Ever wonder what it would be like to practice as an EMT or paramedic in another state?

Let’s look at the Golden State to see what makes it stand out when it comes to working in California EMS.

In California, the average pay for EMTs is $41,438, according to a November 2020 report from Salary.com. California paramedics make $49,103 on average.

Salary also depends on education level, certifications, and experience. According to the U.S. Bureau of Labor Statistics, the national average for EMT and paramedic pay was $35,400 in 2019.

To understand the job requirements, you also must understand the lay of the land. About 80% of the state is considered rural. Measuring more than 163,000 square miles, California is the third largest state in the U.S. Alaska is No. 1, followed by Texas.

When it comes to rural areas in California, there is a lot of territory to cover, said Art Hsieh, MA, NRP, program director with Paramedic Academy at Santa Rosa Junior College in Windsor, California.

“Once you get to the northern areas, you have a family-owned ambulance service, and they might have one or two ambulances covering several thousand miles of terrain, with a volunteer service arriving first,” said Hsieh. He also is interim executive director at the Paramedic Foundation, which is dedicated to safety practices for paramedics.

The California terrain is just as diverse as the variety of outdoor activities available. Adventure-seeking Californians could ski in the morning at Lake Tahoe, then drive home to San Francisco and take a dip in the ocean by evening, Hsieh said.

“The geography is so diverse, outdoor recreation in California is abundant, so it drives sports and environmental injuries,” he said.

Local California EMS Hold Significant Authority

Unlike other states that generally look to the state for all regulatory guidelines, California uses the Local Emergency Medical Services Agency (LEMSA) for regulatory purposes, Hsieh said.

“The regulatory practice in California is divided between state EMS authority and then LEMSA, so most practitioners, EMTs, and paramedics know their LEMSAs well but hardly contact the state (officials) because the LEMSA is the delegated authority for enforcement and regulation,” Hsieh said.

The LEMSA model was born out of necessity, said Hsieh, given the sheer size of the state.

We talked to Sergy (Esam) El-Morshedy in the Legislative, Regulatory & External Affairs department, with California EMS Authority in Rancho Cordova, California, to get a better picture of what it’s like for EMTs and paramedics.

When asked about which types of calls come in most and for what injuries, here’s what he shared. “In 2019, the most common primary impression for medical calls was ‘general weakness’ and the most common injury was ‘non-specific trauma.’”

California’s Melting Pot

Developing cultural competency is a useful skillset when treating patients that come from various cultural backgrounds.

California is a diverse state when you explore factors such as socioeconomic, economic, and cultural diversity. Here’s how California looks from an ethnic diversity perspective, according to the Public Policy Institute of California.

  • 39% Latino
  • 37% White
  • 15% Asian American
  • 6% African American
  • 3% Multiracial
  • Less than 1% American Indian or Pacific Islander

With such a diverse population to care for, Hsieh emphasized the importance of creating a diverse California EMS workforce. That way, staff are better equipped to understand cultural differences and that will help providers give better care.

“We do have a diverse population [in California], from an ethnic racial background perspective,” Hsieh said. He added that rich diversity and cultural interaction creates both “challenges and opportunities to grow your practice.”

Cultural education and training classes for EMS personnel are essential to help your team better understand different cultural populations in patients. If formal classes aren’t an option, consider volunteering to develop your own in-house cultural diversity training program and train your peers, an idea from EMSWorld.

Fire and Volunteer EMS Opportunities

California EMS employer diversity is fairly significant depending on which part of the state you reside. In rural areas, Hsieh said it’s common to have two volunteers on a fire engine even though they are not EMTs.

“You have fewer paid professionals and more volunteers, so the number of paramedics goes down in these practice areas,” he said. “In Southern California, it is mostly fire-based and it’s more of a career-based system.”

In Northern California, he said there’s a greater mixture of some “fire-based systems and private commercial agencies contracted by cities and counties to provide emergency medical transport.”

This is because there are fewer paid professionals in rural areas and there is less training and a decrease in EMS response, he added.

“The relative lack of paramedics in rural areas of the state provides opportunities for AEMTs to practice in those areas,” Hsieh said.

Explore the requirements to work in California EMS.