FMCSA Medical Examiner Certification Training Course

This course has been designed to meet the core curriculum for the medical examiner training and re-training requirement in accordance with the National Registry for Certified Medical Examiners Federal Motor Carrier Safety Administration (FMCSA) in an accelerated five-hour class.

This course will cover the eight core competency areas designated by NRCME, specifically designed for the family physician, NP’s and PA’s. This course assumes a prior mastery and skill set in the basics of history and physical examination techniques.

Upon successful completion of the course, Medical Examiner candidates should be prepared to sit for the FMCSA National Registry of Certified Medical Examiners certification or recertification examination.

All Medical Examiners who conduct physical examinations for commercial motor vehicle (CMV) drivers must be trained, tested, and certified to be on the FMCSA National Registry. Drivers may only obtain DOT physicals from examiners who are on the FMCSA National Registry.

To be eligible to sit for the FMCSA National Registry examination, Medical Examiners must obtain training from an organization that is CME accredited to provide health care professional training.

Please note that the IAFP is offering only the training course. Those taking the course will receive verification of training allowing you to register for the Federal exam. For complete instructions on registering with the NRCME as an examiner, and finding a testing location, please go to this website:
https://nationalregistry.fmcsa.dot.gov/home

After successful completion of this training program, you may register for your NRCME number on the above website, and after successful completion of the exam you will be listed as an NRCME examiner in the National FMCSA Registry.

Douglas W. Martin, MD, FAAFP, FACOEM, FAADEP is a family physician who is a practicing occupational medicine physician in Sioux City, Iowa. He is a past president of both the IAFP, the American Academy of Disability Evaluating Physicians (now IAIME), and the American College of Occupational & Environmental Medicine (ACOEM). Dr. Martin is the current Course Chair of the Medical Review Officer, AMA Guides to the Evaluation of Permanent Impairment, and Musculoskeletal Evaluation and Treatment CME Courses of ACOEM. He serves on the Editorial Advisory Board of the Official Disability Guidelines, an evidence-based treatment guidelines document. He was part of the team that developed the American Board of Family Medicine (ABFM) KSA on Musculoskeletal Medicine and is the current Board Chair of the Interstate Postgraduate Medical Association. He has been involved in educating physicians during his 30-year medical career on several topics, including the prevention of disability. He is frequently called upon as an expert in medicolegal contexts, specifically on the management of musculoskeletal injuries and impairment and disability issues. His book Independent Medical Evaluation – A Practical Guide published by Springer, is the first handbook specifically written for those physicians who perform IMEs.

Outside of medicine, Dr. Martin is a lifelong Scouter, an Eagle Scout, and a Silver Beaver Recipient. He volunteers on the Public Health team for National and World Scout Jamborees. He and his wife are involved in two Haiti relief mission organizations, Time4Haiti and Diakonia (www.time4haiti.org www.diakoniahaiti.org). He officiates sub varsity football and is the public address announcer for Dakota Valley High School football, known as the “Voice of the Panthers”. 

Faculty Disclosure

Iowa Academy of Family Physicians asks all individuals involved in the development and presentation of Continuing Medical Education (CME) activities to disclose all relationships with commercial interests. This information is disclosed to CME activity participants. Iowa Academy of Family Physicians has procedures to resolve apparent conflicts of interest. In addition, faculty members are asked to disclose when any discussion of unapproved use of pharmaceuticals and devices occurs.
Unlabeled/investigational uses of commercial products are not discussed in this activity.

Dr. Martin disclosed that neither he nor any member of his immediate family has a relationship or financial interest with any proprietary entity producing health care goods or services.

In addition to our speaker, the IAFP Education Committee along with IAFP staff have also disclosed that neither they nor any member of their immediate family has a relationship or financial interest with any proprietary entity producing health care goods or services.

Section One: Background, rationale, mission, and Medical Examiner’s role

At the end of this activity, the participant will be able to:

a) Recite the mission of the Federal Motor Carrier Safety Administration
b) Describe the National Registry of Certified Medical Examiners
c) Detail the qualifications to become a Certified commercial driver medical examiner

Section 2: Driver’s responsibilities and work

At the end of this activity, the participant will be able to:

a) demonstrate how to confirm a CMV driver’s identification and medical history.
b) recite the typical physical requirements necessary to operate a commercial motor vehicle.
c) explain the general concerns regarding prescription and over-the-counter medications and how they may negatively affect safe commercial driving.

Section 3: Medical Examination

At the end of this activity, the participant will be able to:

a) perform and document the required commercial driver medical examination as required by the FMCSA
b) explain what basic clinical tests are required and how to interpret them
c) mitigate abnormal physical examination findings with commercial driving risk assessment

Section 4: Additional diagnostic tests or medical opinions

At the end of this activity, the participant will be able to:

a) Perform, obtain, and document relevant diagnostic tests that may need to be additionally completed on a commercial driver to determine qualification, depending upon the diagnosis.
b) Obtaining medical specialist/treating physician opinions when appropriate.
c) Evaluate abnormal diagnostic tests and how they impact commercial driver certification.

Section 5. Informing and Educating CMV driver:

At the end of this activity, the participant will be able to:

a) Describe what counselling is necessary to be given to the commercial driver regarding medications
b) Describe what conditions need to be met for a driver to move from a temporary disqualifying condition to becoming certified.
c) Describe what drivers need to do if they they wear contact lenses and / or hearing aids as a preventive strategy

Section 6. Determining driver certification outcome

At the end of this activity, the participant will be able to:

a). explain the differences between regulation and guidance regarding medical certification
b) recite the time limited certification intervals for common chronic medical conditions
c) demonstrate an understanding of the current exemption processes for hearing and seizure disorders
d) detail when a skilled performance evaluation is necessary

7. Section FMCSA reporting and documentation requirements.

At the end of this activity, the participant will be able to:

a) demonstrate how a commercial driver medical examination is documented on the proper forms
b) demonstrate how to complete a proper commercial driver medical certificate
c) demonstrate how to upload the results of an examination to the NRCME website
d) recite the re-certification requirements to maintain a listing on the NRCME system.

The AAFP has reviewed Accelerated NRCME Online Training and deemed it acceptable for up to 5.00 Enduring Materials, Self-Study AAFP Prescribed credit(s). Term of Approval is from 07/01/2024 to 06/30/2025. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AMA/AAFP Equivalency - Providers may choose to include the following in addition to the AAFP credit statement:
AAFP Prescribed credit is accepted by the American Medical Association as equivalent to AMA PRA Category 1 credit(s)™ toward the AMA Physician's Recognition Award. When applying for the AMA PRA, Prescribed credit earned must be reported as Prescribed, not as Category 1.

Recertification Process

If you are a certified medical examiner through the FMCSA/NRCME, your certification is valid for 10 years, and you are required to recertify every 10 years. For those of you certified previously, you are eligible to recertify any time before your certificate expires. To maintain your ability to continue to perform DOT exams, you are required to complete an accredited training course and pass the NRCME certification exam before your certification expires. You can complete the recertification starting at 9 years following your initial certification. The NRCME will send you an email at your 9-year certification anniversary, giving you instructions that you must complete the re-training and re-certification requirement within one year. 

Take the following steps to complete these requirements:

1. Complete either live or online training.
   3. Log into your National Registry account and upload your training certificate
   4. Contact one of the 2 FMCSA-approved testing organizations (Prometric or PSI) to schedule the certification test
   5. Take and pass the certification test prior to your National Registry certification expiration

TIPS FOR MEDICAL EXAMINERS

1. Make sure that you as an examiner periodically check your listing on the NRCME website to make sure you are Certified prior to doing exams, and to update your demographic information. Since FMCSA uses this database for all communication to you, it is imperative that your contact information including physical address, telephone, and email address are up to date. Frequently, examiners will forget to log back in when their medical licenses are renewed, and if the database shows that your license has expired, it will no longer show you as a valid certified examiner.

2. The examiner or administrative assistant who enters the exam information on the NRCME website sometimes will make an error. Errors can occur when incorrect entries or spelling of driver names are made, incorrect certification expiration dates are inputted, etc. and some have realized that, when they attempt to go back into the website to change it, that the system does not allow them to do it. FMCSA wants the examiner (or assistant) to enter a new exam in this situation. Their software will override the prior incorrect exam as long as it is entered under the same examiner and within a few weeks, it will “red flag” the entry if the input has been entered under a different examiner (obviously to catch drivers who “doctor shop”)

The material presented at this program is being made available by the IAFP for educational purposes only. This material is not intended to represent only, or necessarly best, methods or proedures appropriate for the medical situations discusses; but rather is intended to present an approach, view, statement, or opinion of the faculty, which may be helpful to other who face similar situations. The IAFP disclaims any and all liability for injury or other damages resulting to any individual attending this program and for all calims, which may arise out of the use of the techniques, demonstrated therin by such individuals, whether a physician or any other person shall assert these claims.

Every effort has been made to assure the accuracy of the data presented at this program. Physicians may care to check specific details such as drug doses and contraindications, ctc., in standard sources prior to clinical application.

Materials will be produced solely for the education of attendees. Any use of content or the name of the speaker or the IAFP is prohibited without written consent of the IAFP.