Maryland Institute for
Emergency Medical Services Systems

1. EMS Operational Program Affiliation
   • NEW: You must be affiliated with a MIEMSS-approved EMS operational program
   • CHANGE: This is now explicitly required for renewal (not just verification)
2. Annual Protocol Updates
   • NEW: Must complete the three most recent years of Annual EMS Protocol Updates
   • IMPORTANT: These are specific MIEMSS courses, not general continuing education

• ✅ Mandatory affiliation verification
• ✅ Three most recent years of protocol updates (specific requirement)
• ✅ State Medical Director-designated continuing education categories
• ✅ Technical proficiency verification option (if choosing the CE route)

Requirements:

• National Registry (NREMT): Current active status registration as an EMT or higher
• Complete the 3 most recent years of Annual Maryland Medical Protocols for EMS Updates
• Maintain affiliation with an EMS operational program

1. 24 hours of continuing education in categories designated by the State EMS Medical Director during your current certification cycle.
   
   Categories designated by the State EMS Medical Director:

   Categories	Hours
   Airway/Ventilation/Respiratory	3
   Cardiovascular	3
   Medical	2
   OB/GYN	1
   Pediatrics	2
   Toxicology/Environmental	1
   Trauma/Burns	3
   Total	15

   
   

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2. 1-9 hours of your 24 continuing education may be substituted with technical skills. Hands-on skills may include MIEMSS-approved hands-on technical proficiency verification.
   
   Technical Proficiency Verification may be completed through your Maryland State EMS Operational Program or BLS program. Link to maps of BLS programs
   
   Flexible Content Options: If your skills verification totals less than 9 hours, you have flexibility in how you complete each remaining hours. These hours may be fulfilled through (MIEMSS-approved):
   • Local content relevant to your service area
   • Individual educational content that meets your specific learning needs
   • Any other MIEMSS-approved continuing education, including skills.
   
   This flexibility allows you to tailor your remaining education hours to areas most relevant to your community and individual needs.

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3. Complete the 3 most recent years of Annual Maryland Medical Protocols for EMS Updates.   
   
   Please note that any time spent on Annual EMS Protocol Updates does NOT count toward your required 24-hour continuing education requirement.

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4. Maintain affiliation with an EMS operational program