CERTIFICATION v. LICENSURE
The Legal Differences Between Certification and Licensure
Although the general public continues to use the terms interchangeably, there are important functional distinctions between the two concepts.
The federal government has defined “certification” as the process by which a non-governmental organization grants recognition
to an individual who has met predetermined qualifications specified by that organization.1 Similarly, the National Commission
for Certifying Agencies has recently defined certification as “a process, often voluntary, by which individuals who have
demonstrated the level of knowledge and skill required in the profession, occupation, role, or skill are identified to the
public and other stakeholders.”2
Accordingly, there are three hallmarks of certification (as functionally defined).
Certification is:
voluntary process;
by a private organization;
for the purpose of providing the public information on those individuals who have successfully completed the certification process (usually entailing successful completion of educational and testing requirements) and demonstrated their ability to perform their profession competently.
Nearly every profession certifies its members in some way, but a prime example is medicine. Private certifying boards certify
physician specialists. Although certification may assist a physician in obtaining hospital privileges, or participating as a
preferred provider within a health insurer’s network, it does not affect his legal authority to practice medicine. For instance,
a surgeon can practice medicine in any state in which he is licensed regardless of whether or not he is certified by the
American Board of Surgery.
Licensure, on the other hand, is the state’s grant of legal authority, pursuant to the state’s police powers, to practice a
profession within a designated scope of practice. Under the licensure system, states define, by statute, the tasks and function
or scope of practice of a profession and provide that these tasks may be legally performed only by those who are licensed. As
such, licensure prohibits anyone from practicing the profession who is not licensed, regardless of whether or not the individual
has been certified by a private organization.
Confusion between the terms “certification” and “licensure” arises because many states call their licensure processes
“certification,” particularly when they incorporate the standards and requirements of private certifying bodies in their
licensing statutes and require that an individual be certified in order to have state authorization to practice. The use of
certification by the National Registry by some states as a basis for granting individuals the right to practice as EMTs and
calling the authorization granted “certification” is an example of this practice. Nevertheless, certification by the National
Registry, by itself, does not give an individual the right to practice.
Regardless of what descriptive title is used by a state agency, if an occupation has a statutorily or regulatorily defined scope
of practice and only individuals authorized by the state can perform those functions and activities, the authorized individuals
are licensed. It does not matter if the authorization is called something other than a license; the authorization has the legal
effect of a license.
In sum, the National Registry is a private certifying organization. The various state offices of EMS or like agencies serve as
the state licensing agencies. Certification by the National Registry is a distinct process from licensure; and it serves the
important independent purpose of identifying for the public, state licensure agencies and employers, those individuals who have
successfully completed the Registry’s educational requirements and demonstrated their skills and abilities in the mandated
examinations. Furthermore, the National Registry’s tracking of adverse licensure actions and criminal convictions provides an
important source of information which protects the public and aids in the mobility of EMT providers.
1 U.S. Department of Health, Education, and Welfare,
Report on Licensure and Related Health
Personnel Credentialing (Washington, D.C.: June, 1971 p. 7).
2 NCCA Standards for the Accreditation of Certification Programs, approved by the member organizations of the National
Commission for Certifying Agencies in February, 2002 (effective January, 2003).