Emergency Medical Technician Program Certification Pass Rates by Size and Geographic Region: A Five-Year Descriptive Analysis.

Authors

Jacob C Kamholz, Shea L van den Bergh, Christopher B Gage, Kayla M Riel, Jonathan R Powell, Ashish R Panchal

Published in

Journal of the American College of Emergency Physicians open. Volume 7. Issue 6. Pages 100520. Epub Oct 05, 2026.

Abstract

Emergency medical technician (EMT) educational programs demonstrate student certification performance variability. Prior evaluations identified program size and regional disparities, yet whether these patterns persist is unclear. This study described national variation in EMT certification pass rates by cohort size, geographic region and cohort year.
We conducted a repeated cross-sectional descriptive analysis of United States civilian EMT annual program cohorts from 2018 to 2022 using National Registry of Emergency Medical Technicians Cognitive Examination data. We included cohorts with >5 candidates testing annually. Cohorts were grouped by fixed cohort size quartiles (Q) and National Association of State EMS Officials (NASEMSO) region. Outcomes were first- and cumulative third-attempt pass rates. Descriptive statistics summarized cohort characteristics and outcomes, and pairwise comparisons assessed group differences.
Of 10,923 EMT educational program cohorts identified, 8567 (78.4%) were included. Median first- and cumulative-third attempt pass rates were 63.9% (interquartile rate [IQR]: 50.0, 77.7) and 77.8% (66.7, 88.3), respectively. Pass rates varied by cohort year, cohort size, and region. Median pass rates were highest in 2022. Q4 (≥46 candidates) had higher median first-attempt and third-attempt rates compared with Q1 (6-10) (first: 68.2%, 60.0%; third attempt: 81.6%, 71.4%). West NASEMSO region cohorts had higher median pass rates than all other regions.
From 2018 to 2022, EMT program success varied across cohort size, geographic region, and cohort year. Larger cohorts had higher median pass rates, and NASEMSO West cohorts had the highest median pass rates. These findings support continued EMT program evaluation and highlight the need for more education data to understand mechanisms for differences.

PMID:
42891018
Bibliographic data and abstract were imported from PubMed on 18 Oct 2026.

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