Publications

Emergency medical technicians (EMTs) and paramedics play critical roles in delivering emergency services to Californians. Since the beginning of the COVID-19 pandemic employers have reported increased difficulty recruiting and retaining EMTs and paramedics. In light of this situation, there is a compelling need to learn more about their supply, distribution, and demographic characteristics as well as the pipeline of new EMTs and paramedics that are trained in the state.

Data from the California Emergency Medical Services Authority (EMSA) and several national sources were analyzed to determine what conclusions can be drawn about California’s EMT and paramedic workforces from existing data sources, and to identify information needed to improve understanding of these critical occupations. Findings regarding EMT and paramedic employment and demographic characteristics were compared to findings for California’s overall workforce, firefighters, police officers, registered nurses (RNs), licensed vocational nurses (LVNs), and nursing assistants.

The limited data available about California’s EMTs and paramedics and new graduates of training programs suggest that:

• California has approximately 12,000 employed EMTs and 10,000 employed paramedics.
• Less densely populated rural counties have substantially more certified EMTs and licensed paramedics per capita than more densely populated urban counties.
• Most EMTs and paramedics in California are employed full-time and work for private companies.
• EMTs and paramedics are predominantly male and are younger than California’s overall workforce.
• EMTs and paramedics are less racially/ethnically and linguistically diverse than California’s general population and the state’s labor force overall.
• Of California’s 58 counties, 54 have EMT training programs but only 24 counties have paramedic training programs.

However, it is difficult to determine whether these findings are broadly representative of California’s EMTs and paramedics because:

• EMT certification and paramedic licensure records do not indicate whether certificate and license holders are employed as EMTs or paramedics.
• Most providers of EMT and paramedic training do not systematically report data about graduates.

The available data also do not provide information about the career trajectories of EMTs and paramedics. Anecdotal reports suggest that many leave the emergency medical services (EMS) workforce due to burnout or to enter other occupations that pay higher wages. The limited racial/ethnic diversity among EMTs and paramedics also raises questions about the extent to which EMS workplaces foster equity and inclusion. Systematic collection of information about EMT and paramedic career trajectories could provide insights for improving recruitment and retention in these critical occupations.