The New Paramedic Test

Written by Joey Finn

"I took the new National Registry paramedic test and got stopped at 110 questions. I then proceeded to walk out of the testing center convinced that I had failed the test."


I Took The New National Registry Paramedic Test and Passed

If you have stumbled upon this simple, single-page website, then you likely know that National Registry did away with the practical portion of the certification test for both AEMT and Paramedic and instead requires a single, computer-based written test. This change went into effect July 1st, 2024. The old written test was completely multiple choice, but the new version is only partly multiple choice and also features quite a bit of scenario-based questions along with some matching and ordering type of questions.

I took the new National Registry paramedic test in the second week of August and got stopped at 110 questions. I then proceeded to walk out of the testing center convinced that I had failed the test. Four hours later, I was notified by email that I had passed.

New Paramedic Test Pass Email From National Registry

A Bit About My Paramedic Background

I finished EMT school in 2003, and a paramedic program in 2006, taking the National Registry Paramedic exam in December of 2006. This included a written test with an actual pencil and scantron paper test -- the last year this was done, to my knowledge -- followed by the practical examination the following day.

Eleven more years of EMS and fire department work later and I walked away, becoming self-employed and happier than ever in the summer of 2017. On July 4th, 2024, with a lapsed National Registry paramedic certification and two lapsed state paramedic licenses, I decided to look into how I could reacquire a paramedic license. My research led me to the Paramedic Re-Entry Pathway via the National Registry. After a few days of researching what I would need to undertake this (basically attending a paramedic program after 1977, 60 hours of state-approved or CAPCE-approved continuing education hours that meet all requirements of the National Continued Competency Program, a current or expired state paramedic license, and a BLS/CPR card.)

A Crash Course In Paramedicine

In just under 50 days, I completed a 60-hour online paramedic refresher course through Impact EMS, Completed a BLS course, an ACLS course (I would need this for a state license anyway, so I went ahead and attended the class before my test. It's also a good class to prepare for re-entry into the field as well) skimmed through all of my old Brady Paramedic textbooks from 2005, and utilized several online paramedic exam prep websites. My favorite, which I believe very closely mimics the new National Registry Paramedic test is Pocket Prep. I also found Kaplan's National Registry Paramedic Prep Book (affiliate link) extremely helpful.

"I had around 40 multiple choice questions and 70 or so scenario based questions. Many of the scenario questions came with 7 or 8 questions per scenario, and these were pretty straight forward in my opinion."

My Take on the New National Registry Paramedic Test

My test began at 8am in the morning, and like I stated above, I got stopped at 110 questions (the test can go up to 150 questions.) The worst part was that I had to pee like a racehorse about 20 questions into it, and didn't realize that I could have signed out to go use the restroom. I do not recommend drinking coffee or any considerable amount of fluids before your test.

My guesstimation is that I had around 40 multiple choice questions and 70 or so scenario based questions. Many of the scenario questions came with 7 or 8 questions per scenario, and these were pretty straight forward in my opinion. I recall only one drag and drop question, the rest of the scenario questions on my test were "pick the three correct answers" out of six possible choices.

The multiple choice questions seemed extremely difficult to me and came in runs of 5-10 questions at a time. They were heavy on pathophysiology -- like really obscure pathophysiology questions like hormones, aldosterone, parts of the brain, and disease processes I have never heard of before. I am convinced that many of these were pilot questions that did not count towards my total score. I don't recall there being any questions at all related to OBGYN or ACLS.

Onwards and Upwards

I walked out of the test convinced that I had failed. Four hours later, I found out I had passed via email and my NREMT account. Just remember that there are many questions and versions of the new test, and that this was just my experience from the test I took. Your mileage may vary. I hope this article helps someone successfully navigate the new National Registry Paramedic exam. Godspeed!


Please don't consider this article as advice. Your test can and most likely will differ from the test that I took. Please only consider this a look at my own personal experience with the National Registry's new testing process. As always, try hard and believe in yourself. The test isn't particularly fun to take, but it is very doable. Here is My original Reddit post. For a completely unrelated experience on the web, please check out GearMoose, an awesome shopping website.

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