Paramedic License Requirements in Maryland

Maryland paramedics are licensed by the Maryland Institute for Emergency Medical Service Systems (MIEMSS). Eligibility depends on meeting requirements for national certification and on meeting additional state-specific requirements.

Paramedics are EMS providers. Paramedic is the highest level of pre-hospital provider and represents a minority of the workforce. In 2015, there were 3,424 Maryland paramedics, counting those who were inactive – this compares to 19,377 Emergency Medical Technicians. In order to be eligible for certification at the paramedic level, a person must first meet certification requirements at the EMT level; this is a standard requirement, set by the national certification agency. Maryland has gone further, setting an experience requirement at this level.

A student must be at least 18 before beginning clinical training at the paramedic level.

Select a Maryland Paramedic Topic:

Paramedic Education Requirements

The prospective paramedic will need to complete an approved course of study.

A Maryland paramedic program will be approximately 1,100 hours. This is not including previous education at the basic EMT level. An EMT program, though, is much shorter; Maryland sets the minimum at 165 hours.

MIEMSS has provided a list of approved programs in regions I through V (

Programs must be nationally accredited (or going through the accreditation process) to qualify graduates for first-time national certification.

Educational requirements are modified for some individuals who already hold healthcare licensing. A licensed nurse, physician, or physician assistant can complete a healthcare provider to paramedic bridge program. A Cardiac Rescue Technician (CRT) can complete a CRT to paramedic bridge program. (CRT is Maryland’s intermediate level EMS designation).

Educational Options

A visit to the website of CAAHEP, the national accreditation agency, reveals that Maryland has both degree and non-degree programs (

All programs are designed to develop paramedic competencies to national standards (as measured by certification examinations). Degree programs typically include supporting coursework such as psychology. One Maryland program culminates is a bachelor’s degree. Bachelor’s level study develops leadership and research skills as well as practitioner skills.

Examination Requirements

The prospective paramedic will need to meet certification requirements of the National Registry of Emergency Medical Technicians (NREMT). He or she will need to pass two separate examinations. Both must be passed within a twelve-month period.

The psychomotor examination assesses skills such as cardiac management and patient assessment. Students can locate some upcoming examinations through the NREMT website ( However, some examinations may not be shown as they are closed to many test takers. The program coordinator/ instructor may be the best resource.

The cognitive portion of the national certification examination is available through Pearson VUE. It is computer-adapted and available on an ongoing basis. Candidates may schedule their examination in Maryland or in other states. MIEMSS has provided a map of Pearson VUE sites that are either located in Maryland or located near the Maryland border in Delaware, DC, Virginia, West Virginia, or Pennsylvania ( The NREMT advises candidates to make sure that the particular level examination that they seek is available at the chosen site.

Before scheduling, the graduate will need to have his or her examination eligibility confirmed. The school will upload a course completion certificate. MIEMSS has provided an instruction sheet in the testing resources section. A Maryland candidate will pay for a first attempt only if he or she does not have an affiliation (

The prospective paramedic will also need to pass a state-specific protocol examination. The minimum score is 75%.

Experience Requirement for Initial Applicants

Maryland requires an applicant for initial paramedic licensure to have one year of experience with an EMS Operational Program or to have provided care during fully 150 ambulance responses.

The Application Process

Prospective Maryland paramedics can expect their affiliated organizations to take an active role in the credentialing process.

Some forms are available on the MIEMSS website (


An out-of-state paramedic can be granted reciprocity based on National Registry status. The prospective Maryland licensee will need to complete a Maryland protocol review course. He or she must be affiliated with a Maryland EMS Operational Program and have completed the Release and Affiliation form.

After meeting these requirements and completing the applicable portions of the application, the reciprocity candidate will submit a $35 fee, along with documentation of healthcare level CPR certification and all current EMT licenses or certifications.

When all other requirements have been met, the candidate will be notified of eligibility to take the protocol examination. Scheduling information is found in the FAQ section of the MIEMSS website (

Renewal Requirements

Maryland licenses are renewed on a biennial basis. The paramedic will need to have current active NREMT status. He or she will also need to verify current affiliation with an EMS Operational Program.

Additional Information

Information about paramedic requirements is available from the Maryland Institute for Emergency Medical Service Systems ( The Office of Licensure and Certification can be reached at 410-706-3666 or 1-800-762-7157.

Professional organizations include the Maryland Emergency Medical Services Program ( and the Maryland Flight Paramedics Association (