Okay, let's do that first, and this thing should work. So we're going to talk about how to become a CDME and how to stay one. So these are things we have to tell you. This is a required part of our class. FMCSA doesn't establish fees, charts. They don't pay for my, for anything for me. They don't, they're not responsible for how we decide what we charge or any of that kind of stuff. The, we do have to verify you, which we've already done, just to make sure you're really you. And then I'll give you a second to read this. This is, this affirmation of training is a required thing that we do with you. And AOCOPM is your teaching agency, I think we're called. So how do you become certified to, as a CDME? You have to be licensed as a physician, PA, nurse practitioner, or chiropractor. If doing a physical examination is in scope for that kind of a thing in your state, okay? You have to finish this class, you have to sign up for the registry, and then pass the test. Those are the things you have to do to become certified. There are a lot of training organizations. We're one of them. Any, but you can, well, they've made this less hard than it used to be. Ten years ago, this was a computer Easter egg hunt, and now you just go to the NRCME website, and you actually, when you open things, I want to become a CDME, it, like all the things you need to know are right there. It's actually much better. If you're not registered yet, which I think, if you've registered previously, if you already have a number, a national registry number, then you can skip this step. If you don't have a national registry number, the first step is go to the NRCME website with a fair amount of time set aside, and all of your papers there, you'll need your NPI number, your state license number, your practice address, and they'll, and a bunch of other stuff, your birthday, and. Training letter. No, not yet. That comes later. You need, but you need those things to register in the system. This is just registering to be a, to get a number, because you can't, and what you need the training letter is when you want to set up, take the test. Right. That's when you need the training letter. So, then you're going to go take, so now you're registered, you have a number from the NRCME. Next thing you need to do is sign up to take the test. And I think you have to upload it to the website. When you, when you get ready to sign up to take the test, they'll have you upload your training certificate. They may want you to upload a copy of your actual medical license, or they may verify it. So, make sure you take your license with you when you go to take the physical test. When I did mine, like the wild card's fine. When I went to take my test, they needed, again, the paper copy of my training certificate and my medical license that they scanned at the testing center. I mean, they came back, but they scanned them while you were there. Training has to be less than three years old. So, like if you're 2014 class, you can't just take the test now. You have to take a new test. Take your government issued ID, your medical license, your NRCME number, your certificate, and a lot of patients. And Liz has talked about her experience there. This is old data. The pass rate was 88 to 90%. This is all takers. If you need accommodation for testing, contact NRCME directly, and they'll help you work with a testing organization. They have to tell the testing organization to give you that thing. If you're somebody that gets, you know, double time for tests or needs wheelchair access or something like that, they can do it, but you have to let them know. You'll get a letter back that looks kind of like this that has your number and congratulates you for being certified. How do you get ready? So, I would, what am I going to do? I'm going to go all the way through the 2021 handbook, which is online. It's 114 pages with a lot of white space on the pages. There's not a lot there, quite honestly. I'm going to read and go through both the cardiovascular and the neurologic MEP tables, because those, while they are not rules, they are at least guidance that they put out. And I presume will be the basis for the testing. I need to tell you just for a second about how they put the test together. So, the test was created, I can tell you what they were doing 10 years ago. I don't know exactly what they're doing now, but when they put this whole thing together to make sure that the test was going to be suitable for all the people that might want to need to take it, they made a committee of two MDs, two DOs, two nurse practitioners, two PAs, and two chiropractors. And they had to all agree on the question being suitable. Oh, really? Okay. So, one of the things that what happens is that because everybody had to agree that all the questions were suitable, things like aortic valve diameter was way beyond the chiropractors. So, that just, that question just isn't there. But the chiropractors are expected to be able to operate a calendar. So, if you had some medical condition, they would look at the chart, and it says you have to, you know, there's a six-month waiting period, or a four-month waiting period, or, and then you have to have this test, then they would, that would be a great question. Because everybody can operate a calendar, and they can see you've got the report from your echocardiogram. And one of the fun things about the way the whole tables are constructed, it doesn't require that you had a normal test, just required you had the test. So, and so, it's that kind of stuff. So, that's what you're going to focus on when you're preparing for the test, is what are the things that are easy for everybody to understand with all the different backgrounds? Know the absolute statutory disqualification fails, and there aren't all that many of them, but there are still some, okay? Know about the insulin rule. Know about the alternative vision standard. Make sure you can do the calculations for audiometry. Because they'll give you everything. Because they'll give you, they'll give you like, yeah, you only need some of the numbers to add together, and know how to do the math pretty easily. And I, the one that I should have added on here was I would, I'm going to go through last, that the, they now have online the retraining modules. I would review the, I'm going to go back through the retraining modules. And just read them to remind me what, where their emphases were. They are now available as a reference copy from the FMCSA website. So, they're there as are under resources. And that's what I'm going to do. I'm probably not going to do much about the JNC thing, because it might, it'll just make my head hurt too much. Know about the SPE process. Who needs one? What, who starts the process? What, what the driver needs to do, and how that works. Okay. Know about the waivers that are available in the process for the driver. So, you can provide that advice to them. I think there's going to be more process things, unless would you pass this person, not pass this person. And I pray to God that the question about, like, which of the following is an endocrine test will have disappeared? Because that's not helpful to anybody. So, if you, if you want to stay certified, you've become certified, stay certified. Submit or upload your driver exams the next business day via their portal or some alternate means, participate in periodic monitoring audits if they ever call you. And join the listserv so that you'll get the announcements from them. You will, unlike many things you might sign up for, they will not spam you. In fact, they under spam you. They under communicate. If you miss an email, like, they sent one email last July, they said you need to go do all this stuff. They never sent another one. They said, hey, you got another month. They just sent one. If you missed it, you missed it. Thankfully, if you're on, like, the, the, one of the ACMED listservs, Natalie Hardenbaum, where we, where we publish everything that's important, so you have more chances to see it. How do you stay certified? So make sure you keep, you need to go into the, into your profile and update your license information. If you get to the license expiration date, you'll drop off the thing. Now you can go back and re-update your thing, re-update your license expiration and you'll pop back up, but you'll actually drop off the list of doctors they can find. Because as far as FMCSA can tell, you don't have a current license. Now, all you have to do is just change the date in the database. But you have to go do it. Huh? Manually. It's like when you, when you renew your license, I thought, I'm going to renew my license. It gets sent in, but no, no, no, no, no, no. I got a, I got a nasty grin from, from them going, you don't have a current license. Well, yeah, I have a current license. So go into the website and you have to manually go and change it. You have to go, just change the date, expiration date, and you'll be fine. And I think you have to upload. Nope. Nope. That's what you do. You do when you start, when you start, you do to create yourself as a, as a, as a provider. They want an actual copy. But after that, during your period of certification, you just have to keep changing, like both of my licenses are in two year cycles, so I have to go every two years, I have to go and update the number, the date in my, in my profile. And it's when, if you have more than one state listed, cause you can, you can do that. It's when your last one becomes uncertified. That's when you drop off the database. Um, if you move your clinic or change your email, make sure you tell them. Um, they will reflect the correct data though. They'll reflect the correct address on the form, but then they print that their, their, their map still has it in the wrong place. The map still has it the old place. They don't agree. Geocoding. Search examiners in some area and you're listed on the wrong area. That would also be correct. But you're also aren't FMCSA needs to know where your office is. If they want to come see you, they need to work where to go. So you need to tell them what your address is. Um, and as I said, it is hard to get them to read geocode. You, my four years on five years later, I'm still where my old clinic office was. They've got the correct address. They just don't ever read geocode. You, they just don't fix it on the map and put the little pin in the right place. Um, and you're out through some sort of periodic education that they got the first set of modules out this year, last year. So, and that'll happen. And then resurify every 10 years. I think now they figure out how to do one set of recertifications. They'll probably do the same thing again in 2027. We can hope. Um, if you get thrown off, you can, you can disappear for a lot of reasons off the registry. Um, you need to contact them to get unremoved. Um, when you fall off the list, because you're, you're licensed to update, you're not, you've not been removed from the registry. You just fall off the public site. But the, um, but as soon as you fix it, you'll go back on the public site, like the next day. Um, but this is if you actually get thrown off the registry. Um, peer record training was supposed to be, you would get your initial class from somebody like us, take the test five years later, you get the secure thing. You would do it online for free and, um, from FMCSA and then 10 years come back and see us. We're now in the 10 year part. That's what this is all about. Um, but you get to another 10 years, um, in 2017, they said the five-year periodic training was coming soon. Um, cause the earliest people were certified 2012, the very earliest people. Um, Coming soon with that five-year thing. You guys keep doing your CDM, your exams. You're doing just fine. Um, 2020 in April, 2022, they said, Hey, we're getting close. Stand by. And then came out in July, July 14th. We got that email that told you that you have to recertify. Um, and they're finally going to do that. They finally came out with a module for periodic retraining. Um, and that, that they gave us till the end of the year to do that. Um, and they promised not to take any action against anybody who missed a period of training that they forgot to offer how thoughtful. Um, so you do appear at retraining. Um, I was, when I started, when I got, I went the day after I got the notice from FMCSA, I was already 1,603 days overdue, which has been over four years. Um, and then you go in, you do these four modules, you read them at the end of the module. You've got a thing you have to fill out and scan, and then you met, you scan it back to them at FMCSA that says, I promise I did it, it's actually not bad. It gives you, it lets you know where FMCSA brain is right now. I would read this carefully before you go take the test, because I think this is where their thought processes are since they don't communicate with us any other way, this is what we get, hopefully everybody did this Lance, I don't know whether you'll be able to take the test without doing this or not. I don't know. Um, and you access the system the same way you go in, if you're going to put in results from a task. And it's just a thing that just says on the left-hand side, which is like putting a new exam. There's a thing that says recertification or periodic training, I think is what it says. Um, and if you were certified less than four years ago, when you get to year between year four and year five, I mean, you need to take this module. It is available online. It is free. Um, and then you'll do, if you're between five and nine years ago, you got the catch-up period that ended December 22nd. Keep in mind, 39,000 docs providers have not done this and I, they, they're threatening to throw everybody off the registry that didn't complete. Um, so go do that sooner rather than later. Um, and you'll do refresher training, which we're here for, and then we'll go take an exam before the end of the year. Anybody who was certified anytime in 2012 or 2013 is extended out to the end of 2023 automatically. They did this weird, only the government would explain it this way, where they said, if you were certified in January, you get that 11 months, pure certified February, get that 10 months. And, you know, so it was the whole, it's the end of 2023. We all get to the end of 2023 to take the, and pass the exam. Oh, okay. So, um, why is this all become important? And so, uh, this is what they told us before your training. Oh, I've got to look at this on here. Sorry. I don't think there's anything new out here. I think we're done. Oh, okay. So initial concept, there were lots of people certified. Um, and, um, way back. So when we first started doing this, we initial training, there were rules. There were some super long waiting periods and we told people this was a mess. Um, there were a couple of non-negotiables, but we told you to use your best clinical judgment. I think we've done all this. We did all this yesterday. Okay. I'm going to stop that one. And there's a chat question, which I will open right now. Any chat, any people from chat, what are the retraining modules? So the retraining modules are it's four PDF documents that are available to you on the FMCSA website. And you, if you've not done them, you'll, what you do is sign into the FMCSA website, the same way you would sign in to enter a exam. And on the left-hand side, the bottom thing is refresher training. And you have to do those, read those four modules. And there's some questions built in and stuff. And at the end of it, you'll certify that you completed the four modules, scan that back into FMCSA, um, and tell them that you did, you did your homework. Um, if you are a new applicant who doesn't have to do that, you can still go. And there's a reference copy of it. That's available on the FMCSA website. And I would encourage that you look at that because that'll give you a pretty good idea of where FMCSA's brain is right now, um, for testing purposes. Can I ask a quick question? Sure. So I'm on the FMCSA website right now. And, uh, there's like registration, which there's all this U S uh, U S dot, um, number, which, which do I register for? Cause it looks like this is for more like for the drivers. So are you, are you a, are you a brand new person or have you done this before? Brand new person. Okay. So you're going to register for, it should be, it should be on the NRCME website. Okay. So I would do, I would do the NRCME website first and then it's the FMCSA. No, just go to NRC, NRCME is the national registry of certified medical examiners. That's, that's where you want to be. So the way I get there is I take, is go to Google and type like FMCSA space and RCME, um, and that'll take you to their website and there's actually like, I want to be a, I want to be an examiner or I want to be a CDME and then just follow that path. Okay. Like exactly. Yeah. Don't try and find it from inside the FMCSA website. You'll never get there. Okay. Um, okay. Use your favorite search engine and, and type NRCME. If you type FMCSA NRCME, you'll go directly into their system. Um, if you don't, you'll end up on some training site. Is it the medical examiner registration? Like the national registry? Okay. Okay. That one. Oh, okay. That was not easy to find even we, we, we all agree. It is not easy to find. Okay. Um, thank you. After you certify every month, you know, if you haven't done an exam, you have to go in and sort of yourself certified. You haven't done any. Correct.

Certified Driver Medical Examiner

NRCME registration

recertification

medical license

FMCSA retraining