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We get a lot of calls and emails from people who have failed the NREMT. We seem to get more from people who have failed the NREMT three times. They are about to take a refresher class and come to us for advice. Our Chief Knowledge Office Dan Limmer answers their questions – and we wanted to share some of his advice.

Ask the Hard Questions: Why Did I Fail the NREMT Three Times?

Dan recommends some introspection. Ask yourself some tough questions, like:

  1. Did I learn from my course? Not all courses are created equal. If you don’t believe your course was high quality, you have some catching up to do.
  2. Did I study and work hard to learn? If not, you now realize why you aren’t successful.
  3. Do I have any learning, reading, or attention deficit issues that need to be addressed before I try again? If so, talk to your instructor. See what resources are available from your school or by physician referral. Be sure to document any disabilities and present them to your school for accommodations and to the NREMT for extended time to take the exam.
  4. Have I lost confidence in passing? If so, you’ll need to get that back before you try again.

Take an EMS Remedial Course

The National Registry requires you to take a remedial training course if you don’t pass the NREMT on your third attempt. Remedial training helps you learn the stuff you missed the first time around and deepens your understanding of what you do know. Importantly, NREMT remediation should also focus on improving your test-taking and critical thinking skills.

It’s frustrating to fail three times. But this is a chance to get the knowledge, skills, attitude and confidence you need!

Limmer Education’s EMT and AEMT Remediation programs are NOT boring lectures driven by boring slides. If you engage in all sessions, you’ll walk away with a much deeper understanding of EMT curriculum and skills, with the mental tools you need to apply your knowledge to your practice – and to pass the NREMT.

Each online class begins with an overview and case study. The session will then cover important terms and concepts for each topic using a variety of dynamic methods – including critical thinking activities and detailed drawings. The 2-hour session will conclude with NREMT-style review questions to help you better understand and succeed on the exam.

In addition to the remedial EMT and AEMT classes, you also get access to: Diagnostic exams to identify your strengths and weaknesses, and our popular 2 hour NREMT Review video, which is jam-packed with in-depth NREMT-style review questions, answers and tips that you can’t find anywhere else.

text graphic titled "nremt remediation: pass the nremt after a failed attempt" with two columns, one for 24-hour emt remediation and one for 36-hour aemt remediation

Limmer Education Remediation Courses include a 24-hour course for EMT and 36-hour course for AEMT. Be sure to take the remedial course with the intent to learn—don’t just go through the motions to get three more attempts.

Our courses are accepted by the National Registry as remediation after three failed attempts. (They are also CAPCE-accredited for continuing education.)

Failed the NREMT Once or Twice?

emtreview.com product logo is a staff of aesculapius inside a light blue star of life inside a hexagonYou may not need remediation yet. But if you’ve failed the NREMT or NRP at least once, take a look at EMTReview.com. The membership site is designed to help overcome the types of issues that keep people from passing. It provides a review of course content, structured study, interactive exams, and much more. One of the biggest benefits of membership (especially for students who have failed the NREMT) is weekly, live NREMT study sessions. During the study session webinars, Dan Limmer personally reviews NREMT-style practice questions and answers any questions participants have about the exam.

EMTReview.com addresses the three major issues students face:

  • EMS knowledge (the site lets you choose EMT and/or Paramedic)
  • Ability to read and analyze an NREMT question
  • Getting your confidence back

While we prefer you come to work with Dan before your third NREMT attempt, it is never too late. We hope we will see you at EMTReview.com to help you pass the test. It is what we are here for—and what we do best.

What About EMS Refresher Courses?

When you look online, you’ll see lots of courses advertised as EMS refreshers. These are for people who had their NREMT certification, but did not re-certify before the expiration date. If your certification is lapsed, you should take a refresher somewhere other than where you took your original course. It is time to go somewhere else and get knowledge from a different source. Dan recommends these refresher courses, which are all offered in an online format:

  • FOAMfrat: These guys offer an engaging refresher course for paramedics. The course gives you access to both instructor-led and self-paced content.
  • Distance CME: EMT/EMR and Paramedic/AEMT refresher courses offered by the great and caring team at Distance CME.
  • Treasure Coast Medical Institute: Our friend Dr. Marjorie Bowers brings a wealth of experience to her paramedic refresher course. For EMT hopefuls, Kevin Franklin teaches an excellent EMT refresher.

These online courses will help fill in knowledge gaps and satisfy the National Registry’s refresher policy for lapsed certifications.

Join the discussion 33 Comments

  • Anthony East says:

    I took the nremt twice now and I’m not confident enough to wanna take it again to fail. Any advice?

    • Dan Limmer says:

      Hi Anthony–thanks for leaving us a message. Being unsuccessful twice can shake the confidence a bit–but the third time is a high stakes attempt. You are far from alone here.

      The first thing I would say is that you can’t do what you did for the first two attempts. I find that people re-read the book or took practice exams that gave them a false sense of confidence. Basically there ate three things I believe you need. Only you know how much each of these play in your situation: knowledge of the material, ability to read and answer an NREMT-style question, and confidence. Confidence usually comes from the first two.

      Since you’ve left a note here at Limmer Education I’m going to tell you about a few of the options we have. The first is EMTReview.com or ParamedicReview.com (depending on what exam you are taking). This site has live study sessions where most people are in your situation. We go over questions and knowledge each week. There are numerous other items on the site from a review plan to interactive exams and more. That is $19.99 per month and I think it would be worth a month. If your class wasn’t awesome we have optional audios to help get your knowledge up to speed.

      I’d also recommend our “PASS” apps (EMT, AEMT, and paramedic). They contain tough questions that will help your knowledge as well as learning the NREMT style question. But the key is how you use it. Many just fly through the exams and then look at their grade. I want you to look at the rationale when you get a question wrong, then look back at the question and figure out what you missed that would have helped you get the question right.

      I hope you’ll try our products. They have helped others in your situation. Perhaps I will see you in office hours soon.

      • Jim Dwyer says:

        I have taken the test for paramedic three times and have failed. I have even got a tutor. I don’t know what to do. Help??


    • Albert says:

      Hey Anthony, did you notice any similarities in the questions between your first and second try?

    • Pamela Scarfo says:

      Tell you how many times I’ve failed this test if anybody could please help me I’d appreciate it I’ll do whatever it takes

  • Erika U says:

    Hi Dan!
    Confidence in this test is lost no in myself but one of the things I don’t understand is why we are tested for common sense as a prospect EMT and for what I have seen on the field while I was doing ride alone I don’t see anything that I have learn from the book which is a lot of wording no direct to the point but the test is mostly like Paramedic test, and for what I have been asking around they make it harder because EMT don’t get enough education as Paramedics do shouldn’t be like that. One of the many opinions of medics and Emts that I work with which emts have done 2 to 4 tries and other mostly all the option 6 times. its very sad
    However, I am not giving up but at the same time I don’t have any confidence in this test anymore, I am not the kind of person that memories things I am more of the hands on then test me “artist mind” and right I just review my last 3 tests results and only one subject is above passing, on the other hand i truly need help and motivation that I can do this that I can pass but for now I don’t even know from where to start anymore

  • Daniel Limmer says:

    Hi Erika–I’m sorry you are having trouble with the exam. I see a couple of common threads in your post. Obviously you are discouraged. But I also see that you have feelings about the exam which aren’t helping your prospects of passing. Many times educators and people you ride with say negative things about the NREMT. This affects your perceptions of the exam. It is valid and you have no choice than to take it and pass to become an EMT. I’d start by recommending you reframe your thinking. It is a valid test and you have to prepare for it, not fight it emotionally and cognitively.

    The test doesn’t ask you a lot of facts (like your class exams likely did). This is a shock. It is probably why you feel like it is a paramedic exam. Your education involves more than the book. You have lectures, labs, ride time, and other things to help bring things together.

    I’d love to see you take a good refresher course (we have some options listed on this site). Don’t go back to where your class was. Try something different. Then you will have three more attempts. I would recommend exam preparation that is like the NREMT. Our EMTReview.com site is what I would recommend. We have live online study sessions, features to help you read and understand the questions better, and practice exams. If you want something else you can try our EMT PASS app. It has questions to give you the NREMT feel. Either of these options will help you with that “not direct to the point” issue.

    I also advise students to also make sure they have studied and have no learning or attention span issues that may be getting in the way (both are common in EMS).

    I wish you the best. Please let me know if I can answer any additional questions.

  • Tyler W says:

    I have taken the NREMT P twice now… failed the first time passing only one section and now the second time i did even worse… I am taking the prep course by Marjorie next week… i have used the lc ready and do pretty fair on the sections, I am very discouraged and the whole test i thought I knew the information, the question style is stumping me (I think) I have watched you’re videos but there are only a few any advise helps
    Thank you

  • Dan Limmer says:

    Hi Tyler. I believe I responded to you on another site as well. The quick version here:

    You will do well with your course with Dr. Bowers. She is awesome.

    I also recommended coming by ParemedicReview.com where we have live study sessions weekly as well as more of that YouTube-like videos in our interactive exam review (plus a lot more!). I hope to see you there.

  • Tyler Mullen says:

    I took a paramedic course back in 2017 and completed it. I passed the NREMT Practical exam without issue but failed the written three times. After this due to a loss of confidence, I took a break from taking the test. I then took a refresher course online that the paramedic program themselves created for me and got approved for 3 more tests. I attempted the test twice more and failed and finally just gave up and did not use my final attempt. I would have to take a paramedic course over again but my question is; Is it worth it? Is there any hope for me of passing? Thanks Mr. Limmer

    • Dan Limmer says:

      Hi Tyler–Yes. You should go back and pass it. You will have two issues after the length of time–knowledge and mojo. I personally think that mojo will be the bigger issue but even with the refresher course, you may still want to brush up.

      I find that there are a lot of reasons people don’t succeed. While I cite the mojo and time, quite frankly many people in your situation didn’t have a great course, didn’t really study or work hard, and some have learning or reading issues.

      I would encourage you to work to figure out the issue. You passed your course. It is time to pass the test. You have probably seen my responses before yours in this thread. Please come by my ParamedicReview.com live study sessions. I’d love to work with you there.

      • Georgia says:

        I failed my NREMT for EMT 3 times so I’m required to take a refresher. I don’t why I have failed so hard. I felt like I knew all the questions this last time I took it. I had been studying my butt off just to not pass again. What should I do?

  • richard says:

    So i failed my NREMT-P for a 3rd time. to say i am discouraged is an understatement. So im about to sign up for foamfrat’s refresher course. But this 3rd time i did worse than on my previous 2 attempts. but also on this 3rd time there were questions(and it seemed like many) that i knew the answer to, which lead me to feeling more confident about the test. sadly this was not the case. I even brain dumped and wrote all my formulas(parkland,gcs, heart leads) down on the scratch paper before i started the test, sadly no joy. at this point i have no idea what i am doing to not pass this thing. And i say “what i am doing” , because i know its me not the test at this point. So dan what can i do to better my self before i stress my self out and try this again?

  • Dan Limmer says:

    Richard–the FOAMFrat people are really smart, dynamic, and talented. I am sure you will do well there. Good choice. Go there and learn. Don’t just go through the motions to get more attempts.

    I just responded to Tyler (the post above). I talked about a lot of causes. In yours, I hear that you went in and did a brain dump before you started. I think that may be an issue. Not the dump, the mindset. Anything you can go in and brain dump you would remember anyway. I think you are grasping instead of mastering. I think your score on the third exam reflects this.

    My philosophy has always been a three-part recipe for success. Know the material, read and understand the questions, and believe you can do it (mojo). Only you know what the issue really is. I may sound like a broken record in these posts, but there are so many people in your position. Even with the smart and talented dudes at FOAMFrat, you won’t get there until you reframe this in your head, start fresh, believe you can, and then succeed.

    I’ve helped quite a few at ParamedicReview.com. I’d love to have you stop by after you complete your refresher. I hope you stop by.

  • Nelly K says:

    Hello I’m trying to get information on what I’m able to do now. Ive read through some of the other post on here and seen your response but I’ve also attempted my 3rd attempt and failed again. I passed the practical section when I was in class. This marks my 2 years out of the program. So I’m wondering Now that 2 years have passed am I still able to take a refresher and retake the NREMT or would I have to retake the whole program over? I’ve been studying the emt prep, the practice test that was given to us I’m our program as well as your YouTube videos you’ve posted. I’ve done well on the practice and gotten 80-90%. However I can’t seem to pass the nremt. I really don’t want to go through the program again. I’m a single mother and can’t afford it again out of pocket for I’m out of financial aid and loans to receive. Any advice would be great, thank you!

    • Dan Limmer says:

      Nelly–I’m sorry you are having trouble with the exam. The NREMT questions should be directed to the NREMT. I think that two-year mark is a significant one. I don’t think you’ll have to take the whole course again, but you may need to re-take the practical and/or the refresher course. COVID rules may actually work in your favor a bit as some guidelines have relaxed. Just be sure to get the right information from the source (NREMT) so you don’t waste or duplicate efforts.

      If you must take a refresher, be sure to take a good one. I always tell people don’t look at the refresher as something you have to get through to get more attempts. It is actually a learning experience. Since it has been two years, this is extra important for you. I usually say to go somewhere other than where you took your original course to get new information and influences. If your original location is better for price/location, it is totally ok to go there. Just be sure to learn!

      When you figure out what you need and get it done, drop us a note again and we will talk more about preparing for your next shot at the exam. My best to you!

      • Eric Tompkins says:

        Hi Nelly
        I read your comment and I am finding myself in a similar situation . I was ready to take the nremt early 2020 but Pearson centers were shut down. Subsequently, life got really busy between house projects, emergencies, health , etc, which delayed my signing up for the exam. My retention started to suffer and when I took my first exam, finally, I failed. I just took the exam a second time and failed again. Well, I need to wait two weeks and my 24 months will be up 28 December. I wondering if you were able to get an extension through nremt and if you were able to find an accelerated refresher course versus going through the entire course again.

  • mark says:

    I have just failed my 3rd time…I’m not a dumb person and I studied very hard before each time I took the test…I bought a book with mock questions and was able to get all 220 questions correct, I did mock tests on line and did good on them… I do not understand how I can possibly fail. It would be nice if you somehow let us know which answers we failed that would be a good way to study…None of the easy questions ever seem to come up on tests. I did reach out to the head instructor at the college I attended and he said he would go over the test and let me know what my week areas are… I am like sick to stomach over all of this…I don’t know if you want us to fail to make more money off of us or what….these days you can’t trust anyone! Which is why it would be good to show us our tests like normal schools do…not sure if i’m even going to try again…i guess to do so I have to take a 24 hour refresher course….I have hundreds of hours of studying under my wings…not sure what a refresher course would help anything….very dissapointed!

  • Kody says:

    Hi Dan,
    I have taken the NREMT exam twice and was unsuccessful both times. I have EMT PASS app. I felt like I was prepared and studied all I could. Any advice on what I do next ? I am determined to pass this test.
    Thanks in advance!


    • Dan Limmer says:

      Kody–without knowing specifics it is challenging to say what to do in your case. You’ve likely read where I believe the three ingredients in passing the NREMT include knowledge, understanding how the NREMT asks questions, and confidence (mojo). Only you can tell where you are lacking in those areas.

      EMT PASS is an excellent app. All our PASS apps are. I took the NRP exam in December and used Paramedic PASS to brush up and found it very much like the NREMT. The problem is that people don’t always use the app to its fullest extent. It is important to not just fly through questions. There are two important things you need to do while taking those exams:
      1. When you get a question wrong, read the rationale. The look back at the question to see what you missed or undervalued in significance that would help you get the question right next time. This helps you learn how to truly interpret a question.
      2. Keep a notepad by your phone or computer and write down anything you don’t know. Look it up. Make a study card. Do something to help you remember it for next time.

      I also ask people how their EMT class was. Not all are created equal. If you don’t think your class prepared you well, our EMT Review Audio Lecture Series may help you. They are insightful, focused, and (I’m told) not boring. You can find out about them here: https://limmereducation.com/product/emt-review-audio-emt-lecture-series/

      Finally, our EMTReview.com has a lot of options including live weekly study sessions and a more programmed approach to preparation. One month there is $19.99 and I believe that is another solid option. (You can get the audios discounted through this site as well.)

      In any case, on your third attempt, the pressure is higher so that mojo is important going in. My best to you. Perhaps I will see you in the live study sessions soon.

  • John Miller says:

    Hi my name is jonathanmiller I failed the nremt the first time I’m on a volunteer fire department and I am a emr I would love to be an emt i am not confident in taking it again until some help so any advice .

  • Michael kennedy says:

    Hello everybody so i found out today that i failed my 3rd attempt at getting the paramedic NREMT done. I honestly feel lost because i got the same score as the second time i did the exam. I read the book and have notes from when i was i school and i still failed. I really want to overcome this part of my life to become a paramedic. I dont know what else to do to prepare for this exam. Please asking for help!!

  • Mia says:

    Hi Dan, I have taken the national 4 times I am on my 5th attempt. I take my exam soon I have the knowledge of things. I sometimes feel like I get lost when I see different scenarios. I take the practice test that is on this website. I don’t want to have to repeat this exam again for the last time or repeat the class over. I don’t know what I am doing wrong. I try and put my knowledge into the scenarios. Please help thank you.

    • Daniel Limmer says:

      Mia–as you can see by the number of comments on this post that you are far from alone.

      You can see many replies I made above. I try to say something each time to build on what I have said. Be sure to read those previous comments.

      I think an important thing for you is to do something different than you have on your previous attempts. I sense from your message, especially about scenarios (which are abundant on the NREMT exam), that you have trouble reading them. I would say to do two things:

      First, when you take practice exams and get an answer wrong, be sure to read the rationale and look back at the question and determine why. NREMT questions are different than a lot of questions you had in class. They are written in a minimalist format. One word or concept can change an answer. If you miss that or don’t give it the value it deserves, you will get the question wrong.

      The other thing I would say to do is to force yourself to read the question twice before you look at the choices. This will help you identify important concepts and take away any feeling of rushing. Take a breath between each reading and relax. Figure out what the important concepts are before you choose an answer.

      Finally, I would plan on clearing your head and go in with your only goal to read each question well, answer it, and move on. I find that people who have multiple attempts “try” different things like reading into questions less, not second-guessing, etc. This is usually not successful–and usually doesn’t address the problem. Just go in and answer each question to the best of your ability–after reading it thoroughly.

      Best to you on the exam.

    • J says:

      Did you have to do a refresher twice or just after the third try?

  • Heidi Landaverde says:

    I failed my NREMT 3 times now I don’t know what to do to be able to take it again it takes a toll on you.

  • Tawna Bair says:

    I am just wondering what is the pass success rate of people after doing the remedial training through your different programs? And which one has a better pass rate? This will be my fourth time taking the exam and I’m not super confident about it at all.

    • Stephanie Limmer says:

      Hi Tawna- Our EMTReview.com program has been very successful and we have seen many 5 and 6th time test takers pass! The key is to commit to the studying and be sure to attend Dan’s office hours and talk with him for some one on one help!

  • Crystal says:

    Hello! I took the EMT course in 2020 and passed the class in December. I finally took my exam in May 2021 and failed 3 times! Is it too late to take a refresher course? How do I sign up and is the learning experience better?

  • Becky Christiansen says:

    My son just completed the remediation course, and did the 2 hour review… He failed again. This was his fourth attempt and he is beaten down. He said the questions he saw were about rules and things he’d never learned in any of his courses. It’s like they want them to fail. He was top in his class and did great on the practice tests. He took the remediation and nothing seems to help. What is the deal and how do I support him? My heart is broken for him.

    • Dan Limmer says:

      Hi–I’m sorry that your son is having trouble with the NREMT–and also for how it makes you feel. I am glad he is sticking with it and I hope he continues his quest!

      As a parent, I will tell you a couple of things. The first ones are a bit of tough love. I don’t know you or your son and this isn’t personal. I think it is essential to determine if he worked hard at the remediation. Ask him if he watched the videos and really paid attention. Then ask him to show you his scores on the diagnostic test at the beginning of the program and the tests for each of the 10 sections. We only require 75% to get credit for each of the exams. Did he get that on his first attempt on most if not all of the tests? If not, I would say there is still a content issue. While we take 75%, I would want him to have 80 or 85% for a bit of extra comfort approaching the exam.

      Generally, there are three reasons a person doesn’t pass. One is that they don’t know the content. The other is that they don’t have the test-taking experience for the NREMT exam. It is different and more challenging than class exams. The last is that there may be a reading or test-taking issue (dyslexia, poor reading, anxiety).

      The NREMT is like a machine. They don’t look at students and want anyone to fail. They want to create a valid and defensible exam that measures entry-level competence. There aren’t enough “rules” on the exam that would fail him. I think it is potentially the content issue (and you can look at his scores and see where he stands) because of his unfamiliarity with things he sees on the exam.

      It seems you are very invested in this for your son. Have him sit down and do one of the exams with you in the room. How long does he take? Is he reading the questions well and thinking? If he reads you a question out loud, can he explain what the question is asking for and provide a rationale for the answer he chose?

      Let me know about these things. Again, I don’t know your son but I think this is a starting place for him to get to where he needs to be.

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