How to become a paramedic in Ontario: steps and costs

Here’s what you need to do to become a paramedic in Ontario: finish the right college program, qualify for the A-EMCA exam, be ready to drive an ambulance (Class F or C), and complete base hospital certification once you’re hired. The steps are straightforward, but the timing matters—especially for placements, police checks, and licensing.

What “paramedic” usually means in Ontario

Most people start as a Primary Care Paramedic (PCP). Later, some upgrade to Advanced Care Paramedic (ACP) after experience and more training. This post focuses on the PCP path, because that’s the standard entry point.

Step-by-step: the Ontario path from student to hired PCP

1) Meet the program prerequisites

Ontario college PCP programs often ask for senior high school courses like:

• English (Grade 12)
• Math (Grade 12)
• Biology (Grade 11/12)
• Chemistry (Grade 11/12)

If you’re missing one, look for upgrading options (adult learning, online credits, or college pre-health pathways).

2) Apply to an approved PCP program

Choose a PCP program from an Ontario college or an approved training institution. Admissions can be competitive, so apply early and keep an eye on deadlines.

What you’ll do in the program:

• patient assessment and medical emergencies
• trauma care basics
• simulations and lab skills
• clinical and field placements

3) Get “placement-ready” early

This is where many students get delayed. Placements often require documentation before you can start, such as:

• a police check (often VSS)
• CPR and First Aid at the levels your program specifies
• immunization records and health forms

Even if you’re accepted, missing a placement requirement can push your schedule back.

4) Plan for the driver’s licence piece (Class F or C)

To drive an ambulance in Ontario, you need more than a regular G licence. Ontario’s licensing guidance notes that a Class F licence is needed to drive an ambulance, and some services may accept Class C depending on the vehicle and setup.

Also expect medical/vision requirements for commercial-style classes. Don’t leave this to the last month—tests and bookings can take time.

5) Graduate, then apply to write the A-EMCA exam

After you finish an approved paramedic training program (or you’re approved through the equivalency process), you can apply to write the A-EMCA exam. Ontario posts exam applications and information packages on Ontario.ca, and the A-EMCA application form clearly states it’s for graduates of approved programs (or those found equivalent).

6) Apply to services and go through hiring

Each employer is different, but a typical hiring pipeline can include:

• interviews (sometimes more than one round)
• a physical ability test or fitness standard
• driver abstract review
• background checks and reference checks
• medical clearance

If you can, talk to recent grads from the program you’re applying to. They’ll usually tell you what parts of hiring felt hardest.

7) Once you’re hired: base hospital certification and patient care standards

Once you’re hired, you still have an Ontario-specific step: base hospital certification/authorization. Ontario’s patient care standards system ties paramedic controlled acts to medical oversight, and Ontario’s regulation describes how the base hospital medical director may authorize paramedics to perform specific controlled acts.

In everyday terms: once you’re hired, you train and get signed off so you can practise at your level (PCP or ACP) under the rules your service follows.

Timeline at a glance

A common timeline looks like this:

• 2 years: PCP diploma (varies by program)
• After graduation: A-EMCA application + exam scheduling
• Hiring window: depends on employer postings and testing dates
• After hiring: base hospital certification and service onboarding

Some people move quickly. Others take longer because of licensing bookings, hiring cycles, or repeating a requirement.

Example first-year budget (Ontario college PCP)

Below is a realistic planning example using a published Year 1 domestic tuition figure from one Ontario college, plus common “extra” costs students run into.

Example budget (Year 1):

• Year 1 tuition (domestic): $7,711
• Books & supplies: $800–$1,200
• CPR/First Aid: $150–$250
• Police check (VSS): $80–$150
• Class F licensing: $300–$600 (training + tests)
• Immunizations/health forms: $0–$500 (depends on coverage)
• Emergency fund: $500

Estimated total (Year 1): about $9,500–$11,000

Your number could be higher if you need upgrading courses, extra driving lessons, or you’re paying international tuition. Still, this budget stops the “surprise costs” that hit mid-semester.

Pay check: one detail that changes yearly math

A lot of paramedic schedules use 12-hour shifts. With patterns like 4-on/4-off, the average can work out to about 42 hours/week, which equals 2,184 hours/year. That’s why some pay grids and step progressions use 2,184 instead of the office-style 2,080.

If you’re comparing wages, use both:

• hourly × 2,080 (standard full-time comparison)
• hourly × 2,184 (common 12-hour rotation comparison)

Read: Paramedic salary in Ontario (hourly and yearly)

How to check employer pay and conditions (without guessing)

Look for the wage grid

Job ads can be short. Wage grids are clear. If you can find the collective agreement or wage schedule, you’ll see:

• starting vs top rate
• how fast steps increase
• premiums and overtime rules

Use Ontario’s salary disclosure as a reality check

Ontario publishes the public-sector salary disclosure list for employees paid $100,000+ in a year. It won’t tell you “average paramedic pay,” but it can show what’s possible in a specific region—often reflecting senior steps and overtime-heavy years.

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