Requirements: Paramedic

A paramedic is licensed by the state, and then approved to practice by the county where they work. The training is much longer than an EMT course.

The steps

1. Get your EMT certification first. Paramedic programs build on EMT training.
2. Meet the program's entry requirements. These vary a lot. One California community college program asks for 2,000 hours of EMT experience plus anatomy and physiology coursework, while others have different rules. Read each program's page.
3. Complete an accredited paramedic program. One example is a 40-unit program with classroom (didactic) training followed by a clinical and field internship. Length in months and hours differs by program, and program pages often list units rather than hours.
4. Pass the NREMT paramedic exam. Graduates are prepared to sit for it, and passing it leads to state licensure.
5. Apply for your California paramedic license through the California EMS Authority.
6. Get accredited locally. To work in a county, you also need that county's accreditation, which usually means a valid license, a county orientation, proof of employment with an approved paramedic provider, and an application and fee.

What it takes to keep going

• You must keep your license current and follow your county's protocols, which can change.
• Local accreditation can be withdrawn if you do not meet requirements. If it is withdrawn for more than a year, you reapply.

Is it worth the extra time?

Nationally, paramedics earn more than EMTs (about $60,600 vs. $44,470 median, BLS, May 2025), have a larger scope and more options, such as flight and critical care work, and are often preferred by fire departments. The cost is time, tuition and a harder exam. Many people work as EMTs for a while first to decide.

Program hours, prerequisites and local accreditation steps differ, so verify them for the program and county you are considering.