How to Become a Paramedic in the UK and the US

If you have a cool, calm and collected attitude during times of crisis, this might be the right career for you.

Two male paramedics transporting a patient on a stretcher into an ambulance in the background
Jaromir Chalabala /

If you’re thinking about entering the medical profession, then there are few healthcare roles as challenging and unpredictable as that of a paramedic.

From day one, you will be thrown into potentially dangerous situations and asked to treat patients in unfavourable surroundings, all the while attempting to figure out the best course of action to take. It’s a job that requires intense mental and physical robustness, as well as the ability to stay calm and operate effectively under pressure.

On the plus side, it’s also a hugely rewarding job: through their interventions, paramedics save peoples’ lives on a daily basis. This sense of job satisfaction – as well as the variety and flexibility of the role – is a particularly attractive selling point. And, despite the high levels of stress involved, it draws large numbers of new applicants every year.

So, if you’re one of the many potential candidates in the UK or the US considering this exciting career path but are unsure of where to start, then read on; this is the definitive guide on how to become a paramedic.

1. Research the Profession

As with any career-related choice, it’s vitally important to do your research before you come to any decision. This will allow you to weigh up both the pros and cons of the role and ascertain whether or not it’s a good fit for you.

Job Description

Paramedics are registered health professionals (ie: their title is protected by law) who operate almost exclusively in the pre-hospital environment. This means that in the event of any medical emergency, they will attend the scene of the incident directly, in order to administer potentially life-saving treatment, before transporting the patient to a medical facility for further treatment if necessary.

They are highly skilled and trained in all areas of emergency medicine and are often supported by emergency medical technicians (EMTs) and sometimes doctors. They are also expected to be skilled drivers, capable of navigating large ambulances (and other emergency response vehicles) through heavy traffic.

They are authorised to administer powerful drugs and perform highly advanced medical procedures under their own judgement – often in non-clinical environments – making them immensely valuable and respected members of the healthcare community.

Their main responsibilities typically include:

  • promptly attending medical emergency calls to the public as and when required
  • treating all kinds of medical problems, from traumatic injuries to cardiac arrests (and across all ages, from new-born infants to the elderly) in accordance with the framework of their treatment protocols
  • dealing with all members of the public, especially if they are intoxicated, anxious or under the influence of drugs
  • transporting patients to hospital if they require immediate further treatment
  • providing safe, detailed and thorough handovers of patients to hospital staff (usually within the emergency department)
  • safely manoeuvring a variety of vehicles to a blue-lights-trained standard
  • keeping legally admissible notes and documentation of treatment administered for all patients
  • liaising with other emergency services professionals, such as the police and the fire service, in major incidents
  • regularly checking and ensuring that all the equipment and drugs under their care are fit for purpose and in date
  • performing occasional audits for the purpose of effective healthcare governance
  • managing their own ongoing professional development and adhering to competency guidelines through continual refresher training.

Essential Skills and Qualities

As already mentioned, becoming a paramedic isn’t for everyone. Some of the more essential traits that you’ll need to demonstrate include:

  • communication skills – paramedics have to obtain information from acutely sick patients, reassure worried relatives, deal with bystanders and keep the emergency department updated; this requires the ability to communicate in a variety of ways to a range of people
  • multitasking skills – while dealing with all of the above, they also have to manage the actual treatment of the patient, as well as figure out what the next step should be
  • patience – often, uncooperative patients or meddling bystanders can make your job 10 times harder; you need to remain professional at all times and not lose your cool
  • attention to detail – detecting abnormalities in your clinical assessment of the patient or noticing potential clues within the surrounding environment (such as a nearby empty bottle of pills, for instance) can speed up the diagnostic process
  • mental robustness – on any given shift, you might be faced with a hugely upsetting and/or graphic scenario; while you will be supported in dealing with this, it shouldn’t affect your ability to treat
  • physical fitness – shift work can be physically demanding, so the fitter you are, the easier you will find it (there may be times when the lift’s not working, too, and you will have to carry all that equipment up 10 flights of stairs)
  • ability to work under pressure – whether it’s a time-sensitive cardiac arrest or a desperate parent looking to you for help, you need to be able to blot out all distractions and work quickly and effectively
  • diplomatic skills – knowing how to manage people is a fundamental aspect of any health professional’s job; patients can sometimes fail to understand what is in their best interests, which means that you may have to adopt a more tactful approach
  • decision-making skills – emergency medicine is all about effective decision making; from deducing what is wrong to how best to treat it, you will often have to make big calls under intense pressure
  • leadership skills – paramedics are typically the senior member of a two-person crew; therefore, you will also be expected to instruct and help develop the EMT working alongside you.

Working Hours and Conditions

Paramedics typically work 12-hour shifts (totalling around 40-50 hours per week, depending on your employer), which covers days, nights and weekends, and incorporates compulsory protected breaks in between.

While on shift, you will be based within a designated station, although it may be more appropriate during busier periods to remain out in your ambulance or vehicle.

As you will be attending calls, you can expect to work in any kind of surroundings, regardless of the weather; you might also be asked to provide cover for specific events such as concerts, festivals or sporting events.

You may also be forced to deal with distressed or intoxicated patients who are hostile or even physically abusive (although, in these instances, a police escort can be requested for your own protection before you agree to administer treatment).

Salary Prospects

In the UK, entry-level paramedics within the NHS are considered Band 5 employees, meaning that you will start off on £23,020 ($30,570) per year before progressing to Band 6 and £28,050 ($37,250) per year after two years. You will also be entitled to a yearly pay rise that could see you exceed £36,640 ($48,660) per year with experience. Private healthcare provider salaries may differ.

In the US, job salaries tend to vary, although the Bureau of Labour Statistics (BLS) puts the average figure at around $33,380 (£25,130), rising to around $56,990 (£42,910) for senior paramedics.

Job Outlook

Unlike many professions that may be subject to automation or employment trends, there will always be the need for paramedics to attend emergency calls. Indeed, given ageing populations and the subsequent associated health issues, it is likely that this demand will only grow.

The BLS estimates that between 2016 and 2026, paramedic employment figures will rise by 15%, a projection that is much higher than the average.

2. Get the Qualifications

Although paramedicine has traditionally been viewed as more of a vocational field, it has become increasingly professionalised in recent years.

Mirroring the changes made in nursing, most entry-level paramedics now require a full degree in an accredited course, although those with existing training and experience, such as EMTs or military medics, can complete accredited conversion and/or top-up courses in order to gain their licence.

In the UK, you would typically require a paramedic science degree from a pre-approved university, although some trusts continue to offer trainee paramedic positions that balance diploma-level study with on-the-job experience. More recently, some trusts are also now offering degree apprenticeships as part of the government’s fledgeling Trailblazer programme.

Whichever route you choose, you would need to register with the Health and Care Professions Council (HCPC) upon completion of your studies.

In the US, the process differs slightly, with the extent of the education pathway varying in each state.

In most cases, an associate degree (usually conducted by a community college) is considered a standard requirement, although the EMT basic training programme (which can take between six months and two years to complete, depending on the training provider) is a more common pathway into the profession.

Most states also require you to pass an accredited examination before you can legally practise.

In all cases, you will also need an existing full driving licence (some UK trusts also require a Class C licence, although it may be possible to undergo examination for this during training).

3. Land Your First Job

Gaining a licence to practice doesn’t necessarily guarantee you a job. Many trusts and providers advertise jobs internally and externally, and you may need to relocate in order to secure a position.

Of course, in reality, networking is an important part of this. You will take on numerous placements during your training, and this is an opportunity to make contacts and prove to senior paramedics that you can be trusted. A good reference can go a long way when it comes to applying to jobs in different locations, after all.

Alternatively, securing a trainee or apprentice position will guarantee you a job (as long as you pass the relevant tests and prove yourself competent); as a result, the competition for these roles is particularly fierce. The key is to prove that you have a mature and well-balanced personality and are capable of making good decisions under pressure.

Practical experience is also a huge advantage, so spend as much time as possible volunteering in a care-related field, such as at an old people’s home or with St John Ambulance (a first aid charity based in the UK but also operating in the US, as well as several other countries across the world).

4. Develop Your Career

Ongoing professional development is vitally important for any health professional, and paramedics are no exception.

You will be encouraged to constantly improve and undertake training courses designed to maximise your scope of practice, as well as potentially specialise in a particular area (such as CBRN medicine or air ambulance response). With experience, you can also develop your clinical skills further and take on an advanced or a consultant paramedic role where you will have greater autonomy and responsibility.

Alternatively, you can take a step back from treatment and focus on the management and leadership aspect of the role via a team leader or senior manager position, while if you have a passion for academia, you could pursue research projects and get involved in the teaching and development of new paramedics.

You could also take your skills abroad. Conversion courses exist in most countries to bring you in line with the relevant practice requirements. As a medical professional, meanwhile, your expertise would be highly valued by charities, NGOs and peacekeeping entities such as the United Nations or Médecins Sans Frontières (Doctors Without Borders).

Paramedics are always high in demand anywhere in the world, and while the work can be stressful, frustrating and, at times ugly, it can also be extremely rewarding.

If you have the right temperament, a strong stomach and the ability to stay calm under pressure, then there could be an exciting career waiting for you in this dynamic and extraordinary field.

Do you think you have what it takes to become a paramedic? Let us know in the comments section below.


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