State Department: Alaska

State Department: Alaska

By Mike Rubin Sep 06, 2018

If you’re an EMS worker who is thinking of relocating or just wants to learn more about life across the U.S., EMS World’s new State Department is worth a look. Each month we’ll start with a featured state “snapshot,” then bring you exclusive guidance from local healthcare leaders. Our goal is to accentuate everyday aspects of potential destinations from a prehospital provider’s point of view.


  • Number of EMS providers: Approx. 1,100 EMT-1s, 1,500 EMT-2s and 3s, 500 MICPs
  • Average straight-time wages: EMT $10.99/hr., paramedic $32.40/hr.1
  • Cost of living index: 130.9 (U.S. average = 100)10
  • Recertification cycle: 2 years
  • National Registry state: Yes, for paramedics
  • Volunteering: Plenty of opportunities—65% of EMS providers are volunteer
  • Large EMS employers: Anchorage Fire, Capital City Fire/Rescue (Juneau), Fairbanks Fire, Kenai-area fire departments, air medical services
  • Paramedics with degrees: Not a priority
  • State EMS website: (protocols)
  • Population: Approx. 740,000
    • Change since 2010: +4%
    • Average population per provider: 239
  • State area: 665,000 square miles 
    • Average population per square mile: 1
    • Rank (↓): 50
  • Most populous cities: Anchorage (Approx.) 292,000, Fairbanks 32,000, Juneau 31,000
  • Violent crime one-year change: Anchorage +1%2
    • State violent crime rank (↑): 503
    • State property crime rank (↑): 483
  • Health rank (↓): 294
  • Top state income tax: None6
  • Average sales tax: 1.8%6
  • Average property tax: 1.02%6,7
  • Median home value: Approx. $308,0008
    • One-year change: +1%8
  • Median monthly rent: $1,6958
  • Electricity cost: $0.22/kwh9
  • Average temperatures: Summer 52ºF, Winter 3ºF5

Alaska Lifestyle

When Todd McDowell was growing up in New Mexico, his mother took him on cross-country road trips. A lot.

“Mom was a schoolteacher who believed in mixing education with recreation,” Alaska’s EMS manager recalls. “By the time I graduated from high school, I’d been to 40 states.”

That number is 50 now—a rare achievement and broad perspective for a man who considers Alaska the most beautiful state of all.

“It’s truly the last frontier,” McDowell says. “Once you’re outside Anchorage, it gets remote pretty quickly. Alaska’s the place to be if you like the outdoors.”

The outdoors in McDowell’s world includes 17 of the 20 tallest mountains in the U.S., 6,600 miles of coastline, 3,000 rivers, 3 million lakes and 100,000 glaciers—more than in the rest of the inhabited world. But even the breathtaking beauty of an unspoiled wilderness has a dark side—literally.

“I lived in Barrow (the northernmost city in the U.S., 350 miles above the Arctic Circle) for a number of years,” McDowell says. “The sun set at the end of November and didn’t rise again until January.

“Of course, you have the opposite in the summer: sunshine 24 hours a day. If you wake up at 3 in the morning, it looks like 3 in the afternoon. The sun just kind of spins around the sky.”

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Alaska EMS

If you’re getting the impression EMS in Alaska is pretty far from what most of us know, you’re right. McDowell offers this example:

“I flew medevacs from Barrow to Anchorage, where we have two Level II trauma centers. Most of you probably take relatively short flights in helicopters to get to definitive care, but up here you might need three hours by airplane. That’s like getting hurt in Billings, Mont., and ending up in Las Vegas.

“It’s a whole other world when the only way in or out is by plane or boat. Some of those places have only 50 or 60 people. They keep first-aid supplies at the community center and call each other when a neighbor needs help.”

McDowell credits volunteers for providing EMS in all but the most populous areas. “You have so many services that handle, say, 50 to 300 calls a year and can’t support full-time staff,” the 44-year-old paramedic says. “That’s why 65% of our responders are volunteers. We rely on them for EMS in most of the state.”

At the other end of the spectrum is Anchorage, Alaska’s largest city, where EMS is run by the municipal fire department. “They operate like any other urban fire service, and they’re real progressive,” says McDowell, “but if you’re looking to do EMS only, Alaska probably isn’t for you. The biggest employers—Anchorage, Juneau, and Fairbanks—want paramedics who are also firefighters.”

Alaska’s certification levels are a mixture of national standards and local terminology:

  • ETT (Emergency Trauma Technician) is a 40-hour course unique to Alaska.
  • EMT-1 corresponds to the national EMT rating.
  • EMT-2 is similar to the old EMT-I/85.
  • EMT-3 falls between EMT-I/85 and EMT-I/99.
  • MICP (Mobile Intensive-Care Paramedic) meets or exceeds National Registry paramedic criteria.

McDowell suggests incoming personnel do their job hunting before relocating. “The hiring process can take a while,” he warns. “Meanwhile, you’re paying for housing, which can be expensive.”

Despite Alaska’s cost of living, climate, and the logistical challenges of practicing medicine in regions with more moose than people, McDowell calls the state a good match for EMS providers with a sense of adventure. “If you like the outdoors and are looking for something different,” he says, “this can be the right place to settle down.”


1. EMS World. EMS World Salary Survey 2018,

2. FBI. Uniform Crime Reporting System, 2017 National Incident Based Reporting System,

3. Ibid., 2016.

4. America’s Health Rankings, United Health Foundation. 2017 Annual Report,

5. Current Results. Average Annual Temperature for Each U.S. State,

6. Tax Foundation. Center for State Tax Policy,

7. Ibid., Property Taxes Paid as a Percentage of Owner-Occupied Housing Value,

8. Zillow. United States Home Prices & Values,

9. Choose Energy. Electricity Rates by State in 2018,

10. Missouri Economic Research and Information Center. Cost of Living Data Series, 2018 Annual Average,

Mike Rubin is a paramedic in Nashville and a member of EMS World’s editorial advisory board. Contact him at

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