A critical element of FMCSA’s safety program is ensuring commercial motor vehicle (CMV) drivers are in adequate physical condition to operate the vehicles safely.

On January 22, 2024 FMCSA published a revised Medical Examiner’s Handbook (MEH), which includes updates to the Medical Advisory Criteria published in the Code of Federal Regulations (CFR).

The MEH provides information about regulatory requirements and guidance to medical examiners (ME) listed on FMCSA’s National Registry of Certified Medical Examiners (National Registry) who perform physical qualification examinations of interstate CMV drivers. The January 2024 edition of the MEH replaces all previous handbook editions and is posted on the National Registry and FMCSA websites and on the FMCSA guidance portal.

Publication of the MEH is the first phase of actions to provide current information and a comprehensive approach to medical certification.

To view the revised MEH, visit the FMCSA or National Registry websites at the links provided below.

FMCSA website: https://www.fmcsa.dot.gov/regulations/medical/medical-examiners-handbook-2024-edition

FMCSA Portal website: https://www.fmcsa.dot.gov/regulations/medical/driver-medical-requirements/medical-examiners-handbook

National Registry website: https://nationalregistry.fmcsa.dot.gov/resource-center

A webinar has been posted on the FMCSA and National Registry websites providing a high-level walkthrough of the revised MEH and can be viewed at the links provided below:

FMCSA website: https://www.fmcsa.dot.gov/regulations/medical/new-medical-examiners-handbook-2024-edition-overview-webinar

National Registry website: https://nationalregistry.fmcsa.dot.gov/resource-center

If you have questions regarding the revised FMCSA Medical Examiner’s Handbook, please contact FMCSA’s Medical Programs Division at This email address is being protected from spambots. You need JavaScript enabled to view it. or (202) 366-4001.

Thank you,
Federal Motor Carrier Safety Administration
U.S. Department of Transportation

National Registry Certification Expires in 2023

All MEs whose National Registry certification expires in 2023, will have a full year to complete the 10-
year periodic training and pass the certification test if MEs take full advantage of the extended 1-year
timeframe by starting training and testing actions on January 1, 2023. To complete these requirements as
outlined in 49 CFR 390.111, please complete the following steps:

1. Contact the private sector training organizations to schedule training
2. Complete training
3. Log into your National Registry account and upload your proof of training (i.e., 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

Regulatory Compliance and your National Registry Account

For all MEs whose certification expires in 2023, depending on when you complete your 10-year training
and testing requirements, you may notice your National Registry user profile indicates that your
certification has expired. This will not impact your ability to perform physical qualification examinations
and use the National Registry system, and as indicated above, FMCSA will not take action against
affected MEs for noncompliance with the regulations for not completing the training and passing the
certification test within the 10-year timeframe. However, any MEs whose certification expires in 2023
that have not completed the 10-year periodic training and received a passing score on the 10-year
certification test by December 31, 2023, will be removed from the National Registry for noncompliance
with the Federal Motor Carrier Safety Regulations.

National Registry Certification Expires in 2024 or Later

All MEs whose National Registry certification expires in 2024 or later will be notified by FMCSA after
their 9-year certification anniversary that they need to complete their 10-year periodic training and pass
the certification test. Once notified, MEs should follow the steps outlined below:

1. Contact the private sector training organizations to schedule training
2. Complete training
3. Log into your National Registry account and upload your proof of training (i.e., 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

If you have questions related to this message, please contact the National Registry Helpdesk at
This email address is being protected from spambots. You need JavaScript enabled to view it. or 617-494-3003.

10-year Periodic Training and Testing Requirement

Due to the delayed launch of the 5-year periodic training, and the extended timeframe for completion,
FMCSA has received numerous questions regarding how the 10-year periodic training and testing
requirements will be implemented as we have some MEs that will reach their 10-year National Registry
certification expiration date starting in January 2023.

Regulatory Requirement

The Federal Motor Carrier Safety Regulations under 49 CFR 390.111 - Requirements for Continued
Listing on the National Registry of Certified Medical Examiners, requires certified MEs to complete
periodic training and receive a passing score on the National Registry Medical Examiner Certification
Test no sooner than 9 years and no later than 10 years after the date of issuance of the ME’s certification
credential by FMCSA.

How to Complete 10-year Periodic Training and Testing

MEs will complete training provided by private sector training organizations in the same manner as the
initial National Registry Medical Examiner training required for certification. After successfully
completing the training and uploading proof of training completion (i.e., training certificate) to your
National Registry account, you will be eligible to take the 10-year certification test. The 10-year
certification test will be provided by the two FMCSA-approved testing organizations (Prometric and PSI)
in the same manner as the initial National Registry Medical Examiner Certification Test.

MEs Past or Currently Due to Complete 10-year Periodic Training and Testing (MEs past the
9-year timeframe)

To ensure that all MEs in this status have a full year to complete the required recertification training and
pass the certification test, FMCSA will not take action against affected MEs for noncompliance with the
regulations for not completing the training and passing the certification test within the 10-year timeframe.
The 10-year periodic training and testing function in the National Registry will be available starting on
January 1, 2023. All MEs will receive an email at the professional contact email address listed in their
National Registry account notifying them when the 10-year periodic training and testing is due to be
completed. To be sure you receive notifications regarding the 10-year periodic training and testing, please
log into your National Registry account and review your profile to ensure your professional contact email
address is correct.

The table below explains how much extra time you will receive to complete the training and testing based
on the training and testing being available January 1, 2023, and the month in which your National
Registry certification expires.

Based on this information, FMCSA encourages MEs to take full advantage of the extended 1-year
timeframe by starting training and testing actions on January 1, 2023.

On January 21, 2022, the Federal Motor Carrier Safety Administration (FMCSA) published the Qualifications of Drivers; Vision Standard final rule, allowing individuals who do not satisfy, with the worse eye, either the existing distant visual acuity standard with corrective lenses or the field of vision standard, or both, to be physically qualified to operate a commercial motor vehicle without obtaining an exemption from FMCSA (87 FR 3390).

The new alternative vision standard eliminates the need for a Federal vision exemption program and allows certified medical examiners, in consultation with an ophthalmologist or optometrist and utilizing the new Vision Evaluation Report, Form MCSA-5871, to evaluate and determine whether to grant a Medical Examiner’s Certificate (MEC), Form MCSA-5876, for up to one year. Final Rule Effective Date: On March 22, 2022, the rule becomes effective, and medical examiners must begin to apply the provisions adopted in the final rule. All provisions are discussed further in the final rule located on FMCSA’s website at https://www.fmcsa.dot.gov/regulations/federal-register-documents/2022-01021

The Vision Evaluation Report, Form MCSA-5871, is also effective on this date and will be available on FMCSA’s website at https://www.fmcsa.dot.gov/medical/driver-medical-requirements/medical-applications-and-forms

Medical Examination Forms: Based on the adoption of the final rule, FMCSA has determined that the Federal vision exemption program is no longer necessary. As of March 22, 2022, medical examiners should not mark the box for accompanied by a Federal vision waiver/exemption on the Medical Examination Report (MER) Form, MCSA-5875, or the Medical Examiner’s Certificate (MEC), Form MCSA-5876. On and after March 22, 2022, any individual who might have been physically qualified by a vision exemption issued by FMCSA will have to be qualified by a medical examiner under the provisions adopted in the final rule. All individuals certified under the new alternative vision standard must provide the medical examiner with a Vision Evaluation Report, Form MCSA-5871, that has been signed and dated by an ophthalmologist or optometrist not more than 45 days before the physical qualification examination begins.

The medical examiner considers the information provided by the ophthalmologist or optometrist, but the final qualification decision rests with the medical examiner. Medical examiners may qualify these individuals for up to one year and a copy of the Vision Evaluation Report, Form MCSA-5871, must be treated and retained as part of the MER Form for three years.

Federal Vision Exemptions: As of January 21, 2022, FMCSA stopped accepting applications for new exemptions or renewal of previously granted exemptions under the Federal vision exemption program. Individuals holding exemptions in effect on March 22, 2022, have until March 22, 2023 to be medically certified under the alternative vision standard, at which time all MECs issued with vision exemptions will become void. FMCSA will notify exemption holders, applicants, and grandfathered drivers by letter with details of the transition to the new standard.

Grandfathered Drivers: The final rule eliminates 49 CFR 391.64(b), commonly known as the grandfather provision for drivers operating under the previous vision waiver study program, on March 22, 2023. Medical examiners may continue to physically qualify individuals under section 391.64(b) until this time. However, individuals physically qualified under section 391.64(b) have until March 22, 2023 to be medically certified under the alternative standard, at which time all MECs issued under 391.64(b) will become void.

Webinars: FMCSA has posted a webinar on the FMCSA website for medical examiners learn more about the new alternative vision standard and their responsibilities in applying it to certification of individual with monocular vision. The webinar can be found at https://www.fmcsa.dot.gov/regulations/medical/new-vision-standard-overview-webinar.

The following update regarding the periodic training delay was issued by the Federal Motor Carrier Safety Administration on 2/20/2020.

Dear Medical Examiner:

Certified Medical Examiners (MEs) listed on the National Registry must complete periodic training every five (5) years under 49 CFR 390.111(a)(5)(i) to maintain their National Registry certification to conduct examinations of interstate CMV drivers. The periodic training will be provided by FMCSA and will only be available to certified ME’s through their National Registry account. However, due to unexpected delays, the training is still not yet available. FMCSA will notify MEs once the training becomes available, and will ensure that all MEs required to complete the training have ample time to do so. In addition, FMCSA will not take action against affected MEs for noncompliance with the regulations for not completing the training within the five-year timeframe.

Note: Training from other third-party training organizations does not meet the regulatory requirement for periodic training, and FMCSA does not provide continuing education units for completing the periodic training.

If you have questions, please contact the National Registry at 202-366-4001 or This email address is being protected from spambots. You need JavaScript enabled to view it..

Sincerely,

Charles A. Horan, III
Director, Office of Carrier, Driver and Vehicle Safety Standards