DOT Medical Examiner Exam Preparation
Guide 2026 Updated Complete Practice
Questions & A-Rated Solutions | NRCME
Certification Exam
SECTION 1: FMCSA REGULATIONS & GUIDELINES (Questions 1-15)
Q1: According to FMCSA regulations (49 CFR 391.45), what is the MAXIMUM duration
for a Medical Examiner's Certificate (Form MCSA-5876) for a driver who meets all
physical qualifications without any conditions requiring monitoring?
A. 12 months
B. 24 months
C. 36 months
D. 60 months
Correct Answer: B
Rationale: 49 CFR 391.45(e) specifies that the Medical Examiner's Certificate is valid for
a maximum of 24 months from the date of examination. The medical examiner may
issue a certificate for less than 24 months based on the driver's medical condition
requiring monitoring (e.g., 12 months for hypertension, 3 months for new treatment).
,Option A (12 months) is common for many conditions but not the maximum. Option C
exceeds federal limits. Option D is not applicable to DOT medical certification.
Q2: A commercial driver presents for their DOT medical examination. Which form
documents the driver's medical history and the examiner's physical examination
findings?
A. Form MCSA-5876 (Medical Examiner's Certificate)
B. Form MCSA-5875 (Medical Examination Report)
C. Form MCSA-5870 (Insulin-Treated Diabetes Mellitus Assessment)
D. Form MCSA-5890 (Skill Performance Evaluation Certificate)
Correct Answer: B
Rationale: Form MCSA-5875 is the Medical Examination Report form that documents
the driver's health history (Section 1: Driver Information and Health History) and the
examiner's physical examination findings (Section 2: Examination). Form MCSA-5876
(A) is the wallet-card certificate issued to qualified drivers. Form MCSA-5870 (C) is
specifically for insulin-treated diabetes assessment by the treating clinician. Form
MCSA-5890 (D) is the SPE certificate for drivers with physical impairments.
Q3 (SATA): Which of the following conditions would require the medical examiner to
issue a certificate for LESS than the maximum 24 months? Select all that apply.
A. Hypertension Stage 1 (140-159/90-99) on stable medication
B. Recent myocardial infarction 3 months ago with cardiology clearance
C. Insulin-treated diabetes mellitus with stable control
,D. Obstructive sleep apnea on CPAP with 90% compliance
E. History of alcohol abuse with 2 years sobriety and SAP clearance
Correct Answers: A, B, C, D, E
Rationale: All options represent conditions requiring shorter certification periods: (A)
Stage 1 hypertension requires annual certification even if controlled; (B) Post-MI
requires monitoring with typically 1-year certification even after clearance; (C) ITDM
maximum certification is 12 months per 49 CFR 391.46 (not 24 months); (D) OSA
requires periodic compliance verification (typically annual); (E) History of substance
abuse requires annual monitoring even after return-to-duty. This question tests
knowledge that ITDM has a mandatory maximum 12-month limit, and other conditions
require individualized shorter periods.
Q4: A driver operates a commercial vehicle only within one state (intrastate commerce).
The driver holds a regular driver's license, not a CDL. According to FMCSA regulations,
which statement is correct?
A. The driver is completely exempt from DOT medical examination requirements
B. The driver must comply with FMCSA standards if the state has adopted them for
intrastate commerce
C. Only drivers crossing state lines require medical certification
D. The driver needs only a state medical waiver, not a DOT physical
Correct Answer: B
Rationale: While 49 CFR Part 391 directly applies to interstate commerce, most states
have adopted FMCSA physical qualification standards for intrastate commercial drivers
, through state regulations. Medical examiners must be familiar with their specific state's
requirements. Option A is incorrect because many states require compliance. Option C
is incorrect because intrastate commercial drivers may still need certification. Option D
is incorrect; state waivers are separate from federal certification.
Q5: Beginning June 23, 2025, what significant change occurred regarding Medical
Examiner's Certificates for CDL/CLP holders?
A. Medical examiners no longer need to be registered with the National Registry
B. CDL/CLP holders no longer need to carry paper copies of their medical certificates
C. The maximum certification period was extended to 36 months
D. Intrastate drivers became exempt from all medical certification
Correct Answer: B
Rationale: The June 23, 2025 regulatory change implemented automatic electronic
transmission of medical exam results from the National Registry to State Driver
Licensing Agencies (SDLAs). CDL/CLP holders no longer need to carry paper
certificates as their medical certification status is verified electronically through the
Commercial Driver's License Information System (CDLIS). Medical examiners must still
submit results by midnight the next calendar day. Option A is false; NRCME registration
remains mandatory. Option C is false; 24-month maximum remains. Option D is false;
intrastate requirements remain state-dependent.
Q6: A medical examiner is completing the Medical Examination Report (Form
MCSA-5875). Which section must the examiner complete to indicate the driver does not
meet FMCSA physical qualification standards?
Guide 2026 Updated Complete Practice
Questions & A-Rated Solutions | NRCME
Certification Exam
SECTION 1: FMCSA REGULATIONS & GUIDELINES (Questions 1-15)
Q1: According to FMCSA regulations (49 CFR 391.45), what is the MAXIMUM duration
for a Medical Examiner's Certificate (Form MCSA-5876) for a driver who meets all
physical qualifications without any conditions requiring monitoring?
A. 12 months
B. 24 months
C. 36 months
D. 60 months
Correct Answer: B
Rationale: 49 CFR 391.45(e) specifies that the Medical Examiner's Certificate is valid for
a maximum of 24 months from the date of examination. The medical examiner may
issue a certificate for less than 24 months based on the driver's medical condition
requiring monitoring (e.g., 12 months for hypertension, 3 months for new treatment).
,Option A (12 months) is common for many conditions but not the maximum. Option C
exceeds federal limits. Option D is not applicable to DOT medical certification.
Q2: A commercial driver presents for their DOT medical examination. Which form
documents the driver's medical history and the examiner's physical examination
findings?
A. Form MCSA-5876 (Medical Examiner's Certificate)
B. Form MCSA-5875 (Medical Examination Report)
C. Form MCSA-5870 (Insulin-Treated Diabetes Mellitus Assessment)
D. Form MCSA-5890 (Skill Performance Evaluation Certificate)
Correct Answer: B
Rationale: Form MCSA-5875 is the Medical Examination Report form that documents
the driver's health history (Section 1: Driver Information and Health History) and the
examiner's physical examination findings (Section 2: Examination). Form MCSA-5876
(A) is the wallet-card certificate issued to qualified drivers. Form MCSA-5870 (C) is
specifically for insulin-treated diabetes assessment by the treating clinician. Form
MCSA-5890 (D) is the SPE certificate for drivers with physical impairments.
Q3 (SATA): Which of the following conditions would require the medical examiner to
issue a certificate for LESS than the maximum 24 months? Select all that apply.
A. Hypertension Stage 1 (140-159/90-99) on stable medication
B. Recent myocardial infarction 3 months ago with cardiology clearance
C. Insulin-treated diabetes mellitus with stable control
,D. Obstructive sleep apnea on CPAP with 90% compliance
E. History of alcohol abuse with 2 years sobriety and SAP clearance
Correct Answers: A, B, C, D, E
Rationale: All options represent conditions requiring shorter certification periods: (A)
Stage 1 hypertension requires annual certification even if controlled; (B) Post-MI
requires monitoring with typically 1-year certification even after clearance; (C) ITDM
maximum certification is 12 months per 49 CFR 391.46 (not 24 months); (D) OSA
requires periodic compliance verification (typically annual); (E) History of substance
abuse requires annual monitoring even after return-to-duty. This question tests
knowledge that ITDM has a mandatory maximum 12-month limit, and other conditions
require individualized shorter periods.
Q4: A driver operates a commercial vehicle only within one state (intrastate commerce).
The driver holds a regular driver's license, not a CDL. According to FMCSA regulations,
which statement is correct?
A. The driver is completely exempt from DOT medical examination requirements
B. The driver must comply with FMCSA standards if the state has adopted them for
intrastate commerce
C. Only drivers crossing state lines require medical certification
D. The driver needs only a state medical waiver, not a DOT physical
Correct Answer: B
Rationale: While 49 CFR Part 391 directly applies to interstate commerce, most states
have adopted FMCSA physical qualification standards for intrastate commercial drivers
, through state regulations. Medical examiners must be familiar with their specific state's
requirements. Option A is incorrect because many states require compliance. Option C
is incorrect because intrastate commercial drivers may still need certification. Option D
is incorrect; state waivers are separate from federal certification.
Q5: Beginning June 23, 2025, what significant change occurred regarding Medical
Examiner's Certificates for CDL/CLP holders?
A. Medical examiners no longer need to be registered with the National Registry
B. CDL/CLP holders no longer need to carry paper copies of their medical certificates
C. The maximum certification period was extended to 36 months
D. Intrastate drivers became exempt from all medical certification
Correct Answer: B
Rationale: The June 23, 2025 regulatory change implemented automatic electronic
transmission of medical exam results from the National Registry to State Driver
Licensing Agencies (SDLAs). CDL/CLP holders no longer need to carry paper
certificates as their medical certification status is verified electronically through the
Commercial Driver's License Information System (CDLIS). Medical examiners must still
submit results by midnight the next calendar day. Option A is false; NRCME registration
remains mandatory. Option C is false; 24-month maximum remains. Option D is false;
intrastate requirements remain state-dependent.
Q6: A medical examiner is completing the Medical Examination Report (Form
MCSA-5875). Which section must the examiner complete to indicate the driver does not
meet FMCSA physical qualification standards?
