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At the Resource - The National Registry of Emergency Medical Technicians - NREMT

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At the Resource

This ongoing feature provides information on free resources accessible to first responder departments nationwide. This includes training, equipment, and funding opportunities that focus on rural and small to midsize communities.

The National Registry of Emergency Medical Technicians - NREMT

The National Registry of Emergency Medical Technicians (NREMT) was created in 1970 as part of the Committee on Traffic Safety’s recommendation for the establishment of uniform standards in EMT training. Since that time, NREMT examinations for EMT competency in one or more levels have been adopted by 46 states, and many of these states use NREMT registration as one of, if not the only requirement in determining reciprocal licensing or certification.

NREMT offers several levels of certification. Emergency Medical Responders (EMRs) have skills at a basic level in emergency care; this level being phased out by some states, many of which recognize EMTs as the first level of responder. EMTs may certify at the beginner (EMT-B), intermediate (EMT-I), and advanced (AEMT) levels, or a Paramedic, which is the most advanced designation provided by NREMT. Registration requires a number of steps, including the completion of an approved course and standardized test, and recertification is required every two years.

EMT-Basic Examination Requirements

In order to take the EMT-Basic examination, applicants must meet several requirements. This includes:
   •   A minimum age of 18
   •   Successful completion within two years of testing of a state course that meets NREMT standards (currently licensed/certified EMTs may submit proof of an approved refresher course or 24 hours of continuing education credit if their course was completed more than two years prior to testing)
   •   Verification of competence and valid CPR credentials from the applicant’s Program Director

Eligible applicants must also complete a state-approved psychomotor exam. Exact requirements and scheduling vary by region; applicants should request information on their state from their EMT course instructor.

Cognitive Exam

The NREMT cognitive exam includes 70 to 120 items completed over a two-hour period, and is designed to test knowledge of EMS care in adult and pediatric patients. If an applicant does not pass, the exam can be retaken after 15 days. After 3 unsuccessful attempts, an applicant must provide proof of completion of 24 hours of remedial training, and after a total of six attempts, the full EMT Basic course must be retaken for testing to be approved.


In order to register for the exam, applicants must first create an account on NREMT’s website; users must include their contact information, personal information, and answers to “challenge questions” as part of this process. After creating the account, applicants should log in and complete all required information through the “Create an Initial Entry Application” section. The testing fee of $70 may be paid at this time, or at a later date; however, applicants will not be issued their “Authorization to Test” (ATT) letter until payment has been made.

Once all information has been submitted, users may monitor the progress of their application by logging in and clicking “Check Initial Application Status.” The status will change to “Submitted” next to “Course Completion Verification” once NREMT has sent the information to be reviewed, and “Print ATT Letter” once all information has been approved and payment has been received.

Scheduling an Exam

NREMT exams can only be scheduled once an applicant has received their “Authorization to Test” letter. This letter will contain the instructions in using the Pearson VUE website to complete the scheduling process.

Once this process has been completed, applicants will receive a certification valid for two or three years from the date of issue, depending on the when the certification process is completed. Applicants certifying between January 1st and June 30th will need to renew by March 31st, two years from the initial date, and applicants certifying between July 1st and December 31st will be registered until March 31st, three years from the initial date. After the first renewal, recertification will need to be completed every two years.

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