Cognitive Exam Retest Information
Disciplinary Policy and Rights of Appeal
Responsibilities of Certified EMT
Individuals applying for Emergency Medical Technician (EMT) certification must meet the following requirements:
18 years of age or older.
Successful completion of a state-approved Emergency Medical Technician (EMT) course that meets or exceeds the National Emergency Medical Services Education Standards for Emergency Medical Technician. You must have completed the course within the past two years. Your Program Director must verify your successful completion of the course on the NREMT web site.
If your initial Emergency Medical Technician (EMT) educational program was completed more than two years ago and you are currently state licensed at the EMT level, you must submit documentation verifying completion of an approved National Scope of Practice EMT refresher course or 24 hours of appropriate continuing education topic hours within the past two years. If your initial EMT education program was completed more than two years ago and you never gained state licensure at the EMT level, you must complete an entire state-approved Emergency Medical Technician (EMT) course prior to applying for National EMS Certification.
Verification from the Program Director that you hold a current CPR credential for health care providers and have demonstrated competence in Emergency Medical Technician (EMT) skills.
Successful completion of a state-approved Emergency Medical Technician (EMT) psychomotor exam.
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Complete a National Registry online application including truthfully completing the Licensing Action and Felony statements. click here for more information on the NREMT Felony Policy. The NREMT may deny certification or take other appropriate actions in regards to applicants for certification or recertification when a felony conviction has occurred.
Pay the application fee of $70.00 (US funds). The application fee is non-transferable and non-refundable. This fee is charged for each attempt of the cognitive examination.
You will receive an Authorization to Test (ATT) once you are eligible for the exam. The ATT letter contains scheduling instructions and important details concerning proper identification required at testing centers.
National Emergency Medical Technician (EMT) certification requires successful completion of both a cognitive and psychomotor exam. Passed portions of the exam (both cognitive and psychomotor) remain valid for a twelve (12) month period.
The NREMT Emergency Medical Technician (EMT) cognitive exam is a computer adaptive test (CAT). The number of items a candidate can expect on the Emergency Medical Technician (EMT) exam will range from 70 to 120. The maximum amount of time given to complete the exam is 2 hours.
The exam will cover the entire spectrum of EMS care including: Airway, Ventilation, Oxygenation; Trauma; Cardiology; Medical; and EMS Operations. Items related to patient care are focused on adult patients (85%) and pediatric patients (15%). In order to pass the exam, you must meet a standard level of competency. The passing standard is defined by the ability to provide safe and effective entry level emergency medical care.
Cognitive Exam Retest Information
In the event you are unsuccessful passing the cognitive exam, the NREMT will provide feedback on your performance. You may apply to retest 15 days after your last examination.
Candidates are given six opportunities to pass the cognitive examination provided all other requirements for National EMS Certification are met. After three attempts, candidates must submit official documentation verifying completion of 24 hours of remedial training. The candidate is given three additional attempts to pass, provided all other requirements for National Certification are met. Candidates who fail to pass after a total of six attempts are required to repeat the entire Emergency Medical Technician (EMT) course.
Throughout your Emergency Medical Technician (EMT) educational program you must demonstrate competence in a wide range of emergency care skills. Your instructor must attest that you have demonstrated competence in the following skills during your course: patient assessment/management of a trauma patient, patient assessment/management of a medical patient, cardiac arrest management/AED, bag-valve-mask ventilation of an apneic patient, spinal immobilization (both seated and supine patient), long bone fracture immobilization, joint dislocation immobilization, traction splinting, bleeding control/shock management, upper airway adjuncts and suction, mouth-to-mouth ventilation with supplemental oxygen, and supplemental oxygen administration to a breathing patient.
You must also successfully complete a state-approved Emergency Medical Technician (EMT) psychomotor examination. Speak with your instructor or State EMS Office about the format and logistics of completing a state-approved Emergency Medical Technician (EMT) psychomotor exam.
Initial expiration dates are determined by the date of successful completion of the entire certification process. Individuals successfully completing the certification process between the dates of January 1 - June 30 will receive an expiration date of March 31 two years in the future. Individuals successfully completing the certification process between July 1 and December 31 will receive an expiration date of March 31 three years in the future.
For example: successful completion of February 14, 2013, certification expiration = March 31, 2015
successful completion of July 7, 2013, certification expiration = March 31, 2016
All subsequent certification periods will be for a two-year period (April 1 - March 31).
If your National EMS Certification lapsed as an Emergency Medical Technician (EMT) within a two year period or you are currently state licensed as an Emergency Medical Technician (EMT), you can obtain National EMS Certification by completing a state-approved Refresher course and successfully completing the cognitive and psychomotor examinations. If your EMS certification expired more than two years ago, you must complete an entire state-approved Emergency Medical Technician (EMT) course and complete the cognitive and psychomotor examinations.
The NREMT complies with the Americans with Disabilities Act (ADA) of 1990 and offers reasonable accommodations for individuals with disabilities. Pearson VUE test centers are also ADA compliant.
Complete information about the NREMT Accommodations Disability Policy can be found here.
Disciplinary Policy and Rights of Appeal
The NREMT has disciplinary procedures, rights of appeal and due process within its policies. Complete information about the NREMT Disciplinary Policy and Rights of Appeal can be found here. Requests to appeal must be submitted within forty-five (45) days of receipt of notice of determination.
Responsibilities of Certified Emergency Medical Technician (EMTs)
Certified Emergency Medical Technician (EMTs) must notify the NREMT within 30 days regarding the following matters:
change in mailing address.
any felony conviction.
disciplinary action taken by any state has resulted in suspension, revocation, or expiration of state registration/licensure; termination of right to practice; voluntary surrender of state registration/licensure while under investigation.
The NREMT considers the individual to be solely responsible for their certification.
In applying for recertification, certified EMS professionals agree to comply with all recertification requirements, rules and standards of the National Registry of Emergency Medical Technicians (NREMT). The recertification applicant bears the burden of demonstrating and maintaining compliance at all times.
To Apply For Recertification You Must:
Be actively working within an emergency medical service, rescue service, or patient health care facility using your EMT skills.
If you wish to request Inactive Status and this is your first recertification, you must provide documentation that you have worked in a patient care setting for at least six months.
Complete all recertification requirements.
Demonstrate continued cognitive competency through continuing education or examination.
Submit your completed recertification application prior to March 31 of the year your certification expires.
Continuing Education Option
Complete a total of 72 hours of education including:
Completion of a State of CECBEMS (F1, F2, F5) approved 24 hour EMT Refresher Course
Completion of 48 hours of additional continuing EMS related education as outlined below
Pay the $15.00 (US funds) non-refundable processing fee at the time of submission of documentation
Maintain skills as verified by your Training Program Director, Director of Operations or Physician Medical Director. (requires signature on your recertification application validating competency of skills)
Obtain current CPR certification at the appropriate level
All continuing education hours, to include the refresher, must be completed within the current recertification cycle. Education completed prior to your previous March 31 expiration date will NOT be accepted. If this is your first recertification, only education completed after the date of initial certification will be accepted.
The recertification by examination option enables you to demonstrate continued cognitive competence without requiring you to document your continuing education.
- Log in to your NREMT account. Complete a recertification by examination application and pay the exam fee. Be sure you are completing the recertification application (and not the initial certification application)
- After 24-48 hours, go to the NREMT website, log in to your account and print your Authorization to Test (ATT) letter. Follow the directions on the letter to schedule your exam
- Take and pass the exam between October 1 and March 31 (of the year your certification expires). You may make one attempt to demonstrate continued cognitive competency by taking an exam (in lieu of documenting continuing education). You will receive an abbreviated recertification application upon successful completion of the exam.
- Return the abbreviated recertification application by March 31 (of the year your certification expires) with signatures and supporting documentation
All other recertification requirements (including felony statement, CPR, active affiliation/practice, verification of skills, etc.) must be met and verified.
Detailed Continuing Education Requirements
Completion of a State or CECBEMS (F1, F2, F5) approved EMT Refresher Course OR Continuing Education
The EMT Refresher course can be completed through two different options:
Traditional refresher course - Completion of a State or CECBEMS (F1, F2, F5) approved 24 hour EMT Refresher course.
Continuing education topical hours - EMT refresher may be completed by continuing education* and must include the following:
|OB, Infants, Children||2 hours|
|Patient Assessment||3 hours|
* Some states require the traditional refresher course and will not accept continuing education hours. Please refer to your state’s particular requirements.
** A maximum number of 10 hours can be applied from Distributive Education toward this section and must be state or CECBEMS approved.
Additional EMS Related Continuing Education-48 hours
The following are maximum hours per course that can be applied towards Additional EMS Related Continuing Education hours:
A maximum number of 24 hours can be applied from any one topic area
Hour for hour credit can be applied for standardized courses (including, but not limited to, ABLS, ACLS, AMLS, EMPACT, EPC, PHTLS, PALS, PEPP, etc.)
A maximum number of 12 hours can be applied from each of the following courses: Teaching CPR - Emergency Driving - Dispatch Training
A maximum number of 24 hours can be applied from Distributive Education towards this section and must be State or CECBEMS approved
Hour for hour credit can be applied for college courses that relate to your role as an EMS professional (1 college credit = 8 CEU). For example, but not limited to anatomy, physiology, biology, chemistry, pharmacology, psychology, sociology, statistics, etc.
Hours from the following courses can be applied hour for hour with no maximum: Advanced Trauma Life Support, EMS Course Instruction, and Wilderness EMS Training.
Courses that Cannot Be Applied Towards Additional Continuing Education Hours: Clinical Rotations, CPR, Emergency Medical Responder Course, home study programs, instructor courses, management/leadership courses, performance of duty, preceptor hours, serving as a skill examination, and volunteer time with agencies.
Submission of an approved CPR credential for the professional rescuer. Credential must be current and valid. Verification may be in the form of an instructor's signature on the recertification application or copies of both sides of a current card.
Inactive status can only be requested by NREMTs who have completed at least 6 months of EMS patient care during their first registration cycle.
Inactive status with the NREMT signifies a National Certified provider who is currently not providing patient care. Often this is misunderstood. Registrants who wish to declare inactive status must continue to meet the NREMT recertification requirements. The NREMT confirms that “inactive” EMS providers are “not working.” Therefore, inactive status is useful for administrators, educators, managers, etc., but not for those who have left EMS and also failed to maintain competency via completion of the recertification education requirements.
Inactive status is not for those unable to obtain and meet the educational requirements or those who have had limitations or revocation of a health care license.
Registrants who request inactive status at the EMR and EMT levels do not need to obtain verification of skills from their training officers. Again, these registrants must complete all refresher, continuing education and CPR requirements. These registrants are eligible to recertify via examination if they so choose. CPR certification remains a requirement even for those who pass the examination.
Registrants who request inactive status at the AEMT or Paramedic levels do not need to obtain verification of skills from their medical directors. Again, these registrants must complete all refresher, continuing education and both CPR and ACLS requirements. These registrants are eligible to recertify via examination if they so choose. CPR and ACLS remain a requirement even for those who pass the examination.
Applying for Active Status when registered as Inactive
Movement from Inactive to Active status requires the registrant to complete Section III of the re-certification requirements. Fundamentally the registrant must work with their future or current employer so that he/she is willing to verify competency of the skills found on the recertification form. In order to do this the registrant must retrieve the form from the NREMT website Click here, have the form completed and then forward it to the NREMT. No fee is required to move from inactive to active status.