Hi Dominic
The good news is that it is possible to work in SA with American qualifications. The bad news is that the HPCSA won't tell us who can do what. They seem to decide on a case to case basis. You can contact them via their website to find out whether they will allow you to register as an ILS or ALS and whether you need to challenge some of our exams at some point and if so, whose.
www.hpcsa.co.za
Be warned: this takes time!
Good luck and we hope to see you some time!

My pleasure.
Please do stay in touch. Apart from the fact that we would very much like to know what the HPCSA tells you, it is also great to get perspectives from colleagues in other areas and compare protocols etc.
Good luck!

My attachments section is not functional yet, so I have also added another document I found from HPCSA outlining the requirements to work in SA for foreigners, under the downloads, general section....Hope it helps...click here --> Foreign Registration

An exchange program was brought up in a former discussion and it sounded like a lot of people would be interested.  The biggest concern was that you would be swopping a fully functioning paramedic for a ride-along medic...  on this side we are so short of paramedics that it might present a little bit of a problem to the big bosses.  Did anyone actually go and find out from their management whether it could be made to work?  If so, can I pretend to be a paramedic and go along!? 

I also work in a hospital that does a lot of training in trauma both for surgical registrars and paramedics.  If a swop from one hospital to another is on the cards I really don't think it's going to be difficult.  To ride along with the pre-hospital crews would in theory have to be arranged with an entirely different department, but we do them so many favours and know so many of the crews, that we might be able to call in a few favours to smooth the way... 

Thanks, Jmedic. That's very helpful. I just (finally) got my state license and shall be looking into this further.