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3 tips for firefighter-paramedics working to pass the National Registry Exam

Don’t let this exam end your firefighting career before it starts

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Earning an EMT or paramedic license is a minimum requirement to work for many paid fire departments.

Photo/Ben Thompson

Medical calls account for the largest percentage of emergency responses. For this reason, earning an EMT or paramedic license is a minimum requirement to work for many paid fire departments.

In most states, the only way to get a license is to pass the National Registry Emergency Medical Technicians (NREMT) exam.

In my time at Birmingham (Alabama) Fire and Rescue Service, I’ve seen this exam put an end to the short careers of many firefighter recruits – men and women who had already finished the firefighting side of recruit school and who were already working on their probationary period at the fire station.

In my department, if these members do not pass the National Registry Exam by the end of that first year, they are relieved of their duties.

As a former paramedic instructor, I have frequently been contacted by worried fire recruits trying to pass the exam and looking for advice and study tips.

For most, my advice is a simple three-step process:

1. Review the NREMT website

2. Study the current American Heart Association (AHA) guidelines in depth

3. Use EMT prep sites the right way

Let’s explore each in greater detail so you can see how the steps aid in test prep.

1. Review the NREMT website

The NREMT website is more than just the place you go to apply for an exam. Yet most EMT candidates leave this site largely unexplored. In my view, this is a big mistake.

Available on the website are links to educational resources, example test items and even videos that show what is expected during the psychomotor skills exam.

In addition, the website goes pretty in depth as to how the test is created and how test questions are vetted. Understanding how the test works can greatly reduce pre-test anxiety. And it can help you zero-in on the content areas where you need to focus your study.

2. Study the AHA Guidelines at the source

The AHA Guidelines are much more than a pamphlet of treatment algorithms. As a testing candidate, you need to not only know what to do, but how and why.

Not all textbooks are equal. Some will go into great depth on this topic, while others may just hit the highlights. This is why you study straight from the source.

From the NREMT website, there is a link for the AHA website. There you will find an outline on the resuscitative science, which breaks everything down into neat little chunks of very specific information written in bold print.

From recommendations for compression depth to the importance of early defibrillation, this information is low-hanging fruit for anyone writing national registry test questions.

3. Use EMT prep sites the right way

The National Registry Exam does more than test your knowledge. With the possibility of having to answer up to 150 questions, it also tests your nerve.

The best way to build your psychological endurance is to take a long practice exam that only reveals your results after you are done.

There are many testing prep services available for today’s NREMT candidate. I am not going to recommend one service over any of the others, as I believe that anything that keeps your mind on the study material is worthwhile. But whichever site you choose, you need to take advantage of the practice exam feature that many of the services offer. This is very different than going through practice questions that reveal the correct answer as you go along. And it better prepares you for the real thing.

And if you really want to push yourself, go to a library or on-campus computer lab to take your practice exam. Do everything possible to make it feel like the real thing. Turn off your cell phone, set a timer and twist in a set of earplugs.

Think of it as a dress rehearsal for the big day.

There is no BIG secret

No matter which method of study is used, all take maximum effort to ensure success. The National Registry Exam is extremely challenging, and there is no big secret to help cheat your way through.

But like many tough moments you will face in a firefighting career, there are thousands of us who have been in your shoes. We know what you are going through and we know you can do it.

The question is, how bad do you want it?

Ben Thompson is a battalion chief in Birmingham, Alabama. In 2016, Thompson developed his department’s first mobile integrated health (MIH) program and shared his experiences from building the program at TEDxBirmingham. Thompson was the recipient of the 2016 Emergency Medical Service Provider of the Year Award and the 2018 Joe E. Acker Award for Innovation in Emergency Medical Services, both in Jefferson County, Alabama. He has a bachelor’s degree from Athens State University in Alabama and is a licensed paramedic. Connect with Thompson through his website Benthompsonwriter.com.

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