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Dynamic Chiropractic – June 17, 2009, Vol. 27, Issue 13

NRCME Implementation Delayed Until Spring 2010

By Clinton M. Smith, DC

Implementation of the National Registry of Certified Medical Examiners (NRCME) program, established by the Federal Motor Carrier Safety Administration (FMCSA) in 2005, has been delayed, most likely until spring 2010.

At the Federation of Chiropractic Licensing Boards' annual convention in Los Angeles last month, attendees heard from Linda Phillips, one of the program directors for the NRCME program. Apparently, such a large program has proved to be a daunting task as regulators attempt to iron out regulatory and statutory issues.

"This has caused some delay in the program and we estimate the Final Rule will be published in the Spring of 2010," said Phillips, who stressed the importance of the inclusion of the chiropractic profession in the program. Her one-hour presentation explained the importance of the NRCME program to the safety of America's roadways and emphasized that chiropractic physicians are an integral part of that plan.

The NRCME program will require any and all examiners who wish to perform Department of Transportation (DOT) examinations to participate in either online or lecture training, and submit to and pass a federal written examination. Upon successful completion of that program, examiners will be listed in the national registry available for trucking and school bus companies to access when looking for DOT physical exam providers.

The FMCSA estimates it will need 40,000 examiners to implement the program, which is estimated to be phased in over a three-year period 60 days after the final rule is published. Details are fluid at this point, but the general consensus outlines the following:

  • Any DC, MD, DO, advanced practice nurse, or physician's assistant will be able to train and be certified through the NRCME examination.

  • All NRCME examiners will be on par with each other, since all will have taken the same training and passed the same examination.

  • All training must meet core curriculum requirements set forth by the FMCSA.

  • Training programs may be conducted online or via didactic lecture.

  • All participants must be granted continuing-education credits by their jurisdictions for the training program.

  • Estimates suggest lecture training may take 12-36 hours; online training may take 8-14 hours.

  • The program provides for disciplinary, appeal and removal procedures from the NRCME.

  • Certification is expected to last six years; update training will be required every three years and retesting will be required after six years.

  • The entire training and testing program will be required to be retaken every 12 years.

Currently, forces are being mobilized within the chiropractic profession to meet the primary core requirement of the program:  uniform CME adoption for all 48 states that allow DCs to perform the exams. The FCLB will be assisting states to help adopt uniform implementation of the federal CME requirement.

The chiropractic profession is unique in the fact that each state has its own CME program requirements. For the profession to capitalize on this large, valuable niche, each state will need to adopt, within the next six months, protocol to allow this federal CME requirement to be fulfilled for each chiropractor participating in the training.

If you perform DOT examinations now, more information on the NRCME program can be found at If you have never performed a DOT exam, it is suggested you begin offering this rewarding, highly professional service in your office and prepare yourself accordingly for the NRCME examination.

For background information on the NRCME program, read "Paving the Road to Equal Opportunity" in the Jan. 15, 2009 issue.

Dr. Clinton Smith, a 1988 graduate of National College of Chiropractic, is a practicing chiropractic physician in the Metro East area of St. Louis. He was one of the initial members of the Working Integrated Product Team of the NRCME program in Washington, D.C., and has been performing DOT examinations, drug collections and breath alcohol testing for 15 years. Contact Dr. Smith with questions or comments at .

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