CAAHEP statement on proposed changes to eligibility requirements by the National Registry of EMTs 

Comment now on the potential impact on EMS educational and patient care quality

June 27, 2022

Statement attributed to: 

Donald A. Balasa, JD, MBA

President, Commission on Accreditation of Allied Health Education Programs

In its recent drafted resolution, the National Registry of EMTs (NREMT) proposes a change in exam eligibility requirements, allowing students from non-accredited programs that “have received state EMS office approval” to sit for the NREMT examination and gain entry into practice. With this change, the NREMT authorizes state agencies to determine (with no parameters) the depth, breadth, and rigor of its “approval.”

Across health professions, nursing, and medicine, nationwide certification and accreditation work hand in hand to ensure programs produce qualified practitioners. The change in NREMT eligibility alters this established relationship, suggesting that expert, peer-reviewed CAAHEP accreditation Standards requiring assessment of student competency are less valuable than passing its certification exam. CAAHEP does not question that the certification examinations offered by the NREMT accurately assess the clinical knowledge in the respective EMS professions. Nonetheless, professional certification or licensing process validity is dependent on the quality of education and assessment of student psychomotor (skill) and affective (behavioral) competencies.

Safeguarding quality education in the health professions is more critical than ever as the world faces ongoing public health challenges, such as the COVID-19 pandemic and workforce shortages.

The following excerpt from the 2021 National Emergency Medical Services Education Standards promulgated by the United States Department of Transportation (DOT), National Highway Traffic Administration (NHTSA), supports the above assertions:

National EMS certification and national EMS education program accreditation are the “bookends” that support the other key elements of the system. The [EMS Education Agenda for the Future: A Systems Approach] recommended an individual should graduate from a nationally accredited EMS education program to be eligible for National EMS Certification. Essential components of the EMS Agenda include a single National EMS Accreditation Agency and a single National EMS Certification Agency to ensure consistency and quality of EMS personnel.

CAAHEP accreditation processes with its Committees on Accreditation, including the

Committee on Accreditation of Educational Programs for the Emergency Medical

Services Professions (CoAEMSP), verify that educational programs meet minimum

standards and continuously engage in ongoing quality improvement. Accreditation

allows program flexibility and innovation while requiring programs to meet

performance thresholds and publish these results for the public to view.

Research on the value of accreditation on graduate outcomes in the health professions verifies that a positive effect exists between programmatic accreditation and student success (Anderson et al., 2018; van Zanten, 2015). Within the Emergency Medical Services literature, a recent study evaluating the effect of accreditation on paramedic graduate outcomes found that first-attempt and cumulative pass rates on the NREMT exam were significantly higher for graduates of accredited programs (Rodriquez et al., 2018). Accreditation protects students, as they can be assured that attending an accredited program meets the requirements for employment and that accreditation is associated with success in their professional careers. Similarly, and importantly, accreditation protects the public by confirming that graduates of accredited programs have the requisite skills and knowledge to provide quality patient care.  

CAAHEP, CoAEMSP, and its Sponsors (listed below) have worked collaboratively for 28 years to maintain the Standards and Guidelines for EMS educational programs, incorporating changing national practice standards and knowledge requirements. The CAAHEP Board of Directors encourages all interested parties to voice their concern to the NREMT and express their support for quality assurance through CAAHEP accreditation. Please submit your comments by August 17th.


About the Commission on Accreditation of Allied Health Education Programs

The Commission on Accreditation of Allied Health Education Programs (CAAHEP) is a non-profit programmatic postsecondary accrediting agency recognized by the Council for Higher Education Accreditation (CHEA). CAAHEP carries out its accrediting activities in cooperation with 25 review Committees on Accreditation, including the Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions (CoAEMSP). In service to its stakeholders and the public, CAAHEP’s mission is to provide value by setting standards for quality assurance in health professions education. 


CAAHEP Sponsors that endorse its Standards and Guidelines for Educational Programs in the Emergency Medical Services Professions include:


American Academy of Pediatrics

American Ambulance Association

American College of Cardiology

American College of Emergency Physicians

American College of Surgeons

American Society of Anesthesiologists

International Association of Fire Chiefs

International Association of Fire Fighters

National Association of Emergency Medical Services Educators

National Association of Emergency Medical Services Physicians

National Association of Emergency Medical Technicians

National Registry of Emergency Medical Technicians




Anderson, M. M. & Garman, A. N. (2018). Preparing future healthcare leaders through graduate education: Impact of program accreditation on quality improvement. Journal of Allied Health, 47(2), 121-125.


Rodriguez, S., Crowe, R. P., Cash, R. E., Broussard, A., & Panchal, A. R. (2018). Graduates from accredited paramedic programs have higher pass rates on a national certification examination. Journal of Allied Health47(4), 250-254.


van Zanten, M. (2015). The association between medical education accreditation and the examination performance of internationally educated physicians seeking certification in the United States. Perspectives on Medical Education4(3), 142-145.