The Emergency Medical Service noted that Pupule was an outstanding specialist in healthcare management and made a significant contribution to the development of the emergency medical care system in the country. She began her professional career as a nurse's aide and nurse, later working as a therapist at the Mazsalaca Hospital and as an emergency room physician at the 7th Riga City Clinical Hospital. In the following years, Pupule held leadership positions in healthcare. She was the deputy director of the Health Department of the Riga City Council and the Riga Regional Hospital Fund, headed the Health Department of the Ministry of Welfare, and then served as an advisor to the state secretary of the Ministry of Health and director of the Strategic Planning Department. From 2004 to 2009, Pupule headed the Operational Medical Service of the Disaster Medicine Center. After the establishment of the unified Emergency Medical Service in February 2009, she became its first director. The creation of the EMS was one of the largest reforms of the emergency medicine system in Latvia, uniting previously fragmented ambulance services into a single structure. Later, Pupule continued her work in the EMS as the deputy director, remaining one of the key specialists in the development of the service. Colleagues remember Renate Pupule as a professional who played an important role in shaping the modern emergency medical care system in Latvia.