What is a Firefighter Paramedic? The Job Explained

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Most people know what firefighters do and what paramedics do. However, some people aren’t aware that there’s a job that combines the two roles: the firefighter paramedic. 

Firefighter paramedics are professionals who have received both paramedic and firefighter training. They are employed by the fire department and respond to community-based emergencies, including fire, medical and other emergencies.

Let’s discuss in detail what a firefighter paramedic is, what they do, and how to become one.

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Also read: The Path to Becoming a Firefighter: Steps to Get Your Badge

What is a Firefighter Paramedic?

Firefighter paramedics are simply firefighters with advanced paramedic training. This means beyond the rigorous firefighter training, they need to hold the highest level of EMT (Emergency Medical Technician) certification. These medics are usually based at the fire department.

Keep in mind most firefighters have a basic EMT certification. While both paramedics and EMTs have the expertise to provide patients with emergency care, there is a limit on what EMTs can do for the patient. In general, they provide basic, noninvasive interventions to those in need of urgent medical care. This level of care is called BLS (Basic Life Support).

Fire medics, on the other hand, provide both basic and advanced life support (ALS). Given their advanced skills and knowledge, these medical care providers can perform complex lifesaving functions.

We’ll discuss in more detail the differences between the two later in the segment because individuals looking to get into these careers often confuse their roles and responsibilities.

Have you ever asked yourself why fire trucks respond to medical calls?

It’s not only the uncertainty that surrounds the actual problem or having extra personnel to assist, but some have trained paramedics and EMTs on board. Their job is to evaluate the patient and make the necessary intervention explained above.

The availability of fire department resources is another reason firefighters respond to these kinds of emergencies. The combined skills of a firefighter and paramedic are especially useful in cardiac arrest emergencies where these advanced skills may be the key to a patient’s chances of survival.

That’s why having a firefighter paramedic is vital for any emergency response team.

Also read: Why Do Firefighters Go to Medical Calls?

What Do They Do?

There’s a lot that firefighter paramedics do daily besides responding to medical emergencies and putting out fires and rescuing people in danger.

Most of the time, firefighter paramedics work alongside firefighter EMTs and other first responders to provide immediate lifesaving care for critical patients.

While each state defines the scope of care that firefighter paramedics have, these responders always play a significant role in first responder healthcare. Some departments may even put these firefighter paramedics on fire department ambulances and provide emergency transport of patients to the hospital.

Firefighter-paramedics are the most skilled among the emergency medical responders. They can administer medications, provide advanced life support, perform cardiopulmonary resuscitation (CPR), and provide oxygen. Monitoring cardiac rhythms, interpreting electrocardiograms (EKGs), starting intravenous (IV) fluids, defibrillating, using monitors, and other complex medical equipment is also part of their job description.

Also read: Paramedic vs Firefighter: What’s The Difference?

Below is a detailed scope of practice.

Duties and Responsibilities

While duties vary from one state to the other, here are general guidelines:

  • Provide emergency medical care and treatment
  • Treat and transport patients in accordance with the state EMS protocol (firefighter-paramedics may or may not transport)
  • Provide the hospital and other medical facilities with patient information including condition and treatment provided
  • Prepare medical and fire reports
  • Maintain stock of medical equipment and supplies
  • Respond to fire, accidents, emergency medical incidents, and other emergencies.
  • Participate and assist in training programs
  • Operate power tools and rescue equipment
  • Drive fire trucks
  • Evaluate and mitigate potential fire and life-safety hazards in buildings
  • Supervise or participate in routine equipment maintenance activities
  • Participate in rescue services
  • Perform overhaul and salvage operations during and after a fire
  • Participates in quality assurance program

How Do You Become a Firefighter Paramedic?

A firefighter paramedic career is both rewarding and demanding, and there’s a lot of critical information you’ll need to know before earning the title. These professionals sacrifice a lot to serve their communities.

To become one, you need to complete certain education and testing requirements.

Every state has its own set of unique requirements, but here’s a general breakdown of the requirements:


Just like any other profession, you need to meet some education requirements to become a firefighter paramedic. This career path requires significant formal education; hence it shouldn’t be taken lightly.

The actual requirements can vary by state.

Prerequisite Education

Qualifying for a firefighter paramedic position usually requires a high school diploma or an equivalent certificate (GED).

If you have taken classes in biology, chemistry, physics, algebra, geometry, and health go a long way in helping your cause.

It’s also advisable to take as many courses as you can in the area of study to prepare you for college classes. Subjects like anatomy and physiology, if available, lay the groundwork for your future as a firefighter paramedic. Some paramedic programs require these classes as a prerequisite.

You will need to get a paramedic license or possibly even a degree in paramedicine before becoming a firefighter. Rarely, some fire departments will hire firefighter EMTs and send them to paramedic school.

Paramedic Training

stethoscope and EKG strip

To become a firefighter paramedic, some states will require you to possess a two or four year applied science degree in paramedicine.

While others will only require a one year vocational paramedic program to get licensed.

This training is in advanced life-support procedures, pre-hospital patient care, emergency pharmacology, EKG interpretation, and more.

It’s available in technical schools, community colleges, and universities. The course title may also vary from school to school.

To be considered for admission to a paramedic program, you have to meet certain prerequisite requirements. Most programs require an EMT or EMT Intermediate level state license, high school diploma or equivalent, at least 18 years of age, and a valid driver’s license. Some will also require Anatomy and Physiology courses before applying.

Some programs may require you to provide proof of immunizations as well as drug screening prior to clinical assignment. Others need you to complete a pre-entrance assessment and interview. So be sure to check the education prerequisites and eligibility requirements for the school you’re interested in before applying for the course.

This course consists of classroom lectures, hands-on training as well as clinical work in hospitals/healthcare facilities and practical experience with an ambulance crew.

Coursework in this major can include:

After the successful completion of the required training, you need to take the final National Registered Paramedic (NREMT) exam to qualify for licensing. The test includes both written and practical sections.

Depending on the state, paramedics can be certified by the National Registered Emergency Medical Technician (NREMT). Some states also have their own exams for providing a state license and county accreditation.

Here are some tips for those thinking about going to paramedic school:

Associate’s Degree Program in Fire Science

Going to paramedic school and becoming proficient as an emergency medical provider is only half the job of a firefighter paramedic. Considering how competitive this field is, getting a degree in fire science can boost your odds of getting a firefighter paramedic job. Many institutions today also offer a master’s degree, bachelor’s degrees, and certificate programs.

This associate’s degree program usually takes two years to complete and can be attained at various types of colleges, including community colleges, technical colleges as well as some universities. Both on-campus and online programs are available for your convenience.

While online classes provide you with more flexibility, on-campus programs offer you vital in-person training. However, if you’re unable to attend facility-based sessions for one reason or the other, online learning can work just as fine.

It contains the same components, but to meet certain requirement levels for the course, you may be required to visit the campus for training and testing.

The curriculum for this two-year program vary depending on the school, but the core courses may include the following:

Getting a degree in fire science can also open doors to other careers such as fire and arson investigator, fire inspector, and fire prevention specialist.

Fire Academy Training

Candidates who successfully pass all the tests (background checks and drug tests included) are required to participate in the firefighter training program (usually called a fire academy), which takes between 10 to 24 weeks.

To learn more about the fire academy read: Fire Academy 101: What to Expect and How to Prepare

Fire academy training can also be completed before getting hired, through a college firefighter 1 academy program. This is training that you will have to pay for, but they sometimes have schedules that will fit with those who are working full-time.

They may have evening and weekend programs for those who are unable to attend the program due to work or family commitments. These part-time programs, however, can take longer to complete (usually about 6 months).

The program usually involves an intense classroom and physical training with hands-on practice. It focuses on all aspects of basic firefighting skills from hazardous materials control, search and rescue to fire behavior, usage of fire equipment, control techniques, and more.

Live-fire training is also part of the course to teach trainees how to effectively and safely fight fires. This, of course, is conducted under qualified supervision. These drills aim to teach trainees how to think clearly and arrive at logical conclusions under stressful situations.

So basically, you’re required to apply the knowledge you obtain from the classroom instruction to solve problems that may arise during live training and, of course, in real-life fire situations.

These academies can be very challenging. In order to set yourself up for success, read: Can You Fail the Fire Academy? Yes, Here’s How

To get an idea of what the fire academy is like, here is a video of a fire academy week 2 from South Metro Fire Rescue in Colorado:

Some fire departments also have apprenticeship programs that provide intensified classroom instruction and hands-on training with experienced firefighters. But unlike in fire academies, this program can take up to four years to complete with no guarantee of a permanent position.

However, those participating in the fire department hiring academy will get paid for their time.

Bear in mind this is a very competitive field, so landing a job is not easy. Qualification standards such as education level, interviews, physical fitness may be included.

Hiring Requirements

Most fire departments require applicants to take and pass written and physical examinations besides the educational requirements. The written tests are usually not job-specific, but rather general education type questions to gauge your cognitive abilities.

The test covers an extensive range of topics related to reasoning and judgment. It may include; number facility, mathematical reasoning, mechanical reasoning, observation & memory, spatial orientation, situation judgment drills, personality assessment, writing communication, and reading comprehension.

The questions are usually in multiple-choice and true/false format, but of course, this varies from department to department. The number of questions and time allocated to complete the test may also vary. Some fire departments, however, opt to evaluate the applicants’ paramedic skills in addition to the written examination.

For more information about the firefighter written test, read: Firefighter Written Test: What to Expect and How to Prepare and The 14 Best Firefighter Exam Prep Books and Tools

The physical test, on the other hand, is to evaluate your physical fitness level. This is to ensure you can keep up with the physical demands of the job, such as carrying heavy equipment, moving debris, carrying victims who are unable to walk, and more.

But you should note some departments opt to conduct their own physical ability test. So we’ll discuss the physical requirements in more detail below.

To be considered for the job, you must also hold a valid driver’s license, CPR certification, and pass a medical exam, including a drug test. Job interviewing is the final step of the hiring process and, of course, the most important.

Here are some more resources for getting hired as a firefighter:

Physical Requirements

Beyond medical training, firefighter paramedics must be physically prepared for their work. Firefighting is a physically demanding job that requires the applicant to pass a physical ability test. The fitness evaluation usually measures endurance, strength, aerobic, upper body, and agility.

The performance test may include:

  • Hose drag with a specific time frame
  • Running up and down the stairs
  • Lifting and carrying objects weighing up to 25 pounds from below the waist
  • Frequent climbing, walking, standing, squatting, balancing, grasping, crawling, and kneeling
  • Carrying full equipment weighing 50 pounds or more
  • Pushing and pulling objects that weigh 50 pounds or more
  • Penetrating a locked door and other forcible entry scenarios
  • Ladder raising and extension
  • Breaching and pulling ceiling repetitively

Most departments across the country use the Candidate Physical Ability Test (CPAT) to assess candidates. It’s a sequence of events that are designed to simulate tasks and movements firefighters engage in during and after a fire. The test usually includes eight timed events.

For more information about the firefighter physical test (CPAT), read: 8 Tips for the Firefighter Physical Test: Passing the CPAT

Here is a video that explains the CPAT test:

In order to ensure employees are in their best physical shape, some departments carry out fitness assessment tests once a year.

With a physically strenuous profession like this and dealing with life-or-death situations, it’s not a good idea to only strive for minimal physical standards. Train constantly to stay in great shape.

To learn more about getting into physical shape to be a firefighter, read: The Fitness Requirements for a Firefighter – Explained

Characteristics of a Firefighter Paramedic

fire department ambulance

Here some important qualities for firefighter paramedics, as well as all other firefighters.

  • Leadership – Firefighter paramedics display a willingness to take charge and responsibility for the outcomes of their actions and decisions. Demonstrating accountability will compel your colleagues and other responders to follow it. As a paramedic, you having the highest medical training and authority on medical calls.
  • Confident – Firefighter paramedics should express confidence through body language, words, and appearance. This gives you the ability to control the emergency scene. Keep in mind there’s a fine line between confidence and cockiness.
  • Excellent clinical judgment – This means making critical decisions within the patient’s needs in a complex environment. You’ll be making potentially lifesaving decisions, as well as directing staff in incident response; hence this skill is vital.
  • Focused and calm – Whether responding to a fire, crash, or medical emergency, firefighter paramedics should have the ability to stay calm and focused under stressful circumstances. A calming demeanor helps reduce the patients’ anxiety and bring order to a chaotic scene.
  • Critical thinker – Thinking outside the box is critical to help implement a fast and workable solution to complex patient care situations. Critical thinking is usually taught in the classroom. A good fire medic should have the ability to apply it in the field.
  • Self-disciplined – Developing this skill can positively impact your personal growth and career development while avoiding burnout.
  • Exceptional communication skills – Since this job requires lots of face to face interactions with people, from patients and their families to hospital staff, first responders and colleagues, conveying the right information and preventing misinformation is paramount.
  • Self-motivated— Firefighter paramedics should have the internal drive to complete tasks and assignments without supervision. It also means having an enthusiasm for learning and improvement.

What is the Difference Between a Firefighter Paramedic and a Regular Paramedic?

A regular paramedic is not trained to put out fires and respond to emergencies other than those related to medical issues or traumatic injuries. While a firefighter-paramedic can respond to emergencies such as building or forest fires, road accidents, hazardous material incidents, natural disasters alongside medical issues.

Regular paramedics are usually employed by ambulance companies and firefighter paramedics are employed by fire departments or districts.

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