Background <p>Paramedics play a vital role in pre-hospital emergency care, and their university education is critical to ensure professional competence. This study aimed to evaluate the adequacy and effectiveness of university-level education received by paramedics working in Emergency Health Services in Türkiye.</p> Methods <p>A cross-sectional descriptive study was conducted with 156 paramedics employed in 112 Emergency Health Services stations across Antalya. Data were collected via a structured questionnaire developed by the researchers. The survey was administered either in-person or online. Participants’ views on curriculum content, infrastructure, and self-perceived professional competence were analyzed using descriptive and inferential statistics.</p> Results <p>No statistically significant association was found between self-efficacy levels and core curriculum exposure (<i>p</i> = 0.247), simulation training (<i>p</i> = 0.174), written materials (<i>p</i> = 0.716), practice rooms (<i>p</i> = 0.665), or access to a training ambulance (<i>p</i> = 0.449). Nevertheless, many participants emphasized the need for more comprehensive and hands-on training, particularly in emergency scenarios, highlighting a gap between theoretical knowledge and real-world readiness.</p> Conclusions <p>Although theoretical instruction was generally considered sufficient, practical skill development was reported as inadequate by many paramedics. These findings suggest a need to enhance university paramedic programs by expanding simulation-based education and clinical internships to better align with field demands.</p>