About the NRCME Exam: Everything You Need to Know
The National Registry of Certified Medical Examiners (NRCME) exam is administered by the Federal Motor Carrier Safety Administration (FMCSA). It is required for all healthcare providers who wish to perform Department of Transportation (DOT) physical examinations for commercial motor vehicle (CMV) drivers.
Who Needs to Take the NRCME Exam?
The following licensed healthcare professionals are eligible to become certified medical examiners on the National Registry:
- Doctors of Medicine (MD)
- Doctors of Osteopathy (DO)
- Doctors of Chiropractic (DC)
- Physician Assistants (PA)
- Advanced Practice Registered Nurses (APRN)
- Nurse Practitioners (NP)
NRCME Exam Format
The NRCME certification exam consists of 120 multiple-choice questions. You must answer a sufficient number correctly to demonstrate competency in performing DOT physical examinations according to FMCSA standards.
Key exam details:
- Format: 120 multiple-choice questions
- Time limit: Varies by testing center
- Passing score: Determined by psychometric analysis (not a fixed percentage)
- Testing: Computer-based at approved testing centers
- Cost: Testing fee varies ($50-100+)
- Recertification: Every 10 years (with training update every 5 years)
What Does the NRCME Exam Cover?
The exam tests your knowledge of FMCSA physical qualification standards under 49 CFR Part 391, including:
- Cardiovascular conditions — hypertension guidelines, cardiac events, anticoagulation
- Respiratory conditions — sleep apnea screening, COPD, pulmonary function
- Neurological conditions — seizure history, stroke, TBI
- Musculoskeletal assessment — limb function, range of motion, SPE certificates
- Vision and hearing standards — acuity requirements, exemptions
- Diabetes and endocrine — insulin-treated diabetes mellitus (ITDM) exemptions
- Psychiatric conditions — medication considerations, fitness for duty
- Substance abuse — drug and alcohol testing, disqualifying conditions
- General medical standards — certification periods, conditional certifications
- Regulatory knowledge — MER form completion, advisory criteria application
How to Prepare for the NRCME Exam
Before taking the exam, you must complete an FMCSA-approved training program. However, training alone is often not enough to pass. Many medical professionals benefit from additional exam-focused preparation:
- Complete your FMCSA-approved training course
- Practice with exam-style questions — Our question bank mirrors the actual exam format
- Review FMCSA guidelines — Focus on 49 CFR Part 391 and advisory criteria
- Take practice exams — Simulate test conditions to build confidence
- Focus on weak areas — Use performance tracking to target your study time
Ready to Start Preparing?
Join thousands of medical professionals who have used NRCME Prep to pass their certification exam. Our practice questions, study materials, and exam simulations are designed specifically for the NRCME.