Matt, glad to hear your decision to proceed with paramedic training. Some suggestions; having been in the field as an EMT-B, you have both some advantages and disadvantages over those who enter paramedic training without field training. As we all know there is the book/classroom way of doing things and the real world way of doing things (sometimes resulting in bad habits). When you are in class and when you take your written and practical exams, try not to bring your real world way of doing things into the school realm. Having field experience will allow you to place into perspective the theories taught in the classroom, but always keep in mind, you will be tested on the classroom material. Likewise, and I am sure you already know this, until you are approved to perform ALS skills, do not be tempted. It places both you and your preceptor in serious jeopardy. With the new DOT requirements for paramedics, a lot more theory is being taught to give you the diagnostic capabilities and the ability to provide the expanded scope of practice that paramedics are now required to provide. The current EMT-B and EMT-I programs are more geared towards the techniques and skills of care. There is greater emphasis on anatomy, physiology, pharmacology and pathophysiology then in the past. With 12 lead ECG’s being the new standard of care, do not become overwhelmed with the volume of cardiology material, take things slowly and thoughtfully and you will do fine. There are a lot of good supplemental books out there to help you. If, your current assignments include riding on a combination BLS/ALS ambulance, pick the brain of those paramedics you have come to respect, both new and old, for both have valuable lessons to teach. When it comes time to take your National Registry Exam, get plenty of rest. While the written was challenging, it was nothing compared to the stress of the practical. Take care, I am sure you will do great. Pete