Failed the NREMT 3 Times? Don’t Panic—Here’s Your Ultimate Comeback Plan

Okay, so you’ve failed the NREMT three times.

Not ideal but it’s fine. Your confidence might have taken a hit and that’s pretty normal. You’re not completely out of the race yet.

This is not the end of your paramedic journey.

Plenty of other medics have run into the same issue. You’re in good company.

Because here’s the thing, you’re not stupid.

You passed EMT. You passed all your other class exams. The NREMT is just its own beast and you need to learn how to tackle it.

Hey, I’m Shay. I’ve been working in EMS for over a decade now. I’ve also taught in multiple parametric and EMT courses.

Today I’m going to cover everything you need to know to crush the National Registry on your next attempt.

And there’s really only 3 big reasons you failed.

• You only memorized facts
• You didn’t study the right things
• You suffer from a big case of test anxiety

Full Disclosure

To be completely honest, no I haven’t been in this boat.

However, all this is exactly how I’ve worked with students to get them through the exams.

This is your life raft. No fluff, no sugarcoating—just actionable advice, a bit of humor, and a lot of encouragement.

Ready? Let’s set sail! (Ok I’m done with the boat references.)

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Why Failing the NREMT Happens (and Why It’s Okay)

First, let’s debunk a myth: failing the NREMT doesn’t mean you’re not cut out for the job.

It just means something’s off. Maybe it’s your study strategy. Maybe you weren’t prepared for how weird the NREMT is.

We’ll go over both those options in just a bit, don’t worry.

The NREMT is a beast. It’s designed to make you second guess how you’re doing. It’s a good way to test your knowledge under a little duress.

Think of it as an annoying but necessary rite of passage.

So, remember those 3 big reasons?

• You just memorized facts
• You skipped studying the important stuff
• Text Anxiety

Keep those in mind while we go through your next steps to finally passing the NREMT.

What Happens After Failing the NREMT Three Times?

After three strikes, you’re not out. That’s the good news.

However, you do need to complete a remediation program. It’s a requirement to make sure you fill any knowledge gaps before attempting the exam again. Think of it as a reset button, not a punishment.

Clear your calendar and be prepared to spend even more time studying for your next exam date.

This is your last chance to clarify any gaps in your knowledge before the big day.

How to Start the Remediation Process

Sounds scary but it’s actually pretty easy.

• Step 1: Contact your state EMS office.

They’ll guide you through the next steps, like finding an approved remediation program.

If you’re already working somewhere, they may have their own program. Check with your employer first.

• Step 2: Choose your program wisely.

Look for courses that offer personalized instruction, practice tests, and hands-on guidance.

Again if your boss has one they want you to go to, listen to them.

• Step 3: Complete the program and reapply for the NREMT.

You’re back in the game, baby.

Cool, you’re in class and ready to re-re-re-retake that exam. Let’s figure out exactly why you failed the first couple of times and double down on the solution.

3 Big Reasons You Failed the NREMT-P

It’s Not Just About Memorizing Facts

First of all, I’m 100% for learning how to memorize things.

Memorization is the most basic form of learning. While that may sound like I’m hating on it, I actually think that’s why it’s the most important part.

Everything else is built off that base.

But if you see a NREMT questions like “your patient just OD’d on a 300 mg bolus of gummy bears, what size ET tube are you using?,” all the memorization in the world won’t save you.

The NREMT wants to see you think.

It’s testing your decision making and critical thinking skills. Which is why you get some weird questions thrown at you. They’re intentionally convoluted and want to make you really think.

It’s less “What’s the answer?” and more “What’s the right thing to do for this patient right now?”

Critical Thinking Practice

If this is your problem, your issue is how you’re practicing for the exam.

You’ll need to spend less time studying off a study guide and more time taking the test.

And a great way to do that is with the Pocket Prep App

It’s a whole program designed to mimic the NREMT as closely as possible. You can focus on specific hard sports or let it choose for you.

It’s an awesome resource for anyone trying to pass the National Registry Exam.

I have been recommending Pocket Prep to all my students in EMT and Paramedic classes, and now I’m happy to be an affiliate for them.

So check them out HERE to see what their awesome program can help you with.

Test Anxiety Is Real

Palms are sweaty, knees weak, arms are heavy and there’s vomit on your sweater already…

Wait that’s Eminem.

But still, this is what it can feel like when you start getting worked up about the exam. You did all this studying and preparation. You’ve been acing your practice tests. And then?

Your brain takes a vacation and you forget how to spell your name on the test.

And this might be the hardest part to over come.

It’s a positive feed-back loop. You get all nervous about the test. Then you do bad. Then you take it again but you’re more nervous. Then you fail, again.

It’s like a bad habit that reinforces itself.

Beating Test Anxiety

So what can you do about it?

Exposure therapy. And no I don’t mean actually going to therapy (though you can if you want). I mean get as must exposure to NREMT style questions as humanly possible.

Thankfully that’s pretty easy.

We already talked about how good Pocket Prep is for studying. I recommend it here too. But take it one step further.

Practice like you were actually taking the exam.

Get out of your comfortable study spot. Go to a library or a coffee shop. Pull up your practice exam and start a timer.

Don’t talk to anyone. No little breaks. Pretend like you’re actually taking the test.

This is the only way to beat test anxiety. Take more of them and beat it into submission.

Gaps in Your Study Routine

Okay for real now. Were you really studying as hard as you said you were?

Did you even have a study plan? Or did you just walk in to a room with your text book and start winging it?

You can’t blame anyone for results you got with the work you didn’t do.

It’s fine if that’s what happened. Now you know. We have a way forward and we know where to focus our energy before the next test.

Study Game Plan

Next time you study, get out your timer.

Turn off all notifications and remove all distractions. Then start your timer. Any time you look at your phone, talk to someone, or just get distracted, stop the timer.

I bet you will be amazed at how little time you actually spend studying.

Again, it’s totally fine. I started doing this anytime I work (like writing this) and I’ve learned a lot. Mostly about how easily distracted I am. The difference between what I think I was doing and how long I was actually working is insane.

Once you realize how easily distracted your little ADHD paramedic brain is, try and go longer chunks of time before getting distracted.

If you only made it one minute before checking the clock, try for two next time.

Slowly you’ll develop that muscle and be able to focus harder for longer.

But wait. You set your timer and realized you were actually super focused the whole time. Congrats, you have Jocko level discipline.

The Knowledge Gap

So why are you still failing?

You probably didn’t come up with a good study plan. It can be hard to make your own study guides if you’ve never made one before.

The most important part is prioritizing your weak spots.

And that’s why Procket Prep is back! It will let you take realistic NREMT exams and get feedback on where you’re crushing and what you need to work on.

Your weak areas are great points to bring up in your remediation class.

And if you want a full guide on how to make a personalized study guide, you can find my guide to guides here.

AND that’s a wrap

You’re ready for your next crack at the National Registry. Don’t waste it. You’re going to keep building this test up in your head every time you take it and don’t pass.

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Extra Tips for Success

• Be prepared to work hard. This test isn’t supposed to be easy.
• Study Groups: Don’t join them. People love them because they are fun, but I truly don’t think they help your grades.
• Tutors: A good tutor can pinpoint your weak spots and help you develop your strengths. Find a paramedic you trust and ask for their help. We’re nerds. We love sharing our nerdy little knowledge nuggets.

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From Medics Who’ve Been There

Plenty of EMTs Paramedics have failed the NREMT multiple times.

They went through what you’re feeling right now—frustration, doubt, maybe even a little self-pity.

And guess what? They came out the other side stronger and better prepared.

Failing the NREMT doesn’t define you.

What does define you is how you bounce back. You’re smart, capable, and determined.

If you weren’t, you wouldn’t be here reading this.

So buckle up, follow this game plan, and go conquer that exam.