NRCME Recertification Training
FMCSA-Compliant Training for Medical Examiners that Meetsย All National Registry Requirements for 10-Year Recertification
Developed by Dr. Michael Megehee โ one of only ten experts selected by the FMCSA to help create the original NRCME examiner training standards.
Refresh your FMCSA Core Curriculum knowledge and prepare confidently for your NRCME recertification exam. Complete your recert training 100% online, at your own pace, with full 1-year access. Earn 7 AMA PRA Category 1 Creditsโข or 7 PACE Chiropractic CE hours.
- ๎ณTrusted by 28,000+ medical professionals
- ๏Earn 7 Continuing Education Hours
- ๏Pass the NRCME exam or we'll pay your test fee
- ๏98% said this training prepared them to pass the exam
Important: This Training Is for Medical Examiners Renewing Their NRCME Credentials
If you are a driver looking to renew your DOT medical card, please visit our DOT physical page. This training is specifically for certified medical examiners completing their FMCSA-required 10-year recertification.
Why Choose TeamCME for Your NRCME Recertification Training?
TeamCMEโs founder, Dr. Michael Megehee, was selected by the FMCSA as one of only ten experts nationwide to help create the original NRCME examiner training standards – a level of expertise unmatched by other providers. Itโs one reason more than 28,000 medical professionals rely on TeamCME for NRCME training.
Our recertification course was the first to incorporate updates from the 2024 Medical Examinerโs Handbook. It focuses on the areas examiners tend to misremember or struggle with when preparing for the NRCME exam. Youโll revisit essential clinical decision-making scenarios, reinforce key judgment calls, and ensure youโre applying FMCSA guidance correctly.
With TeamCME, youโre not just taking training to renew your NRCME credentials – you’re ensuring that your DOT physicals are being performed correctly.
Ready to train with the experts who helped write the rules?
What’s Included
7 Continuing Education Credits
Earn AMA PRA Category 1 Creditsโข, ANCC, ACCME (Equal to AANP) or PACE CE credits.
1 Year Online Course Access
Includes 11 modules with in-course knowledge checks designed to prepare you for the exam and real-world DOT physicals.
Sample NRCME Exams
290 practice test questions & two sample NRCME exams that mirror the real certification test . Unlimited retakes included.
TeamCME Medical Examiner Reference Manual
Downloadable guide to use while studying and as a quick reference during physical exams
CE Credits Included With Your Recertification Training
This course includes 7 hours of continuing education and will be issued upon completion of your training.
For Physicians & Physician Assistants:
Earn 7 AMA PRA Category 1 Creditsโข
For Nurse Practitioners:
Earn 7 AANP-equivalent credits
For Chiropractors:
Earn 7 PACE-approved Chiropractic CE hours
NRCME Recertification Course Curriculum
There are 9 video modules in this course, 2 lessons, and practice tests that will leave you feeling well-prepped for passing the NRCME exam so you can renewing your NRCME credentials and keep performing DOT physicals.
Continuing Education Credits for NRCME Certification
This is the information we are required to provide in order to offer continuing education credits for NRCME certification.
Whatโs included
- Faculty
- Educational Objectives
- Entities providing the CE credits
- Method of Participation and Certificate of Completion
- Disclosure of Conflicts of Interest
- Hardware & Software Requirements
- Disclosure of Unlabeled Use
- Disclaimer
Introduction, Definitions, & Forms โ 50 minutes
FMCSA Overview
- Functions and Structure
- Office of Medical Programs
Regulations vs. Guidelines
- Definitions and Differences
- FMCSA Medical Examiner Handbook
Federal Motor Carrier Safety Regulations (FMCSRs)
- Driver DOT Medical Certification Requirements
- Important FMCSA Regulatory Definitions
Driver Qualifications
- CDL Licensing and Medical Certification
- Motor Carrier Medical Standards
- Compliance Requirements
- Driver Hours of Service
Interstate vs Intrastate Commerce
- Definitions
- Which drivers need a DOT physical exam?
- Issuing a Medical Examinerโs Certificate
DOT Medical Examinerโs Responsibilities
- Qualifications and Examination Protocols
- Determination Pending Guidelines
Federal Exemptions and Skill Performance Evaluation (SPE)
- Exemption Programs
- Applying for Exemptions and SPE
CDL Driver Examination Forms and Records
- Medical Examination Report Form (MCSA-5875)
- Medical Examinerโs Certificate (MCSA-5876)
- Record Retention Requirements
Medical Forms for Special Conditions
- Insulin-Treated Diabetes Mellitus Assessment Form (MCSA-5870)
- Vision Evaluation Report (MCSA-5871)
- Non-Insulin-Treated Diabetes Mellitus Assessment Form (MCSA-5872)
- CMV Driver Medication Form (MCSA-5895)
4 Question Practice Quiz
Vision & Hearing โ 26 minutes
Vision Standard
- Driver Vision History
- FMCSA Vision Requirements
- Color Perception Guidelines
Vision Testing Procedures
- Visual Acuity Test
- Field of Vision Test
- Ocular Motility, Accommodation, and Convergence
Vision Conditions and Documentation
- Monovision vs. Monocular Vision
- Telescopic Lenses
- Eye Professional Documentation
Failure to Meet Vision Standards
- Alternative Vision Standard for Monocular Vision
- Steps for Certification under Alternative Vision Standard
- Ocular Conditions Requiring Specialist Referral
Specific Eye Conditions
- Cataracts
- Glaucoma
- Macular Degeneration
- Retinopathy
- Xanthopsia
Hearing Standard
- Hearing Requirements and Testing
- Whisper Test
- Audiometric Testing
Ear Examination
- Tympanic Membrane and Canal Inspection
- Common Ear Conditions
Hearing Aids and Related Devices
- Acceptable Use of Hearing Aids
- Cochlear Implants
Practice Scenario
- Case Study: Hearing Loss Evaluation
Practice Quiz โ 4 Questions
Cardiovascular โ 32 minutes
Hypertension
- Hypertension Concerns
- Hypertension Guidelines and Stages
- Making the certification determination
- Common Hypertension Medications
Cardiovascular Disease (CVD)
- Certification Considerations
- Cardiovascular Medications
- Documentation and Evaluation
- Heart Transplantation
- Syncope and Pre-syncope
Peripheral Vascular Disease and Aneurysms
- Venous Thromboembolism and Deep Vein Thrombosis (DVT)
- Pulmonary Emboli
- Intermittent Claudication and Rest Pain
- Abdominal and Thoracic Aortic Aneurysms
Arrhythmias
- Pacemakers
- Implantable Cardioverter-Defibrillator (ICD)
- Supraventricular and Ventricular Arrhythmias
Cardiovascular Testing and Metrics
- Exercise Tolerance Test (ETT)
- Echocardiogram (ECHO)
Coronary Heart Diseases
- Myocardial Infarction (MI)
- Angina Pectoris
- Coronary Artery Bypass Grafting (CABG)
- Congestive Heart Failure
- Percutaneous Coronary Intervention (PCI)
Congenital Heart Disease
- Types and Certification Considerations
Cardiomyopathy
- Hypertrophic Cardiomyopathy
- Restrictive Cardiomyopathy
Valvular Heart Diseases
- Heart Murmurs and Classifications
- Specific Conditions (e.g., Aortic Regurgitation, Aortic Stenosis)
- Aortic Valve and Mitral Valve Repair Options
Practice Quiz โ 4 Questions
Diabetes, Gastrointestinal (GI) & Genitourinary (GU) โ 25 minutes
GI and GU Health
- History and Physical Examination
- Abdominal and GU Exam
- Labs and Organ-Specific Tests
GI/GU Conditions and Certification
- Hernia
- Nephropathy
- Dialysis
- Kidney Transplants
Urinalysis Details
- Specific Gravity
- Urinary Glucose
- Protein
- Occult Blood
- CLIA Certificate of Waiver
Diabetes Management
- Non-Insulin-Treated Diabetes Mellitus
- Insulin-Treated Diabetes Mellitus (ITDM)
- Monitoring and ITDM Certification Requirements
ITDM Standards and Compliance
- Driver and Treating Clinician Requirements
- ITDM Assessment Form
- Severe Hypoglycemic Episodes
- State Issued Waivers and Exemptions
Thyroid Disease
- Hypothyroidism
- ย Hyperthyroidism
- Thyroiditis
Practice Quiz โ 4 Questions
Respiratory โ 40 minutes
Respiratory Qualifications for Driving
- Conditions Impacting Driving Ability
- Respiratory Evaluation Criteria
Physical Examination Indicators
- Lung Sounds and Abnormalities
- Pulmonary Testing (e.g., PFT, Spirometry)
Respiratory Disorders
- Allergic Rhinitis
- Asthma
- Hypersensitivity Pneumonitis
Sleep-Related Breathing Disorders
- Narcolepsy and Idiopathic Hypersomnia
- Obstructive Sleep Apnea (OSA)
- OSA Testing and Compliance Requirements
Chronic Respiratory Conditions
- Tuberculosis (TB)
- Chronic Obstructive Pulmonary Disease (COPD)
- Cystic Fibrosis
- Interstitial Lung Disease
Other Respiratory Concerns
- Pneumothorax (Traumatic and Spontaneous)
- Cor Pulmonale
- Chest Wall Deformities
Practice Quiz โ 4 Questions
Musculoskeletal โ 21 minutes
Musculoskeletal Qualifications for Driving
- Relevant Medical Standards
- Acute vs. Progressive Conditions
Musculoskeletal Examination
- Spine and Extremities Assessment
- Range of Motion and Strength Requirements
- Grasp and Prehension Abilities
Musculoskeletal Diseases
- Conditions with Abnormal Muscle Activity
- Multiple Sclerosis
- Parkinsonโs Disease
- Other Neuromuscular Disorders
Skill Performance Evaluation (SPE)
- SPE Eligibility and Application Process
- Fixed Deficit Requirements and Restrictions
- Driving Demonstrations and FMCSA Oversight
Practice Scenarios
Practice Quiz โ 4 Questions
Neurological Conditions โ 24 minutes
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
- Meniereโs 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 โ 4 Questions
Mental Health โ 21 minutes
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 Alzheimerโs Disease
Practice Quiz โ 4 questions
Medication Standard, Drug, and Alcohol Abuse โ 22 minutes
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 โ 4 questions
How to Pass the NRCME Exam
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.
Sample NRCME Exams
There are 290 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.
Steps to Register for the Certification Test
Now that youโve completed the course, whatโs next? This lesson is an outline that guides you through each step.
- ย 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
Training Evaluation
Your training certificate will be generated immediately upon completion of the course evaluation.
Pass the NRCME certification exam or weโll cover your $79 exam fee!
Get Your Training From the Source
TeamCME founder Dr. Michael Megehee has been training medical examiners to perform DOT physicals since 1996.
He was selected by the Federal Motor Carrier Safety Administration (FMCSA) as one of the subject matter experts who helped design the original NRCME training curriculum and write the first certification exam questions. His contribution helped establish the national standard for examiner certification.
In 2012, FMCSA Administrator Anne Ferro recognized his contributions by naming him an NRCME Champion. Dr. Megehee has also published articles in national compliance and healthcare journals.
Dr. Jeff Carlson, TeamCMEโs Chief Medical Officer, co-developed this course and leads the development of TeamCMEโs training programs. He has published on DOT medical compliance and examiner best practices, and has trained examiners nationwide through live NRCME courses.
Together, Dr. Megehee and Dr. Carlson have trained thousands of certified medical examiners nationwide.
FMCSA Accreditation
TeamCME was one of the first organizations accredited by the FMCSA to provide NRCME training. Although the FMCSA discontinued its accreditation program several years ago, our close relationship with the agency continues well beyond that point.
In fact, while serving as the FMCSAโs Chief Medical Officer, the late Dr. Joseph Sentef, MD personally participated in our live trainings- presenting to students and reinforcing the importance of high-quality examiner education.
What Students Are Saying About This Training
โ 4.9 out of 5 based on 907 verified course-completion evaluations
“Used it twice, for certification and recertification. The newest updates were great.”
Jeanene K., NP – Missouri
Trained in 2025
“An enjoyable and educational experience, with a very user-friendly layout.”
Anne M., NP – Florida
Trained in 2025
โEngaging, efficient, and thorough. The NRCME training was well-organized and clearly presented, with interactive opportunities to test knowledge along the way. All of the information was highly relevant and valuable.โ
– John K., MD – California
Trained in 2025ย
โThis NRCME training program is excellent. Iโve already recommended it to other professionals.โ
–ย Craig K., DC – Illinois
Trained in 2025
Read Our Guide on 10-Year NRCME Recertification
How to Recertify as a DOT Medical Examiner
FAQs
Does this NRCME recertification course meet all FMCSA training requirements?
Yes. This course fulfills all FMCSA requirements for approved NRCME recertification training. It was developed by Dr. Michael Megehee, one of only ten experts selected by the FMCSA to help create the original NRCME examiner training standards.
Is this NRCME recertification course updated for the 2024 Medical Examiner's Handbook?
Yes. The course reflects updates and clarifications from the 2024 Medical Examinerโs Handbook and current FMCSA guidance, so you can approach your recertification exam and everyday DOT exams with accurate, up-to-date information.
Are Continuing Education (CE) hours included with this NRCME recertification training?
Yes. You will receive 7 hours of CE, including AMA PRA Category 1 Creditsโข, ANCC, ACCME (AANP-equivalent), or PACE chiropractic CE, depending on your profession.
What is included in the NRCME recertification course?
Your enrollment includes one year of access to nine concise training modules, in-course knowledge checks, 290 practice questions, two sample NRCME exams, downloadable quick-reference tools, a step-by-step recertification guide, an instant certificate of completion, and profession-specific CME/CE credits. Youโll also receive an Insider Guide with strategies to help you prepare confidently for the recertification exam.
How long is your NRCME recertification course, and is it self-paced?
The course takes about five hours to complete: approximately 4.5 hours of video modules plus two short review lessons. It is fully online and self-paced. Your progress saves automatically, and you have one year of access to review videos, documents, practice questions, and sample exams as many times as needed.
Do the practice questions and sample exams match the style of the real NRCME recertification exam?
Yes. The course includes 290 practice questions and two sample practice exams modeled after the structure, style, and difficulty level of the NRCME recertification exam. These tools help you identify weak areas, reinforce key knowledge, and walk into the test fully prepared.
Is there a pass guarantee?
Yes. TeamCME offers a $79 Pass Guarantee. If you complete all course modules, quizzes, both practice exams, and bonus questions, take the NRCME exam within one year of registering, and do not pass, you can submit your exam score report and we will refund your $79 exam sitting fee (one-time refund).
Can I begin reviewing the training materials immediately after registering?
Yes. Immediately after registration, you are taken to your training dashboard where you can begin the course right away.
Do I receive my certificate of completion immediately?
Yes. Your certificate becomes available instantly after completing the course and final online evaluation. It appears in your training portal so you can upload it to your FMCSA National Registry account the same day.
Continuing Education for NRCME Recertification Training
This training is jointly provided by the Postgraduate Institute for Medicine, the Providers of Accredited Chiropractic Education (PACE), and TeamCME.
In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and TeamCME. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. They can be contacted by calling 1-800-423-3576.
The Postgraduate Institute for Medicine designates this enduring material for a maximum ofย 7 AMA PRA Category 1 Credit(s)โข. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Chiropractic Continuing Education Credits are provided by the Providers of Accredited Education (PACE) program of the Federation of Chiropractic Licensing Boards in up to 30 states (see link below).ย Prior to attending, check with your State Licensing Board regarding the acceptance of PACE CE programs.
The FMCSA Accredited National Registry of Certified Medical Examiners Training is approved for 7 continuing medical education credits.
It is intended for Doctors of Medicine (MD), Doctors of Osteopathy (DO), Doctors of Nursing Practice (DNP), Nurse Practitioners (NP), Physician Assistants (PA), Advanced Practice Nurses and Registered Nurses (APN & APRN), Chiropractors, and Physical Therapists (PT) in select states.
Faculty:
Dr. Michael Megehee, Founder of TeamCME, NRCME Champion
Dr. Jeffrey Carlson, TeamCME Co-CEO & Chief Medical Officer
Release date: August 17, 2020
Expiration date: August 18, 2026
Educational Objectives:
Upon completion, the participant should be better able to:
- Recognize current medical standards, advisory criteria, and guidelines
- Describe the role of Certified Medical Examiners
- Apply the FMCSA medical standards in determining driving status
- Utilize physical examination resources to detect driver medical conditions
- Pass the NRCME certification test
- Counsel drivers regarding medical standards for driver medical conditions
- Effectively communicate with drivers and motor carriers regarding FMCSA medical standards
- Counsel drivers regarding their medical condition and short- and long-term aspects that could affect safe driving
Method of Participation and Certificate of Completion:
During the period allotted for training, participants must read the learning objectives and faculty disclosures and study the educational activity.
Upon completion of the training and evaluation form, a certificate of acknowledgment for completing this activity will immediately be available to download and/or print a copy for your own records from within your training portal. This certificate will also continue to be accessible through your personal learning portal.
- Media: Internet
- Mobile: iPhone/iPad & Android
- Computer System Requirements:
Operating System: Windows XPSP2, Windows Vista, Windows 7, Windows 8
Browser: Internet Explorer 8 or higher, Firefox 3 or higher, Google Chrome
Player: Adobe Flash Player 9+ - Mac System Requirements:
Operating System: Mac OS X 10.4.11 or higher
Browser: Safari 3 or higher, Firefox 3 or higher, Google Chrome for Mac
Player: Adobe Flash Player 9+
Disclosure of Conflicts of Interest:
Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy. PIM is committed to providing its learners with high quality activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.
Faculty: The faculty members have nothing to disclose.
Planners and Managers: The PIM planners and managers have nothing to disclose.
Hardware Requirements:
Bandwidth: 128 kb/s Minimum; 512 kb/s Recommended
Speakers or headphones (courses contain audio)
Software Requirements:
Program Permissions / File Types Required to open and view MP4 (for Media), PDF and/or DOC (for attached documents)
Disclosure of Unlabeled Use:
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners.ย Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.ย
Disclaimer:
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patientโs conditions and possible contraindications and/or dangers in use, review of any applicable manufacturerโs product information, and comparison with recommendations of other authorities.
No commercial support was received for this activity.
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