National Registry of EMTs

Policy for International NREMT Certification


In 2011, the NREMT Board of Directors approved the National EMS Certification on an international basis. The Board determined that decisions regarding use of the NREMT in foreign countries would require a case-by-case decision making process that focused on two important elements:
  • Candidates completing EMS education outside the United States must meet or exceeded the same standard applied in the United States
  • A mechanism/partnership is established to recover all expenses associated with administering international based programs or examinations
The NREMT welcomes the opportunity to work with countries requesting the use of the NREMT’s National EMS Certification.

International Partnership Steps

  • Letter of approval
    In the event that a foreign country, state, providence or region of a foreign country and/or school or EMS service requests use of NREMT certification services that entity must present to the NREMT a letter from that countries governmental authority that they approve of this use or the letter must state the country has no opposition to the use of the NREMT certification.

  • EMS Education Approval
    The NREMT will authorize EMR, EMT and AEMT certification to graduates who meet and/or exceed the current National EMS Education Standards as validated by an educational program that is affiliated with CAAHEP accredited paramedic education program and is currently state approved within the United States. The co-sponsoring institution must have faculty present during the delivery of the course.
    At the Paramedic level the education program offered in a foreign country must be affiliated with a U.S. based CAAHEP accredited Paramedic education program.

  • Prerequisites
    Paramedic applicants must hold or have held NREMT Basic certification or a foreign countries equivalent of EMT licensure and have authorization to practice in that country.

  • Cognitive Examinations
    Must be delivered at Pearson Professional Centers or Pearson VUE Select Centers. Examinations must be delivered in English only.

  • Psychomotor Examinations
    All Psychomotor examinations at the EMT, AEMT and Paramedic levels must be administered by a National Registry Representative, appointed by the NREMT.

  • Examination Fees
    The cognitive examination fee is the same fee (in U.S. dollars) as required for all U.S. candidates, plus any international surcharge or site fee established by PearsonVue. The Psychomotor examination fees are established by the NREMT on a case-by case basis and must be prepaid. National Registry Representatives may be appointed who are residents of foreign countries after appropriate training and only with authorization by the NREMT.

  • Entry-Requirements
    All applicants must meet current NREMT entry requirements.

  • Recertification requirements
    All refreshers, continuing education, cardiac resuscitation courses that can be utilized for NREMT continuous certification must be approved by the Continuing Education Coordinator Board for EMS.
Download a PDF of this policy.