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The pre-hospital environment presents significant challenges for novice post-graduate degree paramedic interns as they transition from college into the workforce. Interns are required to perform in high-pressure situations, making critical clinical decisions related to patient care and transport. Although the first year of the paramedic program provides a solid academic foundation, these interns remain early in their professional development. They must now bridge the gap between theory and practice, continually refining their clinical skills and judgment in fast-paced, real-world scenarios. This study explores the experiences of post-graduate interns, as they transition from college into the workforce as part of a two-person ambulance crew within the National Ambulance Service of Ireland. A quantitative survey was designed containing 15 items, including Likert-scale and open-ended questions. The survey was reviewed and piloted before being disseminated to the target population of 243 participants. The survey was conducted online between May and June 2024. A total of 53 students took part in the survey. The participants found that the first year of the paramedic degree programme prepared them to manage the following emergencies; trauma 86.8%, medical 92.5%, maternity 58.3%, paediatrics 67.9%, dealing with the elderly population 81.2%, non-urgent low acuity calls 54.7%, dealing with mental health emergencies 41.2%. Participants identified various levels of confidence in starting their post-graduate internship and 98% would have liked to have some clinical support. The majority of participants believe that a form of mentorship would be beneficial during their internship with 26% stated support should last for 1–6 months, 38% 7–12 months, with 36% stating support should be for greater than 12 months. 44% of participants began to feel confident in their interactions with patients within 2–4 months, and 40% within 5–12 months. There were 91% of participants who were confident in their ability to assume the clinical lead role at the end of their internship. Of all participants, 96% stated that having life experience before starting the post-graduate internship is beneficial. This survey examined the experiences of post-graduate paramedic interns as they transitioned from college into the workforce with the National Ambulance Service of Ireland. While the first year of the program provided a strong theoretical foundation, interns identified key gaps in their training most notably in the area of mental health emergencies, which was considered significantly underrepresented compared to other curriculum components. Participants also highlighted the value of prior life experience in developing the resilience needed for the role. Importantly, all respondents expressed a clear need for a structured clinical support framework to support a smoother and more confident transition into professional practice. Not applicable.