The NREMT is no more an EMS Agency than the SAT tests are a school for children. NREMT's one responsibility is to ensure a basic level of knowledge and understanding of the material. Having taken the test and having passed it, I believe that it is a beneficial system to have in place. I know for a fact that I will not live/work in Santa Barbara, CA for my entire life, so it comforts me that when I decide to move out to a new place, my accredidation as an NREMT will follow me and assist in gaining reseprocity (forgive my spelling. I just woke up and the spell checker program is unavailable.) Canada and all Western countries with organized EMS systems should adopt a similar system, because lets face it... not all EMT programs are the same. In some, the training and hands-on is extensive... in others, merely basic. I sleep better at night knowing that I live in a county that requires all emergency responders to pass a proficiency test.