The problem was that the Fire Department of the City of New York (FDNY) shifted from a three-year recertification program to a fire-year continuing medical education (CME) program for its Emergency Medical Technicians (EMTs). The purpose was to examine the extension of recertification on EMT knowledge and skill retention, and potential impact on patient care. Descriptive research was employed utilizing questionnaires, an extensive literature review, and personal interviews to ascertain: certification alternatives; certification guidelines; model curricula; educational delivery components; CME versus patient care; cost/benefits of extended certifications; and testing significance. The recommendations included: adopting an evaluative timeline; redefining the program; substituting a challenge-type recertification; providing a format for CME drills; and creating an Emergency Medical Services (EMS) training officer/coordinator position.