People decide to become Emergency Medical Technicians for many of the same reasons people want to go into healthcare in general. However, the job of an EMT is based around emergency situations, which requires an EMT to think and act quickly and under pressure. To many, this makes for a very rewarding career within medicine.

If you’ve decided you want to be the first responder to emergency situations as an EMT, you will need to become certified by the state in which you want to practice. While you probably want to dive right into the action, there are several steps you need to take in order to gain your certification. You will need to complete proper schooling, earn your National Registry of Emergency Medical Technicians Certificate, and complete your state requirements before you may practice in your state as an EMT.

1. The first step in becoming an EMT is to go to EMT academy

When you decide you want to become an EMT, you will first need to register for an EMT academy. Academies are most commonly taught at community colleges. Academies may also be taught at fire departments, universities, or hospitals. They are commonly taught by people who currently work in the field, and take 150 to 160 hours or about six months to complete.

2. EMT academy is geared towards the National Registry of Emergency Medical Technicians Certificate Exam

Luke Brandt, a paramedic and former EMT at UCHealth Poudre Valley Hospital, explained that EMT academies are usually geared towards the National Registry of Emergency Medical Technicians Certificate Exam as 46 states use this as the base for their state certification.

The National Registry of Emergency Medical Technicians, or NREMT, gives certificates to students who complete EMT academy and pass both their cognitive or written exam as well as the psychomotor or practical exam. EMT academy courses teach students about the content areas of the exam, which are airway, respiration and ventilation, cardiology and resuscitation, trauma, medical obstetrics and gynecology, and emergency medical service (EMS) operations.

3. Each state has their own standards for new EMTs

While most states require Emergency Medical Technicians at the basic level to have a NREMT certificate, there is variance in what new EMTs must do in order to practice in-state after receiving this certificate. As Brandt works in Colorado, he was able to receive his Colorado EMT license through the State Department of Health after submitting his NREMT certificate. However, other states such as Oregon, require additional testing after receiving the NREMT certificate before they are licensed in the state. Check your state’s requirements by visiting the state health or government website.

4. The NREMT cognitive exam is computer-based and adaptive

When you go to a testing center to take the NREMT cognitive exam, you will take the exam on a computer. Questions are adaptive in that each question is based on the last. For example, if you answer a question correctly, the next question will be harder, while if you answer incorrectly, the difficulty will decrease or stay the same.

Obviously, you must answer a certain number of questions correctly in order to pass, but the NREMT does not define specific scoring parameters. Test-takers are asked anywhere from 70 to 120 questions. To pass the exam, you must meet the NREMT standard level of competency, which is defined as “the ability to provide safe and effective entry level emergency medical care,” according to the NREMT website.

5. While the test is fairly straightforward, you have to put in the time

While academies typically teach to the test, making the information you need fully available, Brandt emphasized the necessity of putting in the necessary time in order to pass.

“I had to put in the right amount of time. I made flashcards, I re-read chapters that I didn’t understand as well, I studied in groups. Anything that will make you successful in a high school or college-level course will help you with your EMT academy,” said Brandt.

6. Use tools like flashcards and study guides to review

Brandt explained that flashcards helped him in his studying due to the fact that much of the test requires that you are well-versed in certain medical terms. Flashcards, either digital or paper, can help you remember these. There are other tools that can help you as well, but it’s important to be strategic.

According to Peterson’s Master the EMT-Basic Certification Exam, “many EMS instructors have written study guides for all levels of EMS provision. Candidates should find one or two study guides that they are comfortable with and stick with them. Purchasing the bookstore’s entire stock of EMT–Basic study guides is not necessary to pass your examination. A good review guide, a course textbook and a workbook, and some guidance from your course instructor are all you need to prepare for the examination.”

7. Diagnostic or practice tests will help you assess where you’re at with your studying

In order to assess how much studying you need to do, simulate the test by taking a diagnostic test. This will show you what you need to focus on. Peterson’s Master the EMT-Basic Certification Exam explains that “an examination is an evaluation tool,” and taking a diagnostic test “will help you determine your strengths and weaknesses and apportion your study time.”

Throughout your studies, taking practice tests will also help you familiarize yourself with the questions and help you learn the material.

8. The psychomotor test is scenario-based and state-administered

The psychomotor portion of the NREMT exam asks you to demonstrate medical tasks in a scenario-based environment. Your EMT academy instructor must attest that you are competent in certain skills based on your course demonstrations. These skills needed are “patient assessment/management of a trauma patient, patient assessment/management of a medical patient, cardiac arrest management/AED, bag-valve-mask ventilation of an apneic patient, spinal immobilization (both seated and supine patient), long bone fracture immobilization, joint dislocation immobilization, traction splinting, bleeding control/shock management, upper airway adjuncts and suction, mouth-to-mouth ventilation with supplemental oxygen, and supplemental oxygen administration to a breathing patient.”

Additionally, you will need to pass a state-administered psychomotor test. While the psychomotor exam is required to earn your NREMT certificate, it is not administered by the NREMT. Therefore, testing format may vary. However, many states use scenario-based format where a test-taker is given a patient with a certain medical condition, and they are asked to perform appropriate treatment. Brandt said that during his psychomotor test, he was given a skill sheet and asked to do a scenario-based medical assessment, demonstrating the skills listed on the skill sheet.

9. Get face time with people who work in the field to gain insight

An EMT has a stressful job, and graduation rates at  EMT academies are low. Brandt speculated that this is because people don’t take into account the reality of being an EMT, and instructors explain what the job is truly like. Before going through the training and testing, Brandt encouraged making sure you are solid in your reasons for wanting to become an EMT, and are prepared for the difficult aspects of the job.

“You have to make sure it’s something that fits you. I suppose the best way to find that out is by going to your local fire department. They tend to be pretty good about answering your questions. Ask the EMT academy instructors questions. If you know anyone who works in the field, talk to them,” said Brandt. “Any face time you can get with someone who actually works in the field will be helpful. Ask them, ‘what do I need to do to evaluate myself?’”

A career in the field of emergency medical services has high rewards as well as challenges. Brandt explained that much of the learning happens on-the-job, but taking your training seriously is critical due to the nature of the job. And of course, you have to pass the exams in order to gain your licensure. Adequately preparing for the test will help you feel confident both in your exams, as well as when you first start your career as an EMT.

For more information about the EMT exams, visit the Peterson’s Public Safety/EMT page.