The National Registry of Certified Medical Examiners (National Registry) is a Federal program that establishes requirements for healthcare professionals that perform physical qualification examinations 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. The National Registry web site is accessible to carriers, drivers, enforcement officials, and the general public.
All healthcare professionals whose scope of practice authorizes them to perform physical examinations, as defined by the state in which they practice, and who intend to perform physical examinations and issue medical certificates for commercial motor vehicle (CMV) drivers to meet the requirements of Section 391.41 of the Federal Motor Carrier Safety Regulations (FMCSRs) must be certified and listed on FMCSA's National Registry by May 21, 2014.
Why is the National Registry necessary?
FMCSA developed the National Registry of Certified Medical Examiners final rule as part of the agency's commitment to enhancing the medical oversight of interstate drivers, and preventing commercial vehicle-related crashes, injuries and fatalities. The final rule addresses four NTSB recommendations on a comprehensive medical oversight program for interstate drivers.
Who is impacted by this program?
The program impacts medical examiners who need to obtain certification in order to continue issuing medical certificates for truck and bus drivers, CMV drivers who need to obtain medical certificates from examiners on the National Registry, motor carriers who must ensure their interstate drivers have been medically certified by an examiner on the registry, and training and testing organizations that will deliver these aspects of the program.
Are there any National Transportation Safety Board (NTSB) recommendations related to the establishment of the National Registry of Certified Medical Examiners?
The National Registry final rule addresses four NTSB recommendations on a comprehensive medical oversight program for interstate drivers that include the following elements:
- Individuals performing medical examinations for drivers are qualified to do so and are educated about occupational issues for drivers (H-01-017);
- A tracking mechanism is established that ensures that every prior application by an individual for medical certification is recorded and reviewed. (H-01-018);
- Medical certification regulations are updated periodically to permit trained examiners to clearly determine whether drivers with common medical conditions should be issued a medical certificate. (H-01-019); and
- Individuals performing examinations have specific guidance and a readily identifiable source of information for questions on such examinations (H-01-020).
Who can perform FMCSA medical examinations for CMV drivers?
FMCSA's current regulations require that all MEs be licensed, certified, and/or registered in accordance with applicable State laws and regulations to perform physical examinations. This includes but is not limited to doctors of medicine, doctors of osteopathy, physician assistants, advanced practice nurses, and doctors of chiropractic.
MEs must be knowledgeable of the specific physical and mental demands associated with operating a CMV and the requirements of Section 391.43(c), including the medical advisory criteria prepared by the FMCSA as guidelines to aid the medical examiner in making the individual determination whether a driver should be issued a medical certificate, and be proficient in following the medical protocols necessary to adequately perform the medical examination.
Beginning May 21, 2014, all MEs who wish to conduct medical examinations for interstate CMV drivers must complete training about FMCSA's physical qualifications regulations and advisory criteria and pass a certification test to be listed on the National Registry of Certified Medical Examiners. All medical certificates issued on or after this date must be issued by examiners listed on the National Registry of Certified Medical Examiners.
What do I have to do to become a certified ME?
To become certified as a ME, you must complete the necessary training and pass the certification test required by FMCSA. In order to take the certification test, you must first register through the National Registry web site and receive a unique identification number. You will provide your unique identification number to the testing organization that you select from the list of approved testing organizations on the National Registry web site.
CMV drivers in interstate commerce must use MEs listed on the National Registry to obtain a medical certificate beginning May 21, 2014. Medical certificates issued prior to this date are valid until the expiration date. Contact information for the MEs is available online at the National Registry web site to drivers who wish to obtain a CMV driver physical examination.
How can a healthcare professional obtain more information about the National Registry?
Go to the National Registry web site http://nrcme.fmcsa.dot.gov and read the information provided. For ongoing updates, register for the National Registry Listserv by selecting the link.
When will a ME be required to complete a training program?
Compliance Date May 21, 2014 – All CMV drivers seeking a medical certificate must use a ME on the National Registry.
ME Registration Date August 20, 2012 – MEs may register at the National Registry web site and receive their unique identification number that will be used to sign up for the mandatory testing.
How do MEs find training and testing organizations?
Visit the National Registry web site at http://nrcme.fmcsa.dot.gov and go to the training and testing section for more information.
How will a ME know that a training provider's program meets all of the National Registry requirements?
The ME candidate may visit the National Registry web site at http://nrcme.fmcsa.dot.gov to obtain the regulatory requirements for training, including the eight topics (the core curriculum) that must be covered by the training. The training organization must be accredited by a nationally-recognized medical profession accrediting organization that provides continuing medical education units and the training must include all of the topics outlined in the final rule.
The training organization must provide training participants with proof of participation and FMCSA point-of-contact information. Although FMCSA posts contact information on the National Registry web site for training organizations that send it to the National Registry, FMCSA does not approve or endorse training providers or courses. The ME candidate is required to determine whether a training course meets the regulatory requirements.
Where will MEs go to take the test?
The test will be offered by private sector test delivery organizations throughout the United States. FMCSA will post contact information for testing organizations on the National Registry website. In addition, testing organizations may administer the test online with remote monitoring.
Are ME candidates required to pay for the training and testing?
Yes. The ME candidate is responsible for paying any fees charged by the training and testing organizations.
FMCSA neither establishes nor regulates the schedules of fees established and collected by training or testing organizations, and does not receive any monies collected by these organizations or providers. Training and testing providers are not reimbursed by the Federal government but may charge fees for training and test delivery. The providers are responsible for the entire process of fee determination, collection, and refund, if warranted. The providers are also responsible for any advertising of their services, determining the schedules for training and testing sessions, and managing requests for training and testing.
If an ME candidate does not pass the test can he/she take the test again?
If the candidate fails the test, he or she must wait at least 30 days before taking the test again.
How long will the ME's Certification be valid?
FMCSA will issue a certification document that will expire 10 years from the date of issuance. After the initial training and certification, a ME must complete periodic training every 5 years to refresh his or her knowledge of both the medical standards for CMV drivers and any changes to FMCSA examination standards or guidelines. MEs are required to complete recertification testing every 10 years. FMCSA may remove a ME from the National Registry if he or she does not complete the periodic training (after 5 years) or pass the recertification testing (after 10 years on the National Registry).
Do all medical examiners have to be certified?
Yes. All MEs who intend to perform physical examinations and issue medical certificates for interstate CMV drivers must complete the mandatory training and testing requirements in the National Registry rule by May 21, 2014. The requirements are set forth in Section 390.101 through 390.115 of the Federal Motor Carrier Safety Regulations (FMCSRs).
If I attended a medical examiner training course prior to the publication of the rule, does that qualify me to take the certification test?
Yes, provided the curriculum for the training course covers all the topics outlined in the final rule and, the training organization must be accredited by a nationally-recognized medical profession accrediting organization that provides continuing medical education units.
How will the exam be administered?
The testing organizations may administer the exam at a testing facility where candidates can take the examination using test booklets and test forms, or using computer terminals. Alternatively, the testing organization may provide an on-line testing option where the candidate may take the test from his or her office or other location provided the testing organization has a monitoring mechanism to detect cheating or other inappropriate activity during the on-line test.
What will MEs be required to do after they are added to the National Registry?
After an examiner is certified to be on the National Registry, the examiner must apply the qualifications standards consistently and uniformly during the examination of drivers. Each ME listed on the National Registry will also be required to complete and transmit to FMCSA once every calendar month the following information about each CMV driver examined during the previous month: name, date of birth, driver's license number and State, date of examination, an indication of the examination outcome (for example, medically qualified), whether intrastate driver only, and date of driver medical certification expiration. If the ME does not conduct any exams during any given month, he/she must submit that information. Data will be submitted electronically via a secure FMCSA National Registry web site.
Are there any other requirements that a ME must adhere to after they are added to the National Registry?
Yes, MEs also have to comply with the following administrative requirements as of May 21, 2014:
- Submit Form MCSA-5850 for each driver examined electronically every month via the National Registry website. If no exams were performed during the month, that must also be reported;
- Retain original completed Medical Examination Reports for all drivers examined and a copy or electronic version of the driver's medical examiner's certificate for at least 3 years from the date of the examination;
- Submit to periodic audits;
- Provide FMCSA with medical examination report forms and other documents as requested;
- Continue to be licensed, registered, or certified in accordance with the applicable State laws and regulations of each State in which you perform examinations with a scope of practice that includes performing physical examinations;
- Submit any changes in the application information to FMCSA within 30 days of the change;
- Report to FMCSA any information related to any termination, suspension, or withdrawal of your license, registration, or certificate under State law; and
- Maintain documentation of State licensing, registration, or certification and completion of all required training.