How to Become a DOT Medical Examiner: Step-by-Step Guide

Becoming a certified DOT medical examiner allows you to perform commercial driver medical examinations—a valuable service that can generate significant revenue for your practice. Here’s the complete step-by-step process to get certified.

Step 1: Verify Your Eligibility

To become a DOT medical examiner, you must be a licensed healthcare provider in one of these categories:

• Doctor of Medicine (MD)
• Doctor of Osteopathic Medicine (DO)
• Physician Assistant (PA)
• Advanced Practice Registered Nurse (APRN / Nurse Practitioner)
• Doctor of Chiropractic (DC)
• Other providers authorized by their state to perform physical examinations

You must hold an active, unrestricted medical license issued by a U.S. state, territory, or the District of Columbia. If your license has any restrictions or disciplinary actions, you may not be eligible.

Step 2: Complete an Accredited Training Program

Before you can take the NRCME certification exam, you must complete a training program that has been accredited by the FMCSA. These training programs cover:

• FMCSA regulations governing commercial driver medical certification
• The physical qualification standards in 49 CFR Part 391
• The FMCSA Medical Examiner Handbook
• How to perform the DOT physical examination
• Medical conditions and their impact on driving safety
• Certification decision-making

Training programs are available online and in-person from various accredited providers. Most can be completed in 1–2 days. After completing the training, you will receive a certificate of completion that you’ll need when registering for the exam.

Step 3: Register on the National Registry Website

Create an account on the FMCSA National Registry website. You will need to provide your medical license information, training certificate details, and personal identification. This establishes your profile in the system.

Step 4: Pass the NRCME Certification Exam

The NRCME exam is a 120-question multiple-choice test administered at approved testing centers. It covers all aspects of the DOT physical examination process and FMCSA medical certification guidelines.

This is where most candidates need the most preparation. The exam tests FMCSA-specific regulatory knowledge, which differs significantly from general clinical practice. Read our complete guide on passing the NRCME exam for detailed strategies.

To prepare effectively, combine studying the FMCSA Medical Examiner Handbook with practicing exam-format questions. our NRCME practice tests include 670+ practice questions across all 14 exam categories.

Step 5: Get Listed on the National Registry

Once you pass the exam, your name is added to the National Registry of Certified Medical Examiners. This listing is publicly searchable, allowing commercial drivers and motor carriers to verify your certification. You can then legally perform DOT physical examinations.

Step 6: Maintain Your Certification

Your NRCME certification is valid for 10 years. During that time, you must:

• Maintain an active, unrestricted medical license
• Stay current with FMCSA regulation updates
• Continue performing examinations according to FMCSA guidelines
• Complete recertification training and pass the exam again before your certification expires

How Long Does the Entire Process Take?

From start to finish, most providers complete the process in 4–6 weeks:

• Training program: 1–2 days
• Exam preparation: 2–4 weeks (recommended)
• Exam scheduling and completion: 1–2 weeks
• Registry listing: typically within a few days of passing

Is It Worth It?

DOT physicals are a steady, recurring revenue source. Commercial drivers are required to have physicals every 1–2 years, creating consistent demand. Many practices charge $75–$150 per examination, and established examiners can perform multiple exams per day.

Beyond revenue, being a certified medical examiner adds a valuable credential to your practice and serves an important safety function by ensuring commercial drivers are medically fit to operate large vehicles on public roads.

Get Started with Exam Preparation

The certification exam is the most challenging part of the process for most candidates. Start your preparation early with our NRCME practice tests, which include practice questions, full-length exams, and study guides designed specifically for the NRCME certification test.