

While EMTs aren’t required to earn an associate or bachelor’s degree to fulfill their roles, they do need to complete a number of steps before receiving credentials. The following section takes interested learners through the requirements and illuminates each step of the path.

Complete basic education requirements

While EMTs don’t need a degree, they do need a high school diploma or GED. If you don’t already possess a high school diploma, you need to either finish any outstanding course requirements or pass the General Education Development (GED) examination. Students can find more information about requirements via the GED Testing Service.

Gain CPR certification

Most EMT training programs require entrants to already possess CPR training to begin the course. Many local and online organizations provide training for certification. Students can use both the American Red Cross and the American Heart Association to find more info on local and eLearning options.

Find an EMT program

All aspiring EMTs must complete a state-approved education program in emergency medical technology to be considered for certification. Students should attend an accredited program if they want to avoid issues with certification after they graduate. The Commission on Accreditation of Allied Health Education Programs maintains a database of accredited EMT programs for each state. These are most commonly provided by emergency care training facilities, community colleges and trade/technical schools.

Pass the cognitive examination

Every student hoping to work as an EMT must first pass the National Registry Emergency Medical Technician cognitive exam. A computer adaptive test of between 60 and 110 questions, the exam covers topics such as airways, respiration and ventilation; cardiology and resuscitation; EMS operations; medical care; obstetrics and gynecology; and trauma. The exam usually takes two hours and students can earn between 70 and 120 points. In order to pass, examinees must meet what the National Registry of Emergency Medical Technicians defines as a “standard level of competency.”

Pass the psychomotor exam

Administered by individual states’ emergency management services offices or local training institutions, this exam requires students to demonstrate their ability to successfully perform a number of emergency skills. Examples include conducting patient assessments, managing cardiac arrests, immobilizing spines, caring for long bone fractures, immobilizing dislocated joints, controlling bleeding, managing shock and providing mouth-to-mouth or other ventilation procedures. Students should check with their state’s EMS office to find out where tests are administered and what score they need to pass.

Skills You Need for Success

Even though jobs for EMTs are projected to grow exponentially and the role provides both stability and opportunities for growth, this career is not for the faint of heart. Individuals seeking a standard 40-hour work week with predictable tasks need not apply, as EMTs often have long and varied days that call on them to use a range of unique skills and qualities to get through the workweek.

The following section highlights some of the personality traits and interests the most successful EMTs possess.

  • Physical Endurance

    EMTs work physically demanding jobs requiring them to lift significant amounts of weight, spend long amounts of time kneeling or on their feet and contort their bodies to reach wounded individuals. They need to be physically fit to withstand the wear and tear on their bodies.

  • Problem Solving

    No two days are the same for EMTs, meaning these professionals must be able to think on their feet and make quick decisions based on limited information. They must use these skills when deciding how to best provide emergency care to a patient.

  • Communication

    EMTs interact with many different types of people throughout each day, and it’s imperative that they be able to communicate effectively with them – especially in stressful situations. They must also be able to clearly communicate information to hospitals, explain procedures to patients and communicate with fellow EMTs about how to proceed.

  • Patience

    Depending on where they work, some EMTs may experience significant periods of hurry up and wait. They may have a nonstop morning followed by a quiet night, or they may get calls with no breaks starting 30 minutes before their shift is meant to end. Because of this, EMTs must have patience. This also applies when dealing with members of the public.

  • Curiosity

    “This is a field where you never stop learning – or at least you shouldn’t,” notes former EMT Stephen Richey. “There’s a concept in evolution called the ‘Red Queen Conundrum,’ taken from the Red Queen in Alice in Wonderland,” he notes. “She said, ‘You have to run in place as fast as you can just to stay where you are,’ and I think that’s very true working in this field.”

  • Maturity

    EMTs regularly experience strenuous, potentially traumatic situations that aren’t for the faint of heart. They also often encounter patients or bystanders who have lost their sense of reason and are dealing with issues of shock. Within these moments, EMTs must remain rational. “You will have to be able to stand above the fray when everyone else is losing their ability to be cool,” says Richey.

  • Sense of Humor

    Being able to laugh may seem counterintuitive when considering the job description, but the reality is that working as an EMT can really take its toll on an individual if they don’t know how to diffuse their emotions. “This job can be frustrating and if you’re running 911 calls, you get to see the dark side of humanity at times,” notes Richey. “You either learn to laugh at what you can laugh at or this job will eat you alive.”

What’s Next? Career Growth Opportunities

After gaining experience as an EMT, many of these professionals question how they can continue growing their careers and taking on additional responsibilities and leadership opportunities. While some pursue roles as advanced EMTs or paramedics, others look to related careers that utilize and build on their existing skillset in a new way. The following section highlights just a few related career paths that offer exciting opportunities for current EMTs looking for a new challenge.


Firefighters bravely work to protect the public from outbreaks of fire in homes, offices, forests, and other settings. They are trained in driving the fire truck, using various fire extermination devices, providing basic services to those injured, and rescuing people from dangerous situations.

  • Median annual salary: $49,080
  • Employment outlook 2016-2026: +7%
  • Education needed:

    Non-degree training in emergency medical services

  • Skills needed: Effective firefighters possess the courage needed to put themselves in dangerous situations, the knowledge needed to protect themselves and others from those situations, and the stamina required for working long shifts that are often physically demanding. They must also know how to keep their calm and communicate effectively in high-pressure environments.

  • Source: BLS, 2018

Emergency Management Director

Working alongside other medical and emergency response professionals, EMDs create plans for responding to emergencies or natural disasters. They develop protocols and plans for both during and after an emergency takes place to help individuals and communities return to normalcy as soon as possible.

  • Median annual salary: $72,760
  • Employment outlook 2016-2026: +8%
  • Education needed: Most EMDs possess a bachelor’s degree in emergency management, public health/administration, business or a related field.

  • Skills needed: Oral and written communication, critical thinking, the ability to make tough decisions quickly and leadership.

  • Source: BLS, 2018

Dental Hygienists

Dental hygienists work to support dentists and prepare patients by cleaning their teeth, looking for obvious signs of dental issues, and helping patients employ preventative care measures through education.

  • Median annual salary: $74,070
  • Employment outlook: +20%
  • Education needed:

    Associate degree in dental hygiene

  • Skills needed: Dental hygienists must be able to accurately assess patients, communicate effectively with their patients and supervisors, create oral health plans, and ensure they follow protocol when providing services.

  • Source: BLS, 2018

Diagnostic Medical Sonographer

Working alongside other medical professionals, these individuals operate and maintain diagnostic imaging equipment to obtain images that help doctors and nurses better assess any medical issues within patients. They may also take medical histories.

  • Median annual salary: $65,620
  • Employment outlook 2016-2026: +17%
  • Education needed:

    Associate degree in sonography

  • Skills needed: In addition to being able to follow procedure and protocol when taking diagnostic medical images, sonographers must also be able to communicate with a variety of different patients and medical professionals and stand on their feet for many hours at a time. They also need to feel confident working with technology.

  • Source: BLS, 2018

Registered Nurse

RNs provide many of the same basic skills provided by EMTs but do so within the walls of a hospital rather than in an ambulance. They also take medical histories, support nurses and doctors, perform basic procedures (e.g. taking blood, completing diagnostic tests), and administer medicine.

  • Median annual salary: $70,000
  • Employment outlook 2016-2026: +15%
  • Education needed:

    Bachelor’s degree in nursing

  • Skills needed: Successful RNs are critical thinkers who can quickly assess the needs of a variety of patients while also communicating with them effectively. They possess the stamina to work long shifts and prioritize their emotional health in order to effectively cope with the stresses of the job.

  • Source: BLS, 2018

Additional Resources

  • American Ambulance Association

    The AAA provides a professional space where EMTs and other emergency medical professionals can come together for educational training, networking and access to helpful resources.

  • An EMT Blog

    This personal blog documents the daily life and thoughts of an EMT while addressing some of the most common thoughts and questions they may have.

  • EMS1

    Functioning as a news site but specifically for those working in emergency medical services, EMS1 offers up-to-date information on the state of the industry.

  • EMT FAQs

    Students with questions about becoming an EMT generally or about the educational requirements specifically can review this helpful page provided by SUNY Dutchess.

  • Everyday EMS Tips

    This regularly-updated blog highlights some of the emerging and current topics within the field and regularly shares guest posts by those working as EMTs.

  • Journal of Emergency Medical Services

    JEMS serves as the “conscience of EMS” by providing news, leadership training and regularly posted articles on the latest in-patient care and EMS operations.

  • National Association of Emergency Medical Technicians

    This professional organization provides continuing education, advocacy, and regional/national events for members.

  • National Registry of Emergency Medical Technicians

    In addition to providing EMT certification, the NREMT offers a wealth of resources to aspiring and current EMTs.

  • The Pros and Cons of Working As an EMT

    Individuals considering this career path often wonder about the highs and lows of the position; this helpful article addresses some of those.

  • Real Talk: A Day in the Life of an EMT

    For visual learners, this nearly hour-long YouTube video allows interested students to ride alongside an EMT and see firsthand a typical work day.

  • What It’s Like to Be an Emergency Medical Technician

    The Association of American Medical Colleges shared this fascinating article written by two current students who discuss their work as EMTs.