The composition of an emergency medical services team is not a matter of a single regulation, but four separate sets of requirements – for a paramedic, a system nurse, a system physician, and a driver. Each of these roles has its own legal basis, its own educational path, and its own authority that confirms qualifications. For the provider, this means that the staffing compliance of a team does not simply come down to checking diplomas – one must know which regulation to apply to which person.
Four roles in an emergency medical services team and one common legal basis
The starting point is Article 36 of the Act of September 8, 2006, on the State Emergency Medical Services (consolidated text: Journal of Laws of 2026, item 141). The regulation divides emergency medical services teams into four types, differing in the number of persons authorized to perform emergency medical procedures and whether a physician must be included in the composition.
| Team type | Minimum number of authorized persons | Composition | Legal basis |
| Specialist (S) | 3 | system physician and system nurse or paramedic | Art. 36 sec. 1 item 1 of the PRM Act |
| Basic two-person (P2) | 2 | system nurse or paramedic | Art. 36 sec. 1 item 2 letter a |
| Basic three-person (P3) | 3 | system nurse or paramedic | Art. 36 sec. 1 item 2 letter b |
| Motorcycle rescue unit (M) | 1 | system physician, system nurse or paramedic | Art. 36 sec. 1 item 3 |
A separate category is the driver. They are part of the team only if none of its members meet the conditions for driving an emergency vehicle, specified in Article 106 section 1 of the Act of January 5, 2011, on vehicle drivers – which is the exact same regulation that governs the driver’s qualifications described further in this article.
Therefore, in many P teams, the function of a driver is simply performed by one of the persons authorized to provide services, provided they have the appropriate driving license and have completed the course. A separate driver position appears where the provider decides to separate these roles organizationally, regardless of whether the act obliges them to do so.
What education and qualifications must a paramedic have?
The profession is regulated by the Act of December 1, 2022, on the profession of a paramedic and the professional self-government of paramedics (consolidated text: Journal of Laws of 2025, items 339, 637). The basis is a higher education diploma in emergency medical services (bachelor’s or master’s degree), full legal capacity, a state of health allowing the practice of the profession, and written and spoken proficiency in the Polish language. Since the entry into force of the act, this profession has had its own professional self-government – the National Chamber of Paramedics (KIRM) – and a mandatory document “Right to Practice the Profession of a Paramedic” (PWZ), issued after entry into the Register of Paramedics. The register is in an active phase of construction: according to KIRM data from August 6, 2026, 482 paramedics were registered (481 with Polish citizenship, 1 with Ukrainian), compared to 338 a month earlier and 201 at the end of May 2026. The pace of entries is growing from month to month – the practical conclusion for the provider is simple: the PWZ status of a specific employee must be verified on an ongoing basis, and not based on data from a few weeks ago.
Two paths to the qualifications of a system nurse
The definition is contained in Art. 3 item 6 of the PRM Act. A system nurse is a person who meets one of two conditions:
- Holds the title of specialist or is in the course of specialization in the field of emergency nursing, anesthesiology and intensive care, surgery, cardiology, or pediatrics.
- Has completed a qualification course in one of these same fields and has at least 3 years of work experience in an appropriate ward, emergency department, admission room, or ambulance service.
Both paths provide the same legal status of a system nurse. However, the nursing community has been pointing out for years that this does not automatically translate into an identical scope of independent procedures – some authorizations, such as endotracheal intubation without a doctor’s order, are reserved by a separate regulation exclusively for persons with a specialization in anesthesiology and intensive care. The mere fact of classifying a given person into the “system nurse” category does not, therefore, end the verification process – it is worth checking which of the two paths a given person has actually completed.
Which medical specializations open the door to an S team?
Art. 3 item 3 of the PRM Act distinguishes three groups of physicians authorized to work in a specialist team.
The first includes persons holding the title of specialist or undergoing specialization training in the field of anesthesiology and intensive care, emergency medicine, or neurology.
The second group consists of specialist physicians in internal diseases, cardiology, general surgery, pediatric surgery, orthopedics and traumatology of the musculoskeletal system, and pediatrics.
The amendment of April 24, 2025, added a third, narrower category: a physician after the second year of specialization, i.e., a person who has been undergoing specialization training for at least 2 years and has obtained written confirmation from the specialization supervisor that they have the knowledge and skills to perform the tasks of a system physician. This solution is intended to partially alleviate the shortage of system physicians, who are a bottleneck in staffing S teams in many regions today.
Must an ambulance driver be a paramedic?
No. The law does not require the person driving an ambulance to have any medical qualifications – the driver and the medical team member are two separate roles, regulated by different provisions.
To drive an emergency vehicle, one must meet the conditions set out in Chapter 16 (Art. 106–111) of the Act of January 5, 2011, on vehicle drivers: be 21 years of age, have an appropriate category driving license, a medical and psychological certificate stating no contraindications, have completed a course for driving emergency vehicles conducted by a higher-level driving technique improvement center, and have a permit issued by the starosta – valid for 5 years, but no longer than the validity of the certificates. The act does not impose a requirement for prior driving experience – this additional criterion is sometimes confused with the statutory minimum, although in practice some employers do expect experience in driving large vehicles. A person combining the function of a driver with the role of a paramedic or system nurse must meet both sets of requirements simultaneously – medical and traffic-related.
Staffing a basic team after the 2025 amendment from the provider’s perspective
The amendment to the PRM Act of April 24, 2025, formally divided basic teams into two- and three-person teams, instead of the previous uniform two-person minimum. This material deliberately omits the vehicle interior configuration and the financing mechanism resulting from this change – it focuses solely on the staffing aspect.
From the point of view of the provider submitting a P3 team for a tender or inspection, it is crucial to document that all three people in the composition meet the definition of a system nurse or a paramedic with the appropriate legal basis. It is not enough that the third person is physically present.
The decision to transition from P2 to P3 beyond the statutory minimum remains at the discretion of the manager of the medical entity that is the team provider – this was already confirmed earlier by the Ministry of Health in responses to interventions by the Commissioner for Human Rights. The regulation defines a minimum threshold, not a recommended norm.
Other regulations for a specialist team and sanitary transport
The staffing of an S team is described in the table above: a minimum of three people, including a system physician and a system nurse or paramedic.
The situation looks completely different in sanitary transport, usually carried out by type A ambulances. This service functions outside the State Emergency Medical Services system, based on separate regulations on guaranteed services and conditions of contracts with the National Health Fund (NFZ), and not Art. 36 of the PRM Act. In a typical configuration, a sanitary transport team consists of a driver meeting the requirements for emergency vehicles and an orderly, whose qualifications are specified by the regulation of the Minister of Health of July 20, 2011, on qualifications required from employees in particular types of job positions in medical entities – sometimes this role is performed by a paramedic.
The exact composition is sometimes specified by the physician ordering the transport and by the terms of a specific contract with an NFZ branch. When specifying a fleet combining type A vehicles with types B and C, it is worth separating these two legal regimes in the personnel documentation right away – combining them into a single qualification verification procedure is a frequent source of errors.
Does a paramedic already need to have the right to practice the profession?
They do not have to – but only within a strictly defined, ending transitional period.
The National Council of Paramedics was established on January 11, 2025. Persons who, in the period from the entry into force of the Act on the profession of a paramedic until the end of 2 years from the establishment of the Council (i.e., until January 11, 2027), meet the conditions specified in Art. 2 items 1–4 of this Act, are recognized as paramedics by virtue of law and are entitled to the right to practice the profession without the need to obtain the PWZ document beforehand. However, they may practice the profession without a formal document and entry into the register only until the end of 4 years from the establishment of the Council, i.e., until January 11, 2029 – after this date, submitting an application for a PWZ is a condition for further work. The lack of a PWZ for an employed paramedic is therefore not an irregularity in itself today, but it has a hard expiration date, which is worth entering into the provider’s personnel review schedule right now, and not only closer to 2029.
200 educational points that the provider cannot ignore
The obligation of professional development of a paramedic is regulated by the regulation of the Minister of Health of August 18, 2023, on the continuous professional development of paramedics, issued on the basis of Art. 116 of the Act on the profession of a paramedic. The settlement period lasts 5 years and begins on January 1 of the year following the obtainment of the right to practice the profession. To fulfill the obligation, one must collect at least 200 educational points, of which:
- a minimum of 120 points must come from an improvement course ending with an exam (at least 30–32 didactic hours);
- up to 8 points for one seminar (1 point per hour of classes);
- the remaining pool – from other forms of self-education provided for in the regulation, whereby a surplus of points over the required 200 does not carry over to the next period.
Since January 11, 2026, the tasks related to issuing the continuous professional development card and approving the fulfillment of this obligation have been taken over by the National Chamber of Paramedics – previously the card was issued by the competent voivode. This is a new contact address and a new document to track in the personnel files of every paramedic.
What this means for the provider when planning staffing and tenders
Compiling the four roles in one place, with the legal basis provided for each of them, allows avoiding a typical mistake – treating “staffing compliance with regulations” as a single, universal checklist. In practice, it involves four separate, independently changing elements: the PWZ status and entry into the register for paramedics, the validity of the continuous professional development card, the compliance of the P2 or P3 team composition with the decision made beyond the statutory minimum, and the validity of drivers’ permits for emergency vehicles, which expire after 5 years regardless of the rest of the medical documentation. When specifying a new vehicle – regardless of whether it is a type A ambulance for sanitary transport or a type B or C for work in a P or S team – the configuration of the medical compartment should directly result from who will actually work in it, and not the other way around. This is one of the places where vehicle selection and staffing compliance intersect, and therefore they should be considered together when planning the fleet.
FAQ
A sanitary transport team usually consists of a driver meeting the requirements for emergency vehicles and an orderly or a paramedic – the exact composition is determined by the physician ordering the transport and the terms of a specific contract with the NFZ, because sanitary transport is not subject to Art. 36 of the PRM Act.
The basic course for category B includes 6 hours of theory and 8 hours of practice ending with an exam, the supplementary course is shorter. The price depends primarily on the specific driving technique improvement center and the driving license category – in publicly available price lists, the difference between centers can be several times higher, which is why the real cost is worth checking directly at the chosen center, rather than assuming a single averaged amount.
Within the meaning of the PRM Act, both persons are a system nurse, but not all independent procedures are available identically to both paths. Some procedures, such as endotracheal intubation without a doctor’s order, are reserved by a separate regulation exclusively for specialists in anesthesiology and intensive care – for the provider, this means that when planning staffing, it is worth knowing not only “is this a system nurse”, but also which of the two paths a given person has completed.
They will lose the right to practice the profession without a formal document after January 11, 2029.
Yes – if someone on the team meets the conditions for driving an emergency vehicle from Art. 106 sec. 1 of the Act on vehicle drivers, a separate driver is not required.
