Transition Interest and Roles Assessment for Nationally Certified Emergency Medical Service Clinicians in the U.S...

The U.S. Emergency Medical Service (EMS) system faces persistent workforce shortages. Thousands of military personnel transition out of service each year with EMS-related training, yet little is known about their roles or willingness to pursue civilian EMS careers. Despite low national unemployment rates among veterans, many remain underutilized in healthcare occupations. We aim to describe the current roles of nationally certified military EMS clinicians and assess their interest in transitioning to civilian EMS employment.

We conducted a cross-sectional survey of National Registry-certified EMS clinicians actively serving in the U.S. military. Respondents recertifying between October 2021 and April 2022 were invited to complete a voluntary, one-time survey. The analytic sample included military-affiliated clinicians aged 18-85 who reported an EMS job role and responded to a question about interest in civilian EMS transition. Descriptive statistics multivariable Poisson regression with robust standard errors were used to characterize EMS roles and identify factors associated with transition interest. Referent groups for categorical variables were selected based on the subgroup with the largest number of respondents.

Among 1,937 included respondents, the median age was 32 years (interquartile range: 27-40), and most were male (66.6%) and White, non-Hispanic (58.3%). Respondents represented all major military branches, with the largest proportion from the Air Force (60.3%). Most held emergency medical technician certification (82.5%). Overall, 60.5% expressed interest in civilian EMS employment after separation. Transition interest was highest among clinicians in the Army (prevalence ratio: 1.23; 95% confidence interval: 1.11-1.36), Navy (1.31; 1.17-1.45), and Coast Guard (1.13; 1.01-1.27) compared to the Air Force. Those in educational or non-traditional roles had higher prevalence of interest than those in hospital-based roles, while older clinicians had significantly lower prevalence of interest.

Findings from this convenience sample suggest that a substantial portion of military EMS clinicians, particularly younger personnel and those affiliated with the Army, Navy, and Coast Guard, may be interested in transitioning to civilian EMS roles. While not representative of all military EMS personnel, these patterns highlight the potential utility of structured veteran-to-civilian EMS pathways. Future research using more representative sampling strategies is needed to confirm these trends and inform workforce development efforts.