NRCME Training Course Curriculum
This medical examiner training course conforms to the Federal Motor Carrier Safety Administration's (FMCSA) training curriculum modules and topics on regulations and guidelines for conducting CMV driver medical examinations. FMCSA regulations and guidelines are reviewed regularly, and the training is updated as required. This course was last reviewed on 01/21/2024.
Course content meets or exceeds the eight topics outlined in FMCSA's current core curriculum specification.
Module 1 – Introduction
This module identifies duties specific to the certified medical examiner and commercial motor vehicle operator. The examiner will learn the purpose of the Federal Motor Carrier Safety Administration (FMCSA) and National Registry of Certified Medical Examiners (NRCME). The job related stresses of operating a commercial motor vehicle (CMV) will also be discussed.
Module 2 – Driver Medical History and Documentation
This module discusses proper documentation and ensuring completeness of the self reported driver medical history. The learner will also identify strategies on how to avoid an inaccurate driver history.
Module 3 – Vision
This module discusses the vision qualification requirements for the CMV driver. The learner will review critical components of the vision exam, diseases affecting the eye, and findings that may indicate a need for additional testing.
Module 4 – Hearing
This module discusses common ear disorders and symptoms which may affect the ability to operate a CMV safely. The learner will review how to correctly administer acceptable hearing tests and identify passing parameters. The learner will also identify potentially disqualifying otic diseases.
Module 5 – Hypertension
This module reviews how to properly assess a CMV driver for hypertension, inform and educate the driver about the effects of hypertension, and the potential impact of hypertension on a driver's medical fitness for duty. The learner will identify how to determine driver qualification or disqualification status according to the FMCSA's stages of hypertension.
Module 6 – Cardiovascular Assessment and Cardiovascular Disease
This module reviews FMCSA required components of the cardiovascular exam and cardiovascular diseases that may affect a driver's medical fitness for duty. The medical examiner will identify modifiable and non-modifiable factors that may increase the driver's risk for cardiovascular disease. The examiner will also identify symptoms and/or findings requiring further testing or medical opinion from a specialist.
Module 7 – Respiratory Assessment and Respiratory Disease
This module discusses FMCSA required components of the respiratory history and physical exam. The examiner will identify common respiratory conditions found in the CMV driver including sleep apnea, obstructive/restrictive disorders, and infectious diseases. Also discussed are risks associated with medication classes used in pulmonary/respiratory therapy and their relation to safe driving.
Module 8 – Neurologic Assessment and Neurologic Disease
This module reviews assessment of neurologic function and disease in the CMV driver. The medical examiner will learn the various cognitive aspects of operating a CMV and apply these concepts when evaluating a driver's medical fitness for duty. The learner will also study risk assessment factors in the driver with neurologic disease.
Module 9 – Musculoskeletal Assessment and Musculoskeletal Disease
This module reviews the relationship between musculoskeletal health and the physical demands of operating a CMV. The medical examiner will learn FMCSA required components of a musculoskeletal health history and physical exam. Phamacokinetic interactions of medicines commonly prescribed for musculoskeletal disorders are also reviewed.
Module 10 – Diabetes Mellitus
This module reviews the challenges and safety issues associated with driving a CMV with a diagnosis of diabetes mellitus. The learner will identify common side effects of medications used to treat diabetes and potential safety issues for the CMV operator. Implications of end organ disease as a result of diabetes are also discussed.
Module 11 – Other Diseases and Medication Use
This module reviews assessment of common abdominal and renal diseases. Proper use and documentation of the urinalysis test is presented. The learner will also review how to identify possible medication side effects which may interfere with safe driving. The acceptable uses of controlled substances in the CMV driver are presented.
Module 12 – Psychiatric Evaulation
This module reviews the relevance of psychiatric health and conducting a focused psychiatric exam on the CMV driver. The medical examiner will review specific mental health disorders and their potential impact on the driver operating a CMV.
Module 13 - Drug Abuse and Alcoholism
This module reviews the effects of drug and/or alcohol on ability to operate a CMV. FMCSA guidelines for medical examiners examining individuals suspected of substance abuse are discussed. Medical examiners will review how to qualify or disqualify a driver based on history of substance use.
Module 14 - DOT Physical Exam Video Demonstration
This module is a video demonstration of how to conduct a complete head to toe evaluation of the CMV driver.
