The EMS stations should have training courses to take. Realistically, I'd put new staffers as EMTs and have them promote to Paramedic via a training academy course. Let alliances and other players make EMS academies and run courses like EMT (for firefighters that aren't on medical units), Paramedic (for faster treatment and transport times) and Rescue courses (i.e. High Angle Rescue, Critical Care, Ebola, etc.)
Those courses are realistic and should be set help a variety of units go faster, deescalate situations and maybe even change the casualty count when they arrive.