Initial Certification & Licensure Requirements

Initial certification/licensure is the process involved in obtaining a Maryland Pre-hospital Clinician certification or license for the first time, excluding reciprocity. As this process varies for each level of Maryland certification/licensure, please select an EMS clinician level from the list below for specific information:

Requirements for Initial Certification (Emergency Medical Responder, EMT) or Licensure (Cardiac Rescue Technician, Paramedic, Emergency Medical Dispatcher)

Emergency Medical Responder and EMT applicants who are 16 or 17 years of age must have written permission from a parent or legal guardian.
Applicants must be 16 years of age to participate in any EMS BLS clinical training or internship.
Applicants for ALS licensure must be at least 18 years of age before participating in any ALS clinical training or internship.

Certification Quick Reference Guides (Updated June 2026)

Emergency Medical Responder - Quick Reference
Emergency Medical Technician - Quick Reference
CRT - Quick Reference MIEMSS is only re-certifying existing CRTs.
Paramedic Quick Reference
Emergency Medical Dispatcher Quick Reference

Descriptions of each EMS clinician level.

License Transparency / Timeline Information

Emergency Medical Responder

Submit the application for Initial EMR Licensure through the MIEMSS eLicensure Portal
Estimated Time to Submit Application: 3 minutes
Time to Determine if Application is Complete: 3 – 5 business days
Time to Determine if Application is Approved: 3 – 5 business days
Additional steps in the application process
- Have the applying service affiliation approve the applicant's affiliation, if applicable
- Receive electronic verification of completion of the initial EMR course
- Submit the internship through the MIEMSS eLicensure Portal and receive approval from the Office of Clinician Services
- Successfully complete the National Registry of Emergency Medical Technician's cognitive exam
- Successfully complete the psychomotor exam administered by the education program
- Receive approval from the Office of Integrity, if applicable

Emergency Medical Technician

Submit the application for Initial EMT Certification through the MIEMSS eLicensure Portal
Estimated Time to Submit Application: 3 minutes
Time to Determine if Application is Complete: 3 – 5 business days
Time to Determine if Application is Approved: 3 – 5 business days
Additional steps in the application process
- Have the applying service affiliation approve the applicant's affiliation
- Receive approval from the Office of Integrity, if applicable
- Receive electronic verification of completion of the initial EMT course
- Submit the internship through the MIEMSS eLicensure Portal and receive approval from the Office of Clinician Services
- Successfully complete the National Registry of Emergency Medical Technician's cognitive exam
- Successfully complete the psychomotor exam administered by the Office of Clinician Services
Application Process Changes as of July 2024
- The Internship Packet must be submitted and approved prior to testing the psychomotor examination

Paramedic

Submit the application for Initial Paramedic Licensure through the MIEMSS eLicensure Portal for verification of active status with the National Registry of Emergency Medical Technicians
Estimated Time to Submit Application: 3 minutes
Time to Determine if Application is Complete: 3 – 5 business days
Time to Determine if Application is Approved: 3 – 5 business days
Additional steps in the application process
- Complete the Maryland Medical Protocol Orientation for ALS Clinicians
- Have the applying service affiliation approve the application for initial licensure
- Receive approval from the Office of Integrity, if applicable

Emergency Medical Dispatcher

Submit the application for Initial Emergency Medical Dispatcher through the MIEMSS eLicensure Portal
Estimated Time to Submit Application: 3 minutes
Time to Determine if Application is Complete: 3 – 5 business days
Time to Determine if Application is Approved: 3 – 5 business days
Additional steps in the application process
- Have the applying service affiliation approve the applicant's affiliation
- Receive verification of active status with IAED
- Receive approval from the Office of Integrity, if applicable