Moving to Canada as a paramedic is possible, but two different authorities are involved. Immigration status, such as permanent residence (PR, the right to live in Canada permanently), comes from Immigration, Refugees and Citizenship Canada (IRCC), the federal immigration department. The right to work as a paramedic comes from the province where you will work, and Job Bank, the federal jobs site, says licensing by a regulatory body is required in all provinces. For paramedics, even the type of licensing body changes from one province to the next. Job Bank's list shows colleges of paramedics in provinces such as Alberta, Saskatchewan, Manitoba and Nova Scotia, while in Ontario, British Columbia and Quebec the licensing body is part of the provincial government. It also says the steps to get a licence differ in each province or territory, and that you need to contact the regulator where you want to work to learn what to do.

Getting licensed as a paramedic in Canada

Job Bank says paramedics need a one- to three-year college, hospital-based or other recognized paramedical program, and that anyone driving an emergency vehicle needs the right class of driver's licence. Each province then runs its own process for people trained abroad. For example:

• Alberta. The Alberta College of Paramedics uses the Canadian Organization of Paramedic Regulators (COPR) to assess international applicants' credentials at the primary care paramedic (PCP) and advanced care paramedic (ACP) levels, and that assessment must be finished before you start registering with the College. After it, you apply for provisional registration, which lets people who have not yet passed the registration exam work under supervision until they do.
• Ontario. The Ministry of Health's Standard Paramedic Equivalency, open to paramedics trained outside Canada, starts with the Standard PCP Equivalency, which compares your training and experience with Ontario's PCP program. If you pass, you can apply for the AEMCA exam (Advanced Emergency Medical Care Assistant), the provincial exam on which new primary care paramedics are evaluated; a separate ACP equivalency, open once you hold an AEMCA certificate, leads to the ministry's ACP exam. The process does not evaluate critical care or aerophysiology training done elsewhere.
• British Columbia. The Emergency Medical Assistants Licensing Board can license international applicants as emergency medical responders, PCPs, ACPs or critical care paramedics, and each licence includes the services of the categories below it. Your regulator or training school completes a form comparing your competencies with B.C.'s, and every applicant must pass a jurisprudence exam on B.C.'s rules: 25 questions in two hours, with 80% needed to pass and three attempts allowed.

Immigration routes for paramedics

Express Entry is IRCC's online system for immigration applications from skilled workers. You fill in a profile, it gets a points score, and in each round IRCC invites the highest-ranking candidates eligible for it. Our Express Entry guide explains the steps.

IRCC's list for its healthcare rounds includes paramedical occupations, the occupation group Job Bank uses for paramedics. To be counted in those rounds, you need at least 12 months of full-time work (or the same amount part-time) in that one occupation within the past three years, in Canada or abroad, and you must still meet the minimum rules for Express Entry. Our guide to category rounds explains what these rounds are.

Provinces can also nominate people for PR, as our provincial nominee guide explains. These provincial routes list paramedics:

• Saskatchewan: the Health Talent Pathway includes paramedical occupations. You need a Saskatchewan health job offer that the province's nominee program has approved through an Employer Position Assessment, and you must be eligible for Saskatchewan licensing.
• British Columbia: paramedical occupations are on the list of jobs eligible for the Health Authority stream, for health workers employed by a B.C. health authority.

Alberta's Dedicated Health Care Pathway, by contrast, lists physicians, nurses and several other health professions, but not paramedics.

Will my paramedic level carry over?

Not automatically: in each province above, the regulator places you at one of its own levels. B.C. asks for the protocols, clinical practice guidelines or scope of practice you are authorized to use where you work now, then tells you which licence you are eligible for and which exams you need, and it can require exams or training to cover any gaps it finds. Ontario compares you with its PCP program first, and critical care training from elsewhere is not part of its equivalency review. Alberta's COPR assessment works at the PCP and ACP levels. Titles differ too: Job Bank's list shows Saskatchewan's college registering emergency medical responders and technicians as well as primary, intermediate, advanced and critical care paramedics.

A common mistake paramedics make

Letting your registration at home lapse before you apply. B.C.'s board says international applicants must be registered or licensed as an emergency medical assistant (EMA) or equivalent in another country, and it does not accept transfers based only on training, employment or exams. It also expects you to be in good standing wherever you have held a licence. In Alberta, the order matters as well: the COPR assessment must be completed before you begin registering with the College. Keep your current licence active until a Canadian regulator has decided on your application.

First steps

1. Pick a province and find its paramedic regulator in Job Bank's list.
2. Start that province's first step: the COPR assessment for Alberta, a request for the Standard PCP Equivalency for Ontario, or the competencies comparison form for B.C.
3. Keep your licence at home current and in good standing, as B.C.'s board requires.
4. Check your last three years of paramedic work against IRCC's healthcare list.
5. If you have a job offer in Saskatchewan or British Columbia, read the Health Talent Pathway or B.C.'s eligible jobs list.