NRCME DOT Medical Examiner Training Curriculum

Module 1 – Introduction
Learn how to navigate the NRCME website, the MER and MEC forms.

Module 2 – Driver Medical History and Documentation
This module identifies the job-related stresses of operating a commercial motor vehicle (CMV). The duties specific to the certified medical examiner and commercial motor vehicle operator will also be discussed. This includes:

1. Requirements and ages of commercial drivers
2. What is “Determination Pending” and how to use it
3. How to navigate and complete the Medical Examination Report Form MCSA-5875
4. How to complete the Medical Examiner’s Certificate MCSA-5876

Module 3 – Vision & Medication Use
This module discusses the vision qualification requirements for the CMV driver. The learner will review critical components of the vision exam, diseases affecting the eye, and findings that may indicate a need for additional testing. The learner will also review how to identify possible medication side effects which may interfere with safe driving. The acceptable uses of controlled substances in the CMV driver are presented. Learn how to Bullet-Proof your medication use determinations.

Module 4 – Hearing, Hypertension, Heart Rate & Urinalysis
This module discusses common ear disorders and symptoms which may affect the ability to operate a CMV safely. The learner will review how to correctly administer acceptable hearing tests and identify passing parameters. The learner will also identify potentially disqualifying otic diseases. Learn how to properly assess a CMV driver for hypertension, inform and educate the driver about the effects of hypertension, and the potential impact of hypertension on a driver’s medical fitness for duty. The learner will identify how to determine driver qualification or disqualification status according to the FMCSA’s stages of hypertension. Proper use and documentation of the urinalysis test is presented.

Module 5 – Cardiovascular Assessment and Cardiovascular Disease
This module reviews FMCSA required components of the cardiovascular exam and cardiovascular diseases that may affect a driver’s medical fitness for duty. The medical examiner will identify modifiable and non-modifiable factors that may increase the driver’s risk for cardiovascular disease. The examiner will also identify symptoms and/or findings requiring further testing or medical opinion from a specialist.

Module 6 – Cardiovascular Disease Continued & Respiratory Exam
This module discusses the FMCSA regulations and guidelines concerning coronary heart disease, cardiac surgical interventions, cardiomyopathy, anuerysms and venous thrombosis. The examiner will review the required components of the respiratory history and physical exam.

Module 7 –  Respiratory Disease
This module discusses FMCSA identify common respiratory conditions found in the CMV driver including sleep apnea, obstructive/restrictive disorders, and infectious diseases. Also discussed are risks associated with medication classes used in pulmonary/respiratory therapy and their relation to safe driving.

Module 8 – Neurologic Assessment and Neurologic Disease
This module reviews assessment of neurologic function and disease in the CMV driver. The medical examiner will learn the various cognitive aspects of operating a CMV and apply these concepts when evaluating a driver’s medical fitness for duty. The learner will also study risk assessment factors in the driver with neurologic disease.

Module 9 – Diabetes Mellitus
This module reviews the challenges and safety issues associated with driving a CMV with a diagnosis of diabetes mellitus. The learner will identify common side effects of medications used to treat diabetes and potential safety issues for the CMV operator. Implications of end organ disease as a result of diabetes are also discussed.

Module 10 – Psychiatric Evaluation
This module reviews the relevance of psychiatric health and conducting a focused psychiatric exam on the CMV driver. The medical examiner will review specific mental health disorders and their potential impact on the driver operating a CMV.

Module 11 – Musculoskeletal Disease & Drug Abuse and Alcoholism
This module reviews the relationship between musculoskeletal health and the physical demands of operating a CMV. The medical examiner will learn FMCSA required components of a musculoskeletal health history and physical exam. Phamacokinetic interactions of medicines commonly prescribed for musculoskeletal disorders are also reviewed. This module also reviews the effects of drug and/or alcohol on ability to operate a CMV. FMCSA guidelines for medical examiners examining individuals suspected of substance abuse are discussed. Medical examiners will review how to qualify or disqualify a driver based on history of substance use.

Module 12 – Practice Scenarios 
This training course provides practice scenarios that helps to supplement and secure the learner’s knowledge.