The National Registry of Certified Medical Examiners (NRCME) is a program of the Federal Motor Carrier Safety Administration (FMCSA) that certifies and tracks the medical professionals authorized to perform DOT physical examinations for interstate commercial motor vehicle (CMV) drivers. Since May 21, 2014, federal regulation has required that all DOT physicals for CDL holders be performed by an examiner listed on the NRCME — Medical Examiner Certificates issued by non-listed examiners are invalid. To join the registry, providers must complete an accredited training program, pass a national certification exam, register with FMCSA, and recertify every 10 years (with a periodic refresher requirement in between). Examination results must be submitted electronically to FMCSA by midnight of the following calendar day. For occupational-health clinics offering DOT physicals, NRCME credentialing is a prerequisite, not an enhancement — and is one of the most common reasons clinics turn away CDL exam requests.