EMT License Requirements: How to Become an Emergency Medical Technician in Virginia

Virginia’s Emergency Medical Technicians are under the jurisdiction of the Office of Emergency Medical Services (OEMS). They receive their licenses after they successfully complete all portions of the training and testing program.

In-state students are required to earn CPR certification at the healthcare provider level before initiating their EMT programs. This means that they will test on skills such as infant resuscitation and one- and two-person CPR at the onset. They will test on other skills after completing the basic EMT program.

Successful EMTs can earn higher classifications such as Advanced EMT.

Select a Virginia EMT Topic:

Educational Standards

EMT programs must have state authorization. Virginia programs may be sponsored by accredited teaching organizations or regional EMS councils.

Basic entrance requirements are set at the state level. CPR certification is a prerequisite. It must be earned through an approved provider; the Department of Health has provided a list (http://www.vdh.virginia.gov/OEMS/Training/CPRRequirements.htm).

Prospective students can search for approved programs using the search tool found on the Department of Health website (https://vdhems.vdh.virginia.gov/emsapps/f?p=200:4). Students may enroll in EMT training programs as young as age 16 if they have parental permission.

A student can expect at least 154 hours total: at least 144 combined classroom and practical skills training hours and at least ten hours spent in clinical and field settings.

The Examination Process

After successful course completion, candidates will be eligible to test. They will need to create National Registry accounts; this step can be accomplished online. The program will confirm registration.

There are two components to the examination process: practical (or ‘psychomotor’) and cognitive. The psychomotor examination includes three skills stations. The candidate will complete a medical assessment and trauma assessment as well as one other skill station. Both assessment stations require the examinee to physically assess the patient and verbally talk through all aspects of the treatment process. The random skill could be any of seven; possibilities include supine spinal immobilization and bleeding and shock control. The practical examination is administered by CTS. The Office of EMS has provided videos to give students a sense of what to expect at the psychomotor examination (

The candidate will receive points for carrying out particular steps or procedures correctly. Some procedures are denoted as critical; failure to meet critical criteria translates to skill failure. The Department of Health has provided a candidate handbook. Candidates should be aware that standards change periodically and should visit the website for updated information.

The cognitive examination is computer adaptive. The examinee will answer at least 70 questions, covering a range of adult/geriatric and pediatric emergencies. Questions may become more or less difficult based on whether the person is answering correctly.

Virginia candidates take their psychomotor examination before their cognitive examination. They receive an eligibility letter after they complete the course. They will need to make their initial attempt within 180 days. A candidate who does not pass a first attempt will need to obtain a primary retest eligibility letter. If the candidate does not pass on a second attempt, he or she will need to take continuing education.

A candidate who fails one or two stations may be given the option of retesting them on the same day. This counts as a full examination attempt, and a same-day repeat failure will necessitate continuing education. Same day retesting candidates will fill out paperwork at the test site.

A successful candidate can receive an Authorization to Test, or ATT. This authorizes the candidate to schedule a cognitive examination through Pearson VUE. The cognitive test is available on an ongoing basis. A list of Virginia Pearson VUE testing centers is available on the DOH website (http://www.vdh.virginia.gov/OEMS/Training/VUETestingLocations.htm). A candidate is allowed three attempts before remediation.

An individual who is under 18 registers for assessment as opposed to certification. He or she can be eligible for national certification at age 18, provided the proper procedures are followed.

Both examinations must be passed within the allowable timeframes. A candidate who has not met all requirements within two years of course completion can only achieve licensure by completing a new course.

Out-of-State Emergency Medical Technicians

EMTs who hold certification through the National Registry of Emergency Medical Technicians can be granted reciprocity in Virginia. Those who do not hold National Registry certification but are licensed in other states may be granted legal recognition for a period of up to one year. The timeframe will be shorter if there is less than a year remaining on the qualifying license. During the time that an EMT holds the lower status, he or she will need to meet Virginia’s continuing education requirements and take cognitive and practical examinations.

Virginia’s continuing education program is 36 hours total. It includes mandated training hours in a number of specific subject areas. Mandated topics are referred to as ‘Category 1’.

The Application Process

The Office of EMS utilizes an online portal. A candidate will need an account before initiating the examination process. Information should be provided by the program. The Office of EMS has also provided a resource guide (

Out-of-state applicants submit paper applications (http://www.vdh.virginia.gov/OEMS/Training/trainingfiles.htm).

Challenge Process for Other Health Professionals

LPNs, RNs, physician assistants, and military corpsmen may submit challenge applications. They must complete Virginia’s 36-hour recertification program and meet testing requirements.

AEMT Licensing

Virginia has begun issuing licenses at the AEMT level. Licenses are no longer issued at the EMT Enhanced level.

A student must complete a second program. Basic EMT credentialing is a prerequisite for admission into the advanced program. At this stage, the student will need to demonstrate a high school or equivalency diploma.

Additional Information

Licensing information is available from the Office of Emergency Medical Services (http://www.vdh.virginia.gov/OEMS/). OEMS can be reached by telephone at 804-888-9120.