Next month, another 300 firefighters will be trained to become first responders.
Once they complete their training, every municipality and borough on Montreal island will have a team of medically-trained first responders available in case of emergency.
The transition between firefighters and paramedics hasn't always gone smoothly.
But the multi-year training program has produced a truce and mutual respect.
Montrealers still are not used to seeing firefighters show up at the scene of an accident or medical emergency, but paramedics are used to the sight.
After two years of co-operation, the relationships are mostly settled, according to Operational Chief Rick Liebmann.
"The main goal of the first responders and our mission is to save lives so to get there and stabilize the patient but sometimes the way we help could simply be with assisting with medications, assisting with getting history from the family," said Liebmann.
Urgences Sante now receives 300,000 calls each year, and while firefighters will hand over primary care of a patient to paramedics, once on scene they can still be useful, such as by getting a medical history from family members.
Each first responder has 62 hours of basic training under their belts, and has been trained in using a paramedic's basic equipment, including automatic defibrillators and administering epinephrine for allergic reactions.