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EMS Certification and Training

There are three levels for Emergency Medical Technician in Massachusetts: Basic, Intermediate and Paramedic.  Brewster Fire Department currently has 11 paramedics and 31 EMT-B’s.

What is the difference between an EMT and a Paramedic? 

People use these two terms interchangeably. So how do they differ with each other?  The main difference of emergency medical technicians and paramedics is in the scope of their practices. Emergency medical technicians provide basic life support, first aid, CPR/AED and support for the paramedic while the Paramedic provides advanced skills such as intravenous lines and medications, fluid resuscitation, cardiac monitoring and advanced airway management.

The number of hours for the training for each is also very different. Emergency medical technician courses usually last for 110 to 150 hours, with a small clinical experience. Paramedics training on the other hand, requires longer training. Usually it can last for 1,200 to 1,800 hours or it can become a two year course.   Paramedic training involves classroom time, hospital time and in the field training.

What is the training for each?



The Basic Emergency Medical Technicians (EMTs) has an overall objective to improve the quality of pre-hospital emergency care rendered to victims of accidents and sudden illness. As such, the course develops skills in symptom recognition and in all emergency care procedures and techniques currently considered to be within the responsibilities of an EMT providing emergency medical care with an ambulance service.

The course consists of 100 hours of classroom and field training, plus 10 hours of in-hospital observation and training for a total program of 110 hours. These specified training times are minimal; actual training time (including clinical experiences) is expected to range from the minimum of 110 hours to 150 hours or more depending on individual sponsor requirements and student needs. The curriculum follows the Federal Department of Transportation guidelines and is taught by a state approved EMT Instructor/Coordinator.


The training program for Emergency Medical Technician – Paramedic (EMT-P) objective is to provide advanced emergency care and services by a competency – based training program. This is accomplished through rigorous didactic (lectures, discussions and demonstrations), clinical (in-hospital instruction and supervised practice of critical skills) and accompanied by a field internship (supervised experience on an intensive care vehicle). Competencies include but are not limited to the recognition, assessments, and management of medical emergencies under direction of a physician. The EMT-P provides pre-hospital emergency care to acutely ill or injured patients primarily by ambulance service and mobile advanced life support (ALS) units under medical command authority, and secondarily in other appropriate settings under physician’s control.




How do EMT’s and Paramedics maintain their certifications?

A program of continuing education must be undertaken in order to be eligible for recertification at the end of the initial certification period for both EMT’s and Paramedics.  Recertification training requirements are to be completed within the two-year term of certification.  They include:


  1. Successful completion of a state approved EMT curriculum refresher course of not less than 24 hours
    1. 28 hours of state approved continuing education
    2. CPR for the health care provider class


  1. Successful completion of a state approved EMT-P refresher course of not less than 48 hours
  2. 25 hours of state approved continuing education.
  1. CPR for the health care provider class
  2. Advanced Cardiac Life Support (ACLS)
  3. Pediatric Advanced Life Support (PALS)
  4. 12 Lead EKG interpretation