Click on the questions below to read the answer.
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What is the National Registry of Certified Medical
Examiners?
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Who are medical examiners?
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Do medical examiners differ from medical review
officers?
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Why is the National Registry of Certified Medical
Examiners necessary?
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How would the National Registry of Certified Medical
Examiners work?
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Who would be responsible for setting up and maintaining
the National Registry of Certified Medical Examiners database?
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How would having a National Registry of Certified
Medical Examiners impact the general public?
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Will there be an opportunity to provide comments about
the National Registry of Certified Medical Examiners?
Commercial Motor Vehicle Driver Questions
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What impact would the National Registry of Certified
Medical Examiners have on commercial motor vehicle drivers and motor carriers?
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How would the National Registry of Certified Medical
Examiners help me if I live in a rural State?
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How would the medical certificate issued under the
National Registry of Certified Medical Examiners be different from the medical
certificate commercial motor vehicle drivers are required to have now?
Medical Examiner Questions
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How would the National Registry of Certified Medical
Examiners impact medical examiners?
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Do all medical examiners have to be certified?
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How do I become a certified medical examiner?
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How much would it cost to become a certified medical
examiner?
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Where is certified medical examiner training being
offered in my area?
1. What is the National Registry of Certified
Medical Examiners?
The National Registry of Certified Medical Examiners (NRCME) would
be a list of certified medical examiners who fully understand the medical
standards in the Federal Motor Carrier Safety Administration Regulations and
how they relate to the mental and physical demands of operating a commercial
motor vehicle. Medical examiners would be required to successfully complete
required training and pass a certification test before being listed on the
NRCME.
2. Who are medical examiners?
Federal Motor Carrier Safety Regulations define a medical examiner
as, a person who is licensed, certified and/or registered in accordance with
applicable State laws and regulations to perform physical examinations. The
term includes, but is not limited to, Doctors of Medicine (MD) and Osteopathy
(DO), Advanced Practice Nurses (APN), Physician Assistants (PA) and
Chiropractors (DC). (49 Code of Federal Regulations 390.5)
A recent Federal Motor Carrier Safety Administration survey found
that there are over 400,000 potential medical practitioners who could perform
physical examinations for commercial motor vehicle drivers. To perform physical
examinations of the more than 6 million commercial motor vehicle drivers, there
would be a need to train and certify more than 40,000 medical examiners when
the National Registry of Certified Medical Examiners is established.
3. Do medical examiners differ from medical
review officers?
Yes. A medical review officer is a licensed physician who is
responsible for receiving and reviewing laboratory results generated by an
employer's drug testing program and evaluating medical explanations for certain
drug test results. More information on medical review officers is available
online at http://www.dot.gov/ost/dapc/mro.html.
4. Why is the National Registry of Certified
Medical Examiners necessary?
Over the past 20 years (1982-2002), the Federal Motor Carrier Safety
Administration (FMCSA) estimates there has been a 42% increase in registered
large trucks and a 93% increase in miles traveled by large trucks. There are
over 7 million registered large trucks, 700,000 commercial buses, 11 million
commercial driver’s license holders, and over 600,000 interstate truck and bus
companies in the United States. These statistics reflect a significant increase
in the presence of large trucks on our Nation’s highways over the last several
years.
There is also evidence that improper medical certification has
contributed directly to crashes. The National Transportation Safety Board, for
example, has documented cases where drivers with serious disqualifying medical
conditions were involved in significant fatal and injury crashes. Reports from
FMCSA field staff indicate numerous problems on our roads, where drivers who
have disqualifying medical conditions are operating commercial motor vehicles.
These issues indicate there is a need to improve the medical certification
process, and the National Registry of Certified Medical Examiners is one
strategy for addressing this problem.
Interest in certifying medical examiners to evaluate interstate
commercial motor vehicle drivers dates back to at least 1978 when the National
Highway Traffic Safety Administration commissioned a feasibility study on the
issue. This study addressed the primary weakness in the overall system – the
lack of medical examiner understanding of the relationship of driver health to
the task of operating commercial motor vehicles interstate. The study concluded
that there were not enough medical examiners to support a certified medical
examiner system for all interstate commercial driver examinations.
The idea of having a National Registry of Certified Medical
Examiners has been raised periodically by the government since that time. In
August 2005, Public Law 109-59, The Safe, Accountable, Flexible, Efficient
Transportation Equity Act: A Legacy for Users (SAFETEA-LU) was enacted. Section
4116 requires, “The Secretary, acting through the Federal Motor Carrier Safety
Administration - (1) shall establish and maintain a current national registry
of medical examiners who are qualified to perform examinations and issue
medical certificates; (2) shall remove from the registry the name of any
medical examiner that fails to meet or maintain the qualifications established
by the Secretary for being listed in the registry or otherwise does not meet
the requirements of this section or regulation issued under this section; (3)
shall accept as valid only medical certificates issued by persons on the
national registry of medical examiners; and (4) may make participation of
medical examiners in the national registry voluntary if such a change would
enhance the safety of operators of commercial motor vehicles.”
5. How would the National Registry of Certified
Medical Examiners work?
The names of all certified medical examiners nationwide would be
listed in the National Registry of Certified Medical Examiners (NRCME)
database. Medical examiners who wish to pursue certification would participate
in required training and pass a test to obtain certification to conduct the
physical examinations required for interstate commercial motor vehicle drivers.
Contact information for the certified medical examiners would be available to
drivers who wish to obtain a commercial motor vehicle driver physical
examination. The NRCME Web site would be used to disseminate information to
practitioners on new medical discoveries and policies or requirements relevant
to the examinations. The NRCME Web site would also provide program information
to the certified medical examiners, medical examiners who wish to become
certified, and the interested public. The primary method of information
dissemination would be through the NRCME Web site (http://www.nrcme.fmcsa.dot.gov).
A resource center with a toll-free telephone number would also be available.
6. Who would be responsible for setting up and
maintaining the National Registry of Certified Medical Examiners database?
The Federal Motor Carrier Safety Administration is responsible for
implementing, overseeing and maintaining the National Registry of Certified
Medical Examiners database and program. This may be accomplished through
partnerships with public and private-sector organizations.
7. How would having a National Registry of
Certified Medical Examiners impact the general public?
The Federal Motor Carrier Safety Administration is dedicated to
making our highways safer. The National Registry of Certified Medical Examiners
would promote confidence in the quality of the physical examinations of
commercial motor vehicle drivers. Ensuring that commercial motor vehicle
drivers are physically and mentally able to handle the demands of commercial
driving safely would potentially decrease the number of crashes involving
commercial vehicles on our Nation’s highways.
8. Will there be an opportunity to provide
comments about the National Registry of Certified Medical Examiners?
There will be numerous opportunities to comment on the National Registry of
Certified Medical Examiners (NRCME) during its developmental phases. Public
forums are planned during critical developmental stages of the NRCME program.
Public meetings were held on June 22, 2005 in Arlington, Virginia, June 29,
2006 in San Diego, California, and July 26, 2006 in St. Louis, Missouri.
These meetings provided all attendees an opportunity to discuss the NRCME
program with subject matter experts. Additional information about public
meetings can be found online at http://www.nrcme.fmcsa.dot.gov.
There will also be opportunity to comment during the rulemaking process.
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Commercial Motor Vehicle Driver Questions
9. What impact would the National Registry of
Certified Medical Examiners have on commercial motor vehicle drivers and motor carriers?
When the National Registry of Certified Medical Examiners (NRCME) is
established, interstate commercial motor vehicle drivers would be required to
obtain a physical examination and be medically certified by a certified medical
examiner listed on the NRCME. Information regarding certified medical examiners
listed in the NRCME database would be readily available to motor carriers and
commercial motor vehicle drivers through the NRCME Web site,
http://www.nrcme.fmcsa.dot.gov, and a toll-free telephone line.
10. How would the National Registry of
Certified Medical Examiners help me if I live in a rural State?
When established, the National Registry of Certified Medical
Examiners (NRCME) would provide a readily accessible list of medical examiners
who are certified to perform examinations and issue medical certificates
according to the requirements of Section 391.43 of the Federal Motor Carrier
Safety Regulations. The NRCME would make it easier to find a certified medical
examiner in your area. When the NRCME is established, this list would be
available online at http://www.nrcme.fmcsa.dot.gov.
11. How would the medical certificate issued
under the National Registry of Certified Medical Examiners be different from
the medical certificate commercial motor vehicle drivers are required to have
now?
The medical certificate would continue to be used, but would be
revised to include additional information. The difference would be that when
the National Registry of Certified Medical Examiners (NRCME) is established,
the medical certificate would have to be issued by a medical examiner who has
successfully completed the Federal Motor Carrier Safety Administration’s
(FMCSA) required training, has passed a certification test, and is listed on
the NRCME. This would ensure that all medical certificates are issued by
medical examiners who demonstrate comprehensive understanding of the medical
standards in the Federal Motor Carrier Safety Regulations, and how they apply
to the mental and physical demands of operating a commercial motor vehicle.
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Medical Examiner Questions
12. How would the National Registry of
Certified Medical Examiners impact medical examiners?
When the National Registry of Medical Examiners (NRCME) is
established, medical examiners who wish to conduct Federal Motor Carrier Safety
Administration (FMCSA) physical examinations for commercial motor vehicle
drivers would be required to complete required training and pass a
certification test in order to be listed in the NRCME database. The training
would enhance the medical examiner’s knowledge of FMCSA’s physical
qualification regulations and standards, understanding of the mental and
physical demands of operating a commercial motor vehicle, and ability to
determine if a driver can handle these demands safely. Medical examiners would
maintain competency through ongoing training, certification, and
recertification.
13. Do all medical examiners have to be
certified?
When the National Registry of Certified Medical Examiners (NRCME)
is implemented, all medical examiners who intend to perform physical
examinations and issue medical certificates for commercial motor vehicle
drivers to meet the requirements of Section 391.41 of the Federal Motor Carrier
Safety Regulations (FMCSRs) would have to be certified and listed on the
Federal Motor Carrier Safety Administration’s NRCME. In order to be certified,
medical examiners must pass a test demonstrating comprehensive understanding of
the medical standards in Section 391.41 of the FMCSRs, and how they relate to
the mental and physical demands of driving a commercial motor vehicle. When the
NRCME is established, information on training and certification would be
available on the NRCME Web site at http://www.nrcme.fmcsa.dot.gov.
14. How do I become a certified medical
examiner?
When the NRMCE program is implemented, you would be required to complete the training and pass the certification test required by the Federal Motor Carrier Safety Administration (FMCSA) to become a certified medical examiner. Training would be offered in selected locations and online.
The NRCME program is in the process of being developed and is currently in the rulemaking phase. Rulemaking allows for the public to comment on the proposed program model. Therefore, a definitive date when the program will be in place is not yet available. When the NRCME is established, information on the training and certification test would be available on the NRCME Web site at http://www.nrcme.fmcsa.dot.gov.
Information on how to begin performing the commercial motor vehicle driver physical examination in the meantime is available on the FMCSA Web site at http://www.fmcsa.dot.gov, Medical Program link.
15. How much will it cost to become a
certified medical examiner?
When the National Registry of Certified Medical Examiners (NRCME)
is established, there would be a cost for the training, certification, and
recertification required for medical examiners. There is a rulemaking in
process for the NRCME program. As a part of that process, FMCSA will conduct a
regulatory analysis that will include cost/benefit analyses.
16. Where is certified medical examiner
training being offered in my area?
When the National Registry of Certified Medical Examiners (NRCME)
is established, information about training would be found on the NRCME website
at http://www.nrcme.fmcsa.dot.gov.
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