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About the NRCME Exam

The National Registry of Certified Medical Examiners (NRCME) examination is the final step for medical providers seeking to become certified Medical Examiners in the DOT/FMCSA NRCME program. Once certified, a medical provider can perform commercial driver license (CDL) examinations on commercial motor vehicle (CMV) drivers in all the states the provider is licensed to practice in for a period of 10-years. Re-certification is required 10-years from the original certification date.

Exam Eligibility

Candidates eligible to sit for the national exam to become certified Medical Examiners include MD, DO, DC, APN, APRN, NP and PA medical providers. All candidates must complete an accredited training program first, which will afford them a Certificate of Completion. Candidates can then apply for an account with the DOT/FMCSA and will be assigned a 10-digit National Registry number once they have been verified by the DOT. The exam is administered in person and by appointment through Prometric and PSI testing companies, which have locations nationwide and offer Saturday morning testing in most locations. Comira, which is listed on the FMCSA website as a testing company, was acquired by PSI in late 2016. The cost of the exam is $80 and can be scheduled online by candidates using their 10-digit National Registry number issued to them by the DOT. Candidates must bring their Certificate of Completion with them the day they sit for the exam, in addition to presenting a valid state-issued photo ID and a copy of their current medical license.

Exam Content

The 2-hour NRCME exam consists of 120 questions, where 20 questions are pilot questions that are not graded, and the candidate will not know which test questions are the pilot questions and which questions are the actual test questions. Of the remaining 100 questions, 60-70% are from the outline specified by the NRCME and must be followed by all training courses. The remaining 30-40% are clinical questions that test the user's general medical knowledge, as well as testing the user's understanding of the unique role of the medical examiner in contrast to the role of treatment providers. The exam is closed book and administered on a computer. Candidates will be notified of their exam score upon completion and must achieve a 71% to pass. The DOT will email providers their final certificate once they have received the passing score from the testing company, which can take up to 3 weeks.

Medical providers who do not pass their NRCME national exam no longer have to wait 30 days to reschedule. This applies to both initial certification and 10-year recertification. As soon as the FMCSA receives the failing notice from the testing company, they will update the provider's FMCSA account, a process that may take up to 7 days. Once the update is complete, the provider can promptly reschedule their next exam. For more information, please contact the FMCSA directly at or by phone at (617) 494-3003.

An excerpt from our course "Preparing for and Passing the National Certification Examination", included in our accredited training program:

“It is crucial to understand that the FMCSA is expecting the Medical Examiner to act in the role of determining driver fitness for duty and that the decisions the Medical Examiner should make should consider that responsibility and perspective. During the test, you must answer the questions from the Medical Examiner's perspective first and foremost, not from the perspective of a treating clinician. Even so, some of the questions will be about clinical scenarios that may have little or only a passing reference to specific regulatory requirements or guidance recommendations. You will be asked what the next best step is for the Medical Examiner to take, or the most appropriate next action, and the answers will not always be what you think they should be if you were not given those specific choices.

It’s also important to use test-taking strategies. All of the questions are 4 choice multiple choice with a single answer. The computerized testing system will allow you to eliminate specific choices to narrow the correct answer from 4 to 3 to 2, and to flag questions that you are not sure about and want to return to. There are 120 questions on the test, 100 of which are for the examination and 20 of which are questions that the FMCSA is trying out as possible questions for future tests, but you will not know which are the actual test questions and which are the “pilot” questions. You must answer all 120 questions. You will have 2 hours to complete the test, so 1 minute per question. The strategy usually recommended for test taking is to move quickly through the test, marking questions to come back to, using the computerized system to eliminate incorrect choices, and giving yourself enough time after going through the entire test to go back to the questions you were not sure of.

The test is closed book – no study materials will be allowed. On arriving at the testing center you will remove everything from your pockets and will be allowed to bring nothing into the computer testing area – no cell phones, no pens or paper, nothing, and you will be wanded to make sure you have no such items. A passing score is 71%; at the conclusion of the exam, the exam will be immediately scored and you will receive your % correct.”


What to do when you are not able to schedule the NRCME exam: 

It is likely that the DOT/FMCSA are backlogged, causing delays in provider credential verification. In 2014, there were over 17,000 providers who became certified. The remaining years had, on average, 2,500 providers a year certifying. If only half of the initial crowd from 2014 are recertifying, that would still be a larger than normal amount of providers the NRCME have to verify before allowing them to schedule the exam. To further complicate matters, many of the providers from 2014 became certified shortly before the May 14 start of the program and did so to avoid any disruption of commerce.
If you uploaded your PDF training certificate of completion into your DOT account, and manually input the training company name and address, and the accrediting organization’s name (both listed on your training certificate), and checked the box that this was “online” training and not “in-person” training, and if it has been more than 24 hours since you have completed all of these tasks and still cannot schedule the national exam online, you will need to:
1. Call the FMCSA between the hours of 9am to 5pm EST, M-F, call the FMCSA at (617) 494-3003 – press option 2 when the first greeting starts, then press the number 6 on hearing the start of the second greeting. This will bypass lengthy greetings and they will answer if they are not already on the phone.
2. Compose an email to the FMCSA requesting verification to schedule the exam and send it to
3. Attempt to schedule the exam at the end of every business day. You will know you have been verified when you can schedule the exam.


Blog entry discussing Hypertension on the exam:

Blog entry discussing Hypertrophic Cardiomyopathy on the exam:

Testing Options: PSI or Prometric?
NRCME Exam Testing in Hawaii
NRCME 10-Year Recertification
Scheduling Your Recertification Exam
A Tale of Recertification

Enroll in the NRCME Training Institute today or purchase our $99 NRCME Exam Reference Materials. Call us at (941) 600-8411 for more program information and for any current single provider enrollment discounts.

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10-Year Recertification Notice

Certified Medical Examiners on the National Registry are required to be recertified no sooner than 9 years and no later than 10 years from the date of issuance of their medical examiner certification credential. Recertification requires that providers complete an accredited training program such as ours and pass the in-person national NRCME certification examination.

Call (941) 600-8411 for a single-provider discount.