EMR to Paramedic Overview

The first level of pre-hospital medicine is training as an Emergency Medical Responder (EMR), formerly called First Responder. . Emergency Medical Responder is a broad term that means the first person on the scene of a medical or trauma emergency. However, there is an Emergency Medical Responder course that anyone 18 years old or older may take. This course is not currently offered by TTU. This is a course that lasts approximately 3 months or 60 hours. Upon successful completion of this course the candidate will take a comprehensive test given by National Registry of EMTs. When the candidate receives a passing score, a certificate is awarded by the State of Tennessee. This certificate allows a person be a part of a rescue squad, fire department, etc. An EMR is not allowed to work on an ambulance in the State of Tennessee. If that is a person's desire, then more training is needed. The Emergency Medical Responder training is not a prerequisite to becoming an EMT. It is  simply a type of training to obtain more knowledge in pre-hospital medicine. Many people take this training so they know what to do in the event of an emergency, but have no desire to make this a career.

The next level is now called  EMT. EMT is an abbreviation that means "Emergency Medical Technician."  It is the first licensure level a person may earn to enter pre-hospital medicine. However, the EMT level of licensure cannot be used to work on an ambulance. If that is the career choice then the Advanced EMT course must be taken.

EMTs were originally trained to work on ambulances and fire departments. However, in the last few years more and more are working in clinics and emergency departments at hospitals. It is a very exciting and rewarding career, but is also very demanding mentally and physically.

To become an EMT requires 41/2 months of training. There is time spent in the clinical setting with ambulance services and hospitlas.After course completion it will be necessary to take comprehensive,computer adaptive test given by the National Registry for EMTs. Upon successfully passing that test, the student will be eligible to be licensed as an EMT by the State of Tennessee Office of EMS. A license is not necessary for admission into the Advanced EMT but there cannot be more than 120 days lapsed before enrolling in the AEMT course. If it is longer than 120 days before enrolling in the AEMT course it will be necessary to hold a State of TN EMT license.

The next level is the Advanced Emergency Medical Technician or AEMT. It is the minimum level of licensure to achieve for employment at an Ambulance Service. There are several prerequisites for the course but understand that the applicant must have completed the EMT course no more than 120 days prior or be licensed as an EMT. This course will be approximately 4 1/2 months in length. It includes IV administration and limited medication therapy. There is a clinical component consisting of time in the hospital and time at ambulance services. At the end of the course the individual will take a comprehensive written and practical test that is given by the National Registry for EMTs. Upon successful completion the graduate will be eligible for an Advanced EMT license issued by the State of Tennessee Office of EMS.

The highest level a person may achieve in pre-hospital medicine is called Paramedic. The original name of this license was called EMT-Advanced, but so many used the term paramedic that it became the norm. To become a Paramedic requires the person to be licensed as an Advanced EMT first. A person may go from Advanced EMT right into training to be a Paramedic without any pre-hospital experience, but it is not always advisable since that person may not understand what pre-hospital healthcare is all about. The job market for Paramedics is quite large and more opportunities arise all the time.

To become a Paramedic requires 11 months of training after the Advanced EMT course. The clinical portion of this course is very extensive. Clinical is conducted at several ambulance services and various departments in the hospital. Advanced skills such as intubation and cardiac monitoring are taught in this course.

If you have decided to make pre-hospital medicine a career, I congratulate you on that choice. It requires a lot of effort in studying but the rewards are enormous. If you have questions about the various courses, look around this web site and hopefully it will help. If you have specific questions or would like to explore this career further, please feel free to call or e-mail the EMS Program Coordinator ( This e-mail address is being protected from spambots, you need JavaScript enabled to view it EMT-P, I/C).