How to Become an EMT or Paramedic in Texas

DSHS describes five levels of EMS certification. From highest to lowest, they are:

1. 1Licensed Paramedic
2. 2EMT-Paramedic
3. 3Advanced EMT
4. 4EMT-Basic
5. 5Emergency Care Attendant (ECA)

Texas has two paramedic levels. According to DSHS, EMT-Paramedic certification is for those who have completed a paramedic course but have not completed a degree, while Paramedic Licensure is “for those with a two year EMS degree or a four year degree in any field.”

DSHS lists the same core steps for initial certification or licensure. You must:

• Be at least 18 years old
• Have a high school diploma or GED certificate
• Successfully complete a DSHS approved EMS training course
• Submit a completed EMS Personnel Certification application and fee
• Pass the National Registry exam
• Submit fingerprints for a Texas/FBI criminal history check

The training course is where you learn the knowledge and hands-on skills for your level. BLS notes that EMT programs “typically take less than 1 year” for EMT-Basic certification, and that paramedic training builds on that foundation with more advanced care.

DSHS states that “all testing for ECA, EMT, Advanced EMT and paramedic certification/licensure will be done through National Registry of Emergency Medical Technicians at Pearson VUE testing sites.” A few points from the DSHS exam page:

• Education programs and students must register with NREMT at nremt.org.
• Once approved, you receive an Authorization to Test (ATT), which DSHS calls “your permission slip” to contact Pearson VUE and schedule your exam.
• You must meet all of the National Registry’s own requirements to become eligible for state certification.

The NREMT describes its mission as “Advancing EMS through partnership, research, and lifelong clinical assessment.” Its website has exam information and preparation resources for each certification level.

According to the BLS Occupational Outlook Handbook, EMTs and paramedics “assess injuries and illnesses, provide emergency medical care, and may transport patients to medical facilities.” Typical duties include:

• Responding to calls for medical assistance
• Assessing a patient’s condition and determining treatment
• Providing first aid or life support care
• Transporting patients safely to hospitals or other facilities
• Documenting observations and treatment for other medical staff
• Maintaining medical supplies and equipment

BLS explains that paramedics provide “more extensive prehospital care than do EMTs.” That can include giving a wider range of medications, such as through intravenous methods, advanced airway management and interpreting electrocardiograms.

The job is demanding. BLS notes that the “work is physically strenuous,” with plenty of kneeling, bending and lifting while caring for and moving patients, and that schedules may include nights, weekends and holidays. Important qualities include communication skills, compassion, interpersonal skills, physical strength and problem-solving skills. Looking ahead, BLS says overall employment of EMTs and paramedics “is projected to grow 6 percent from 2025 to 2035.”

Texas EMS certification runs on a four-year cycle. DSHS recommends starting the recertification process “three to four months prior to your expiration date.” DSHS renewal options include:

• Passing the National Registry assessment exam
• Completing pre-approved continuing education (CE) in the required content areas
• Maintaining current National Registry certification
• Completing a formal recertification course
• A Comprehensive Clinical Management Program (CCMP) option for eligible EMS provider personnel

If you choose the CE route, DSHS lists minimum totals over the four-year period of 36 hours for ECA, 72 for EMT, 108 for Advanced EMT and 144 for EMT-Paramedic and Licensed Paramedic. All renewal applicants must also complete an EMS jurisprudence exam approved by DSHS. After your initial fingerprinting, DSHS says you do not need to repeat it at renewal, unless you reapply more than a year after your certification expires.

Republic EMS, Ltd. has been a licensed Texas EMS provider since early 2008. We serve Greater Houston, Dallas, San Antonio, Corpus Christi, Beaumont and surrounding areas, and we are dedicated to serving freestanding emergency centers.

• Every unit is staffed with a Paramedic and an EMT.
• Every unit carries a vent, pump and cardiac monitor, so our trucks are MICU-ready.
• Our medics take part in frequent mock codes and in-house AHA training to keep BLS, ACLS and PALS current.
• Our hiring process is rigorous and includes drug screenings, background checks and continuing education.

We are hiring certified Paramedics and EMTs. If you hold a current Texas certification, apply here.