What you need to become an ambulance driver

An ambulance driver is not a single job title — it's a role within a larger emergency medical system, and what you need depends on where you want to work and what your employer requires. Most ambulance services want you to hold a commercial driver's license (CDL) with a passenger endorsement, pass a background check, and complete their own training program. Some services require you to be a certified EMT (Emergency Medical Technician) first; others will hire you as a driver and train you on the job. A few states have specific ambulance driver certifications, but most do not.

The path forward depends on whether you want to drive only, or drive and provide patient care. If you want to provide care — which means better pay and more job security — you'll need EMT certification first. If you want to drive only, you can start with a CDL and let your employer's training take it from there.

Key Takeaways

  • A commercial driver's license with passenger endorsement is the baseline requirement for ambulance driving in most states, though some services hire drivers without one and train them internally.
  • EMT certification (usually 120 to 150 hours of coursework plus a state exam) opens more job opportunities and higher pay, but is not always required to be hired as a driver.
  • Your employer will run a background check, a driving record check, and a medical exam before you start, and will provide their own vehicle-specific training.
  • Ambulance services are run by hospitals, private companies, fire departments, and municipal EMS agencies — each has different hiring timelines and requirements.
  • The path from hire to first shift typically takes four to eight weeks once you have your CDL and pass the background check.

Getting your commercial driver's license

A CDL is issued by your state's Department of Motor Vehicles and requires passing a written test on vehicle operation and safety, a pre-trip inspection test, and a driving test in an actual commercial vehicle. You must be at least 21 years old (some states allow 18 for intrastate driving). The written test covers air brakes, combination vehicles, and passenger transport — the last one is what you need for ambulances.

Before you take the CDL test, most states require you to hold a CDL permit for at least one week. You get the permit by passing the written test at the DMV. The whole process — permit to license — usually takes two to four weeks if you study on your own and schedule your driving test quickly. Some people use a CDL training school, which costs $3,000 to $8,000 but compresses the timeline to one to two weeks and includes the vehicle for your driving test.

Check your state's DMV website for the exact requirements, because rules vary on age, medical certification, and whether you need a passenger endorsement (most states require it for ambulances; a few do not). Once you have your CDL, it's valid for five years.

EMT certification: optional but valuable

An EMT certification shows you know how to assess patients, perform CPR, use a defibrillator, and handle common medical emergencies. There are three levels: EMT-Basic (the most common), EMT-Intermediate, and Paramedic. For ambulance driving, EMT-Basic is the standard. The course is usually 120 to 150 hours of classroom and hands-on training, spread over four to twelve weeks depending on whether you take it full-time or part-time. You then take a state exam (usually the NREMT, the National Registry of Emergency Medical Technicians exam) to get certified.

Many ambulance services will hire you as a driver without EMT certification, but having it makes you more competitive and usually raises your starting pay by $2 to $4 per hour. It also opens the door to patient care roles later, which pay more and have better job security than driving alone. Some services require you to get EMT certification within your first year of employment if you start as a driver.

EMT courses are offered by community colleges, hospitals, fire departments, and private training companies. Cost ranges from $500 to $2,000 depending on the provider. Check whether your state recognizes the NREMT exam or uses its own state exam — most do recognize NREMT, but a few states have their own process.

The hiring process and background check

Once you have your CDL (and EMT certification if you're pursuing it), you can explore to ambulance services. Most services post jobs on their own websites, Indeed, and government job boards. The hiring timeline varies: municipal EMS agencies often have formal hiring processes that take eight to twelve weeks, while private ambulance companies may hire within two to four weeks.

Every service will run a background check, a driving record check, and a medical exam before you start. The background check looks for felonies, misdemeanors, and sometimes traffic violations — standards vary by employer and state. The driving record check is straightforward: they pull your DMV record. The medical exam is usually basic: blood pressure, hearing, vision, and drug screening. Some services require a physical ability test to show you can lift and move patients safely.

Be honest on your process about any criminal history or driving violations. Many services will consider your record in context — a DUI from ten years ago is treated differently than one from last year — but lying about it will disqualify you when ready.

On-the-job training and your first shift

After you're hired, your employer will put you through their own training program, usually two to four weeks long. This covers their specific vehicles, equipment, radio procedures, local geography, and how they handle different call types. You'll ride along with experienced drivers and paramedics, learning their routes and their protocols. Some services require you to pass a written test at the end of training; others just require you to demonstrate competence on the road.

During training, you're usually paid at your starting wage. After training, you'll be assigned to a shift — typically 12 or 24 hours, depending on the service — and paired with a paramedic or another driver until your employer feels you're ready to work independently.

Where ambulance drivers work

Ambulance services are run by four main types of employers: municipal EMS agencies (city or county government), hospital-based services, private ambulance companies, and fire departments. Municipal and fire department jobs usually offer better benefits and job security but have longer hiring processes and may require you to live in the jurisdiction. Private companies hire faster but often have higher turnover and fewer benefits. Hospital-based services fall somewhere in between.

Pay varies by employer type and region. Municipal and fire department drivers typically earn $35,000 to $50,000 per year; private companies often pay $28,000 to $40,000. EMT-certified drivers earn more at every employer type. Rural areas often pay less but have lower cost of living; urban areas pay more but have more competition for jobs.

Frequently Asked Questions

Do I need a CDL to drive an ambulance?

Most states and employers require a CDL with a passenger endorsement. A few private ambulance companies in some states will hire you without one and train you internally, but this is uncommon. Having a CDL makes you hireable almost everywhere and is worth getting first.

Can I become an ambulance driver without being an EMT?

Yes. Many services hire drivers without EMT certification and train them on the job or require them to get certified within a year. However, you'll have fewer job options and lower starting pay. If you want to move into patient care roles later, you'll need to get EMT certified anyway.

How long does it take to become an ambulance driver from scratch?

If you already have a driver's license: four to eight weeks for a CDL (longer if you use a training school), plus four to twelve weeks for EMT certification if you want it, plus two to four weeks for your employer's training. Total: two to six months if you do CDL and EMT in parallel, or four to twelve months if you do them sequentially.

What disqualifies you from being hired as an ambulance driver?

Felony convictions, recent DUIs, a suspended or revoked driver's license, and failing the medical exam (usually for vision or hearing) are common disqualifiers. Some services also reject applicants with multiple traffic violations in the past three to five years. Standards vary by employer.

Do ambulance drivers need to be certified in CPR?

Most services require current CPR certification before your first shift. If you don't have it, you can get certified through the American Heart Association or Red Cross in one day for $50 to $100. EMT courses include CPR training, so if you're getting certified as an EMT, CPR is included.