Two years of college, then the front line of emergency medicine.
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Programs in the fields this career usually comes through. Each has its own page: what it takes to get in, the courses you need and what it costs.
The median pay is about $79,000 a year. Across everyone in the job it runs from about $53,000 at the lower end to about $102,000 at the upper end. The source is listed under Sources at the end of this page.
2 years after high school, on the usual route.
$8,700 to $17,200 all in for tuition, fees, exams and kit. Living costs are not counted.
It depends where you work. You need a licence, certificate or registration in Alberta, British Columbia, Manitoba, New Brunswick, Newfoundland and Labrador, Nova Scotia, Ontario, Prince Edward Island, Quebec and Saskatchewan. Elsewhere there is none to hold, though many employers still ask for training or a certificate.
Good demand nationally, from government outlook data. Demand varies by region, so check your area.
Or read the whole thing here
What you earn and what it costs to get there.
Median
$79,000
Lower end
$53,000
Upper end
$102,000
Job Bank's national median is $38 an hour, about $79,000 a year at 40 hours a week, The lower end ($25.56) and upper end ($49) are the bottom and top of the wage range for everyone in the group. Overtime is common and adds to what you earn.
$42.17 an hour
The median in Ontario, the top province, about $88,000 a year
Manitoba is next at $40, and Prince Edward Island is the lowest at $27.31. The Northwest Territories is higher still, at $47.34. Each paramedic service sets its own pay grid, so starting pay depends on where you work.
Roughly, all in
$8,700 to $17,200
Tuition, fees, exams and kit. Not rent, food or travel
The low end is a two year primary care paramedic diploma at the cheaper end, the provincial certification exam such as the A-EMCA (Ontario's paramedic certification exam), and uniforms, immunizations and a police check. The high end is the same diploma at a higher tuition college with the same fees on top. Many paramedics later add an advanced care year, which costs another $8,000 to $15,000, but that is a promotion rather than a requirement to start, so it is not in these figures. This is one of the cheaper health care credentials to earn.
One of the cheaper health-care credentials to earn.
A defined-benefit pension
One that pays a set amount every month for life. OMERS (the Ontario municipal pension plan), similar plans elsewhere.
Health, dental and mental health supports
Shift premiums and overtime
12-hour shifts
More full days off.
The exact path from high school to qualified.
Short, focused, and competitive to enter.
High school
Grades 11 and 12
Grade 12 with biology and chemistry. Most programs require a standard first aid and CPR certificate to apply.
Primary care paramedic (PCP) diploma
2 years
Two years at a college. Classroom, simulation, hospital placements and ambulance ride-outs. Admission is competitive, with fitness and lifting tests.
Provincial certification exam
After graduation
Ontario's A-EMCA (Advanced Emergency Medical Care Assistant) exam, or the COPR (Canadian Organization of Paramedic Regulators) exam in most other provinces.
Register and get hired
Months
Register with your provincial regulator (where one exists) and apply to services. Each service runs its own testing.
Biology
Required.
Chemistry
Required at most colleges.
Physical education
You will be lifting patients.
English
Charting and communication are constant.
Alberta, Saskatchewan, Manitoba, New Brunswick, Nova Scotia, Prince Edward Island and Newfoundland and Labrador have paramedic regulators that register practitioners. British Columbia licenses paramedics through a government board, Ontario certifies through the Ministry of Health and base hospitals, and Quebec keeps a provincial registry. The three territories do not regulate paramedics yet.Seven provinces use the national COPR (Canadian Organization of Paramedic Regulators) exam.
In Quebec the college program takes 3 years, and instead of a licensing exam you pass a provincial clinical integration program and join a national registry.
Finish Secondary V
Age 16 or 17
John Abbott asks for a high school diploma with Secondary V language of instruction and second language, Secondary IV math and science. You need at least a probationary driver's licence when the program starts.
Pre-Hospital Emergency Care DEC (Diploma of College Studies, 181.A1)
3 years
3 years, 2,865 hours, at about 16 colleges. It replaced 181.A0. In English at John Abbott, which calls it Paramedic, holds physical tests before admission and expects fluent French.
Class 4A licence
During the program
The emergency vehicle driver's licence. John Abbott students must have it by the end of the fifth term. You also need a clean criminal record check and up-to-date vaccinations.
Pass the PNIC (Programme national d'intégration clinique)
Within 2 years of graduating
The national clinical integration program, run by the health ministry with Université de Montréal. A theory exam of about 100 questions, an ethics test and supervised field calls. 60% to pass, $500 to register.
Join the national registry, then get hired
A few weeks
You can register on the national workforce registry of paramedics at the same time as the PNIC (national clinical integration program). Employers such as Urgences-santé also ask for very good French.
Advanced care paramedics work in Montreal and Laval. They train in a 60 credit major at Université de Montréal, open to paramedics with 2 years (3,600 hours) of field work, but admissions to it have been suspended since fall 2023. Paramedics in Quebec are not yet in a professional order. In June 2026 the government started work to bring them into the Ordre professionnel des inhalothérapeutes du Québec (the Quebec order of respiratory therapists). No date has been set.
Things you don't need, but that help.
Advanced care paramedic (ACP)
One extra year. Intubation, IV (intravenous) drugs, cardiac management. More autonomy.
Critical care paramedic (CCP)
Ornge and other air ambulance services. Top of the field.
Community paramedicine
Home visits and chronic care, daytime hours.
Bridge to nursing
Some universities give paramedics advanced standing in a BScN (nursing degree).
Volunteer with St. John Ambulance or ski patrol
Fitness
Lift tests are part of every hiring process.
A clean driving record
You drive an ambulance.
Day to day, pros and cons, where you'd work.
Twelve hours, days or nights. Check the truck, then respond to whatever dispatch sends: chest pain, falls, overdoses, collisions, mental health calls, and a lot of transfers between facilities. Long waits in hospital hallways to offload patients are a real problem in many cities. You work with one partner all shift.
The good
The hard parts
Things people don't tell you.
Primary care, advanced care and critical care paramedics. Most on-road paramedics are primary care (PCP). Only advanced care paramedics (ACP) can give most cardiac drugs.
Job Bank counted about 40,700 paramedics in Canada in 2023, and only 18% were 50 or older. It rates the outlook good in 9 provinces and territories.
Conestoga College asks for an 85% minimum average for its paramedic diploma, higher than many university programs.
Every list is built from the same numbers shown above, so you can see where this career sits next to the others.
Nursing and patient care first, then the rest of the field. See every career in health.
Last checked October 2026. Pay figures are typical full-time annual amounts in Canadian dollars, based on Government of Canada Job Bank wage data and published salary grids. They vary by province, employer and experience. Tuition is for domestic students. How every figure on this site is sourced and checked.
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