Objective: This study of paramedic and nursing/paramedic students aimed to determine the initial careerintentions of full-time paramedic students and to identify the key factors that influence their career choices.Design: A longitudinal study design, utilizing surveys and a focus group, was employed.Setting: The study was conducted in an Australian regional university with a large, on-campus paramedicprogramme.Method: Students were surveyed to ascertain the factors that shape their preferences for employmentand a focus group was conducted with final year students to further investigate the responses. Respondentswere asked to nominate their preferences for employment and identify key factors that influence theirdecision-making. Data were analysed using inferential statistics and textual analysis.Results: There were 509 questionnaires returned from 704 paramedic students (72 per cent responserate). Of the respondents 82 per cent were originally from New South Wales and the Australian CapitalTerritory, the balance from other States/Territories and overseas. Students' career intentions did notnecessarily follow their place of origin with 58 per cent preferring New South Wales or the AustralianCapital Territory, 17 per cent Victoria, 3.5 per cent other States, and 7 per cent indicating other employers.The identified influences on student career intentions were personal (53 per cent), professional (20 per cent),organizational (8 per cent), and community factors (3 per cent).Conclusion: Potential employers need to address graduate needs if they expect to attract the mosttalented graduates. Universities educating paramedics should focus on the needs of students and the profession.