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To become a permanent EMT or Paramedic, you must take the civil service exam. Get Latest Exam Schedule; Once appointed to as a permanent civil service employee, you can apply to take all emergency medical service promotional exams. 2019 Spread Pick'Ems RESULTS! Discussion in 'Iowa Football' started by LAhawkeye, Dec 10, 2019. Post New Thread. LAhawkeye HR All-American. Expand Collapse The closed, invitation-only retreat is attended by 70 medical directors from the most-populated metropolitan EMS systems as well as 18 EMS fellows—33% of the nation’s current EMS fellows.