You need two years experience as an EMT out of training school - then you apply for a course that takes 20 weeks (I think, something like that) , where you learn more anatomy and physiology, more medications, and spend time in hospitals cannulating and intubating patients. And that is basically that, with the exception of Emergency Care Paramedics who are taught to deal with minor injuries and wound care (in order to cover for out of hours GPs).