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The Flight Paramedic Certification (FP-C) is an advanced certification that indicates an individual has attained the designation of Certified Flight Paramedic. The FP-C certification exam is administered by the International Board of Specialty Certification (IBSC) and the Board for Critical Care Transport Paramedic Certification (BCCTPC), a not-for-profit organizations responsible for the administration and development of specialty certification exams for critical care professionals. The test is administered by PSI and Applied Measurement Professionals (AMP) to assure compliance with the highest testing standards. This certification is designed to be successfully approved only for experienced paramedics who have demonstrated advanced knowledge of critical care medicine by passing an exam consisting of 125 scored items and 10 unscored items within a 2.5 hour window. As of February 22, 2018 there are 6458 certified flight paramedics worldwide, 494 of whom hold dual certification as a CCP-C. The FP-C, or CCP-C, and/or Critical Care Emergency Medical Transport Program (CCEMTP) certifications are often a requirement to work as a flight paramedic in the United States. The FP-C does not have an associated course, unlike the CCEMTP, although review courses and study guides available. The FP-C is considered comparable in difficultly to the Critical Care Paramedic Certification (CCP-C). Experience in the air medical or critical care transport fields is recommended before attempting to take the exam. However, there is no minimum education component required, and the examination does not require minimum years of experience, therefore new paramedics who have just completed school are eligible to take the exam and receive certification. In addition, there is no practical skills test associated with the examination, unlike the NREMT paramedic exam. Many agencies may require prospective employees to demonstrate practical competency in other courses (TPATC, ATLS-audit, CCEMTP, etc.) prior to being considered for employment. A candidate must hold a current paramedic license and have active certifications in Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), Prehospital Trauma Life Support (PHTLS), and other advanced certifications.