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Audit Reports


FMCSA Has Not Fully Met Oversight Requirements as It Rebuilds the National Registry of Certified Medical Examiners

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What We Looked At
In the last 5 years, fatalities in crashes involving large trucks or buses increased by 10.6 percent. As part of its mission, the Federal Motor Carrier Safety Administration (FMCSA) oversees its medical certification program and promotes safety through regulations, policies, and monitoring of certified medical examiners and driver examinations. In May 2014, FMCSA initiated the National Registry of Certified Medical Examiners (National Registry) to assist in verifying that medical examiners can effectively determine if interstate commercial drivers meet FMCSA’s physical qualification standards. We initiated this audit given the significant safety risk posed by drivers who do not meet physical qualification requirements. Our audit objectives were to evaluate FMCSA’s procedures for overseeing its medical certificate program. Specifically, we analyzed FMCSA’s procedures for (1) validating and maintaining data quality in the National Registry and (2) monitoring medical examiner eligibility and performance and reviewing driver examinations.

What We Found
FMCSA’s ability to oversee whether drivers meet physical qualification standards to safely operate a commercial vehicle is limited because of a lengthy outage of the National Registry and a resulting backlog of driver examination reports that were not entered into the Registry. In addition, weaknesses associated with the accuracy and completeness of data in the National Registry limit the effectiveness of FMCSA’s oversight. Furthermore, FMCSA has not fully implemented requirements for random periodic monitoring of medical examiners’ eligibility and performance. While FMCSA has conducted initial certification reviews of medical examiners’ eligibility qualifications, the Agency is not yet conducting annual eligibility audits after initial certification. Without these oversight reviews, FMCSA may be missing fraud indicators or other risks that may require mitigation and has less assurance that drivers are physically qualified to safely operate a commercial vehicle.

Our Recommendations
We conducted our audit of FMCSA’s medical certification program during a transition period while the Agency is working to design and deploy a new National Registry. FMCSA concurred with our four recommendations to improve FMCSA’s oversight of its medical certification program once the Agency deploys its new National Registry.



Closed on
No. 1 to FMCSA
Implement Agency plans for eliminating the backlog of driver examination results held by medical examiners.
No. 2 to FMCSA
Develop a plan to allocate resources to the Medical Programs Division to fully implement requirements for medical examiner eligibility audits and random selection performance monitoring.
No. 3 to FMCSA
Update Agency processes for conducting periodic medical examiner eligibility audits and random selection performance monitoring as needed to incorporate upgraded National Registry tools.
No. 4 to FMCSA
Reinstate the conduct of eligibility audits and random selection performance monitoring of medical examiners.