Advanced Standing in AEMT Certification Courses

Bureau of EMS Policy Statement
Policy Statement #99-04
SubjectAdvanced Standing in AEMT Certification Courses
Supercedes/Updates93-07 and 87-38

I. Purpose

The purpose of this Policy Statement is to clarify the procedures for granting Advanced Standing in AEMT certification courses (EMT-Intermediate, EMT-Critical Care and EMT-Paramedic).

Adult students bring to EMS courses a vase diversity of past experience and prior education. Course sponsors need to recognize the experience and expertise that students bring to their classes and tailor the class to avoid redundancy and repetition. When appropriate, Course Sponsors, through their Medical Director and Certified Instructor Coordinator (CIC), are encouraged to review and evaluate the experience and education of the student and grant "advanced standing." This can be in the form of waived attendance of specific class session for the individual or a modified course schedule for the class.

The course sponsor, Medical Director and CIC must take great care in evaluating prior experience and education because of the enormous diversity within similar training programs. As an examples, the specific course objectives of an EMT-Intermediate and EMT-Critical Care program may vary from location to location based on local needs. While some candidates may be competent in a particular objective, others may need review or may not have covered the objective at all in their original course. Even a professional license does not guarantee a candidate's competency in all of the specific objectives of an AEMT course. A Registered Nurse (RN) who is a Certified Emergency Nurse (CEN), and has ACLS and ATLS or equivalent training with work experience in an emergency department, may not need to complete a small portion of a paramedic program and a field internship in order to complete all of the objective. An RN with long term care experience may need to attend the majority of the paramedic course in order to complete all of the objectives.

The only way to determine a student's educational needs is to review the student's prior education and experience, and then assess current knowledge and skills.

II. Who Can Offer Advanced Standing?

In order to award advanced standing at a given level, a course sponsor must first have successfully completed two (2) or more full-original courses at that level.

The course sponsor, medical director and CIC must be thoroughly familiar with the course's objectives, content, and the nuances of AEMT and paramedic education before they are able to properly assess the appropriateness of advanced standing. This can only be achieved through the experience of teaching and administering the course.

Candidates for advanced standing must be registered in an AEMT original course.

III. Candidate Eligibility Requirements

Each candidate must meet the eligibility requirements for the course they are enrolled in as defined by the state approved course curriculum.

To be eligible for advanced standing in an AEMT course, the candidate must have current certification as a NYS EMT or AEMT, which must remain valid throughout the duration of the course, and New York State certification or license in one on the professions listed below:

  • EMT-Intermediate
  • EMT-Critical Care
  • Registered Nurse
  • Nurse Midwife
  • Nurse Anesthetist
  • Nurse Practitioner
  • Physician Assistant
  • Physician

A few specific class sessions may be waived for Licenses Practical Nurses, Respiratory Therapist and other medical and allied health professionals when appropriate.

IV. Procedures

  1. The candidate must be enrolled in an original course.
  2. The Medical Director and CIC shall review and verify the candidate's credentials. This shall include obtaining copies of the candidate's license(s), certification(s) and/or course completion records from relevant continuing education programs (e.g., CPR, ACLS, PALS or equivalent, clinical training and experience).
  3. The candidate's cognitive knowledge, psychomotor skills and clinical proficiency must be assessed. The level of proficiency required to "waive" session attendance or to modify the class schedule must be equal to or greater than the entry-level proficiency of a graduate from the course.
  • The candidate's assessment should be based on the specific objectives for the session to be waived. For classroom session, cognitive knowledge can be assessed with written examinations. For lab sessions, psychomotor skills can be assessed with practical skills testing. It is important to cover all of the objectives for the session. As an example, a trauma lab session could not be waived based solely on the results of a state practical skills exam. There are more than 88 psychomotor skill objectives in the paramedic program, less than a dozen are tested on the state practical skills exam. Simply passing the spinal immobilization (seated-patient) station does not assess a candidate's proficiency in rapid-takedown, rapid-extrication, backboard immobilization, etc..

  • The course Medical Director may grant advanced standing for some of the objectives of the hospital clinical and ALS Field Internship for a candidate who can document prior hospital or prehospital care experience relevant to specific objectives of the clinical/internship experience. All candidates must complete an ALS Field Evaluation. The candidate must demonstrate the ability to serve as a team leader in a variety of prehospital emergency situations.
  • The candidate should serve as the team leader on an ALS unit for at least 50 prehospital emergency responses, a portion of which must included prehospital care of patients requiring ALS care.

  • Once the decision is made by the course Medical Director to grant approval for advanced standing, the candidate and CIC must sign a written agreement that outlines the candidate's course requirements.
  • Once a candidate has successfully completed all course requirements to the satisfaction of the course Medical Director, he/she is eligible to take the state certifying practical skills and written examinations. The sponsor's administrator or CIC must contact the department to make these arrangements (not the candidate).
  • At this time DOH requires at least six (6) weeks advanced notice to schedule a candidate for the written examination.

  • If the course is conducted exclusively for students with advanced standing (i.e., an EMT-P course exclusively for EMT-CC's or a course exclusively for experienced emergency nurses) the sponsor shall file a modified course schedule with the department only after the assessment and evaluation of all candidates has been completed. This may include moving the examination date forward.
  • At this time DOH must receive the request at least six (6) weeks prior to the requested examination date.

  • The course sponsor must maintain, for a period of five years, an individual candidate's file (student record) which includes a copy of the student-sponsor agreement, all of the candidate's credentials, records of performance on assessment exams (written and practical), ALS field internship evaluation and documentation of completion of all course requirements. If a Course Sponsor plans to offer advanced standing they must develop written advanced standing procedures as part of their Policy and Procedures Manual. [NYCRR-800.20 a (8)]

Issued by:
John D. Lewis, ALS Coordinator
Bureau of Emergency Medical Services

Approved by:
Edward G. Wronski, Director
Bureau of Emergency Medical Services
New York State Department of Health