2018 Changes to the NREMT Exam

In 2018, there will be a couple changes made to both the psychomotor (only for the Advanced-EMT and Paramedic levels) and cognitive portions of the NREMT exam.

What changes have been made to the psychomotor portion of the exam?

For this portion of the exam, candidates must now present a Psychomotor Authorization to Test (PATT) letter in order to register for the exam. This can only be obtained when and if the director of a candidate’s program verifies that individual has either successfully completed said program, or the instructor “attest[s] that [a candidate has] early psychomotor eligibility following the completion of the didactic and laboratory portions of an approved program (if permitted by the program director and the State EMS Licensing Agency).” For more information, click HERE. This form does not have to be obtained for the EMR and EMT levels of this exam.

Another change to the advanced psychomotor exam is the alteration of the skill sheets. Changes have been made to the skill sheets to provide clarity to those responsible for testing candidates. These changes are primarily based around clarifying confusing directions or critical criteria, identifying time limits, consolidating information, etc. Click HERE to find out more about these changes. These changes will primarily affect the evaluators, not the candidates. However, it is helpful for all candidates to looks over the revised skill sheets to have a complete understanding of what is expected of them.

What changes have been made to the cognitive portion of the exam?

The only notable change to the cognitive portion of the NREMT exam (at all levels) in 2018 is the addition of the onscreen calculator that will now be available. Click HERE for more information on the calculator functionality. This calculator (which will be available beginning at different times throughout 2018 based on the level of the exam) has basic functions that include:

  1. Addition
  2. Subtraction
  3. Multiplication
  4. Division
  5. Negative
  6. Percentage
  7. Square root
  8. Reciprocal (Inverse)
  9. Store value to variable
  10. Access variable
  11. Clear variable


The above changes to the exam, while noteworthy, should not change the way an individual studies for the exam. They also should not lead a candidate to think their score will be dramatically affected as content and recommended study materials are not at all affected by these changes either.