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In order to perform delegated medical acts in the province of Ontario, Paramedics must be certified by a Regional Base Hospital Program (RBHP). The Centre for Paramedic Education and Research (CPER) provides such certification for Paramedics at the Primary and Advanced Care levels for a total of 9 EMS Service Operators in the Western Region of the province.

In order to receive initial certification, Paramedics must have successfully completed all requirements of a recognized Paramedic Program, and be in receipt of supporting documentation. Each Paramedic must also successfully complete the provincial certification exam at their respective level of care, as well as successfully complete an initial certification event conducted by an RBHP.

Paramedics attending a CPER certification event can expect to be evaluated on their ability to apply the provincial Medical Directives safely and effectively. Evaluation methods may include, but are not limited to, high fidelity simulation scenarios, skills stations, candidate interviews, and/or written evaluations.