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Click on the decades below to read about the milestones in the NREMT’s history.


President Lyndon Johnson's Committee on Highway Traffic Safety recommends the creation of a national certification agency to establish uniform standards for training and examination of personnel active in the delivery of emergency ambulance service. This resulted in the appointment of a Task Force by the American Medical Association's Commission on EMS to study the feasibility of a National Registry for EMTs. The Task Force was headed by Oscar P. Hampton, Jr., M.D., a physician recognized for his pioneering work with the American College of Surgeons’ Committee on Trauma.


Representatives of organizations actively involved in emergency medical service attend the first meeting of the Task Force on January 21, 1970. Organizations invited to participate were:

  • Ambulance Association of America

  • International Association of Fire Chiefs

  • International Rescue and First Aid Association

  • National Ambulance and Medical Services Association

  • National Forest Service

  • National Funeral Directors Association

  • National Park Service

  • National Safety Council

  • National Ski Patrol

  • American Heart Association

  • International Association of Chiefs of Police

The Task Force met only three times to draft bylaws, determine the composition of the Board, discuss funding, and tackle a myriad of other concerns inherent in the birth of the new certifying agency.

On June 4, 1970, the Task Force was dissolved and was immediately reconvened as the first meeting of the Board of Directors of the National Registry of Emergency Medical Technicians. Roddy A. Brandes of the Ambulance Association of America was elected the Board's first Chairman.


Rocco V. Morando is selected as NREMT's founding Executive Director.

The first basic NREMT-Ambulance exam is administered simultaneously to 1,520 ambulance personnel at 51 test sites throughout the U.S. This event marked the beginning of National Board Certification for the nation's Emergency Medical Technicians.


The first recertification of a Nationally Registered EMT is processed.


The NREMT calls a meeting of national EMT-Paramedic leaders and educators to develop initial guidelines for the national EMT-Paramedic curriculum.


Continuing education requirements for recertification are established for EMT-Ambulance and EMT-Non Ambulance personnel.

The NREMT is instrumental in the formation of the National Association of Emergency Medical Technicians.

A brief prepared by the NREMT is reviewed and accepted by the American Medical Association's Committee on Health Manpower, resulting in the addition of EMT-Paramedic to the list of approved health occupations and the subsequent Council of Allied Health Education and Accreditation (C.A.H.E.A.) procedure.


The NREMT contracts with the University of Kansas to develop and pilot test written and practical examinations for the EMT-Paramedic.

National curriculum for paramedic training is developed in conjunction with leading EMS agencies and the University of Pittsburgh.

A multi-media, audiovisual teaching package is produced by the NREMT to train examiners in the administration of an objective practical performance examination for the EMT-Ambulance.


The First NREMT-Paramedic exam is given in Minneapolis, MN.

The Registry becomes a member of the National Commission for Health Certifying Agencies.


Continuing education requirements for recertification are established for EMT-Paramedics.

As a member of the C.A.H.E.A. Joint Review Committee, the Registry helps to develop essentials and guidelines for the accreditation of educational training sites for the EMT-Paramedic.

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Guidelines and examination for the EMT-Intermediate are developed.

The NREMT breaks ground on a new headquarters at 6610 Busch Boulevard in Columbus, Ohio, to house the growing organization.

The first NREMT-Intermediate exam is given in Jackson, Mississippi.


The NREMT’s new headquarters were dedicated on June 23.


For the first time, two versions of the EMT-Ambulance exam are introduced, reducing the possibility of exam compromise.


Free-standing EMT-Intermediate written and practical examinations are developed and implemented.


The NREMT exams are now used by 24 states and territories as the sole basis for certification at one or more levels. An additional 15 states and territories accept NREMT exams in lieu of their state examinations, at one or more levels.

The NREMT becomes an active participant in a research project conducted by the National Council of State EMS Training Coordinators to collect data and determine the need for standards and guidelines for the EMT-Defibrillator level of care.


The NREMT incorporates all new standards of the American Heart Association into the examinations at all three levels of certification.

The U.S. Department of Defense develops and disseminates Directive No. 6000.10 on Emergency Medical Services which states, "All EMS health care personnel working in an emergency care area shall have current certification in Basic Life Support. Technicians or hospital corpsman working in EMS and/or assigned to ambulance duty shall have a minimum of EMT-A certification from the National Registry of EMTs."


The NREMT adopts examination blueprint changes to meet the newly released National Standard EMT-Intermediate and EMT-Paramedic Curricula as developed and promulgated by the U.S. Department of Transportation.

The NREMT begins to include appropriate questions related to criminal convictions on all applications for initial certification and recertification.

New examinations are written and used at the EMT-Intermediate level according to the U.S. Department of Transportation’s EMT-Intermediate curriculum.


NREMT Executive Director Rocco V. Morando retires but continues his service as Executive Consultant to the Board of Directors.

The NREMT headquarter building is renamed the Rocco V. Morando Building.

The NREMT accepts its 300,000th EMT-Ambulance application.


William E. Brown, Jr., RN, MS, CEN, NREMT-P assumes the position of Executive Director.

All branches of the U.S. military begin to comply with the Department of Defense Directive requiring National Registration for EMTs in the military.

A new category, EMT-Basic, is established, combining EMT-Ambulance and EMT-Non-Ambulance.

The National Association of State Emergency Medical Services Directors replaces the International Association of Chiefs of Police on the Board of Directors.

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The NREMT participate in the revision of the U.S. Department of Transportation’s EMT-Basic curriculum.


The NREMT implements a scientifically developed policy to accommodate candidates with learning disabilities in accordance with the Americans with Disabilities Act.

The Board of Directors approves funding for a National EMT Training Blueprint project and study design for a knowledge and skills retention study.


The NREMT endorsed the EMS Education and Practice Blueprint.

The NREMT votes to support the Commission on Accreditation of Allied Health Education Programs, which replaced the American Medical Associations Committee on Allied Health Accreditation as the sponsoring body for accreditation.


The NREMT conducts a Practice Analysis study to determine key areas required for practice. All exams are updated based on the data obtained from this study.


The NREMT installs a new computer system which improves communications with state offices

The NREMT begins registration of First Responders.

The NREMT works with the Center for Emergency Medicine of Western Pennsylvania on revision of the EMT-Intermediate and EMT-Paramedic curricula.


The NREMT Board approves formation of the Longitudinal EMT Attribute Demographic Study (LEADS) project committee to learn more about the important issues facing EMS personnel and to help identify the critical issues affecting the profession.


The NREMT Mission Statement is adopted -- To certify and register Emergency Medical Services Professionals throughout their careers by a valid and uniform process to assess the knowledge and skills for competent practice.

The NREMT adopts the EMT-Intermediate/99 level and retains Registry certification of the EMT-Intermediate/85 until completion of the EMS Education Agenda for the Future process has been completed.

The LEADS committee completes first survey and snapshot on EMS education.

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The Board of Directors adopts a Strategic Plan to help guide the direction of the organization.

The LEADS committee completes second survey and snapshot on EMS work life.


The NREMT exams are now used by 43 states and territories as the sole basis for certification at one or more levels.

The LEADS committee completes third survey and snapshot on EMS compensation.


The NREMT increases fees for the first time since 1973.

The LEADS committee completes fourth survey and snapshot on EMS driving safety and health risk.


The NREMT implements a Research Program for the betterment of NREMT programs and to contribute to the EMS community.

The NREMT receives accreditation of all five levels of exams from the National Commission for Certifying Agencies, a certification accrediting agency sponsored by the National Organization for Competency Assurance.

The LEADS committee completes fifth survey and a post 9/11 survey.


The LEADS committee completes sixth survey and snapshot on ambulance safety.


The NREMT exams are now used by 46 states and territories as the sole basis for certification at one or more levels.

The NREMT begins the process to transition from pencil-and-paper based exams to computer based testing in January 2007.


NREMT hosts regional meetings with State EMS Officials to explain benefits of computer adaptive testing (CAT) and its delivery via computer based testing (CBT).

Many item writing meetings and pilot tests are conducted to prepare for CAT.

Computers are programmed to allow online applications via the NREMT website.

An Education Network is developed to allow EMS Education Program Directors to validate course completion for candidates applying for National EMS Certification.


NREMT successfully launches computer based testing via a contract with Pearson VUE. CBT allows next day delivery of results to candidates across the United States, enhances examination security, allows next day delivery of results to state licensing agencies and permits testing when the candidate is ready at over 300+ locations across the country.

NREMT begins electronic delivery of communiques to State EMS Officials and Educators.

NREMT Staff participates in development of the National EMS Education Standards.

NREMT Board passes a motion to require all Paramedic Education Program graduates to be enrolled in nationally accredited programs in 2013 in order to obtain National EMS Certification at the Paramedic level.

NREMT Board, based upon a motion by Mark King, State EMS Director in West Virginia, passes a plan to re-instate former NREMTs into the NREMT if states require continued maintenance of NREMT certification.


NREMT Board of Director holds a long range Strategic Planning session to develop concepts for plans from 2009 to 2015.

NREMT begins item writing for implementation of the National EMS Scope of Practice Model in accordance with the National EMS Education Agenda for the Future: A Systems Approach and in conjunction with State EMS Offices.


NREMT implements an online system to recertify NREMTs via the website.

NREMT hosts 11 item writing meetings in order to meet the pilot test item demands to continue computer adaptive testing.

NREMT completes a third study “Practice Analysis,” which forms the basis for the test plan until 2014. The outcome changes the test to five areas, Airway/Oxygenation/Ventilation, Cardiology, Trauma, Medicine and Operations with 15% of all items covering Pediatrics throughout the test.

NREMT begins work with EMS educators, CoA representatives and NASEMSO members on development of a psychomotor competency portfolio project.

NREMT begins development of a LEADS ten year report. LEADS is a Longitudinal EMT Attribute Demographic Study project which NREMT has led since 1999. The LEADS studied the EMS workforce and had over 15,000 EMS providers in the study.

NREMT completes a survey of Paramedic Program Directors regarding Paramedic Accreditation opportunities, barriers and knowledge. The survey has an 89% response rate and confirms Paramedic Program Directors favor the accreditation requirement.

NREMT hosts a meeting of State EMS Officials, Fire Chiefs, IAFF representatives, AAA members, NAEMSP representatives and State Medical Directors to begin a process to re-design NREMT recertification requirements.

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NREMT has a record year of applications for National EMS Certification. 140,686 applicants take NREMT examinations

The National Association of State EMS Officials (NASEMSO) proclaims by resolution that the NREMT is the National EMS Certification as outlined in the EMS Education Agenda for the Future: A Systems Approach.

NREMT hosts a “summit” of 8 Paramedic programs that pilot tested the Psychomotor Competency Portfolio project during the past year. Results indicate greater success of students on NREMTs cognitive and psychomotor examination.

NREMT replaces computer system hardware to virtual servers.


NREMT releases revised psychomotor examinations for EMR, EMT and AEMT levels of certification.

Alabama and Vermont become the first states to implement the Mark King Initiative, a process whereby former NREMTs can be re-instated into the NREMT after the state mandates continued National EMS Certification by the NREMT.

NREMT issues the first Advanced-EMT National EMS Certification (NRAEMT)

NREMT hosts along with Educators and State EMS Directors and Medical Directors a course for physician EMS fellows on Education, Measurement and the State Regulatory Process.

NREMT signs a contract extension with Pearson VUE for another five year term ending in 2016 which allows delivery of CBT without an increase in fees for the duration of the contract.

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