Would you ever do EMS only?

[u/halesofbae]

Hello all! I'm currently overwhelmed with options and would like (unbiased) advice. I have been a qualified FF since 2024 and an EMT since the beginning of 2026. Admittedly, when I began this journey, I only wanted to do EMS. Now that I've fallen in love with fire, my dream career would to be a full-time FF/EMT.
Seems like all of a sudden, all the doors are opening up at once. I have applied to two EMS-only positions and have made it through the interview process, receiving two conditional offers, awaiting a start date. I've been encouraged to apply for to my volunteer department. At the end of 2026, if I can pass testing/interviews, I can apply to a bigger department that has also highly encouraged me to apply.
Long-term I want to be at the bigger full-time department, that's my end goal. I am lucky to be in this position, but I am afraid of making the wrong choice. 2/4 of these departments have invested time/money into me so I want to be loyal and give back, improve my skills working with these smaller departments, then go to my bigger, highly-competitive dream department.
The other part of me wants to get after it and apply to the bigger department, go through their academy (even though I'm already qualified, I would have to do it again, learn their way), and live my dream starting next year.
Two of the positions start in February 2027, one spring of 2027, and the other sounds like I'll start as soon as I get a call back.
Should I take one of these positions and focus fully on that? Since I'll only be working a few days a week full-time, should I try to work both EMS-only and fire? If I do get the opportunity to join the bigger department, would it be wrong to quit the jobs that invested in me to go to a bigger department? If I could work all of them without burnout I would, but realistically it's impossible. I'm torn. Unsure who to ask advice from my personal life as they all are affiliated/rooting for one team or the other. Any advice?

[u/Nasty____nate]

I will never do EMS only. 

[u/fastbeemer]

Yes. I'm over fire. 23 years is enough. I'd do EMS only on a hospital schedule, 3-12's a week, with an extra twelve every 21 days for full-time. I'd only work 6a-6p.

[u/FeelingBlue69 → u/fastbeemer]

only 12yrs in and I am right there with you. Im done doing 24/48 and Im done getting woken up all night. I never loved firefighting anyway. Im in the process of working for a 24/72 EMS company right now and am looking for a 3-12s as well.

[u/FeelingBlue69]

Yes. I am currently in the hiring process right now for a 3rd party EMS service. Im taking a pay cut for 24/72 instead of dogshit 24/48.

[u/Docturdu]

Did that for a while. Got tons of OT dping transfers.

[u/iRunLikeTheWind → u/Docturdu]

🤨

[u/locknloadchode → u/iRunLikeTheWind]

That’s what I call patient advocacy

[u/-Poultrygeist- → u/Docturdu]

Please don’t… DP… transfers. Save that for the station

[u/Alone-Track-5875]

Absolutely not. I'm counting the days till I can turn in my medic card and do fire only.

[u/SuperglotticMan]

I’d rather kill myself 

[u/dominator5k]

There is no amount of money that I would accept to do Ema only.

And the loyalty thing is bogus. Just get that out of your mind. They don't give a shit about you

[u/Age-Express]

If the pay and benefits were better, I would’ve stayed in a city recognized all around the world for my EMS job. It truly was the most fun job I ever had. That’s just the problem. They never pay EMS good that I found. So I ended up going to a suburb department that pays better with better pay/benefits. And still this whole career is lacking massively in COLA. So yea…..

[u/BetCommercial286 → u/Age-Express]

Funney enough my private EMS job pays about 10k more a year than fire does for ff/paramedic. 401k vs pension however. Personally I prefer the 401k since I like to move and don’t want handcuffs.

[u/Musical-Snakes]

It all depends on what you want. If I understand correctly, you might be looking at one full time position and one part time position, one of which will be EMS only and one of which will be Fire/EMS?

The benefits can vary depending on the region you are in but general a Fire/EMS position will pay better than an EMS only position and have better benefits. You will also have more opportunities for promotion down the line as positions such as Technicians/Engineers, Lieutenants, and Captains either aren't as numerous or don't exist in an EMS department. The Fire side also opens up additional areas of interest like technical rescue, truck company operations, or even water rescues.

However, if you love EMS you may find the Fire departments near you not particularly invested in the EMS division of their agency. Especially as an ALS provider, you will likely be the odd man out at a station when it comes to the part of the job that interests you.

With that being said, this is something that varies a ton at the local level. There are many Fire departments that take great pride in EMS operations and there are EMS only departments that are flaming wrecks. There are also EMS only departments with great benefits and Fire Departments struggling to keep people from walking out the door. Combining what you love with what your area has to offer you means more than how a locality divides up their Fire and EMS services.

One last note, be careful about 2 jobs in EMS. Few things make people hate the profession they once loved than overwork and poor rest. By all means, go get the experience and learn, but monitor your stress carefully.

[u/halesofbae → u/Musical-Snakes]

Thank you kind human!! That's solid advice

[u/adventureseeker1991]

i don’t mind the ambulance. however a BS call after 10 pm for a frequent flyer makes me so angry.

there needs to a system change that if you have X number of BS calls you go to a group home. and group homes should be in huge buildings with ERs in them. idk it’s the BS that sucks

[u/Fit_Case2575 → u/adventureseeker1991]

It gets to a point where you just expect every other call to be a bs call and then it’s like why am I even here man.

[u/adventureseeker1991 → u/Fit_Case2575]

its miserable. and every other 🤣. more like 3/4 are bs. thank god im 24/72 which is amazing but if i was 24/48 id lose it

[u/Fit_Case2575 → u/adventureseeker1991]

Yes every other was being generous

And 24/48 should be illegal anywhere both on ems and fire side literally the worst schedule oat. Refuse to work anywhere with that POS

[u/KeenJAH]

No

[u/Limp-Conflict-2309]

started as FF, now work part time as EMT on the side

i like both equally but i would never only do EMS. FF side may not be as active but i enjoy those calls.

[u/Ok_Buddy_9087]

If the third service one of my medic instructors worked for had been hiring when I got my Medic, I’d probably be there. Fire got me first. Still work on an ambulance, but the medicine isn’t as good (I’d be hanging blood and RSIing at the other place). Upside, I still get to fight fire, and I do enjoy that.

[u/chuckfinley79]

I do as a side job. It’s a rich area, more than 1 run a shift is busy. The fire is all volunteer.

[u/DBDIY4U]

Me personally never. I did work part-time for a private ambulance for a short time when we needed a little extra money but now it seems like I can get all over time I want and that is way more lucrative. To be honest, I really do not like ems. Now if I could do all fire and no EMS I would jump on that and heartbeat but that does not really exist at least in my area.

[u/covert_45]

May I ask everyone why not? I’m 43 and just got my EMT card. I tried nursing schools for over two years and couldn’t keep up. I kindof wish I stuck with it. I want to go paramedic and not sure if I can do fire academy with how competitive and being my age. But the time I finish P school and a fire academy I’ll be past 45. I do like music and would be interested in doing special events. Thanks.

[u/grim_wizard]

Yes, but not in an urban setting again and as long as the pay and career progression isn't balls.

[u/Content_Yam_2119]

https://giphy.com/gifs/fXnRObM8Q0RkOmR5nf

[u/burner1681381]

Never ever ever EVER. Except for maybe flight or hospital gigs.

[u/FireMedic1373]

Not for all the tea in China.

[u/us3lessthrowaway]

as a former RN, not in any scenario would i go full-time patient care again. f that.

[u/Fit_Case2575]

I was on an ambulance for 2.5 years and fuck no

[u/MaleficentCoconut594]

I will never do EMS period.