DOT Certification Training
for Chiropractors

Neurological Exam

• Key Assessment Areas (e.g., Reflexes, Sensory, Motor Function)
• Nerve Roots and Myotomes

Seizure Disorders

• Non-Discretionary Seizure Guidelines
• Single Provoked vs. Unprovoked Seizures
• Epilepsy
• Federal Seizure Exemption

Headaches, Vertigo, and Dizziness

• Types of Headaches
• Incapacitating Symptoms and Driving
• Meniere’s Disease

Infections and Tumors of the CNS

• CNS Infections
• Central Nervous System Tumors

Static Neurological Conditions

• Embolic and Thrombotic Stroke
• Transient Ischemic Attack (TIA)
• Intracerebral and Subarachnoid Hemorrhage

Traumatic Brain Injury

• Types and Severity
• Cognitive and Physical Impairments

Practice Quiz – 4 Questions

Psychological (Mental) Disorders

• Medical Advisory Criteria
• Key Risks for Driving Safety
• Evaluation Criteria for Certification

Psychiatric Medications

• Antidepressants and Antipsychotics
• Anxiolytics, Stimulants, and ECT
• Considerations for Medication Side Effects

Mental Health Conditions

• ADHD
• Bipolar Disorder
• Major Depression
• PTSD
• Personality Disorders
• Schizophrenia and Related Psychotic Disorders

Cognitive Disorders

• Dementia and Alzheimer’s Disease

Practice Quiz – 4 questions

Medication Standard

• Controlled Substances and Schedule I Drugs
• Prescription Exception Criteria
• Prescription and OTC Medication Assessment

Drug Testing Requirements

• Types of Testing (Pre-Employment, Post-Accident, etc.)
• Substance Abuse Resources (MRO, SAP)

Marijuana, THC, and CBD

• THC Limitations and Federal Regulations
• CBD Products and Non-DOT Drug Testing

Alcohol Abuse

• Evaluation and Screening (e.g., CAGE Questionnaire)
• Certification Considerations and SAP Involvement

Practice Quiz – 4 questions

Our training exceeds the FMCSA core curriculum and covers everything you should know as a medical examiner. This is not necessarily the same as what should be known for the test. These insights were created to help to span the gap.

For each subject, we provide additional points and things to review that you are likely to see on the certification exam.

There are 270 practice test questions and two sample NRCME exams of 120 questions that mirror the questions on the certification test. Each question is accompanied with an explanation.

The questions are specifically constructed to challenge your preparedness and augment your ability to pass the actual certification test.

Now that you’ve completed the course, what’s next? This lesson is an outline that guides you through each step.

•  Downloading Your TeamCME Certificate of Completion
• Creating a National Registry Account (if not already created)
• Uploading Your Certificate onto the National Registry
• Registering for the Certification Exam
• Obtaining Your National Registry Certificate

Your training certificate will be generated immediately upon completion of the course evaluation.

Yes. Chiropractors are eligible to become FMCSA-certified medical examiners and can perform DOT physicals in nearly every state. The only exceptions are New York, Michigan, and Washington, where scope-of-practice laws prohibit chiropractors from providing DOT exams.

FMCSA recognizes chiropractors, along with MDs, DOs, NPs, and PAs, as qualified providers once they complete NRCME training and pass the certification exam. According to Dr. Joseph Sentef, former FMCSA Chief Medical Officer, chiropractors perform DOT certification exams with the same competency as MDs, DOs, and NPs.

For most chiropractors, getting certified means you can offer DOT exams as a federally required service that every commercial driver must have. It creates steady demand, brings in a reliable stream of extra income, and takes less physical effort than performing adjustments. Many chiropractors also find that working with drivers leads to new patients who return later for care beyond the exam itself.

Yes. This training includes 7 hours of PACE-approved CE credit. Most states accept PACE, but a few do not. In non-PACE states, chiropractors may still be able to self-report or count the credit depending on their board’s policies. Because rules vary, we recommend checking your state board’s guidelines.

The total cost is about $278 – $199 for NRCME training and a $79 exam fee at a Prometric or PSI testing center.

What makes TeamCME different is who built the course. It was developed by Michael Megehee, DC, who was appointed by the FMCSA in 2005 as a subject matter expert on the teams that created the original core curriculum for NRCME training. He also wrote test questions used on the NRCME certification exam.

Thousands of chiropractors have trusted TeamCME not only because our price is fair, but because our training comes directly from one of the doctors who helped shape the national certification process.

With enrollment, you also get CE credit, 1 year of access, practice exams, and a completion certificate- everything you need to prepare confidently, without the downtime and added expense of live training.

The training itself takes about 5 hours to complete, plus a couple of extra hours if you go through the included practice tests. Once you finish, you’ll immediately receive your completion certificate and can apply for your FMCSA National Registry Number.

After you receive your registry number, FMCSA requires a 24-hour wait period before you can schedule the NRCME exam. From there, the timing depends on Prometric or PSI test center availability. Some chiropractors can book within a few days, while others may wait a couple of weeks depending on location.

Once you’ve passed the exam, you’ll be added to the National Registry of Certified Medical Examiners after FMCSA verifies your medical license. Most chiropractors are fully listed within a few weeks of completing training, though processing times and test center schedules can vary.

Becoming a certified medical examiner is straightforward. Here are the steps:

1. Complete NRCME Training from an FMCSA-compliant provider (like TeamCME). Then download your certificate of completion.

2. Apply for your FMCSA Registry Number. Use your certificate to apply for an account and receive a 10-digit National Registry number at the FMCSA National Registry website.

3. Schedule and pass the NRCME Exam at a Prometric or PSI testing center.

4. Stay current by completing FMCSA refresher training every 5 years and recertifying at 10 years.

Our training was built by Michael Megehee, DC, who served as a subject matter expert for FMCSA when the original NRCME curriculum was developed and contributed questions for the certification exam. That means you’ll be fully prepared for the real test, with training created by someone who helped create it.

Certified Medical Examiners (MEs) are certified for 10 years from the original certification date. During their ninth year of certification, they must take a recertification training and pass the National Registry certification test.

There is also a required 5-year periodic training which the FMCSA provides online at no cost. This is made available for free online through the medical examiners National Registry account. This must be completed during the fourth year of certification.

A DOT exam usually takes about 30 minutes and pays $85-$120 on average. That equals an effective hourly rate of $170-$240.

A typical chiropractic adjustment may take 12-15 minutes and bring in $40-$60, which often works out to less per hour- and it’s more physically demanding over time. DOT exams are a way to bring in steady income while reducing the wear and tear of daily adjusting.

There are 9 video modules totaling about 4.5 hours plus two lessons that take about 30 minutes. The course is 100% online and self-paced. Your progress is saved, you have 1-year access, and you can review the videos, documents, practice questions, and sample NRCME exams as many times as needed. Practice exams simulate the 2-hour certification test.

Your training certificate will be available to download immediately after you complete the final module and short training evaluation inside the course. You’ll find it in your training portal. This certificate is what you’ll use to apply for your FMCSA National Registry Number and move on to scheduling your NRCME exam.

If you do not pass on your first attempt, you can retake the NRCME exam with an approved vendor, potentially as soon as the next day if an appointment is available, and there is no limit on retakes.

TeamCME offers a pass guarantee: if you complete all modules, quizzes, both practice tests, and bonus questions, take the NRCME exam within 1 year of registration, and submit your score report, we will refund your $79 exam sitting fee (one-time refund).

You’ll have 1 full year of access to complete the training, which is more than enough for most providers. But we also understand that life and practice get busy. If you’re near the end of your training and need a little extra time, just reach out- we’ll work with you rather than cut off your progress.