Dr. Roth started his career in EMS as an EMT with the University Ambulance Service at Penn State. He continues to pursue his interest in prehospital care serving as the Medical Director of the City of Pittsburgh, Department of Public Safety and the Allegheny County Emergency Operations Center. He also serves as the Medical Director for the Dick's Sporting Goods/Pittsburgh Marathon. He serves as an Emergency Medicine consultant for the Pittsburgh Steelers Football Club and the Pittsburgh Penguins.

As director of the newly accredited EMS Fellowship at UPMC, Dr. Roth helps guide physicians through their training to become EMS physicians. He has collaborated with prehospital care providers and emergency medicine researchers on numerous studies looking at the prehospital aspects of acute cardiac interventions, quality improvement, and medical care at marathons.

Dr. Roth is board certified in Emergency Medicine and the subspecialty of Emergency Medical Services.