programs typically follow the u.s. nhtsa ems curriculum, dot or national registry of emts. while many regionally accredited community colleges offer paramedic programs and two-year associate degrees, a handful of universities also offer a four-year bachelor's degree component. the national standard course minimum requires didactic and clinical hours for a paramedic program of 1,500 or more hours of classroom training and 500+ clinical hours to be accredited and nationally recognized. calendar length typically varies from 12 months to upwards of two years, excluding degree options, emt training, work experience, and prerequisites. it is required to be a certified emergency medical technician prior to starting paramedic training. entry requirements vary, but many paramedic programs also have prerequisites such as one year required work experience as an emergency medical technician, or anatomy and physiology courses from an accredited college or university. paramedics in some states must attend up to 50+ hours of ongoing education, plus maintain pediatric advanced life support and advanced cardiac life support. national registry requires 70 + hours to maintain its certification or one may re-certify through completing the written computer based adaptive testing again (between 90 and 120 questions) every two years. paramedicine continues to grow and evolve into a formal profession in its own right, complete with its own standards and body of knowledge, and in many locations paramedics have formed their own professional bodies. the early technicians with limited training, performing a small and specific set of procedures, has become a role beginning to require a foundation degree in countries such as australia, south africa, the uk, and increasingly in canada and parts of the u.s. such as oregon, where a degree is required for entry level practice. ukraine as a part of emergency medicine reform in 2017 ministry of healthcare introduced two specialties — "paramedic" and "emergency medical technician". a paramedic is a person with at least junior bachelor degree in "healthcare" field. for a person with basic nine-year school education, the term of training is four years (junior bachelor's degree equivalent); with 11 years of schooling - two years for junior bachelor or 3–4 years for bachelor's degrees. structure of employment