Individuals applying for National Paramedic Certification (NRP) must meet the following requirements:
The Application Process
Disciplinary Policy and Rights of AppealThe National Registry has disciplinary procedures, rights of appeal and due process within its policies. Complete information about the National Registry Disciplinary Policy and Rights of Appeal can be found here.
Americans with Disabilities ActThe National Registry complies with the Americans with Disabilities Act (ADA) of 1990 and offers reasonable accommodations for individuals with disabilities. Pearson VUE test centers are also ADA compliant. Complete information about the National Registry Accommodations Disability Policy can be found here.
- 18 years of age or older.
- Current National EMT Certification (National Registry) or state license at the EMT level, or higher.
- Successful completion of a CAAHEP-accredited Paramedic program (or a program that has been issued a CoAEMSP "Letter of Review") within the past two years . The course Program Director must verify the candidate's successful completion of the course through the National Registry website.
- All Paramedic candidates who started their Paramedic education program after August 1, 2016 are required to complete a psychomotor competency portfolio.
- Program Directors must verify that candidates have met the requirements of the portfolio through the National Registry website
- Have a current CPR-BLS for "Healthcare Provider" or equivalent credential.
- Successful completion of the National Registry cognitive (knowledge) and psychomotor (skills) exams.
- Passed portions of each examination (cognitive and psychomotor) remain valid for 24 months. This policy is effective for candidates with a course completion date on or after November 1, 2018. For candidates with a course completion date prior to November 1, 2018, passed portions of each examination is valid for 12 months.
- If the initial Paramedic educational program was completed more than two years ago and the candidate is currently state licensed at the Paramedic level, candidates are required to submit documentation verifying completion of a state-approved Paramedic refresher course or 48 hours of equivalent continuing education covering the mandatory and flexible core content topics specified within the past two years.
- If a candidate's Paramedic state license has lapsed, or an individual's National Paramedic Certification (NRP) has lapsed for more than two years, Paramedics must use the re-entry process.
- If a candidate has never held a state license as a Paramedic or National Paramedic Certification (NRP) and it has been more than two years from the completion of the candidate's Paramedic course, they must complete an entire state-approved and CAAHEP-accredited Paramedic program prior to applying for National Paramedic Certification.
The Application Process
- Create an account/login profile on this website.
- Submit a National Registry application and answer all questions truthfully.
- The National Registry may deny certification or take other appropriate actions in regards to applicants for certification or recertification when a criminal conviction has occurred.
- Pay the application fee of $125 (US funds). The application fee is non-transferable and non-refundable. This fee is charged for each attempt of the cognitive examination.
- Candidates will receive an electronic Authorization to Test (ATT) once you are eligible for the exam. The electronic ATT contains scheduling instructions and important details concerning proper identification required at testing centers. You can find the ATT in the 'Check Application Status' page.
- change in mailing address (the best way to update a mailing address is by editing the user profile page)
- any criminal conviction.
- disciplinary action taken by any state has resulted in suspension, revocation, or expiration of state registration/licensure; termination of right to practice; voluntary surrender of state registration/licensure while under investigation.
Disciplinary Policy and Rights of AppealThe National Registry has disciplinary procedures, rights of appeal and due process within its policies. Complete information about the National Registry Disciplinary Policy and Rights of Appeal can be found here.
Americans with Disabilities ActThe National Registry complies with the Americans with Disabilities Act (ADA) of 1990 and offers reasonable accommodations for individuals with disabilities. Pearson VUE test centers are also ADA compliant. Complete information about the National Registry Accommodations Disability Policy can be found here.
The National Registry Paramedic (NRP) cognitive exam is a computer adaptive test (CAT). The number of items a candidate can expect on the NRP exam will range from 80 to 150. Each exam will have between 60 to 130 ‘live’ items that count toward the final score. The exam will also have 20 pilot questions that do not affect the final score. The maximum amount of time given to complete the exam is 2 hours and 30 minutes.
The exam will cover the entire spectrum of EMS care including: Airway, Respiration & Ventilation; Cardiology & Resuscitation; Trauma; Medical; Obstetrics/Gynecology; EMS Operations. Items related to patient care are focused on adult and geriatric patients (85%) and pediatric patients (15%). In order to pass the exam, candidates must meet a standard level of competency. The passing standard is defined by the ability to provide safe and effective entry level emergency medical care.
We strongly encourage candidates to review the following information: Paramedic Cognitive Exam Test PlanBased on the most recent practice analysis, the National Registry Board approves a cognitive exam test plan. A test plan is a blue-print that tells the computer testing software how to build a candidate's exam. The table below indicates what percent of the test will focus on each topic area
Cognitive Exam Retest InformationIf a candidate is not successful in passing the cognitive exam, the National Registry will provide a candidate feedback on their performance. Candidates may apply to retest 15 days after the last examination.
Candidates are given a total of six opportunities to pass the Paramedic cognitive examination, provided all other requirements for National EMS Certification are met. After three attempts, candidates must submit official documentation verifying completion of remedial training. Remedial training must be completed by a state approved instructor or an approved CAPCE course. After remedial training is complete, the candidate is given three additional attempts to pass the Paramedic cognitive exam, provided all other requirements for National Certification are met. Candidates who fail to pass after a total of six attempts are required to repeat the entire Paramedic course.
Remedial Training RequirementsThe Paramedic remedial training requirement can be satisfied through three different options:
The exam will cover the entire spectrum of EMS care including: Airway, Respiration & Ventilation; Cardiology & Resuscitation; Trauma; Medical; Obstetrics/Gynecology; EMS Operations. Items related to patient care are focused on adult and geriatric patients (85%) and pediatric patients (15%). In order to pass the exam, candidates must meet a standard level of competency. The passing standard is defined by the ability to provide safe and effective entry level emergency medical care.
We strongly encourage candidates to review the following information: Paramedic Cognitive Exam Test PlanBased on the most recent practice analysis, the National Registry Board approves a cognitive exam test plan. A test plan is a blue-print that tells the computer testing software how to build a candidate's exam. The table below indicates what percent of the test will focus on each topic area
Cognitive Exam Retest InformationIf a candidate is not successful in passing the cognitive exam, the National Registry will provide a candidate feedback on their performance. Candidates may apply to retest 15 days after the last examination.
Candidates are given a total of six opportunities to pass the Paramedic cognitive examination, provided all other requirements for National EMS Certification are met. After three attempts, candidates must submit official documentation verifying completion of remedial training. Remedial training must be completed by a state approved instructor or an approved CAPCE course. After remedial training is complete, the candidate is given three additional attempts to pass the Paramedic cognitive exam, provided all other requirements for National Certification are met. Candidates who fail to pass after a total of six attempts are required to repeat the entire Paramedic course.
Remedial Training RequirementsThe Paramedic remedial training requirement can be satisfied through three different options:
- Traditional refresher course: Completion of a State or CAPCE(F1, F2, F5) approved 48 hour Paramedic refresher course.
- NCCR 30 hours of continuing education: Completion of the 30 hour National Competency Component from the NCCP model.
- Continuing education topic hours: Paramedic remedial may be completed by continuing education* and must include the topics and hours listed here under Traditional Model.
Content Area |
Percent of Exam |
Adult / Pediatric Mix |
Airway, Respiration, & Ventilation |
18% - 22% |
85% Adult - 15% Pediatric |
Cardiology & Resuscitation |
22% - 26% |
85% Adult - 15% Pediatric |
Trauma |
13% - 17% |
85% Adult - 15% Pediatric |
Medical; Obstetrics & Gynecology |
25% - 29% |
85% Adult - 15% Pediatric |
EMS Operations |
10% - 14% |
N/A |
The Psychomotor ExamFind A Psychomotor ExamParamedic candidates are tested on six skills: Patient Assessment: Trauma, Dynamic Cardiology, Static Cardiology, Oral Station Case A, Oral Station Case B, and an Integrated Out-Of-Hospital Scenario.
Patient Assessment-TraumaCandidates are required to perform a "hands-on," head-to-toe, physical assessment and voice treatment of a simulated patient for a given scenario, including:
You will be evaluated on your ability to manage a cardiac arrest situation, including actual delivery of electrical therapy and "voicing" all interpretations and treatments given a scenario. The presentation of the portion will be similar to a "megacode."
Given four (4) prepared ECG tracings with associated patient information, you must verbalize the interpretation of each rhythm and voice all associated treatments.
Oral Station - Scenario A & BOral Station
You will be evaluated on your ability to verbally manage all aspects of an out-of-hospital call given two (2) separate cases: Oral A & Oral B
In each case, you will be evaluated in the following categories:
Paramedic Psychomotor Exam RetestParamedic candidates are allowed two (2) full attempts to pass the psychomotor examination (one "full attempt" is defined as completing all six (6) skills and two retesting opportunities if so entitled).
Candidates are eligible to retest three (3) or less skills when taking a full attempt of the psychomotor examination. Candidates are eligible for two (2) retest attempts of the three (3) or less skills failed for no more than twenty four(24) months from the date of the examination, provided they meet all other current requirements for National EMS Certification. If offered, only one (1) retest attempt may be completed on the same day. Candidates not completing the failed portion of the examination within that twenty four(24) month period will be required to repeat the invalid portion.
Candidates who fail a full attempt or any portion of a second retest must submit official documentation of remedial training over all skills before starting the next full attempt of the psychomotor examination and re-examining over all six (6) skills, provided all other requirements for National Certification are fulfilled. This official documentation must be signed by the Paramedic Training Program Director or Physician Director of training/operations that verifies remedial training over all skills has occurred since the last unsuccessful attempt and the candidate has demonstrated competence in all skills.
Documentation may be emailed to [email protected], faxed to1-614-888-8920, or sent to 6610 Busch Blvd., Columbus, Ohio 43229.
Should a candidate fail the second full and final attempt of the psychomotor examination, the candidate must complete a new, state-approved and CAAHEP-accredited Paramedic Education Program.
Patient Assessment-TraumaCandidates are required to perform a "hands-on," head-to-toe, physical assessment and voice treatment of a simulated patient for a given scenario, including:
- Scene Size-Up
- Primary Survey/Resuscitation
- History Taking
- Secondary Assessment
You will be evaluated on your ability to manage a cardiac arrest situation, including actual delivery of electrical therapy and "voicing" all interpretations and treatments given a scenario. The presentation of the portion will be similar to a "megacode."
Given four (4) prepared ECG tracings with associated patient information, you must verbalize the interpretation of each rhythm and voice all associated treatments.
Oral Station - Scenario A & BOral Station
You will be evaluated on your ability to verbally manage all aspects of an out-of-hospital call given two (2) separate cases: Oral A & Oral B
In each case, you will be evaluated in the following categories:
- Scene Management
- Patient Assessment
- Patient Management
- Interpersonal Relations
- Integration (verbal report, field impression, and transport decision)
Paramedic Psychomotor Exam RetestParamedic candidates are allowed two (2) full attempts to pass the psychomotor examination (one "full attempt" is defined as completing all six (6) skills and two retesting opportunities if so entitled).
Candidates are eligible to retest three (3) or less skills when taking a full attempt of the psychomotor examination. Candidates are eligible for two (2) retest attempts of the three (3) or less skills failed for no more than twenty four(24) months from the date of the examination, provided they meet all other current requirements for National EMS Certification. If offered, only one (1) retest attempt may be completed on the same day. Candidates not completing the failed portion of the examination within that twenty four(24) month period will be required to repeat the invalid portion.
Candidates who fail a full attempt or any portion of a second retest must submit official documentation of remedial training over all skills before starting the next full attempt of the psychomotor examination and re-examining over all six (6) skills, provided all other requirements for National Certification are fulfilled. This official documentation must be signed by the Paramedic Training Program Director or Physician Director of training/operations that verifies remedial training over all skills has occurred since the last unsuccessful attempt and the candidate has demonstrated competence in all skills.
Documentation may be emailed to [email protected], faxed to1-614-888-8920, or sent to 6610 Busch Blvd., Columbus, Ohio 43229.
Should a candidate fail the second full and final attempt of the psychomotor examination, the candidate must complete a new, state-approved and CAAHEP-accredited Paramedic Education Program.