New Research Quantifies Impacts of National Registry of Certified Medical Examiners

Contact: Rebecca Brewster
(770) 432-0628
April 17, 2017

Arlington, VA – The American Transportation Research Institute (ATRI), the trucking industry’s not-for-profit research organization, today released the results of its analysis of the Federal Motor Carrier Safety Administration’s National Registry of Certified Medical Examiners (NRCME), conducted in collaboration with Mayo Clinic.

ATRI and Mayo Clinic jointly surveyed over 900 commercial drivers, 300 motor carriers and 1,200 certified medical examiners (CMEs) to better understand the impacts that the NRCME has had on the trucking industry since its implementation in 2014.  The NRCME was designed to improve the DOT physical exam process and ensure that medical examiners understand FMCSA regulations and guidance for issuing medical certificates.

ATRI’s research focused on commercial driver and motor carrier impacts and identified the following:

  • A majority of drivers (63.3%) reported increased exam costs following implementation of the NRCME, yet were not experiencing commensurate improvements in exam quality; only 6.2 percent of drivers reported improved exam quality post-NRCME implementation.
  • 6 percent of drivers reported spending 20 minutes or less with their CME, with 6.5 percent of those drivers spending 10 minutes or less, an insufficient time to complete all required processes of a DOT physical.  Drivers certified by chiropractors were more likely to have important medical checks omitted.
  • Among the 5.9 percent of drivers who were not issued a medical certificate on the day of their physical exam, 22.6 percent cited having a medical condition that required treatment before certificate issuance as the reason.
  • Motor carriers still have significant concerns related to the medical certification process, including requests by CMEs for additional medical documentation causing certification delays, driver confusion of how regulatory changes impact the ability to hold a valid medical certificate, and concerns with the competency of CMEs.  Nearly 50 percent of motor carriers reported that they specify which CME their drivers see to ensure medical exam quality.
  • Less than one percent of carriers reported no major concerns with the medical certification process.
  • The ability of drivers to find a CME close to where they live may be more challenging in the future as 15.3 percent of CMEs reported that they have quit performing DOT physicals or plan to quit performing DOT physicals.

“The data show a polarity in quality of medical examiners,” said Clayton T. Cowl, MD, MS, Chair of Mayo Clinic’s Division of Preventive, Occupational and Aerospace Medicine.  “Those examiners who are performing only minimal examinations may have received substandard training or are not taking their role seriously. The key seems to strike a balance between meeting the regulatory intent of the examinations and communicating with drivers ahead of time to minimize confusion regarding the need to document clinical stability. This is particularly true for drivers with multiple or complex medical conditions from whom medical examiners do need more documentation in order to make a certification decision.”

“The inconsistency in quality of exams provided our drivers creates real challenges for us as a fleet.  Where in one terminal location a driver may be required to undergo extensive tests and provide additional documentation prior to getting a medical certificate, drivers in other locations are expedited through with cursory exams,” said Victor Hart, Director of Safety for DOT Transportation.

You can download a copy of this report, as well as a white paper detailing the findings of Mayo Clinic’s survey of medical examiners, on ATRI’s website by clicking here.

Click here to listen to ATRI’s Rebecca Brewster and Mayo Clinic’s Dr. Clay Cowl discuss the research findings.

ATRI is the trucking industry’s 501(c)(3) not-for-profit research organization.  It is engaged in critical research relating to freight transportation’s essential role in maintaining a safe, secure and efficient transportation system. To learn more about ATRI, visit

Mayo Clinic is a nonprofit organization committed to clinical practice, education and research, providing expert, whole-person care to everyone who needs healing. For more information, visit or

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