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Our DOT Certification Training Course for Medical Examiners was designed by one of the original Subject Matter Experts who collaborated with the Federal Motor Carrier Safety Administration (FMCSA) to develop a curriculum, identifying the critical knowledge and skills needed for those performing DOT physical exams. This training thoroughly prepares  providers for the NRCME certification exam, instilling them with the knowledge to correctly apply the FMCSA driver physical qualification standards and guidelines.


Only $199
for a Complete NRCME DOT Training Package!

Medical providers eligible to sit for the national exam to become a Certified Medical Examiner are Doctors of Medicine, Doctors of Osteopathic Medicine, Doctors of Chiropractic, Advanced Practice Nurses, Advanced Practice Registered Nurses, Naturopathic Doctors, Doctors of Nursing Practice, Clinical Nurse Specialists, Nurse Practitioners and Physician Assistants. Acupuncturist in Florida; Doctor of Physical Therapy in Arkansas, Louisiana and North Dakota and Texas; Doctor of Oriental Medicine in New Mexico; and Registered Nurse in Colorado are all eligible to become certified Medical Examiners.

The above listed providers must meet the following criteria:

  • Possess a valid and current medical license, certificate or registration in the jurisdiction where they will perform these examinations, in accordance with applicable state laws and regulations;
  • Complete our accredited NRCME training course and obtain a Certificate of Completion.
  • Obtain a personal National Registry Number from the Federal Motor Carrier Safety Administration (FMCSA) by registering in the National Registry of Certified Medical Examiners.
  • Register and pass the NRCME Certification Exam from an FMCSA-approved testing organization.

The National Registry of Certified Medical Examiners (NRCME) is a Federal program that establishes requirements for healthcare professionals that perform physical qualification examinations and issue medical certificates for truck and bus drivers. To become a certified medical examiner (ME) and be listed on the National Registry, healthcare professionals must complete training and testing on the Federal Motor Carrier Safety Administration’s (FMCSA) physical qualifications standards and guidelines.

Becoming a certified medical examiner is easy. Just follow these steps:

1) REGISTER and complete our training program to obtain your Certificate of Completion, which is required for your application to sit for the NRCME Certification Exam.

2) Using this certificate of completion, apply for your account and 10-digit National Registry number on the National Registry of Certified Medical Examiners website located at    https://sfm.fmcsa.dot.gov/nrcme/register .

3) FMCSA will issue the 10-digit registry number and then verify your credentials. This process can take 1-3 weeks. Providers will only know they have been verified when they can schedule the national exam, no verification notice is sent out.

4) Use your National Registry number to schedule and sit for the $79 certification exam. Locate a local testing location to take your NRCME Examination (see https://nationalregistry.fmcsa.dot.gov/).  Pay the required fee and schedule your date and time. Be sure to bring the following items to the testing location:

  • A valid state issued picture ID
  • Valid license to practice in your healthcare profession
  • Certificate of completion provided by NRCME Training Online
  • Your National Registry Medical Examiner identification number

After Passing the FMCSA Medical Examiner Certification Test:

  • You will receive a Medical Certification credential valid for 10 years and be listed on the National Registry
  • As an NRCME examiner, you will now:
    • Report results of driver exams every month;
    • Submit to periodic monitoring and audits;
    • Maintain certification by completing periodic training every 5 years; and
    • Take and pass the certification exam every 10 years.

Review the Complete Guide to NRCME Certification.

The training program consists of 12 learning modules including vision, hearing, cardiovascular, hypertension, respiratory, neurological, musculoskeletal, diabetes, psychological, and substance abuse. Our video lecture format is easy to follow and guides the clinician through performing a thorough driver history, physical exam, and determining driver fitness to operate a commercial motor vehicle. At the completion of each training module a 26 question survey is administered.  Upon completion of the survey the trainee can print a certificate of completion qualifying them to sit for the National Registry Exam.

The TeamCME Online NRCME Training  program meets or exceeds core curriculum requirements as specified by the Federal Motor Carrier Safety Administration (FMCSA).

Training Includes:

  • 365 Days of access to NRCME training modules
  • 12 Hours of training webinars conducted by board certified physicians and nurse practitioners
  • Over 200 NRCME practice test questions, written by a NRCME Champion
  • Live phone support
  • Earn AMA PRA Category 1 Credits™  or PACE CE credits upon program completion
  • Print your certificate of completion online upon successful program completion

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.

For all the information on obtaining live NRCME training, [Click Here].

The following are sample NRCME exam questions that have been provided by the DOT/FMCSA:

Question 1:
According to FMCSA regulations, which of the following must the medical examiner evaluate when examining a driver’s eyes?
A. Pupil reactivity
B. Iris symmetry
C. Conjunctival injection
D. Corneal thickness

Correct Response:
A. Pupil reactivity
This is the correct response because it is the only option that is included on the Medical Examination Report Form for physical examination of the eyes. This is a cranial nerve test. A positive finding indicates a significant neurological problem that must be worked up or have an explanation that clarifies whether or not the driver has a condition that may interfere with the ability to safely operate a CMV.
Incorrect Responses:
B. Iris symmetry
This is incorrect because determining iris symmetry is not required by FMCSA.
C. Conjunctival injection
This is incorrect because most causes of conjunctival injection would not be disqualifying. Causes that are suspicious for a disqualifying condition need additional evaluation. While this abnormal finding should be explained, with determination of possible effects on safe driving before making a certification decision, it is not a condition that is specified in FMCSA regulations.
D. Corneal thickness
This is incorrect because it is not measured in an office examination except by an eye specialist.

Question 2:
According to FMCSA regulations, medical qualification for two years can be given to a driver who has
A. An SPE certificate for a left below the knee amputation (BKA).
B. Hypertension.
C. A recent diagnosis of Lewy body dementia.
D. Documented medical marijuana use for pain control.

Correct Response:
A. An SPE certificate for a left below the knee amputation.
This is the correct response because in order to obtain the SPE certificate, the driver had to demonstrate the ability to perform all tasks for the commercial driver job description.
Incorrect Responses:
B. Hypertension.
This is not the correct response because drivers with hypertension are only given a medical certificate that is good for one year.
C. A recent diagnosis of Lewy body dementia.
This is not the correct response because this is a progressive, degenerative condition with no known treatment. The effects of Lewy body dementia impact the ability to operate a CMV safely.
D. Documented medical marijuana use for pain control.
This is not the correct response because marijuana remains a drug listed in Schedule I of the Controlled Substances Act. It remains unacceptable for any safety-sensitive employee subject to drug testing under the drug testing regulations of DOT to use marijuana. Also, FMCSA medical guidelines state that “driving impairment due to marijuana use is well substantiated.”

Question 3:
During his visit to the medical examiner, a driver complains of severe pain in his finger for the last two weeks after it was punctured. The examination reveals an infected, swollen finger. After the medical examiner inquiries, the driver states that the pain is made worse when he grips the steering wheel. Which of the following should the medical examiner do next?
A. Obtain a hand X-ray.
B. Assess capillary refill in the hand.
C. Obtain a culture and sensitivity.
D. Assess the driver’s grip strength.

Correct Response:
D. Assess the driver’s grip strength.
This is the correct response because the condition does not present a safety risk unless it interferes with the ability of the driver to hold and control the steering wheel.
Incorrect Responses:
A. Obtain a hand X-ray.
This is not the correct response because this is a diagnostic test that a healthcare provider or specialist would perform or order. Your role as a medical examiner is to determine if the condition interferes with the ability of the driver to safely operate a CMV.
B. Assess capillary refill in the hand.
This is not the correct response because given the information in the question it is not the primary consideration for determining if the driver can safely operate a CMV.
C. Obtain a culture and sensitivity.
This is not the correct response because this is an action that a treating healthcare provider or specialist would do in the course workup and treatment- Your role as a medical examiner is to determine if the condition interferes with the ability of the driver to safely operate a CMV.

Question 4:
A new driver who had a myocardial infarction six months ago is certified after completing an acceptable exercise tolerance test and is cleared by a cardiologist. According to FMCSA guidelines, which of the following is recommended regarding recertification and exercise tolerance test monitoring intervals?
Recertification / Exercise tolerance
A. Every year / Every year
B. Every two years / Every year
C. Every year / Every two years
D. Every two years / Every two years

Correct Response:
C. Every year / Every two years
This is the correct response because according to FMCSA medical guidelines, when a myocardial infarction is part of the medical history, there is a significant increased risk for another myocardial infarction to occur within six months to a year; therefore, a maximum of one-year certification is the guideline. Myocardial infarction guidelines also recommend exercise tolerance testing at least every two years to demonstrate continued ability to safely operate a CMV.
Incorrect Responses:
A. Every year / Every year
This is not the correct response because the FMCSA medical guidance is to obtain an exercise tolerance test every two years. In this question, there is nothing to indicate that more frequent testing is necessary.
B. Every two years / Every year
This is not the correct response because it reverses the guidelines. Even if you do not recall the recommendation, logically, one would eliminate this option because having the driver obtain a test every year and then waiting for up to a year to review the test results is not reasonable when unacceptable test results indicate the driver may not be able to safely operate a CMV.
D. Every two years / Every two years
This is not the correct response because the guideline is to recertify every year. Even if you do not recall the actual guideline, one would logically eliminate this option because this is the maximum recertification period for a driver who meets all qualification requirements. It is appropriate that a driver at increased risk for an incapacitating cardiac event should be monitored more frequently.

Question 5:
A 46-year-old male driver presents for recertification. He has a history of chronic gastro esophageal reflux disease (GERD). He takes esomeprazole (Nexium) and over-the-counter cimetidine (Tagamet). He states that he feels fine, but has trouble finding foods that do not trigger his GERD when he is on the road. Which of the following should the medical examiner do first?
A. Disqualify the driver until he has a nutritional consultation.
B. Certify the driver and advise him to carry non-triggering foods in a cooler.
C. Contact the driver’s physician and request an upper GI study.
D. Correlate the GI history findings with the abdominal examination.

Correct Response:
D. Correlate the GI history findings with the abdominal examination.
This is the correct response because given the information in the question; a medical examiner would need to examine the driver before having sufficient information about the health of the driver to consider any of the other options.
Incorrect Responses:
A. Disqualify the driver until he has a nutritional consultation.
This is not the correct response because until completion of the examination, there is insufficient
information to make a certification decision. In addition, there is no regulation or medical guideline that requires a nutritional consultation in order to be certified.
B. Certify the driver and advise him to carry non-triggering foods in a cooler.
This is not the correct response because until completion of the examination, there is insufficient information to make a certification decision.
C. Contact the driver’s primary care provider and request an upper-GI study.
This is not the correct response because until completion of the examination, one does not have sufficient information to make a referral decision.

Question 6:
A 25-year-old female driver denies a history of any medical problems. She is a non-smoker who exercises regularly without symptoms. The medical examiner auscultates bilateral wheezes during the examination. The driver’s SpO2 is 90 percent in the medical examiner’s office. The rest of the examination is normal. The driver should be
A. Temporarily disqualified pending results of a cardiac workup.
B. Qualified since she has no cardiac symptoms.
C. Temporarily disqualified until further evaluation.
D. Qualified because her O2 saturation exceeds the minimum.

Correct Response:
C. Temporarily disqualified until further evaluation.
This is the correct response because the driver has a non-diagnosed respiratory or thoracic illness that might interfere with the ability to safely operate a CMV. The driver should not be certified until the etiology is confirmed and treatment has been shown to be effective, safe, and stable. Also, according to FMCSA medical guidelines, a SpO2 of less than 92 percent warrants obtaining an arterial blood gas analysis.
Incorrect Responses:
A. Temporarily disqualified pending results of a cardiac workup.
This is not the correct response because while it is correct that the driver should not be certified, there is nothing in the question data that indicates evaluation should be limited to the heart.
B. Qualified since she has no cardiac symptoms.
This is not the correct response because the information in the question does not provide sufficient data to rule out the presence of a disqualifying cardiac or other thoracic problem.
D. Qualified because her O2 saturation exceeds the minimum.
This is not the correct response because according to FMCSA guidelines, a SpO2 of less than 92 percent warrants obtaining an arterial blood gas analysis.

The National Registry was developed to improve highway safety and driver health by requiring that medical examiners be trained and certified to determine effectively whether a commercial motor vehicle (CMV) driver’s health meets FMCSA standards. This supports FMCSA’s goal to improve safety and reduce fatalities on our Nation’s highways. Testing and training organizations play a vital role in achieving this goal by educating medical examiners about FMCSA medical standards for CMV drivers, and enhancing their understanding of the mental and physical demands of operating a CMV to help determine if a driver can safely handle these demands.

Medical providers who completed a different training program and already have their Certificate of Completion but are seeking additional NRCME study materials and sample questions to prepare for the national certification examination can purchase our program’s additional reference materials for $99 by clicking here.

Click on a testing organization below to access their site and schedule your exam appointment. Locate a local testing location to take your NRCME Examination.  Pay the required fee and schedule your date and time. Be sure to bring the following items to the testing location:

  • A valid state issued picture ID
  • Valid license to practice in your healthcare profession
  • Certificate of completion provided by NRCME Training Online
  • Your National Registry Medical Examiner identification number

Testing Organization Websites

Comira Testing http://www.comiratesting.com/

Prometric https://www.prometric.com/

PSI Exams https://candidate.psiexams.com/

The exam fee is $79

Certified Medical Examiners are certified for 10-years from the original certification date. The FMCSA will provide the required (5) five-year refresher training online to Medical Examiners at no cost. Medical Examiners eligible to take the (5) five-year periodic online training will be notified by email from the FMCSA.