EMS TRAINING OFFICER RESOURCE

EMS TRAINING OFFICER RESOURCEAn Introduction to the NREMT utilities from the Massachusetts Office of Emergency Medical ServicesDepartment of Public Health

TABLE OF CONTENTS

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OVERVIEW

Background 3

Important Terms to Know 4

Requirements to Maintain Massachusetts Certification 5

What is the NCCP? 6

What are the different parts of the NCCP? 7

Scope of Practice Transition 8

What does a training officer do? 9

Who is a training officer? 10

As a training officer, where should I create an account? 11

REGISTERING YOUR AGENCY AND TRAINING OFFICERS

Registering your agency 13

Registering as a training officer: Non-NREMT MA providers 14

Registering as a training officer: NREMT/MA providers 15

Processing pending affiliation requests 16

REGISTERING YOUR PROVIDERS

Non-NREMT MA Providers: MASSEMT.org account 18

NREMT/MA Providers: NREMT.ORG account 20

Processing pending affiliation requests 21

CONTINUING EDUCATION

Maintaining Training Records 23

Adding Courses for your affiliated EMTS 24

Editing course 28

Applying Training to Multiple Certification Levels 29

Entering refreshers as continuing education 30

Defining methods of instruction 31

RECERTIFICATION

Requirements to Maintain Massachusetts Certification 33

Reviewing “Recertification Packets” 34

Validation of Skills for Recertification: EMT-Basic 35

Validation of Skills for Recertification: EMT-I/Paramedic 36

MA recertification process 37

Recertification by examination 38

Special circumstances with recertification 39

OPTIONAL NREMT CERTIFICATION

Optional National Registry Certification for EMTs 41

Optional National Registry Certification for Paramedics 43

BACKGROUND

Announced in April 2013, Massachusetts OEMS is adopting national standards for certification and recertification, in collaboration with the National Registry of EMTs (NREMT).

All new EMT candidates (at all levels) are required to first receive National Registry certification, but Massachusetts providers certified before July 1, 2013 (who do not have NREMT certification) are not required to obtain NREMT certification.

Changes have occurred for initial education and testing, recertification and continuing education.

This guide is intended to help agency Training Officers (TO) navigate these changes.

For provider-specific questions, please consult the “Provider’s Guide to National Standards” on the OEMS website.

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IMPORTANT TERMS TO KNOW

NATIONAL EMS SCOPE OF PRACTICE◦ A nationwide quality improvement initiative to ensure that EMTs in every state have the same modern education

and training. A move towards national standards is meant to provide not only a higher level of care from all providers but care that reflects evidence-based medicine, with quality and patient safety as top priorities. (See slide 5 for more information). Please note, completing the National Scope of Practice transition does not result in NREMT certification.

NATIONAL EMS CERTIFICATION◦ The National Registry of EMTs has been recognized by numerous federal, state and private entities as the nation’s

EMS certification standard.

OLD-MA [RECERTIFICATION] STANDARD◦ The requirements for recertification prior to the National Standards Adoption and available for individuals

recertifying in 2014. Please note, these individuals still need to create a massemt.org profile and complete the necessary submissions. The “Old-MA standard” only refers to educational requirements and not the process for submitting recertification paperwork. The same applies for “Old-NREMT standard.”

NATIONAL CONTINUED COMPETENCY PROGRAM (NCCP)◦ The new requirement for recertification (optional in 2014); the NCCP is a pilot program for modern EMS continuing

education; it eliminates the often stagnant refresher and offers a more flexible infrastructure to ensure the current needs of the national and local EMS systems are being met.

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REQUIREMENTS TO MAINTAIN MASSACHUSETTS CERTIFICATION

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1. CONTINUING EDUCATION (complete one of the following)◦ Old-MA standard (only available for 2014 expirations)

◦ Old-NREMT standard (only available for 2014 expirations)

◦ New-NCCP standard

◦ Recertify by written exam

2. ONLINE PROFILE (even for 2014 expirations) on either the NREMT.org website or the MASSEMT.org website (see slides 11 & 17).

3. AGENCY AFFILIATION◦ An agency can be any entity that provides pre-hospital medical care.

Examples include but are not limited to: ambulance services, fire or police departments, first responder services, disaster response teams, ski patrols.

◦ Individuals without an agency may align with the State EMS Office (by Region) for education oversight and recertification

4. MEDICAL DIRECTOR validation of recertification requirements (ALS only)

5. SCOPE OF PRACTICE TRANSITION required by the end of the individual’s next recertification period (2016/2017).

6. STATE ONLINE RECERTIFICATION available after December 15th on the OEMS website

WHAT IS THE NCCP?

The National Continued Competency Program is a pilot program for modern EMS continuing education; it eliminates the often stagnant refresher and offers a more flexible infrastructure to ensure the current needs of the national and local EMS systems are being met.

PRINCIPLED BY:

◦ PROFESSIONAL STANDING Having an unrestricted license to practice

◦ COGNITIVE COMPETENCY Having knowledge required for position

◦ PRACTICE PERFORMANCE Having skills required for position, monitoring through CQI locally and nationally

◦ LIFE-LONG LEARNING Professional responsibility to remain updated on advances, maintain rarely used skills

◦ EMPHASIS ON Only 1/3 of hours may be earned via distance/online courses; INTERACTIVE LEARNING defined as online learning without an instructor available to

assist students during the course

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WHAT ARE THE DIFFERENT PARTS OF THE NCCP?

Three components to continued competency:◦ NATIONAL REQUIREMENTS

◦ Determined by NREMT board of directors, based on recent research, EMS physicians, EMS provider stakeholders. Topics focused on recent advancements or changes in clinical practice, curricula disseminated by NREMT. 50% of overall requirements. EMT Transition completed by performance of national requirements during next certification cycle. Paramedic transition separate course.

◦ LOCAL REQUIREMENTS◦ This will be chosen by local authorities (state EMS, regional EMS, service management/Training Officer) to include

changes to protocols, areas for improvement based on continued quality improvement, new techniques and procedures. May include service mandates such as ACLS, PALS, M&M rounds. 25% of overall requirements. For 2014/2015 this will be an open category; please fill it with elective courses (as below).

◦ INDIVIDUAL REQUIREMENTS◦ Chosen by based on Self-Assessment guide, based on perceived or identified areas for improvement in clinical

practice, “elective” courses, based on interest and availability. 25% of overall requirements.

Decrease in total hours required:◦ EMT 40 hours: 20 National / 10 Local / 10 Individual

◦ EMT-I/AEMT 50 hours: 25 National / 12.5 Local / 12.5 Individual

◦ PARAMEDIC 60 hours: 30 National / 15 Local / 15 Individual

For more information, see the NCCP Training Officer’s guide

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SCOPE OF PRACTICE TRANSITION: NOT REQUIRED UNTIL 2017

The Scope of Practice transition is a nationwide quality improvement initiative to ensure that EMTs in every state have the same modern education and training. Please note, completing the National Scope of Practice transition alone does not result in NREMT certification.

The transition course updates the knowledge and skills of all providers, to allow for a national standard skill set, and provideconsistency across the country. Course completion based on meeting objectives, not minimum hours.

Transition course curricula available online, and like all continuing education done outside of an accredited training institute, the course must receive OEMS/Regional approval before being held.

WHO NEEDS TO TRANSITION?◦ All non-NREMT MA EMT-Basics, EMT-Intermediates, & EMT-Paramedics

◦ All NREMT EMT-Bs who tested before 12/31/2011 and EMT-Ps who tested before 1/1/2013 (and all NREMT EMT-Is)

◦ If your NREMT certification number starts with a(n) “B”, “I” or “P” you must undergo transition

◦ If your NREMT certification number starts with a(n) “E”, “A” or “M” you do not need to transition

WHAT DO YOU NEED TO DO TO TRANSITION?◦ EMT-Basic to EMT: Automatically completed the first time an EMT completes the national component of the

NCCP

◦ EMT-Intermediate to AEMT: Approximately 70 hour transition course that will require passing the NREMT’s AEMT written exam. As this transition will result in a new, higher certification, these individuals will not have to complete any other continuing education that cycle. EMT-Intermediates may also elect to drop to their certification to the EMT level.

◦ EMT-Paramedic to Paramedic: Approximately 10-20 hour transition course; credit hours from completing the course can be applied to the individual’s Local or Individual credit hours on an hour-for-hour basis.

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WHAT DOES A TRAINING OFFICER DO?

As your agency’s training officer, you are responsible for:◦ Maintaining agency registration on NREMT website

◦ Approving and maintaining affiliation requests

◦ For all levels of EMTs, Medical Directors, and other Training Officers.

◦ All EMTs are required to have an account on nremt.org or massemt.org, and you are responsible for maintaining a current roster.

◦ Managing education

◦ Review and approve continuing education courses for your agency, and apply those courses to your affiliated providers.

◦ Approving recertification

◦ Auditing individuals’ training records for accuracy

◦ Reviewing felony and disciplinary statuses, and endorsing recertification.

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WHO IS A TRAINING OFFICER?

Depending on your agency’s size and pre-existing TO positions, each service should designate one or more individuals to be responsible for the education of your providers.

The assigned Training Officer must have the service director and Medical Director’s written authorization and functions as an extension of service management, but access should be restricted to only necessary staff.

Use of Training Officer privileges will be monitored by OEMS and abuse/misuse punished up to and including certification revocation or criminal proceedings.

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AS A TRAINING OFFICER, WHERE SHOULD I CREATE AN ACCOUNT?

Your Personal

Provider Account

Your Official

Training Officer Account

Current MA-EMT certification &

Current NREMT certification

nremt.org

(same login as your TO account)

nremt.org

(same login as your personal account)

Current MA-EMT certification &

Lapsed NREMT certification*

massemt.org

(different account/login than your TO account)

nremt.org

(different account/login than your personal account; you may need to contact the NREMT to

activate a new TO only account)

Current MA-EMT certification

Never NREMT certification

massemt.org

(different account/login than your TO account)

nremt.org

(different account/login than your personal account; you may need to contact the NREMT to

activate a new TO only account)

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* Only applies if your lapsed NREMT certification was lower/higher than your current MA-EMT certification. If your lapsed NREMT certification is the same level as your current MA-certification, you are eligible for the Mark King Initiative, and would use the nremt.org website for both logins. Please contact OEMS for more information.

REGISTERING YOUR AGENCY & TRAINING OFFICERS

REGISTERING YOUR AGENCY

If you have not done so already, you must make a training officer account, and create an agency for your providers to affiliate with.

Each service should be registered only once, and may be registered in more than one state.

In order to register your agency, you must first set up your NREMT account. Please review the next two slides on creating an account first.

When you are asked to select your agency, first review to see if anyone else has registered it; If you agency is not listed, follow the “Agency Request” link and provide.

◦ Agency name, address, phone numbers, and select [SUBMIT] at the bottom of the page.

◦ You must await verification from the NREMT before continuing.

◦ Verification from the NREMT typically takes several days. Please contact them directly if you are experiencing any difficulties registering your agency.

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REGISTERING AS A TRAINING OFFICER: NON-NREMT MA PROVIDERS

If you have never held NREMT certification but will be acting as the Training Officer for your service/agency, please go to NREMT.org to create your TO account.

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Click on “Create New Account”

Click on “Create new account”

Choose a username (case sensitive), password (case sensitive), provide your name, e-mail address and security questions.

Under role requested, select training officer.

REGISTERING AS A TRAINING OFFICER: NREMT/MA PROVIDERS

If you have already hold NREMT certification and will be acting as the Training Officer for your service/agency, please go to NREMT.org to update your account.

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Click on “Edit”

Log into your account

Click on “Edit”

Click on “Add training officer to this account”

PROCESSING PENDING AFFILIATION REQUESTS

In order to verify professional standing, as Training Officer you must accept the affiliation requests for staff, Medical Directors and other Training Officers. Please note, you will see pending affiliation requests from both sites (NREMT.org & MASSEMT.org on this page).

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Log on to nremt.org and select “Training Officer”, then “Pending Affiliation Requests”

Select “Approve” or “Reject” as appropriate, and click [APPLY]

REGISTERING YOUR PROVIDERS

MASSEMT.ORG ACCOUNT: NON-NREMT MA PROVIDERS

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Click on “Create New Account”

Please note, this webpage is for providers who have never heldNREMT certification. If youpreviously held NREMT certification,but have not reactivated it, pleasecontact OEMS or the NREMT formore information on the Mark KingInitiative.

Open your browser and go to themassemt.org home page.

MASSEMT.ORG ACCOUNT CONTINUED: NON-NREMT MA PROVIDERS

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Choose a username (case sensitive), password (case sensitive), provide your name, e-mail address, OEMS certification number and security questions.

If you receive an error message that your OEMS certification number is invalid, please contact OEMS at 617.753.7300 and reference massemt.org.

NREMT.ORG ACCOUNT: NREMT/MA PROVIDERS

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Providers who have their NREMT certification should already have a NREMT login to the NREMT website. If they do not, please have them create one by going to nremt.org, creating a user account (with the appropriate information), and selecting “Nationally certified EMS professional” as their user role.

If they believe they have an account already, but have forgotten the login information, please have them use the “forgot your password” link on the homepage. Any issues with creating an account should be directed to the NREMT at 614-888-4484 (ext. 2).

Click on “Create New Account”

PROCESSING PENDING AFFILIATION REQUESTS

In order to verify professional standing, as Training Officer you must accept the affiliation requests for staff, Medical Directors and other Training Officers. Please note, you will see pending affiliation requests from both sites (NREMT.org & MASSEMT.org on this page).

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Log on to nremt.org and select “Training Officer”, then “Pending Affiliation Requests”

Select “Approve” or “Reject” as appropriate, and click [APPLY]

CONTINUING EDUCATION

MAINTAINING TRAINING RECORDS

For continuing education courses held at your service, you must continue to apply for and receive approval through your region, but may enter the course completion credits online for providers, as an alternative to roster submission to OEMS.

◦ No matter the submission method, you must maintain original sign-in sheets with signatures on-site for audit.

◦ For students not affiliated with your service, you must provide each student with a copy of the sign-in sheet or course completion certificate with approval number and instructor signature.

Providers may enter their own continuing education records for courses held outside your department, but you may request that they provide a completion certificate before verifying records for recertification.

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ADDING COURSES FOR YOUR AFFILIATED EMTS

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As the Training Officer, you have the ability to submit continuing education course rosters for all of your affiliated EMTs (regardless of whether their account is on the NREMT.org or MASSEMT.org website). To do so, login and follow these directions:

Click on “Training Officer”

ADDING COURSES FOR YOUR AFFILIATED EMTS

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Click on “Manage Education”

ADDING COURSES FOR YOUR AFFILIATED EMTS

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Choose the appropriate category

and select “Add Class”

ADDING COURSES FOR YOUR AFFILIATED EMTS

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Enter course name, sponsor, and description, course approval number (in comments), method of instruction and date of course completion, and select “Next”.

Enter certification level course applies to.

Enter Class detail areas, and hours of material (per approval if available)

Select EMTs from roster to apply education to, and click [SUBMIT]

These courses will now appear on the EMTs education profile, as well as your Training Officer education page.

EDITING COURSES

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Courses entered by a training officer for multiple students cannot be edited, and in order to modify, the course must be deleted and re-entered. Following re-entry, the course may be applied to different certification levels.

APPLYING TRAINING TO MULTIPLE CERTIFICATION LEVELS

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Once you have created courses to apply to one level of EMT, you can apply it to other levels.

Once a course has been completed, select “Training Officer”, then “Manage Education”, then “Show details” corresponding to the training or education type of interest.

Click “Manage Users” next to the course of interest, then complete Step 2 “Apply course to additional users” indicating the certification level and providers.

ENTERING REFRESHERS AS CONTINUING EDUCATION

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For providers who expire in 2014, “traditional” refreshers can be entered on the massemt.org or nremt.org website under the “National” category of the NCCP (under the category listing).

For providers who expire in 2015 and have already completed a traditional refresher, they may apply that credit to their overall NCCP continuing education hours (any category) but they will need to ensure that they have also addressed any material required under the Nation portion of the NCCP that the traditional refresher does not address.

DEFINING METHODS OF INSTRUCTIONClassroom Lecture

◦ Where students and instructor engage in didactic education while both physically present

Case Review◦ E.g. Morbidity and Mortality Rounds with Medical Director, case review with supervisory staff, while both physically present

In-Service◦ Courses mandated by service, covering topics applicable to operational need, encompassing didactical and hands-on skills, while both students and

instructors physically present.

Practical Lab/Hands On◦ Psychomotor skills education, with both instructors and students physically present

Conference◦ Subject-matter experts presenting material at Conference, with both instructors and students physically present

Teaching◦ Teaching topics within the NCCP is the same as attending the topic. Teachers of the topics obtain the same credit as learners on an hour-for-hour

basis, with no limits if course within level of certification. Each course may only be applied once per certification cycle.

Internet/Computer-Based◦ Distributive education, where student and instructor not physically present, and student does not have opportunity to ask questions of instructor. May

be interactive or non-interactive. Limit of 30% education obtained this way

Correspondence Course◦ Distributive education, where student and instructor not physically present, and student may ask instructor questions via correspondence (e-mail,

etc.) and receive a non-live response.

Video Review◦ Non-interactive distributive education without opportunity for students to ask questions.

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RECERTIFICATION

REQUIREMENTS TO MAINTAIN MASSACHUSETTS CERTIFICATION

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1. CONTINUING EDUCATION (complete one of the following)◦ Old-MA standard (only available for 2014 expirations)

◦ Old-NREMT standard (only available for 2014 expirations)

◦ New-NCCP standard

◦ Recertify by written exam

2. ONLINE PROFILE (even for 2014 expirations) on either the NREMT.org website or the MASSEMT.org website (see slides 11 & 17).

3. AGENCY AFFILIATION◦ An agency can be any entity that provides pre-hospital medical care.

Examples include but are not limited to: ambulance services, fire or police departments, first responder services, disaster response teams, ski patrols.

◦ Individuals without an agency may align with the State EMS Office (by Region) for education oversight and recertification

4. MEDICAL DIRECTOR validation of recertification requirements (ALS only)

5. SCOPE OF PRACTICE TRANSITION required by the end of the individual’s next recertification period (2016/2017).

6. STATE ONLINE RECERTIFICATION available after December 15th on the OEMS website

REVIEWING “RECERTIFICATION PACKETS”

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As the Training Officer, you will be responsible for reviewing your affiliated EMTs’ recertification once they have been submitted.

When providers have finished their requirements for recertification, they complete a recertification request online, and it is forwarded to you (and a medical director for AEMTs and Paramedics) for approval.

Log on to nremt.org and select “Training Officer”, then “Pending Recertification Packets” and select the level of training.

From here, you affirm to the validity of candidate’s legal and disciplinary status and education. You may click on the candidate’s name to view their education entry and recertification application form.

You can now sign-up to receive email notifications of pending requests but you must elect to receive this service; login to your account and then follow the prompts to set up email notifications.

NOTE: Con-Ed completion and recertification verification may occur until March 31st of the year of expiration, but MA card processing may be delayed and providers cannot provide pre-hospital care in MA without a current certification in hand. Thus OEMS recommends completing requirements and submitting application for recertification by February 15th of the year of expiration.

VALIDATION OF SKILLS FOR RECERTIFICATION: EMT-BASIC

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During TO review of recertification packet, attestation of practical skills for EMT-Basics is required, based on QA/CQI (review of patient care), direct observation (of skill by TO, or designee), or “other”, to include remediation/education in formal course. When you sign-off on your EMTs’ skills, you should be doing so for the following:

VALIDATION OF SKILLS FOR RECERTIFICATION: EMT-I, AEMT & PARAMEDIC

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These providers need a skills verification by their service’s Medical Director, in conjunction with approval of education completion, felony/disciplinary history, by their service Training Officer in order to recertify.

The verification and attestation can occur based on either QA/QI, direct observation, or “other” which generally includes remediation/Con-Ed or clinical time, at the discretion of the MD.

Directions for MD account creation and verification may be found on the nremt website.

MA RECERTIFICATION PROCESS

Following the completion and submission of continuing education application and verification by Training Officer/Medical Director from either the NREMT.org or the MASSEMT.org websites, EMTs at all levels must complete a MA-recertification application. The application will be available after December 15th

on the OEMS website.

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RECERTIFICATION BY EXAMINATION

As an alternative to completing continuing education, providers may recertify by proving competency on a cognitive examination.

◦ In order to be eligible, the applicant must be actively working within an EMS system or health care facility, using EMT skills.

Between October 1 and March 15 providers complete a “Recertification by Examination” application, and will receive an Authorization to Test letter in their account by the next business day.

Providers will then schedule their exam with PearsonVue and take a current exam based on certification level.

◦ Note, examination material will include transition course content, and providers will be held accountable for all of this information. Successful completion of the examination will satisfy transition requirements.

◦ Providers have one attempt to pass the examination, and if unsuccessful, must complete standard requirements.

Following examination completion, providers will receive an abbreviated recertification form from NREMT. The completed form (with required signatures) most be submitted to NREMT by March 31 of expiration year.

◦ To allow for processing time and continued practice, we recommend completion prior to February 15th.

◦ All other recertification requirements still apply, including felony statement, CPR, active affiliation/practice and verification of skills, and must be verified by Training Officer.

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SPECIAL CIRCUMSTANCES WITH RECERTIFICATION

The NREMT and OEMS reserve the right to investigate recertification material at any time. Training Officers and Providers must retain verification of attendance of all education they require. Failure to submit documentation when audited will result in denial of eligibility to recertify.

Certification is designed to help assure the public that EMS Professionals are competent to deliver care, EMS Professionals and Training Officers must take seriously their responsibility in meeting and documenting recertification requirements.

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OPTIONAL NREMT CERTIFICATION

OPTIONAL NATIONAL REGISTRY CERTIFICATION FOR EMTS

Massachusetts EMTs are eligible to apply for, and receive National Registry certification at any time, and must complete the following procedure:

◦ After ensuring they meet the entry requirements listed on nremt.org, EMTs create an account on nremt.org and complete an application for certification

◦ If initial education was more than two years prior, information about last refresher course, and skills verification form required (details on the next slide).

◦ Following payment of fee, Authorization to Test (ATT) letter issued, and cognitive exam may be taken at any PearsonVue testing centers nationwide.

◦ Certification results reported within two business days

◦ Education tracking now performed at nremt.org

◦ Obtaining NREMT certification (through testing) during your MA recertification period will result in recertifying your MA certification (no continuing education required).

Please note, already certified MA EMTs are not required to seek NREMT certification. This is a completely optional process.

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OPTIONAL NATIONAL REGISTRY CERTIFICATION FOR EMTS: SKILLS VERIFCATION

In accordance with A/R 2-319, MA EMT-Basics who have completed their courses more than 2 years ago with a refresher in the last two years,

and are voluntarily applying for NREMT certification require a skills verification.

This skills verification must be performed either by an individual with Training Officer designation on NREMT.org website or an

Instructor/Coordinator on behalf of a Training Institution.

The skills verification must include performance of the following skills using NREMT skill sheets:

◦ Patient Assessment/Management-Medical

◦ Patient Assessment/Management-Trauma

◦ Bag Valve-Mask (Apneic Adult Patient)

◦ Oxygen administration by Non-rebreather Mask

◦ Cardiac Arrest Management/AED

◦ Spinal Immobilization (Supine Patient)

◦ Random skills verification (choose one of: Bleeding Control/Shock Management, Joint Immobilization, Long Bone Immobilization, Spinal Immobilization of Seated Patient)

Skills must be documented on NREMT form, and submitted directly to NREMT via fax or mail, and the I/C or Training Officer must retain a copy of

the form for their own records and audit purposes.

The I/C or Training Officer signing the skills verification form as well as their affiliated ambulance service is responsible for the accuracy of the skills

of the individual evaluated.

If functioning as service’s Training Officer, you may only perform verification for providers affiliated with your service.

If the I/C or Training Officer determines the individual being evaluated cannot perform these skills appropriately, the I/C or Training Officer must

ensure the individual undergoes remediation prior to being re-evaluated. The I/C or Training Officer is responsible for documenting the remediation

session and the topics covered, and keeping this documentation on file.

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OPTIONAL NATIONAL REGISTRY CERTIFICATION FOR PARAMEDICS

Massachusetts Paramedics are eligible to apply for, and receive National Registry certification at any time, and must complete the following procedure:

◦ After ensuring they meet the entry requirements listed on nremt.org, Paramedics create an account on nremt.org and complete an application for certification

◦ Following payment of fee, Authorization to Test (ATT) letter issued, and cognitive exam may be taken at any PearsonVue testing centers nationwide.

◦ A National Registry Psychomotor exam may be taken anywhere in the US, dates and locations listed at nremt.org. Cognitive and Psychomotor exams may be taken in any order, within 12 months of each other.

◦ Certification results reported within two business days

◦ Education tracking now performed at nremt.org

◦ Obtaining NREMT certification (through testing) during your MA recertification period will result in recertifying your MA certification (no continuing education required).

Please note, already certified MA EMTs are not required to seek NREMT certification. This is a completely optional process.

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