Yes, I'm an Emergency Medical Technician - Basic (EMT-B, or EMT for short), which is kind of like an entry-level Paramedic (technically termed EMT-P, everyone says Paramedic). What Paramedics can do that I can't are mainly administer a bunch of different drugs through an IV (I can only give a few drugs, and only orally or by direct injection), and manually defibrillate someone with severe heart problems with (I can only use an automated difibrilator, which is computerized and decides on its own if and when to shock, and can only deal with certain types of heart problems). Also, Paramedics can intubate (put a tube down your throat to help you breath), and I can't, although I can stick a tube into your mouth or up your nose to keep your airway open. I can stop your bleeding, be it a paper cut or arterial squirting; I can splint a broken finger or a broken thigh with the bone sticking out through the skin; I can deal with amputations, avulsions (near-amputation, part hanging on pretty much by skin or some tendons), poisoning, cessation of breathing or heartbeat, evisceration (your guts are hanging out your opened belly), eyes popped out of your head, gunshot and stab wounds, motorcycle accidents, fetuses that want to become newborn babies...some of that requires a full Paramedic, some doesn't, but anything that requires a Paramedic I can at least keep stable until they arrive if I get there first.
As an EMT, I work for a private ambulance company, and I volunteer at a local volunteer fire station. These are completely separate. Private ambulance companies mainly handle patient transport between medical facilities (hospital to hospital, or hospital to nursing home or the other way 'round). These patients have some kind of medical condition that prevents them from going by their own car or someone else driving them in a regular car. Private ambulance patients may also be people who are semi-permanently (or permanently) residing in a nursing home and they need to go to a doctor's office (eye, dentist, whatever) for a regular checkup, to a dialysis center for dialysis, or some other specialty care center. The vast majority of patients transported by private ambulances are what we call routine or mundane; there is very little excitement here, very little actual EMT skill use other than taking vital signs. On the other hand, fire departments (career/paid, or volunteer) handle the 9-1-1 calls for an ambulance, and they see it all. These are the guys responding to traffic accidents, shootings, women unexpectedly in labor, whatever. I am a member of a volunteer fire department as an EMT (just because it's called a fire department, it doesn't mean that every member is a fire fighter; some, like me, can be EMT only) as well as working for a commercial private ambulance company. I do not drive the ambulance for the volunteer fire department, because I do not have an Emergency Vehicle Operator certification, but I do drive an ambulance at my paying job, because commercial ambulance company drivers are not required by law to have that certification, although they are trained by the company they work for.
Not every EMT can drive an ambulance, and not every ambulance driver is an EMT. Two certification are required as a minimum to drive an ambulance in this state: First Responder (FR), and Emergency Vehicle Operator (EVOC, the C standing for Certified, which everyone says although it isn't actually part of the title). A First Responder is someone with about half the training of an EMT, and includes very basic life support and trauma care. An FR cannot ride in the back of an ambulance alone with a patient. FRs typically are not of much use in metropolitan areas where response to a 9-1-1 incident is typically a matter of a few minutes. FRs are of great use in more rural areas, where the nearest fire station may be more than twenty minutes away. FRs typically respond from their home in their own car, showing up at an incident well ahead of the ambulance, and they keep the patient alive until actual EMTs arrive. Because the driver of an ambulance obviously is not taking care of the patient in the back, it is considered the minimum certification to drive the ambulance; the reason why any certification at all is required is so that the driver can assist the EMT when they first arrive and get the patient ready to transport ("packaging the patient"). The EVOC is a 24-hour-long course (not all at once, of course), about half of that is class and the other half is driving on a closed course. Proficiency is demonstrated by driving around a laid-out course defined by orange traffic cones, in many spots barely wider than the vehicle; the circuit must be completed within a certain amount of time, and includes backing up, serpentine paths and lane changes, and multi-point turn-arounds.
For the record, when I said earlier that an ambulance should only transport a patient with lights and sirens if that patient is dying, that wasn't quite entirely accurate. The actual standard is that they must be in danger of losing life or limb.
Also, of course, most of what I said is correct for Maryland, USA, and may or may not be the same in other states or countries.
