Paramedic to PA School: A Paramedic Q&A on the Path

According to Mike, becoming a paramedic is not easy, but it is extremely rewarding if you put in the time. The path has four main steps:

- Step one, become an EMT-Basic. People often undervalue this stage and rush toward paramedic, but as Mike puts it, you cannot have good ALS (advanced life support) without good BLS (basic life support). His time as a Basic was essential for learning to assess whether a patient is sick or not sick.
- Step two, find a good program and enroll. Many are run by community colleges, which keeps cost down. Programs typically take about 12 months for a certification or 2 years for an associate degree, meeting 2-4 days a week, often 15-18 credit hours a semester, plus required ride-along shifts.
- Step three, take the National Registry. This national certification exam has a practical and a written portion, usually on separate days, and your program director must approve you to sit for it.
- Step four, find a job and get state licensure. You become a Nationally Registered paramedic after passing, but you must be affiliated with an agency and tied to a physician/medical director to actually practice.

Mike explains that EMS has multiple levels of care. The most basic is an EMT-Basic, which is what most people picture when they hear EMT. Basic school is typically a couple of months, and what an EMT can do is set by the state and medical director. Common Basic skills include assessments, splinting, administering low-level medications like Tylenol, aspirin, and glucose paste, and assisting with a patient's already-prescribed medications like nitroglycerin or an albuterol inhaler.

A paramedic is typically the highest level of EMT care in the field. Paramedics carry a wide range of medications and a portable monitor, make differential diagnoses, and follow protocols set by the medical director. They can perform advanced skills such as intubation, IVs and IOs, needle decompression, cardioversion, defibrillation, and pacing. Mike carries a drug box and, based on protocol and assessment, can administer many medications.

Mike works in a busy fire-based EMS system in a major metropolitan area bordering Washington, D.C., on a 24/72 schedule (24 hours on, 3 days off). There is no typical day, which he loves. Shift change is at 0700, but crews arrive early to check the unit and equipment, replace expired medications, run maintenance checks, and secure the narcotics. His department runs just under 500 calls a day as a whole, with a medic unit averaging around 8 calls; a detailed call can take 2 hours while a simple one might take 30 minutes.

On how it helps him become a PA, Mike says PA schools really value the patient care experience paramedics bring. You learn the basics of diagnosis and treatment planning, how to work as a team, and how to think on the fly. Just as importantly, he says the job taught him to lead and to follow, to be humble and ask for help, to gain confidence in his decision making, to do more with less, and the true meaning of empathy and compassion.

Becoming a paramedic is a serious commitment, but it builds exactly the kind of hands-on, high-stakes patient care experience PA programs respect. If you are weighing it as your route to PCE hours, learn from people already doing the work, like Mike, and go in with clear eyes. When you are ready to map your application, our resources and coaching are here to help.