NREMT Roadblock – Time to Be Done

[pmdcnomore]

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I've been a paramedic for 30 years, NREMT-certified until 2011. Recently, I had a great job opportunity out of state that required me to reinstate my NREMT. After two months of jumping through hoops just to get permission, I’ve now failed the cognitive exam six times—something I’ve never experienced in my entire EMS career.

I’m currently state-certified and actively working in the field. I’ve been a critical care medic, a preceptor, and have handled high-pressure situations most medics will never face. I took refresher courses, studied hard, and prepared as best as possible, yet I still can’t pass this test.

The EMS “shortage” must not be as bad as they claim because experienced medics are being pushed out by unnecessary barriers. NREMT’s own rules state that you must "successfully complete the cognitive exam", which I did in 2006 and six more times in 2024-2025. Nowhere does it say a passing score is required—just that it must be completed. But apparently, "successfully completing" means something different to them.

At this point, I’m convinced NREMT is just a for-profit scam that’s taken $1,000 from me while keeping me from moving forward in my career. I’ve put in three decades of service, and now, because of one flawed test, I can’t take a job that I’m more than qualified for.

I know I’m not the only one who’s gone through this. Has anyone else had a similar experience? Any advice on getting past this ridiculous obstacle? Or is this just the new reality of EMS?

 

[CCCSD]

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I've been a paramedic for 30 years, NREMT-certified until 2011. Recently, I had a great job opportunity out of state that required me to reinstate my NREMT. After two months of jumping through hoops just to get permission, I’ve now failed the cognitive exam six times—something I’ve never experienced in my entire EMS career.

I’m currently state-certified and actively working in the field. I’ve been a critical care medic, a preceptor, and have handled high-pressure situations most medics will never face. I took refresher courses, studied hard, and prepared as best as possible, yet I still can’t pass this test.

The EMS “shortage” must not be as bad as they claim because experienced medics are being pushed out by unnecessary barriers. NREMT’s own rules state that you must "successfully complete the cognitive exam", which I did in 2006 and six more times in 2024-2025. Nowhere does it say a passing score is required—just that it must be completed. But apparently, "successfully completing" means something different to them.

At this point, I’m convinced NREMT is just a for-profit scam that’s taken $1,000 from me while keeping me from moving forward in my career. I’ve put in three decades of service, and now, because of one flawed test, I can’t take a job that I’m more than qualified for.

I know I’m not the only one who’s gone through this. Has anyone else had a similar experience? Any advice on getting past this ridiculous obstacle? Or is this just the new reality of EMS?

Successfully complete means a passing score. There is no “scam”.
Would you want an MD who took the Boards but didn’t pass to provide medical care..?

 

[MMiz]

I've seen similar posts for a variety of standardized certification exams.

Just because you're struggling to pass the test doesn't make it unfair. Just because there is a shortage of workers doesn't mean they should lower standards.

Ultimately if you want to be certified you'll need to take the test. I'd pour my time and resources into high quality review courses.

 

[NomadicMedic]

Get remediated and then try Dan Limmer’s prep program. Good luck.

 

[DesertMedic66]

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I've been a paramedic for 30 years, NREMT-certified until 2011. Recently, I had a great job opportunity out of state that required me to reinstate my NREMT. After two months of jumping through hoops just to get permission, I’ve now failed the cognitive exam six times—something I’ve never experienced in my entire EMS career.

I’m currently state-certified and actively working in the field. I’ve been a critical care medic, a preceptor, and have handled high-pressure situations most medics will never face. I took refresher courses, studied hard, and prepared as best as possible, yet I still can’t pass this test.

The EMS “shortage” must not be as bad as they claim because experienced medics are being pushed out by unnecessary barriers. NREMT’s own rules state that you must "successfully complete the cognitive exam", which I did in 2006 and six more times in 2024-2025. Nowhere does it say a passing score is required—just that it must be completed. But apparently, "successfully completing" means something different to them.

At this point, I’m convinced NREMT is just a for-profit scam that’s taken $1,000 from me while keeping me from moving forward in my career. I’ve put in three decades of service, and now, because of one flawed test, I can’t take a job that I’m more than qualified for.

I know I’m not the only one who’s gone through this. Has anyone else had a similar experience? Any advice on getting past this ridiculous obstacle? Or is this just the new reality of EMS?

First: as a 30 year medic you really need to get off your high horse with the “I’ve handled high pressure stuff that most medics will never face”. You are not super medic and you are not above any other medic.

Second: successfully complete means pass the test. In order to be successful you must pass it. You can complete the test and fail it which means you were not successful.

 

[Rubicon Bob]

I've been a paramedic for 30 years, NREMT-certified until 2011. Recently, I had a great job opportunity out of state that required me to reinstate my NREMT. After two months of jumping through hoops just to get permission, I’ve now failed the cognitive exam six times—something I’ve never experienced in my entire EMS career.

Might I suggest, if you pass, that you maintain your NRP, instead of letting it lapse.

At this point, I’m convinced NREMT is just a for-profit scam that’s taken $1,000 from me while keeping me from moving forward in my career.

Lots of folks will tell you that NREMT is a scam, and not worth the money to maintain.

Just curious, would it have been easier, and cheaper, if you simply had maintained it (NRP), rather than letting it lapse?

 

[DrParasite]

I've been a paramedic for 30 years, NREMT-certified until 2011. Recently, I had a great job opportunity out of state that required me to reinstate my NREMT. After two months of jumping through hoops just to get permission, I’ve now failed the cognitive exam six times—something I’ve never experienced in my entire EMS career.

Maybe you're not as good as you think you are?

I’m currently state-certified and actively working in the field. I’ve been a critical care medic, a preceptor, and have handled high-pressure situations most medics will never face. I took refresher courses, studied hard, and prepared as best as possible, yet I still can’t pass this test.

Maybe you're not as good as you think you are?

The EMS “shortage” must not be as bad as they claim because experienced medics are being pushed out by unnecessary barriers. NREMT’s own rules state that you must "successfully complete the cognitive exam", which I did in 2006 and six more times in 2024-2025. Nowhere does it say a passing score is required—just that it must be completed. But apparently, "successfully completing" means something different to them.

if you haven't achieved a passing score on the cognitive exam, then you haven't successfully completed the exam.... failing an objective exam means you haven't been successful... not sure what is unclear here...

At this point, I’m convinced NREMT is just a for-profit scam that’s taken $1,000 from me while keeping me from moving forward in my career. I’ve put in three decades of service, and now, because of one flawed test, I can’t take a job that I’m more than qualified for.

or... Maybe you're not as good as you think you are, as you can't pass the current baseline entry-level exam?

I know I’m not the only one who’s gone through this. Has anyone else had a similar experience? Any advice on getting past this ridiculous obstacle? Or is this just the new reality of EMS?

I won't speak for others, but if you can't pass the basic exam, maybe you're not as good as you think you are?

ALL cognitive exams (or any computer-based exam really) are designed to test one thing: have you demonstrated competency in the material being tested? That's it. don't care about your name, race, experience, age, intellect, or training provider: you will be asked a bunch of questions, and based on how you answer them, if you answer them correctly, your competence will be validated by an objective 3rd party. Oh, and this evaluation is based on the entry-level standards and objectives set forth by NREMT.

Now, you might be a super medic, a great guy, known throughout your agency, and the go-to guy whom everyone wants to have with them when they have a train wreck patient... but if you can't pass the entry level exam, that's a major red flag... esp after 6 attempts. Paramedic programs have gotten more difficult over the past 3 decades, and you might not know as much of that fancy book learning as you think you do.

I haven't taken a registry exam in over a decade, but I've taken multiple computer based exams... most I've passed, but some I have failed. In all cases, it's never the exam's fault that I wasn't prepared enough or didn't know the answers to the questions being asked.

 

[DrParasite]

BTW, even though I don't teach EMS anymore (I'm about to let my instructor cert lapse), I am still an adjunct instructor in another department teaching students to pass a different exam (and hoping to get accepted to an associate professor job that I applied for), I want you to know that I tell all of my students that I want everyone to be successful, to do all of the work, show up for class etc.... but at the end of the day, none of what they do in class matters, as the important evaluator is if they can pass the objective computer-based exam to earn their certificate.

The test doesn't it doesn't care about their experience, how many other certs they have, or if they have a degree or not, all that matters is if they have enough knowledge on the topic to pass the objective exam to earn the certification.

Just something for you to ponder.