In 2026, Portugal Shifts Paramedic Training to Fire Academy, Adds 5-Year Recert

Portugal’s emergency health service is about to undergo its most significant shake-up in two decades. INEM has approved a training overhaul that will take effect in 2026, shifting most classroom hours to the National Fire-Fighters School, side-lining medical schools, redefining certification, and sparking a debate on quality of care, potential impact on ambulance crews, and eventual response times amid growing controversy.

Quick Glance – The Key Points

• Centralisation: Base courses such as TAT, TAS, SBV and SAV migrate to the Escola Nacional de Bombeiros.

• Regulatory pivot: INEM keeps only “institutional” modules—Introdução ao SIEM and protocol courses for each response level.

• Five-year recertification becomes mandatory; route may be coursework, formal exam or professional track record.

• Accreditation audits frozen until the agency finishes an internal organizational revamp.

• Unions and academics fear a “levelling down” of standards; INEM defends “uniform protocols” and faster deployment.

1. Why Lisbon Says the System Needed a Reset

The agency’s board argues that the previous patchwork of providers, syllabi, and fees generated uneven competences across the country. By moving core content under a single roof, management hopes to guarantee standardised practice, simplify career progression, and release INEM instructors to focus on high-complexity protocols, mass-casualty drills and digital simulation. The overhaul was rubber-stamped on 14 January 2026, barely three months after an external audit criticised overlapping jurisdictions and gaps in quality control.

2. What Exactly Changes for Future Ambulance Professionals

Under the new playbook, a candidate will first enrol at the National Fire-Fighters School to secure the TAS or higher licence. Only then will they attend INEM’s succinct “Intro to SIEM” module and the matching protocol course—SBV, SIV or SAV—depending on the ambulance tier they join. A fresh tripulante therefore faces a training ladder that is shorter inside INEM but longer overall, because the fire-fighting academy’s catalogue stretches from basic first-aid to advanced extrication skills. A compulsory re-assessment every five years aims to weed out outdated practices and reinforce clinical governance.

3. Medical Schools on the Sidelines – Reactions and Pushback

Deans learned of the decision through the Government gazette, despite a 2025 Memorandum of Understanding that promised closer collaboration. The Council of Portuguese Medical Schools scheduled an urgent meeting to analyse what some professors call an “unexpected divorce”. The STEPH union warns that the trimmed INEM curriculum is “totally out of sync with international evidence”, while the National Association of TEPHs fears the loss of a dedicated competency framework. INEM counters that medical faculties will remain welcome partners for research, though not for mandatory certification.

4. Will Patients Notice? Service Quality Under the Microscope

For the 5.6 M emergency calls fielded last year, what matters is speed and clinical accuracy on arrival. Supporters claim that clearer protocols, real-time monitoring and audit trails will eventually shave minutes off response times. Critics reply that shorter classroom stints can produce under-prepared crews, especially in rural interior regions where ambulances often operate in isolation. Portugal already lags behind Spain and France for advanced life-support coverage per 100 000 residents, and unions fear the gap could widen if new cohorts emerge with a shallower knowledge base.

5. Transitional Timetable and What Professionals Must Do Now

The agency has opened a one-year grace period: anyone enrolled in the old pathway may finish under current rules and still receive a recognised badge. From January 2027 onward, only the new sequence will earn access to SIEM rosters. Practising TAS and TEPH staff should start compiling e-portfolios of cases, workshops and drills to use the “recognition of experience” option during their five-year recertification window. Meanwhile, INEM has paused audits of external schools until its broader restructuring is complete, leaving a temporary vacuum in third-party oversight.

6. Portugal in the European Context

Neighbouring systems vary: Spain relies heavily on regional fire brigades, France blends medical universities with SAMU centres, and Germany mandates a two-year Notfallsanitäter course led by the Red Cross. By opting for a fire-school core plus a regulator-only protocol layer, Portugal experiments with a hybrid model that could streamline administration but risks eroding academic rigour. Brussels sets no binding curriculum, yet cross-border teams often benchmark against ERC (European Resuscitation Council) guidelines—another area where medical faculties have traditionally taken the lead.

7. Takeaways for Citizens and Health-Sector Workers

Expect the first fully “fire-school” trained paramedics on the streets in mid-2027.

Revalidation every five years will become the norm, bringing Portugal closer to Anglo-Saxon practice.

The political debate is far from settled—watch for possible amendments when Parliament revisits the Emergency Framework Law later this year.

For current volunteers considering a full-time career, early registration with the National Fire-Fighters School may be the most straightforward point of entry.

Patients are unlikely to see immediate changes, but service metrics—door-to-needle time, survival after cardiac arrest—will reveal whether the gamble pays off.

Reporting by our National Affairs desk, with files from Coimbra, Porto and Faro