The question often arises, is there international reciprocity recognition of EMT training or EMT paramedic training around the world? Unfortunately, due to the fact that just the terms “EMT” and “paramedic” alone varies so greatly outside of the US, Canada, and the UK, EMT and EMT paramedic training certification and licensing will not be easily transferred or recognized country to country. Though it does take place and you can explore the necessary steps if you desire to work in another country.

A big hindrance is the difference of the emergency responder terms themselves. In many countries what the US, Canada, the UK, Ireland and other countries recognize as a paramedic level of EMT training, other countries refer to as “first responder”. This creates a conflict of understanding, as in the fore mentioned countries, a first responder is the very basic level of EMT paramedic training certified through an EMT school or EMT paramedic training courses. Often not only is there a different description of the profession among countries, some do not even recognize the term or the profession as stated.

Further variations include differences in the two basic emergency services terminology: EMT and EMS. Many countries use the term EMT (emergency medical technician), while others use EMS (emergency medical service/s). This variation is can also be seen within different states, colleges, EMT schools and paramedic school programs. One entity will refer to its training and paramedic school as EMT courses or EMT training, another entity will use the term EMS for their paramedic school or the “emergency responder” certification training they provide. In fact, even the terms “certification” and “licensure” have different meanings, both in the U.S.and aboard.

In addition, this variation of EMT paramedic and EMT training terminology and the understanding of what the position actually entails has created conflict. The many variations in instructional techniques and criteria required for paramedics have resulted in large differences in the mandatory qualifications between locations - both within individual countries and from country to country. It has brought about changes in many countries, in particular the passing of laws to safeguard the title of “paramedic” (or its local corresponding term) from being used by anyone apart from those qualified and experienced to the identified standard.

Here is an example of the vast differences of among just a few countries when referring to EMT and those who are considered qualified to perform emergency ambulance services (including driving the ambulance):

• Canada requires one to two years of education for Primary Care Paramedic (called EMT in Alberta) and three years of training and education for Advanced Care Paramedic (ALS).
• In Europe you need to be an RN or MD.
• The UK is moving towards an all State Registered Paramedic.
• Australia requires a Bachelors Degree and has only two levels Paramedic/Intensive Care Paramedic.
• New Zealand requires a Bachelors Degree for Paramedic and it requires an Intensive Care Paramedic to obtain a Post Graduate Diploma.
• Paramedics in Japan (called Emergency Life Saving Technician or ELST) have a Bachelors Degree and perform services at about 2/3 of the US Paramedic level, e.g. LMA, defibrillation, adrenaline.
• South Africa has a two year educational program for DipTech Emergency Care Technician (ILS) and a Bachelors Degree for an Emergency Care Practitioner (ALS/CCT).

Universal or International EMT training is also near impossible for many other reasons. There are so many differences among countries in regards to the very basics, not to mention factors that would be involved in the EMS courses: language, measurements, and even medicines. As long as people cannot make a decision between epinephrine and adrenaline or kilometers and miles the possibility of reciprocity in qualifications and certification for EMT paramedic training is near impossible.

The diversified requirements and qualifications also cause it to be difficult to transfer certification and licensing, much less recognize them outside of the area where the EMT training or paramedic licensing was obtained. Despite some countries claiming their EMT training is done through means of “international standards”, there is no “official” international (world-wide) standard. Often the country is referring to the standards within their own nation.

All said, this does not mean that EMT training or EMT paramedic training certification reciprocity among countries is non-existent. There is a cooperative interchange between some countries, in particular from the US and Canada and the UK. One cannot simply move there and begin work however, because there is an application process to undertake. Yet it is not impossible to work outside the country or area in which you received your EMS certification, EMT training or your EMT paramedic training. Many countries, Germany is one example, are providing paramedic schools that make it easier to work overseas once the training is completed.

Regretfully, the majority of EMS systems worldwide have problems with scarce resources and inadequate services. Although you will find a multitude of organizations committed to EMS and medical support worldwide, the majority of these services are largely consigned to hospitals and clinical facilities or disaster relief. Despite those facts, it is not to be misconstrued that EMT paramedic work outside the U.S. and Canada is not a necessary service. If you seek EMT paramedic work outside these countries, it is worth researching for employment.

While there will mostly likely never be a mutual agreement for EMT training certification among the majority of countries (there’s just too much variation in training to make one standard level), should you desire to work outside the area or country in which you received your EMT training, it is worth researching. Just as doctors and nurses wanting to work outside their own borders have organizations and countries who welcome them, you will find the elite position of an expertly trained EMT paramedic professional desirable in many countries.

Working abroad may take an application process (many countries do this on a case-by case basis), and it may also require additional certification or even citizenship. Nonetheless, with the increase of disaster relief and EMT/EMS services being shared among nations (when such an event does occur), universal EMT paramedic and first responder services are being utilized, despite the lack of a universal EMT/EMS certification program. Even so, aspiration of an EMT paramedic career, and any region you desire to work in, is worth pursuing despite the initial obstacles.