CFRN vs FP-C: flight nurse and flight paramedic certifications compared
The CFRN (Certified Flight Registered Nurse) is the flight certification for registered nurses, from BCEN. The FP-C (Certified Flight Paramedic) is the flight certification for paramedics, from IBSC. They're parallel credentials for the two partners in the aircraft. Here's how they compare.
Facts checked against BCEN and IBSC websites on 2026-10-17. Fees and rules change, so confirm with the board before you register.
| CFRN (flight nurse) | FP-C (flight paramedic) | |
|---|---|---|
| Certifying board | Board of Certification for Emergency Nursing (BCEN) | International Board of Specialty Certification (IBSC) |
| Eligibility | Current, unencumbered RN license (US, US territory, Canada, or Australia, or a verified foreign equivalent). BCEN recommends 2 years of specialty experience but doesn't require it. Source | Current, unrestricted paramedic license in your state or country of practice. IBSC encourages 3 years in a critical care or air transport environment and 6–12 months of self-study but doesn't require them. Source |
| Questions | 175 items: 150 scored and 25 unscored pretest items. Source | 135 questions: 110 scored and 25 unscored beta items. Source |
| Time | 3 hours (180 minutes) Source | 2.5 hours Source |
| Passing score | 102 of 150 scored items for exams taken on or after August 31, 2026 (previously 108) Source | 73 of 110 scored items Source |
| Exam fee | $285 for ASTNA members, $380 for non-members Source | $285 with IBSC affiliate membership, $385 for non-members Source |
| How you test | PSI testing centers or live remote proctoring | Computer-based testing (testing center or remote proctor), or onsite IBSC-MEDBOX |
| Valid for | 4 years | 4 years |
| Recertification | Retake the exam, or attest to 100 CE contact hours in the 4-year period: at least 75 clinical and specialty-specific, and at least 50 from accredited sources (at least 75 for applications from January 1, 2027). EMS-only CE (e.g., CAPCE) isn't accepted. Source | Retake the exam, or submit 100 CE contact hours in the 4-year period: at least 75 clinical, including 16 hours from an IBSC-approved FP-C review course, and up to 25 operational. Recert fee $285/$385, plus $125 if submitted less than 30 days before expiration. Source |
| Required by CAMTS? | CAMTS requires a transport certification once a crew member has been employed more than 2 years: CFRN or CTRN for nurses, FP-C or CCP-C for paramedics doing critical care transports. See Basic Requirements. | |
What the exams cover
Both exams test experienced-clinician knowledge, not entry-level knowledge. Expect a lot of overlap: airway and ventilator management, hemodynamics and vasoactive drugs, trauma, medical emergencies, pediatrics and neonates, OB, labs and blood gases, and flight physiology, gas laws, and transport safety. Each board publishes a detailed content outline in its candidate handbook. Start there.
Which one do you take?
It depends on your license, not on which exam seems easier. RNs take the CFRN (or the CTRN for ground transport). Paramedics take the FP-C (or the CCP-C for ground critical care transport). Some dual-licensed clinicians hold both.
Related certifications
- CTRN (BCEN): Certified Transport Registered Nurse, for ground transport nurses. CAMTS accepts it as an alternative to CFRN where pertinent to scope.
- CCP-C (IBSC): Certified Critical Care Paramedic, for ground critical care transport. IBSC notes the FP-C adds flight physiology and flight safety content.
- C-NPT: neonatal and pediatric transport certification for specialty teams.
Next steps
- How to become a flight nurse
- How to become a flight paramedic
- Get hired: requirements and prep resources
Sources: BCEN CFRN, BCEN CFRN FAQs, BCEN recertification, IBSC certifications, IBSC exam requirements, IBSC exam fees, IBSC exam FAQs, IBSC continuing education.