HealthcareRead at source, 23 September 2026

The EMT Shortage: What the Data Shows About EMTs, Paramedics and Turnover

The EMT shortage is a retention problem sitting on top of a modest growth problem. The Bureau of Labor Statistics counts 284,100 EMTs and paramedics in 2025, projects 6% growth to 2035 and about 18,200 openings a year. The American Ambulance Association's 2024 workforce turnover study, run with Newton 360, puts overall turnover among EMTs and paramedics at 20 to 30 percent a year. That gap is the whole story. The national openings figure counts only people who leave the occupation, while a service also loses crews to the service down the road, to fire departments and to nursing. Pay makes it worse: the ambulance services that employ 46% of EMTs pay them less than the other two largest employers, local government and private hospitals.

The EMT shortage in numbers

BLS publishes EMTs and paramedics as one occupation group with two detailed occupations underneath it. Most shortage coverage quotes the combined line, which hides the fact that the two roles are paid and employed very differently.

Two things follow. First, EMTs are nearly two thirds of the combined workforce, so the "EMS shortage" a county reads about is mostly an EMT shortage in headcount terms. Second, growth is not the driver. BLS says many of the openings come from "the need to replace workers who transfer to different occupations or exit the labor force." Growth of 6% over ten years is real, but it is spread thinly; replacement is what fills your job board every month.

Why the national numbers understate what a service feels

18,200 openings a year against 284,100 people employed is a replacement rate of about 6.4% a year. Set that next to the ambulance industry's own turnover figure, 20 to 30 percent, and the national number looks almost calm. Both are correct. They measure different things.

The BLS openings figure counts people who leave the occupation entirely: to nursing, to another career, to retirement. It does not count an EMT who resigns from one ambulance service and starts at another the following week, because the occupation has not lost anyone. The AAA study counts every separation from the employer, which is what a service's schedule actually experiences.

The pay gap inside EMS

The BLS industry breakdown shows the pattern that shapes EMT recruiting more than any other: the employer type with nearly half of all EMT jobs pays less than the next two largest.

An EMT in an ambulance service earns a median $4,900 less than one in a private hospital and $3,520 less than one in local government. Those are the two places an ambulance-service EMT can move to without recertifying, and both are usually recruiting. A private ambulance service is therefore training people for the hospital and the county, whether it intends to or not.

The paramedic column tells a different story, which is the subject of the next section.

The paramedic shortage

Paramedics are the harder hire and the more consequential one: a service that cannot staff paramedics cannot run advanced life support units, whatever its EMT numbers look like. BLS counts 102,200 paramedics, projects the same 6% growth as for EMTs, and reports a median wage of $60,600 — $16,130, or 36%, more than the EMT median.

Two facts matter for the employer.

• Industry pay barely varies. Local government, private hospitals and ambulance services pay paramedics medians within $1,940 of each other. Unlike EMTs, a paramedic does not get a meaningful raise by switching sector; they choose on schedule, call volume, unit staffing and management.
• The paramedic pipeline runs through your EMTs. A paramedic is almost always an EMT first. Inside ambulance services, the paramedic median ($60,040) is $17,780 above the EMT median ($42,260). A service that funds paramedic school in return for a service commitment is buying both retention of the EMT and supply of the paramedic; a service that does not is watching its best EMTs pay for school themselves and take the credential elsewhere.

If you are writing the role rather than diagnosing the market, our paramedic job description and EMT job description templates cover duties, requirements and pay by setting. Advertise the two levels as two postings with two pay ranges; a combined "EMT/Paramedic" title reads as a paramedic job at EMT pay to one audience and a job you are not qualified for to the other.

What EMS agencies do about the EMT shortage

None of the following is new. What separates the services that stay staffed is doing them before the vacancy rather than after.

Widen the entry point

• Hire before certification. Pay for the EMT course and hire the student into a paid role while they train. It converts a credentialed hire into an entry-level one and reaches people who would never have searched "EMT jobs."
• Handle reciprocity for them. Out-of-state EMTs and paramedics face paperwork to practice in your state. Saying in the ad that you will walk them through it removes a reason not to apply.

Stop the first-year loss

• Pair new EMTs with experienced partners for a defined period, and say so in the ad; new EMTs worry about being put on a truck alone on day one.
• Publish the pay step at 12 months, so the move to the hospital down the road is compared with a known raise rather than with nothing.
• Fund the paramedic pathway with a commitment period, as above.

Compete on the schedule

• State the shift pattern in full — 12s, 24s, 24/48 or 48/96 — along with the typical call volume and whether sleep quarters exist. BLS notes EMS schedules can include nights, weekends and holidays, and that some shifts run 12, 18 or 24 hours; the schedule is the job, and candidates screen on it before pay.

Recruiting EMTs and paramedics with social job ads

Most working EMTs are not on job boards. They are on shift, and between calls they are on their phones. A Facebook or Instagram job ad reaches them where they already are, including the people a job board never sees: certified EMTs working in another field, students finishing a course, and volunteers at a volunteer fire or rescue company who might take paid shifts.

Our 2026 benchmark does not break EMS out as its own role family, so the fair comparison is the sector: across healthcare and senior living campaigns (553 campaign-months) the median cost per applicant was $15.42, with a 16% apply rate and a $25.18 CPM, the second most expensive impressions of any sector we run, after behavioral health and education. The lever is what happens after the click. Across all 891 campaigns, those converting under 5% of clickers into applicants paid $53.77 per applicant; those converting 20–35% paid $4.41.

• The ad: hourly rate, shift pattern and certification level in the first two lines, then call volume, 911 or interfacility, and whether you pay for EMT or paramedic school.
• The application: four questions — certification level, state, shifts they can work, start date. Certification numbers and work history can wait for the phone call.
• The response: call the same day. An EMT who applies on a day off is applying to other services that day too.

The wider version of this, across nursing and allied roles, is in our healthcare recruiting strategies guide.

What this page cannot tell you

It cannot size the shortage in your county. National figures describe a country; EMS supply depends on your pay against the nearest hospital and fire department, on how many EMT courses run within reach, and on your state's certification rules. The AAA turnover figures come from the ambulance services that answered its survey, not from every agency. What the data does settle is the shape: modest growth, heavy churn between employers, and a pay structure that moves EMTs out of ambulance services. Recruiting fixes the first. Retention and pay structure fix the rest.

Related: EMT Interview Questions, Firefighter Shortage.

Frequently asked questions