First step- and easiest, but not EASY- is getting the certificates. Look for a school that you will attend regularly, whether it's an easy commute from your home, or somewhere that you will be able to live during course periods.
You also want a facility that has adequate resources to schedule and support the aircraft. One ship operations are fine as long as the aircraft is 100% otherwise you want a spare available. Same for instructors, they're not interchangeable. This is a hugely personal experience and personalities do occasionally clash, and it's good to have a second opinion when you encounter an issue of any sort.
Visit schools, talk to instructors and students, look at aircraft, and listen carefully to the sales pitch.
Commercial and instrument, or ATP required for hire. After 'school' you accumulate hours, experience and skills. My analogy is that your initial training is the foundation and your experience is the framework your career will be built in and on. HEMS isn't hard (except when it is) but it's not a job to build experience and skills at, most HEMS jobs don't fly enough to do that.
I think my employer is not unusual in experience requirements:
Visual Flight Rules (VFR) Program:
• 2000 total flight hours with minimum of 1500 flight hours in category
• 1000 hours PIC in category
• 500 hours of rotor wing turbine time
• 200 hours of cross-country flight time, at least 50 hours of which were at night
• 100 hours unaided night as PIC
• 50 hours total actual or hood instrument time in flight and in category (simulator time does not count)
Many, if not most pilots I work with have much more than the minimum experience.
'Getting there' could well take 5 - 10 years.
Edited by Wally, 30 May 2014 - 08:35.