National Registry psychomotor examinations are standardized examinations administered in a variety of locations across the United States. EMR and EMT psychomotor exams are coordinated by either the State EMS Office or by educational institutions under authority of the state. All advanced level psychomotor exams (Advanced EMT and Paramedic) are authorized and monitored by an official National Registry Exam Representative.

Candidates should begin their search for an examination site by contacting the course instructor. Instructors should be able to guide candidates to the closest recommended exam site. A current listing of scheduled Advanced Level examination sites are provided on the Find A Psychomotor Exam page. If a candidate lives in a state that offers the examination as part of their licensure process, the state may chose to close the examination to residents of other states. If examinations are listed in a state, call the state EMS office and ask them when and where you can take the next psychomotor examination. Note: For initial state licensure requirements, some states only accept psychomotor examinations administered in their states.

EMR and EMT Exams

EMR Psychomotor Exam

EMR psychomotor examinations are not administered by the National Registry. All EMR psychomotor exams are administered by either the State EMS Office or at the training institution (with approval and oversight provided by the State EMS Office). Contact your instructor or State EMS Office about the format and logistics of completing a state-approved EMR psychomotor exam. 

EMT Psychomotor Exam

EMT psychomotor examinations are not administered by the National Registry. All EMT psychomotor exams are administered by either the State EMS Office or at the training institution (with approval and oversight provided by the State EMS Office). Contact your instructor or State EMS Office about the format and logistics of completing a state-approved EMT psychomotor exam. 

EMT Exam Coordinator Resources

The National Registry Exam Coordinator Manuals and User Guides are provided as a reference to candidates and educational institutions.

  • Contact their State EMS office

Candidates with a complaint about the psychomotor exam must initiate the complaints in-person with the National Registry Exam representative during the exam. Complaints will not be valid after the exam has concluded and will not be accepted if the complaint is raised after the candidate receives their exam results. Complaints may be filed for only two (2) reasons:

  • The candidate feels they have been discriminated against. Any situation that can be documented in which the candidate believes an unfair evaluation of your abilities occurred might be considered discriminatory.
  • There was an equipment problem or malfunction during the candidate's performance in any skill.

If either of these two things occur, the candidate must contact the National Registry Exam Representative immediately to initiate the complaint process. The National Registry Representative will supply the necessary complaint forms to be completed in writing. The Quality Assurance Committee, comprised of the Physician Medical Director, the Examination Coordinator, and the National Registry Representative, will review the concerns and make a final determination related to the complaint.


Unofficial results are generally provided to the candidates on the day of the psychomotor exam.

Official exam results are posted on the National Registry’s password-secure website through an individual’s login account, within four weeks.

Remember, candidates are required to successfully complete BOTH the psychomotor and the cognitive examinations to qualify for national certification.

Emergency Medical Responder and Emergency Medical Technician psychomotor examinations are managed and approved by the State EMS Office. Due to this, the approval process varies from state-to-state. The methods for reporting pass/fail results regarding psychomotor examinations are also managed in a variety of methods. If you pass the cognitive examination and the National Registry website does not indicate you obtained National EMS Certification then you should contact your instructor to determine who was responsible for reporting your results to the National Registry.

Advanced Level (Advanced EMT and Paramedic) psychomotor exam results are provided to the National Registry by an approved National Registry Advanced Level Representative.


The 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.

EMR & EMT Exam Psychomotor Exam Accommodations

All candidates must complete the psychomotor examination in the same standardized format. The presentation of any skill may not be altered to accommodate a candidate’s request without first obtaining approval from the State EMS Office. The State EMS Official or approved agent is not authorized to individually make any determination for accommodation of the psychomotor examination. For example, it is not appropriate to move the Simulated Patient in the Patient Assessment/Management – Trauma skill from the floor to an examination table at the candidate’s request because the candidate is physically unable to bend down and assess a patient found lying on the floor. The psychomotor examination is intended to present simulated patients with realistic situations that approximate the candidate’s ability to function in the out-of-hospital environment. The State EMS Official or approved agent and all Skill Examiners must remain vigilant for any situation that may alter the normal presentation of any skill other than that which is intended throughout the psychomotor examination. When in doubt, contact the State EMS Office for assistance.