The physical preparation of paramedicine students for the paramedic role: A scoping review

The paramedic role is physically demanding, yet limited attention has been given to how paramedicine students are physically prepared for practice within tertiary education programmes. The extent to which physical fitness standards and training are embedded in curricula, professional registration requirements or pre-employment testing remains unclear. This review explored how paramedicine students are physically prepared within tertiary education and whether student fitness levels meet the demands of the paramedic role in Australia, New Zealand, South Africa, the United Kingdom (UK), Ireland and Canada. A scoping review was conducted and reported following guidelines from the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Electronic databases (Medline, CINAHL, Scopus, ERIC, Emcare and Informit) and grey literature sources (university handbooks, policy documents and online domains) were searched, with searches completed in June 2025. Curriculum documentation from 51 universities, two organisation or college documents and nine relevant studies were analysed. Four universities (one in Australia and three in South Africa) in the six countries (Australia, New Zealand, United Kingdom, Ireland, Canada and South Africa) included in the review clearly embedded physical fitness training in their curricula. Most Australian institutions addressed fitness only as a requirement of work-integrated learning (WIL), typically mandated by placement providers. Internationally, South African programmes integrated sequenced physical preparation within curricula, while UK and Irish programmes applied entry screening prior to enrolment with manual handling training integrated within curricula. One study found that student fitness levels were comparable to the general population, but there is inconsistent data whether they meet all of the essential job demands of the paramedic role. There is limited and inconsistent integration of physical fitness information and preparation in paramedicine education. Embedding structured physical readiness frameworks into curricula may improve student support and preparedness for WIL. Future research should investigate validated physical fitness standards and strategies to ensure student readiness for the physical demands of the paramedic role.