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Electronic Fetal Monitoring Subspecialty Certification Exam (C-EFM)
Find the current format, timing, scoring, fees, eligibility, and testing options for C-EFM, with direct links to official sources.
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Questions125 multiple-choice items (three options each); 100 scored and 25 unscored pretest items
Testing time2 hours
ScoringCriterion-referenced pass/fail computed by item response theory (Rasch) ability estimate against a predetermined ability standard; no set percentage passing level and no published cut score; reports give word descriptors (very weak to very strong), not numeric scores
Exam feeUSD 210 total (a USD 50 non-refundable application fee plus a USD 160 testing fee); incomplete applications incur a USD 30 reprocessing fee
Prep options
Study resources for C-EFM
Independent prep
Courses and study resources
Exam overview
What to know before choosing your prep
- Who runs it
- NCC
- Category
- Specialty Nursing Certification
- Current version
- Current specification per the 2026 Candidate Guide; no exam version code
- Where it applies
- International / multi-country
- Exam languages
- English
- Testing provider
- PSI (AMP Assessment Centers and Live Remote Proctoring delivery)
- Format
- Computer-based at AMP test centers or via Live Remote Proctoring (LRP) online
- Availability
- 90-day eligibility windows after approval (exam must be scheduled within the first 30 days of the window); LRP appointments available 24 hours a day, test center appointments Monday through Saturday
- Results
- Official pass/fail test results report posted to the candidate's NCC account (with content-area word descriptors)
- Remote testing
- Available
Exam structure
One 2-hour computer exam of 125 three-option multiple-choice items (100 scored, 25 pretest) across five content areas: Electronic Monitoring Equipment 5%, Physiology 12%, Pattern Recognition, Causes, and Intervention 70%, Fetal Assessment Methods 8%, Professional Issues 5%
Where rules vary
The exam is for licensed health care professionals in the United States and Canada.
Eligibility
Current/active/unencumbered licensure in the U.S. or Canada as a physician, registered nurse, nurse practitioner, nurse midwife or midwife, physician assistant, or paramedic (unlicensed interns/residents/fellows may qualify with a program-director letter); no practice experience required
Retake policy
45-day wait after testing before submitting a new application and full fees; maximum of two attempts at the same NCC exam per calendar year