§391.43 governs the medical examination itself, distinct from §391.41 (the certificate the driver must carry). The exam must be performed by a Medical Examiner listed on the FMCSA National Registry, must follow the §391.43(c) medical examination report form (MCSA-5875), and must produce a Medical Examiner's Certificate (MCSA-5876) when the examiner finds the driver qualified.
§391.23 verification of the examiner
Since June 22, 2018, the carrier must verify that the medical examiner is listed on the National Registry at the time of the exam — §391.23(m) makes the verification part of the §391.23 inquiry. The verification note (NRCME registry number + verification date) is filed in the DQF.
What the exam covers
§391.43(f) sets the minimum scope: vision, hearing, blood pressure, urinalysis (glucose, protein, blood, specific gravity), and a physical exam covering general appearance, ears/eyes/nose/throat, heart, lungs/chest, abdomen/viscera, vascular, urogenital, neurological, gait, and back/musculoskeletal. The examiner uses the medical advisory criteria in 49 CFR §391.41(b)(1)–(13) for qualification decisions.
Severity weight
Severity weight 3 in the Driver Fitness BASIC. The new-entrant audit context is where this finding bites — an exam by a non-NRCME examiner is treated as no exam, the DQF is incomplete on that basis, and knowingly using a physically unqualified driver (§391.11(b)(4)) is a §385.321(b) audit auto-fail.
How to prevent it
- Verify the NRCME registry number at every exam and re-verify at the §391.25 annual review.
- File the verification note (date, examiner name, NRCME number) alongside the MCSA-5876 certificate.
- When the certificate renews, re-verify — examiners can be removed from the registry.
How Roadworthy HQ helps
The NRCME verification note is a required item on the driver's DQF tab, uploaded and shown as present or missing next to the medical certificate. Roadworthy HQ does not query the National Registry or watch it for examiner removals; the verification is something you do and then file.