Everything you need to know about completing your NREMT certification

So you’ve decided to become an EMT. Great! You’re now one EMT boot camp and exam away from an exciting new career as an emergency medical technician.

Unfortunately, deciding to become an EMT is as far as some people get, often because they let themselves become intimidated by the idea of taking a test.

Don’t let that be you! There’s no reason a test should stand between you and your dream, and we’re here to help ensure it doesn’t.

When it comes to taking the NREMT (National Registry of Emergency Medical Technicians) exam, there’s no need to panic. Your EMT training program (such as our 14-day EMT Bootcamp) should more than prepare you for the test. But to help make sure that you’re ready for all aspects of the exam, we’ve compiled everything you need to know about completing your NREMT certification.


What is the EMT test?

There are actually two parts of the NREMT exam—a cognitive (written) test and a psychomotor test. Both are required to apply for your final EMT certification.

The cognitive portion of the EMT test assesses your general knowledge of emergency medical care across a full spectrum of topics, including:

  • Airway
  • Respiration & Ventilation
  • Cardiology & Resuscitation
  • Trauma
  • Obstetrics/Gynecology
  • EMS Operations

The psychomotor test, on the other hand, measures your ability to physically complete the responsibilities of an EMT. This test is normally taken as part of your EMT training course—for example, students in our 14-Day EMT Bootcamp take the psychomotor exam on the final day of training.

This portion of the EMT test will assess your skills regarding:

  • Assessment/management of trauma & medical patients
  • Cardiac arrest management
  • Bag-valve-mask ventilation of an apneic patient
  • Spinal immobilization (seated and supine patients)
  • Long bone fracture immobilization
  • Joint dislocation immobilization
  • Traction splinting
  • Bleeding control / shock management
  • Upper airway adjuncts and suction
  • Mouth-to-mouth ventilation with supplemental oxygen & supplemental oxygen administration to a breathing patient

You can find a complete checklist of the NREMT required skills here.

Some of that may sound complicated—and it can be. After all, these are the skills EMTs must master in order to save lives in a wide variety of situations. But by the time you finish your EMT training course, you should know these steps backward and forward.

How many questions are on the NREMT exam?

When you sit down to take your EMT written exam, you can expect anywhere from 70 to 120 questions. 10 of these questions (called “pilot questions”) won’t impact your final score and are simply there to help test possible questions for future versions of the exam. You probably won’t be able to tell which questions are pilot questions, though, so don’t waste time guessing and give every question your best shot.

How long is the EMT test?

In the end, the length of the test is up to you. You’ll be given two hours to complete the exam, but many test takers finish far earlier while others work until the last minute. The important thing is to budget your time, work at your own pace, and if you’re stumped on a question, move on and come back to it later.

And don’t panic—two hours is plenty of time. In fact, less than 1% of test takers are unable to finish the exam according to the NREMT.

How to study for the EMT exam?

  • Keep Your Textbooks And Workbooks – Highlight definitions and any specifics that stand out, then read back over the highlighted portions until you feel confident enough in the concepts that you could teach someone else.
  • Take the Practice Tests – Many EMT courses provide practice exams. Take these as often as you can and retake them until you are happy with your score.
  • AHA Guidelines – Review the AHA Guidelines for CPR and Emergency Cardiovascular Care. This absolutely will be on the test.
  • Study with a Group – Your classmates might have picked up on something you missed.
  • Understand – Memorizing material is helpful, but truly understanding the material is even more so. Try and learn a concept so well that you could explain it to someone who has never been in an EMT class in their lives.
  • Don’t Cram – Spread out your study periods, get plenty of breaks and rest in-between, and don’t exhaust yourself with a cram session the night before the test. Take your time, do it right, and you’ll have your best shot at acing the exam.
  • Ignore the Computer – You’ll be taking your test on a computer, but the exam process itself is very simple—even for those who aren’t computer-friendly. Don’t worry about trying to learn the exam system or how the software algorithms work—just learn the EMT material.
EMT Certification

What score do you need to pass the EMT test?

It’s a fact, no matter how badly we want one, a perfect score on any exam is rare. You’re going to miss a question here or there but it’s not the end of the world—do your best, but at the end of the day, the most important thing is just that you pass.

In order to pass the NREMT cognitive exam, you’ll need a 70% or higher as your final score.*

How do I register for the EMT exam?

Registration for the NREMT exam starts on the www.nremt.org website. Here, you’ll go through the following steps:

  1. Create an account
  2. Update your personal profile and contact information
  3. Create a new application
  4. Pay the application fee
  5. Verify you’ve been approved to test
  6. Print your ATT (exam approval) letter
  7. Follow the scheduling instructions on your ATT letter within 90 days

The NREMT has created a handy checklist (with additional helpful links) here.

Remember, if you miss your exam date, you’ll have to re-apply and pay another application fee!


How hard is the NREMT exam?

The EMT exam is passable… but don’t make the mistake of thinking you can skate by with minimal effort. According to NREMT.org, 72% of first time exam takers passed the NREMT exam in 2019—which means that nearly three of every ten test takers scored lower than a 70% and failed.*

The difficulty of the EMT exam also depends on your grasp of the subject materials. The NREMT exam uses the CAT model (computerized adaptive testing), which means the test will do its best to identify any areas of weakness. There’s no skipping questions and no going back to answer missed questions, and if you do miss a question, the CAT is probably going to rephrase the question and ask it again.

So, if you feel a little shaky in any areas, dedicate some extra study time to fully understanding them. The majority of test takers will pass the exam on the first attempt, but be sure to study hard (and pay close attention during your EMT training program) to make sure you’re in that group.

What is on the EMT exam?

According to NREMT.org, the average exam spans the following topics:

NREMT Average Exam Topics


Because the exam operates on the CAT model, the exact number of questions under any given topic is going to depend entirely on you. The computer wants to be absolutely certain whether you know (or don’t know) a subject, so if you miss a question, you’ll probably see another version of the same question pop up later.

As mentioned previously, there will also be 10 “pilot questions” that will not impact your score, although you probably won’t know which questions are the pilot questions.

Another helpful tip: the test will primarily focus on adult patient care—85% to be exact—while the remaining 15% will focus on pediatric care.

Can I bring anything with me to the EMT exam?


Personal items are not allowed within the testing room. This includes (but is not limited to) mobile devices, watches or smart watches, weapons, hats, bags, jackets, notes, pens, pencils, wallets, or purses. And to make certain none of these make it into the room, be aware that the testing administrators are authorized to pat you down, ask you to pull your hair back, or ask you to roll up your sleeves.

This may sound extreme, but ask yourself—if you were injured and your life depended on the EMT giving you medical treatment, would you want someone who had cheated to pass the NREMT? None of us would. Test administrators take their job very seriously, because the stakes are literally life and death once the test is complete.

Where can I take the NREMT exam?

NREMT exams are given at Pearson VUE testing centers across the country. Your exact testing location and scheduled exam time will be given only after you complete your NREMT registration and pay your registration fee.

After registration, you’ll print your ATT (Authorization To Test), which will include all the important information about where to go and when to be there.

REMEMBER, the ATT is only valid for 90 days and no extensions are available, so schedule your test quickly after registering.

The ATT will also tell you what identification documents to bring with you, so read carefully.


How much does the NREMT exam cost?

The EMT exam registration fee is $80 per attempt. However, if you enroll in our EMT Bootcamp program, the fee for your initial exam (and a second exam attempt, if needed) is included in course tuition.

How many times can you take the NREMT exam?

It’s tough to think about, but some candidates just don’t pass on their first attempt. Remember, three out of every ten won’t get above that necessary 70% grade on their first try.* If this happens to you, don’t panic and don’t get discouraged! You can try again!

You can apply to retake the EMT exam 15 days after your last exam, and you have 6 chances total to pass the NREMT cognitive. After three failures, you will have to pass a remedial training course before trying again.

When will I know if I passed the EMT cognitive exam?

Your NREMT official scores aren’t tallied at the testing facility (so don’t bother bugging your test administrator for a sneak peek at your results… they don’t have them). The NREMT receives your exam electronically and typically will have the final score within two business days.

After two days, log onto your NREMT account and click on “View All Certification Applications”. If you’ve passed, congratulations! You’re now free to apply for EMT certification under a local agency. You won’t see any additional information about your exam results.

If you failed, the NREMT breaks down the exam for you, highlighting the different subject areas as Above Passing, Near Passing, or Below Passing to help you figure out where you need to study before retesting. Remember, you can try again in 15 days.


What happens after I pass the NREMT exam?

First of all, congratulations! Now that you’ve passed the NREMT exam, you can officially apply to a local emergency services agency. In other words, it’s time to put on that uniform and get to work saving lives.

But you’re not completely done with tests. You’ll need to recertify every two years—which means taking the NREMT recertification exam or showing that you’ve completed a specific number of continuing education hours.

Graduates of the Unitek 14-Day EMT Boot Camp have a leg up in the recertification department and can attend future EMT bootcamps for free (provided you have your text book, uniform, and have met all school policies).

That’s it! You now know the ins and outs of becoming a certified Emergency Medical Technician, passing your NREMT exam, and maintaining that certification for years to come. And as always, if you run into any questions not answered here, our Unitek staff is always standing by to help. Give us a call or send us a message and we’ll be happy to get you whatever information you need.

Good luck!

*According to the NREMT, this percentage is subject to review and potentially changes every three years.

becoming a certified Emergency Medical Technician