Written by AI from public information on 2026-10-26. Fees and rules change and vary by province — confirm with the official body before relying on anything here.
Typical cost
about CA$8,000 to CA$20,000
an estimate in Canadian dollars
Time to earn it
about 2 to 3 years
Issued by Provincial paramedic regulators (Canadian Organization of Paramedic Regulators exam)
Required to start: Working as an advanced care paramedic needs the licence or registration of the province or territory.
About
Advanced care paramedics respond to emergencies and treat patients at the scene and on the way to hospital. They do more than primary care paramedics. They may start intravenous lines, give a wider range of medications, read heart rhythms and manage a patient's airway.
This licence is issued by each province and territory. It is the legal permission to work at the advanced care level. Many people with this licence work on ambulances. Others work with fire services, air ambulance programs or industrial and remote-site medical teams. People who start as an emergency medical technician or a firefighter with medical duties often move toward this level to build their skills and widen their job options.
How to get it
Finish the required education
Complete an approved paramedic program that covers the advanced care level. Many people first complete a primary care paramedic program and then add advanced training.
Complete clinical placements
Your program will include time in hospitals and on ambulances. You practise your skills with real patients under supervision.
Pass the national exam
Write the exam set by the Canadian Organization of Paramedic Regulators. Your program or regulator will explain when and how to register for it.
Apply to your provincial or territorial regulator
Send in your education records, exam results and any other documents your regulator asks for. You may also need a criminal record check and proof of good health.
Receive your licence and start work
Once approved, you can work as an advanced care paramedic in that province or territory. Employers will check that your licence is valid.
The exam
The exam is a written test of the knowledge and judgment you need as an advanced care paramedic. It covers patient assessment, treatment, medications and decision-making in emergencies. Some regulators also ask for a practical skills assessment. Study your course material, practise with sample questions and ask your program for guidance.
Licensed by each province
Each province and territory issues this itself, under its own rules. Each province and territory has its own regulator and its own rules. The exact steps, forms, fees and renewal requirements can differ. If you move to a new province or territory, you usually need to apply to the new regulator, and they may ask for extra documents or training. Always confirm the details with the regulator where you plan to work.
Keeping it
Your licence must be renewed on a regular schedule set by your regulator. You will need to pay a renewal fee and show that you are still fit to practise. Most regulators also ask you to complete continuing education and to keep your skills and certifications up to date. Check your regulator's rules so you never let your licence lapse, since you cannot work without it.