CFRN requirements, from license to renewal

• The requirement: RN license only, current and unrestricted; no flight or transport hours count toward it, and the accepted countries are in the table.
• Experience: Two years as a flight nurse before the CFRN, or as a ground transport nurse before the CTRN; a recommendation BCEN does not verify.
• Employers set their own bar: a transport credential is required after 2 years at CAMTS programs (13th edition, 03.05.01, item 3g), and it must be the one pertinent to the program's scope of care. Hiring requirements and the usual route into a flight program: how to become a flight nurse.

1. Apply and pay with the board; the fee depends on ASTNA membership or military status (cost).
2. Approval starts the 90-day window; book any open PSI slot inside it.
3. Choose a PSI center or remote session. The live proctor watches a remote session for the whole exam; the rescheduling cutoff is in the table.

• Length: 175 in all, 150 scored plus 25 pretest; the pretest ones are unmarked and add nothing to the score.
• Time: 3 hours (180 minutes) for either exam.
• Question type: multiple choice, one best answer.
• Outline: in force since August 31, 2026, five domains (counts and pages).

• Length: 150 scored questions plus unscored pretest questions. The outline gives no pretest count, and the 155 / 130 figures on the CTRN FAQ contradict it.
• Time and question type: as for the flight exam.
• Outline: in force since March 30, 2026, four domains, with trauma and medical conditions in one (CTRN certification).

On the day: immediately, on paper at the center or on screen at home, followed by an email. Fail, and the report breaks your raw score down by content area; plan the retake from the weakest one.

Retesting: after a 90-day wait, reapplying for each attempt; the retest price is in the table. Whether to buy Test Assurance at the first application is worked out on the cost page. The board's yearly counts show how often candidates fail; the latest: 930 passed, 680 failed (CFRN, 2025). Shares for both exams over four years: pass marks and pass counts.

• Cycle: the credential lasts 4 years; each credential renews on its own.
• Two routes: testing again, or attesting to continuing education.
• Clinical share: 75 or more of the 100 hours in clinical content of the specialty, with up to 25 non-clinical.
• Accredited hours: today 50 of 100 hours from accredited providers. The board has announced a higher share for applications from January 1, 2027; the change, which applies to all its credentials, is explained on BCEN certifications.
• Fee: $280, or $210 for ASTNA members.