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Formal training and certification is needed to become an EMT or paramedic. A high school diploma is typically required to enter a formal training program. Some programs offer an associate degree along with the formal EMT training. All 50 States have a certification procedure. In most States and the District of Columbia, registration with the NREMT is required at some or all levels of certification. Other States administer their own certification examination or provide the option of taking the NREMT examination. To maintain certification, EMTs and paramedics must reregister, usually every 2 years. In order to reregister, an individual must be working as an EMT or paramedic and meet a continuing education requirement.

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