Every commercial driver operating under a CDL must pass a Department of Transportation medical examination before driving and every two years afterward. The exam is standardized at the federal level under 49 CFR 391.41, administered by a certified medical examiner, and results in a Medical Examiner's Certificate (Form MCSA-5876) that must be kept current throughout a driver's career.Most guides to the DOT physical cover the same basic checklist. This article covers that checklist and the details those guides consistently omit, including the January 2024 update to FMCSA's Medical Examiner's Handbook, the blood pressure staging system and what each stage means for your certification, and what happens if your own doctor is not on the National Registry.The January 2024 Handbook Update: Why Earlier Guides Are OutdatedFMCSA published a new edition of the Medical Examiner's Handbook on January 22, 2024, replacing all previous editions. The agency specifically noted that medical examiners shou