A History of National EMS Certification: Strengthening the EMS Profession

This gavel was handcrafted by Dr. "Deke" Farrington and presented to the National Registry after his term as Chairman in 1975.

Sponsor Spotlight: National Registry of Emergency Medical Technicians

Strengthening the EMS Profession

In 1967, the American College of Surgeons published an article written by Dr. J.D. “Deke” Farrington called “Death in a Ditch.” In this article, Dr. Farrington – often called the Father of Modern EMS – highlighted the dangers of automobile crashes on America’s highways and outlined his vision for preventing the growing epidemic of, in his words, death in a ditch. His article called for a new approach to providing emergency medical care at the scene of emergencies and during transport. In addition to outlining basic standards for ambulances and equipment, he emphasized the requirement for “at least two trained persons…and the attendant’s competence in emergency care should be certified” (Farrington, 1967).

In response to the increase in death and disability on America’s highways, President Lyndon Johnson’s Committee on Highway Traffic Safety recommended the creation of a national certification agency to establish uniform standards for training and examination of personnel active in the delivery of emergency ambulance services. A task force was then created to study the feasibility of a national registry for EMTs headed by Oscar P. Hampton, Jr., M.D., a physician recognized for his pioneering work with the American College of Surgeons’ Committee on Trauma.

Less than three years after “Death in a Ditch” was published, and a year after the Committee on Highway Traffic Safety’s recommendation, a non-profit organization was formed to serve as the nation’s EMS certification agency: The National Registry of Emergency Medical Technicians. In 1971, the National Registry’s Board of Directors elected Dr. “Deke” Farrington as the organization’s Chairman and Rocco V. Morando as the founding Executive Director. Later that year, the National Registry conducted the nation’s first EMT-Ambulance exam, administered simultaneously to 1,520 personnel at 51 test sites across the United States.

As the National Registry continued conducting examinations and certifying Emergency Medical Technicians based on a national standard, Rocco Morando, Dr. Farrington and the Board of Directors recognized another gap: the new EMTs – providing prehospital emergency medical care across the nation – were not linked together by a national association. In response to this need, on January 8, 1975, the National Registry organized a meeting with representatives from every known state-based EMT organization. A few months later, this group formed the National Association of Emergency Medical Technicians (NAEMT) with support from the National Registry and others.

While EMS has evolved since the early 1970s, the importance of National EMS Certification and the core focus of the National Registry has remained consistent for nearly 50 years: to provide a valid, uniform process to assess the knowledge and skills required for EMS professionals. The National Registry accomplishes this goal with a staff that includes highly qualified EMS experts who understand what is involved in treating patients in the out-of-hospital setting. The National Registry also works in close collaboration with state EMS officials, national organizations, and subject matter experts. Because the top priority of the National Registry is the safety of the American public, thousands of hours are devoted each year by experts from the EMS medical community on item development, validation, practice analysis and standard setting. As a non-profit organization, all funds collected support the National Certification process and are reinvested into the EMS community.

As appropriately captured by the theme of this year’s EMS Week, and as demonstrated by the visionaries, leaders, and founders of our national EMS system, we are stronger together.


Farrington, J. (1967). Death in a Ditch. American College of Surgeons, 121-132.