National Registry of EMTs

Certification Eligibility, Discipline and Appeals

The Purpose of Certification and the National Registry

Download a PDF of this policy.

The National Registry of Emergency Medical Technicians (National Registry) is the National EMS Certification as outlined in the National EMS Education Agenda for the Future: A Systems Approach. National EMS Certification is utilized in the EMS licensure process in the United States. The National Registry conducts its activities in accordance with its mission to certify and register Emergency Medical Services (“EMS”) Professionals throughout their careers by a valid and uniform process which assesses the knowledge and skills for competent practice and by maintaining a database of registrants. Registry policies are established to assure the public, EMS licensing or authorizing agencies, employers and other healthcare providers that certified EMS professionals have demonstrated the required knowledge and skills to practice safely and effectively.

The Role of the National Registry

In its role as the Nation's EMS certification, the National Registry:

  • Establishes eligibility requirements for applicants for certification
  • Develops examination requirements (cognitive and psychomotor)
  • Establishes re-certification requirements
  • Reviews applicants’ self-disclosed criminal convictions and actions taken against their healthcare related professional licenses
  • Monitors certification status of registrants and takes appropriate action against the certification when apprised of adverse licensure actions and criminal convictions
  • Provides to licensing or authorizing agencies obtained adverse licensure action and criminal conviction information regarding registered EMS professionals

The National Registry does not :

  • establish, accredit or approve education programs for certification or recertification
  • Assess job performance
  • Assess fitness for all aspects of job performance (physical, mental, criminal background clearance)
  • Investigate complaints regarding EMS practice
  • Establish scopes of practice or standards of care
  • Establish job-related standards of professional behavior

Learn more about the differences between certification and state licensure.

Eligibility for Certification or Recertification
  1. To be eligible to apply for certification or recertification, an individual must at all times be eligible for or hold a full and unrestricted license to practice as an EMS professional under the laws of the licensing or authorizing agency of the jurisdiction(s) in which he practices. The National Registry may deny an individual eligibility for certification or recertification because of the limitation, suspension or revocation of any of the individual’s licenses to practice as an EMS Provider or other healthcare professional by any licensing or authorizing agency or the surrender of such a license while under investigation and/or in lieu of disciplinary action against his license.
    • An individual is not rendered ineligible for certification if the individual is denied licensure solely by reason of seeking licensure in a jurisdiction which does not recognize National Registry certification as a basis for licensure as an EMS professional.
    • An individual is not rendered ineligible because of entry into and successful participation in a non-disciplinary rehabilitation or diversionary program for chemical dependency authorized by the applicable licensing or authorizing agency.
    • An individual may not be rendered ineligible solely on the basis of a limitation, suspension, termination or surrender of a license in any jurisdiction where the applicant does not practice and/or where the action of such jurisdiction is based upon and derivative of a prior disciplinary action taken by another jurisdiction where the applicant has a full and unrestricted license in the jurisdiction in which he practices, and provided further that the jurisdiction, in granting such licensure, was aware of the applicant’s outstanding disciplinary actions in other jurisdiction(s).
  2. An individual must comply with all initial certification and recertification requirements, deadlines, rules and standards of the National Registry as set out in the Entry Requirements and Application Process provisions for the applicable level of EMS professional posted on the National Registry’s website and described in the National Registry’s Requirements brochures. The individual bears the burden of demonstrating and maintaining compliance at all times. The National Registry considers the individual to be solely responsible for his certification.
  3. An individual must truthfully complete and submit an application in the form provided by the National Registry and shall provide all additional information as requested.
  4. An individual must submit a complete recertification application on or before the expiration date (post-marked) for consideration of recertification.
  5. An individual convicted of a felony or any other crime directly related to public health or the provision of emergency medical service will be reviewed for eligibility for certification and recertification under policies outlined in the National Registry's Criminal Conviction Policy.
  6. The National Registry reserves the right to withhold or revoke certification or recertification in the event an applicant fails to make payment in full of all applicable fees. An applicant may not take a National Registry examination if the application fee has been stopped, cancelled or otherwise revoked, either by the applicant or a financial institution. An applicant will not be issued an authorization to take a National Registry examination until payment of the application fee in full has been made for all previous National Registry examinations for which such fee is due. National Registry also reserves the right to hold, cancel or revoke an applicant’s results on a National Registry examination for which payment in full has not been made.
  7. The National Registry also may require an applicant to retake a certification examination if presented with sufficient evidence that the security or integrity of the examination has been compromised, notwithstanding the absence of any evidence of an applicant’s personal involvement in the security compromise.
Review of Applications
  • The National Registry requires submission of accurate and valid information demonstrating an applicant's fulfillment of National Registry requirements for certification and recertification. The National Registry has developed a secure web site to facilitate communication between a variety of individuals who are responsible for providing the necessary documentation to be submitted by applicants and EMS professionals.
  • Individuals using the National Registry web site are subject to and must comply with the website Terms of Use Policy.
Terms of Certification

In applying for certification or recertification, and as a condition for the maintenance of certification, an applicant or registrant agrees that:

  1. The National Registry's examinations, certificates, cards, logos, emblems, the name "National Registry of Emergency Medical Technicians," the copyrighted phrase “The National Registry is the National EMS Certification” and abbreviations relating thereto are all exclusive property of the National Registry and are protected by trademarks and copyrights. They may not be used for any purpose, other than accurately identifying an individual as a National Registry registrant or referencing the National Registry and its examinations, without express written consent.
  2. The individual will immediately relinquish and refrain from using any National Registry certificate, card, logo, emblem, and the National Registry's name and related abbreviations in case of expiration, suspension, limitation, revocation or voluntary surrender of the individual's certification or as otherwise requested by the National Registry.
  3. If the individual misappropriates any National Registry property or refuses immediately to relinquish, refrain from using and correct at their expense any misuse or misleading use of any of the above identified National Registry intellectual property when requested, the National Registry shall be entitled to obtain injunctive relief, damages, costs and attorney's fees incurred in obtaining any such or other relief.
  4. The individual will notify the National Registry within thirty (30) days of the occurrence of any and all of the following: any change in address, e-mail address, telephone number, state of employment and licensure and any other facts bearing on eligibility or certification, including, but not limited to, the initiation of any disciplinary action by any state which has resulted in the suspension, revocation or restriction placed on the individual’s license, or right to practice or voluntary surrender of state registration of license while under investigation (or in lieu of disciplinary action) and any felony conviction.
  5. The individual authorizes the National Registry and its agents to communicate all information relating to National Registry application, certification and review thereof, including the misrepresentation of material information on an application or of National Registry certification status and/or the outcome of disciplinary proceedings, to state and federal authorities.
Examination Irregular Behavior

Applicants should understand that engagement in any of the following activities may be sufficient cause to bar them from future examinations, to terminate their participation in an ongoing examination, to withhold, invalidate or revoke their results on an examination, to declare them ineligible for certification, to revoke their certifications or to take other appropriate action:

  1. The giving or receiving of aid in the examination as evidenced either by observation or by statistical analysis of answers of one or more participants in the examination, including:
    • Any transfer of information or signals between examinees during the examination. This prohibition includes any transfer of information between an examinee and any other person at any time during the testing period, including bathroom breaks.
    • Any appearance of looking at the answers of another examinee during the examination.
    • Allowing another examinee to view one's answers or otherwise assisting another examinee in the examination.
    • Taking or seeking to take an examination for another candidate or causing another individual to take or attempt to take an examination on the candidate’s behalf.
  2. The unauthorized possession or reference to, books, notes, or other study, test or preparation materials at any time at the testing site, including bathroom breaks. Prohibited material includes written or electronically stored information or information transferred by electronic, acoustical, or other means and devices, including cell phones.
  3. The making of threats to or engaging in unprofessional or abusive actions toward National Registry staff or agents.
  4. The offering of any benefit to any agent of the National Registry or the testing service and/or a testing site administrator in return for any aid or assistance in taking an examination.
  5. Creating a disturbance at the testing site, engaging in profane or abusive language directed at examinees or testing site administrators, tampering with the computer or otherwise not following the directions of a testing site administrator.
  6. The unauthorized possession, disclosure, reproduction, dissemination or use of any examination content or materials or the solicitation of same. All examination materials are the property of the National Registry.
Denial or Revocation of Certification and Disciplinary Actions

The National Registry may, in its sole discretion, deny an individual’s eligibility for initial certification or recertification, deny, suspend or revoke an individual's certification or take any other appropriate disciplinary action with respect to an individual’s application, certification and/or recertification or deny authorization to use the National Registry’s website for any and all purposes, including submitting applicant training information in the case of:

  • Ineligibility for National Registry certification.
  • Failure to comply with any policy or rule of the National Registry, including, but not limited to, National Registry’s website Terms of Use Policy.
  • Irregular behavior in connection with any National Registry examination.
  • The intentional and material misrepresentation, withholding of any material information or the failure to provide National Registry updated information on any application for certification or recertification or in any other representation or communication to the National Registry.
  • The intentional misrepresentation by a trainer of any applicant’s satisfaction of the training requirements for certification.
  • Misrepresentation of the individual's status as a registrant of the National Registry.
  • The conviction of, plea of guilty or plea of nolo contendere to, a felony or any criminal offense which is directly related to public health or the provision of emergency medical service in accordance with the National Registry’s Criminal Conviction Policy.
  • Limitation, suspension, revocation or other disciplinary action by a licensing or authorizing agency relating to practice, or the ability to practice safely and effectively, as an EMS professional or the voluntary surrender of a licensee in connection with or in lieu of any such disciplinary action. The National Registry reserves the right summarily to suspend an individual’s certification, prior to the exhaustion of any right of appeal, upon the revocation or summary or emergency suspension of the individual’s license by a licensing or authorizing agency based on the agency’s finding that the individual poses an imminent threat to the public and/or cannot practice safely and effectively.
  • Copying, reproducing, disclosing, disseminating or removing of examination related materials from the test site, attempting to do same or solicit the same.

Notice of Disciplinary Action

When the National Registry makes an unfavorable ruling regarding an individual's application for certification or recertification, request for an accommodation in the administration of an examination, cancellation or revocation of examination results or any disciplinary action, including, but not limited to, the revocation or suspension of certification (collectively “Adverse Decision”), the Executive Director shall send to that individual, by certified mail, return receipt requested, a statement setting forth:

  • The action taken.
  • The reason(s) for the action and, if applicable, a statement of facts constituting the alleged violation of any of the National Registry's rules or standards or the reasons for ineligibility
  • The time period in which the individual may appeal and provide any additional information.

Appeal Process

An applicant or registrant who is subject to an Adverse Decision of the Executive Director, excluding decisions with respect to the timeliness of applications or the scoring or reporting of the examinations, may appeal such decision by mailing a notice of appeal to the office of the National Registry within forty-five (45) days of the date that such decision was mailed (based on postmark). The request for appeal must contain the individual’s statement of the basis of his appeal, as well as any documents in support of the appeal. Materials not included in the request shall not be considered on appeal unless expressly requested in writing by the National Registry.

  1. Upon receipt of a notice of appeal, the Credentials Committee of the National Registry shall consider any additional information submitted by the individual in support of his or her appeal and make such further investigation as it deems appropriate
  2. If the Credentials Committee grants the appeal, it shall so notify the individual in writing from the Executive Director.
  3. In the event the Credentials Committee denies the appeal, the Executive Director shall so notify the affected individual and inform that individual that:
    • He shall have forty-five (45) days from the date such decision was mailed to him to appeal the decision and provide any supporting statement and/or documentation for the appeal;
    • if an appeal is made, a hearing on the appeal shall be held before an Appeals Committee; and
    • the individual may appear at the hearing in person and produce evidence on his behalf, including submission of his written supporting statement and/or documents. The individual may be represented by legal counsel.
  4. Hearing Process
    1. In the event of an appeal, the Chairman of the Board of Directors shall designate an Appeals Committee consisting of three (3) members of the Board of Directors who are not on the Credentials Committee.
      • The Hearing Panel shall convene at a site designated by the National Registry.
      • The Executive Director shall send the individual by certified mail, return receipt requested, a Notice of Hearing. The Notice of Hearing shall include a statement of the time and place of the hearing. The individual making the appeal must confirm in writing his attendance at the hearing no later than seven (7) days before the date and time of the scheduled hearing.
    2. The Appeals Committee shall determine all matters relating to the hearing by majority vote. A written record shall be made of the proceedings, and shall be available to the individual at a reasonable cost following the hearing.
  5. Evidence. Formal rules of evidence shall not apply. All information related to the allegations shall be admissible at the hearing, whether or not such information would be admissible in a court of law. The purpose of the hearing is to assemble as much information as practical regarding all material aspects of the situation, and the Appeals Committee shall be entitled to take into account any such information of the type normally relied upon by individuals of reasonable prudence in the conduct of important personal matters. Disputed questions shall be determined by majority vote of the Appeals Committee.
  6. Decision. The decision of the Appeals Committee shall be made by a majority of the Committee and shall be rendered in writing following the hearing. The decision shall contain the basis for the determination to uphold, modify or overrule the decision of the Credentials Committee and for any sanction(s) applied. It shall be transmitted to the individual by certified mail, return receipt requested. The decision of the Appeals Committee shall be final and binding.
  7. Release of Information. The appeals procedure authorizes the National Registry and its agents to communicate all information relating to National Registry application, registration and review thereof, including outcome of disciplinary proceedings, to state and federal authorities.
  8. Certification Status Pending Appeal. A registrant’s designation as certified on National Registry’s rolls shall not be changed pending the opportunity for the registrant to appeal to the Credentials Committee a decision of the Executive Director to suspend or revoke his certification. Upon the denial by the Credentials Committee of an appeal of the Executive Director’s decision to suspend or revoke a registrant’s certification, the registrant’s certification shall be designated on the National Registry’s rolls as suspended. A registrant shall not be removed from National Registry’s rolls as a registrant until the exhaustion of all appeals or the expiration of the time in which to appeal a decision denying recertification or revoking certification.

Appealing Psychomotor (Practical skills) Examination

An examinee who believes that the psychomotor examination was administered in an inaccurate or unfair manner for any reason, including, but not limited to, an equipment malfunction, discrimination or bias of an examiner, must on the day of the examination immediately register a complaint and request for re-examination. The request shall be made to the National Registry Representative on the complaint form provided.

Upon a complaint being made, a Quality Assurance Committee, consisting of the Physician Medical Director, the Examination Coordinator, and the National Registry Representative shall be convened. When the National Registry Representative is also acting as the Examination Coordinator, a third uninvolved, unbiased person will be appointed to the Committee. The Committee may discuss the matter with the examinee and the involved skill station examiner(s), if necessary, and make such other investigation as they may deem appropriate. If a majority of the Committee determines that reasonable grounds exist for the examinee's complaint, the examinee shall be reexamined immediately by a different skill station examiner. The first examination will be disregarded and only the examinee’s performance on the re-examination shall be considered in determining his score on the examination.

The determination of the Quality Assurance Committee is final and binding upon the examinee. There shall be no further appeal from a failure on the practical examination.

Reconsideration of Eligibility and
Reinstatement of Certification

An individual’s certification may be reinstated after revocation upon new application for certification only on the following basis:

  • The individual satisfies all eligibility requirements for certification in effect as of the request for reinstatement.
  • In the event of a criminal conviction or conviction for a crime directly related to public health or the provision of emergency medical service, no earlier than one (1) year from the exhaustion of appeals, release from confinement or reinstatement of license, whichever is later.
  • In any other event, no earlier than one (1) year from the final decision of ineligibility for or revocation of certification.
  • In addition to other information required for application, an individual seeking reinstatement must fully set forth the circumstances of the decision denying eligibility or revoking certification as well as all facts and circumstances relevant to the application occurring after the decision. Where eligibility is denied because of criminal conviction, the individual bears the burden of demonstrating by clear and convincing evidence that the individual has been rehabilitated and does not pose a danger to others.
Submission of Information to National Registry Concerning
Possible Violation of National Registry Standards

Persons with information regarding a possible violation of National Registry policies should submit such information in writing addressed to the Executive Director. This information should identify the persons alleged to be involved and the facts concerning the alleged conduct in as much detail and specificity as possible, supplying all available supporting documentation. The statement should identify by name, address and telephone number the person making the information known to the National Registry and others who may have knowledge of the facts and circumstances concerning the alleged conduct. Supplemental information may be requested.

National Registry may forward reported information to the state. National Registry will not accept an anonymous letter or take action based upon an anonymous claim.