The National Registry is not a directory that clinics opt into. It is a certification scheme with an eligibility test, a mandatory training programme, an exam, a ten-year credential, a fixed retraining schedule and a documented removal process. All of it sits in 49 CFR Part 390 Subpart D, sections 390.103 through 390.115. If you are a driver choosing a clinic, or a clinician deciding whether to get certified, this is what the rule requires.
Who is eligible at all
Section 390.103(a)(1) sets the professional gate. To receive medical examiner certification from FMCSA a person must be licensed, certified or registered in accordance with applicable state laws and regulations to perform physical examinations, and must be one of: an advanced practice nurse, doctor of chiropractic, doctor of medicine, doctor of osteopathy, physician assistant, or other medical professional authorized by applicable state laws and regulations to perform physical examinations.
That list is wider than most people assume. A doctor of chiropractic and a physician assistant are both explicitly named. The operative constraint is the state authorization to perform physical examinations, not the specific degree.
The order of operations, which the rule fixes
The remaining paragraphs of 390.103(a) have to be done in sequence, and the sequence is part of the requirement.
- Register first. Under 390.103(a)(2), the person must register on the National Registry website and receive a National Registry number before taking the training. Training taken before registration does not count.
- Complete a training programme meeting the requirements of 390.105 (390.103(a)(3)).
- Pass the certification test provided by FMCSA and administered by a testing organization meeting 390.107, where the organization has electronically forwarded the completed test information to FMCSA no more than 3 years after completion of the training (390.103(a)(4)). Let more than three years elapse between training and test and the training has to be redone.
Section 390.109 covers issuance of the FMCSA medical examiner certification credential once those steps are complete.
Staying listed
Section 390.111(a) lists five continuing obligations. The examiner must continue to meet the requirements of 390.103 through 390.115 and the applicable requirements of Part 391; must report any change in the registration information submitted under 390.103(a)(2) within 30 days; must continue to be licensed, certified or registered and authorized to perform physical examinations under the laws of each state in which they examine; and must maintain documentation of that state licensure for each such state plus documentation of all required training.
The documentation duty in 390.111(a)(4) carries two different deadlines, which is unusual enough to be worth quoting: the examiner must produce the documentation within 48 hours of a request for investigations, and within 10 days of a request for regular audits of eligibility.
The retraining and retesting schedule
Section 390.111(a)(5) sets the maintenance cycle against the date the credential was issued:
- No sooner than 4 years and no later than 5 years after issuance: complete periodic training as specified by FMCSA (390.111(a)(5)(i)).
- No sooner than 9 years and no later than 10 years after issuance: complete periodic training and pass the test required by 390.103(a)(4) again (390.111(a)(5)(ii)).
Section 390.111(b) then says FMCSA will issue a new credential valid for 10 years to an examiner who complies with (a)(1) through (4) and successfully completes the training and testing in (a)(5). Note the "no sooner than" in both windows: early training does not count, which catches people who try to get ahead of the deadline.
Why an examiner gets removed
Section 390.113 opens by saying FMCSA may remove an examiner who fails to meet or maintain the qualifications in 390.103 through 390.115, the requirements of other applicable regulations, or the requirements of 49 U.S.C. 31149. It then gives a non-exhaustive list of reasons, and the list is informative about what the agency is actually policing:
- failure to comply with the continued-listing requirements of 390.111 (390.113(a));
- FMCSA finding errors, omissions or other indications of improper certification in the completed Medical Examination Reports or the certificates (390.113(b));
- FMCSA determining the examiner issued a certificate to a driver who failed to meet the applicable standards at the time of the examination (390.113(c));
- failure to comply with the examination requirements in 391.43 (390.113(d));
- falsely claiming to have completed the required training (390.113(e)).
Section 390.115 sets out the procedure for removal. The existence of a documented procedure, rather than a discretionary delisting, is the reason the registry is worth checking: a listed examiner is one the agency has not removed under a process it has to follow.
The VA track, which is genuinely separate
Sections 390.123 through 390.135 run a parallel scheme for qualified Department of Veterans Affairs examiners: certification under 390.123, training under 390.125, testing under 390.127, credential issuance under 390.129, continued listing under 390.131, and reasons and procedure for removal under 390.133 and 390.135. This matters to drivers because of the limit in 391.43(b)(2): a certified VA medical examiner must only perform medical examinations of veteran operators. A VA-track examiner is not an alternative for a non-veteran driver.
What this means when you are picking a clinic
The one hard rule is 391.43(a): the examiner has to be on the registry. Everything above tells you what being on it involves, and suggests a few things worth asking:
- Ask for the National Registry number. Every certified examiner has one, because 390.103(a)(2) issues it before training even begins.
- Ask when the credential was issued. The 390.111(a)(5) schedule runs from that date, so an examiner approaching year 10 has a retest ahead of them.
- If you examine in more than one state, or the clinic operates across a state line, 390.111(a)(3) requires the examiner to be authorized in each state where they perform examinations, not just the one where the clinic is registered.
- A certified VA examiner can only examine veterans, under 391.43(b)(2). Worth confirming before booking.
The listings in this directory carry the certification dates the source register publishes and a last-checked date on every card. They are a convenience for finding and comparing clinics, and they are not the National Registry. For a definitive answer on whether an individual examiner is currently listed, check the registry itself or ask the clinic for the number and verify it.