I'm about 10 weeks out from attempting the CPM credential and I'm trying to figure out where to focus my prep energy. I've heard very different things from different people — some say the written NARM exam is the real challenge, others say the skills assessment is where most candidates struggle. I've been apprenticing for 3 years and I feel fairly solid on the clinical side, but standardized written exams have historically been tough for me.
I'm currently studying about 2 hours a day, working through the NARM study guide and a midwifery textbook. My practice scores on the written portion are around 68–72%, which isn't where I need to be. The pharmacology and neonatal resuscitation sections are my weak spots — I know the practical protocols but translating that to multiple choice questions is harder than it sounds. I've got my skills documentation organized, so that piece feels manageable.
Has anyone done the exam recently who can speak to how pharmacology is weighted? And for those who struggled with the written portion — what's the minimum score needed and how much did focused practice question drilling actually move your score in the final weeks?
Passed the written with 76% on first attempt. The minimum passing score through NARM was 70% when I sat for it. The skills assessment was nerve-wracking in the moment but I didn't find it technically as difficult as the written sections on complications and emergency management.
I found the written exam harder than the skills assessment, but I'm coming from 4 years of apprenticeship under an experienced CPM. The documentation portion of the skills section is more about organization and completeness than clinical difficulty.
Pharmacology was maybe 12–15% of my written exam. Focus on oxytocics, antibiotics for GBS prophylaxis, and neonatal eye prophylaxis protocols.
The neonatal resuscitation questions on the written exam are very scenario-based. You need to know the NRP algorithm cold and be able to apply it in a timed, stressful question format. I drilled 200+ NRP scenarios in my last 4 weeks of prep and it made a real difference.
My practice scores were similar to yours — around 69–73% — and I ended up getting 74% on the actual exam. Pushing through 3–4 hours of practice questions daily in my last 3 weeks is what moved my scores. The format gets very familiar and the trick questions start to feel predictable.
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