CNA vs Medical Assistant (2026)

There is no national nursing assistant license. The gate is federal and then state: Medicare and Medicaid rules require that a facility not use anyone as a nurse aide for more than four months unless they have completed a state-approved nurse aide training and competency evaluation program, and a facility must receive nurse aide registry verification before letting someone work as a nurse aide. Federal rules set a floor of 75 clock hours of training; the credential title, such as Certified Nursing Assistant (CNA), is set by each state.

Typical entry education (BLS)

Postsecondary nondegree award

Typical program length

At least 75 clock hours

Realistic range

Federal rules require that an approved nurse aide training and competency evaluation program consist of no less than 75 clock hours, include at least 16 hours of supervised practical training, and cover at least 16 hours of communication and interpersonal skills, infection control, safety and emergency procedures, promoting residents' independence and respecting residents' rights before any direct contact with a resident. Because the regulation states these as minimums, state programs can be longer.

Exam: Nurse aide competency evaluation

Every approved nurse aide training program must contain the competency evaluation procedures set out in the federal regulation. It is taken after the training program, and passing it is what places you on the state nurse aide registry and lets you use the state's title. The exam's name and format are set at state level, not nationally.

Governing body: CMS

Sets the federal minimum standards, at 42 CFR part 483, for nurse aide training and competency evaluation programs, for the state nurse aide registry, and for when a long-term care facility may use someone as a nurse aide.

Licensed state by state

The credential is issued and titled by the state. BLS notes that in some states a nursing assistant is called a Certified Nursing Assistant (CNA) but titles vary by state. What varies: the number of training hours above the federal 75-hour floor, the format and passing standard of the competency evaluation, whether the state requires continuing education, criminal background checks, and the operation of the state registry itself. Registry listing is what a nursing home must verify before letting you work.

Keeping the credential

There is no national continuing-education requirement placed on the individual. BLS notes some states add requirements such as continuing education. Two federal rules do bite: if 24 consecutive months pass during which you provided no nursing or nursing-related services for pay, you must complete a new training and competency evaluation program; and facilities must review each nurse aide's performance at least once every 12 months and provide regular in-service education.

Certification for medical assistants is generally voluntary rather than a state license. BLS states that although most states do not require it, employers may prefer or require that medical assistants be certified, and that some states do require graduation from an accredited program, licensure or certification. Typical entry is a one- to two-year postsecondary certificate or associate degree, though some medical assistants enter with a high school diploma and learn on the job.

Typical entry education (BLS)

Postsecondary nondegree award

Typical program length

1-2 years

Realistic range

BLS reports that postsecondary medical assisting programs, for a certificate or an associate degree, take about 1 or 2 years to complete. Medical assistants without postsecondary education may instead learn through on-the-job training or an apprenticeship, which BLS says may take several months.

Accreditation: CAAHEP

The largest programmatic accreditor of health sciences education. Graduating from (or being a student in) a CAAHEP-accredited medical assisting program is the primary eligibility route for the CMA (AAMA) Certification Exam.

Accreditation: ABHES

The alternative accreditor AAMA accepts: being a student or graduate of an ABHES-accredited medical assisting program also makes you eligible for the CMA (AAMA) Certification Exam. AAMA lists further eligibility categories beyond accredited-program graduates.

Exam: CMA (AAMA)

The main eligibility route is being a student or graduate of a medical assisting program accredited by CAAHEP or ABHES; AAMA also lists categories for previously certified CMAs, qualifying medical assisting educators, and certain other postsecondary medical assisting or apprenticeship program graduates. The credential is valid for 60 months.

Exam: RMA

A separate voluntary medical assisting certification. AMT publishes several eligibility routes and notes that requirements may change and that applicants are held to the criteria current at the time of application.

Exam: CCMA

Eligibility requires a high school diploma or equivalent (or being scheduled to earn one within 12 months) plus either completion of a medical assistant training or education program within the last 5 years, or 1 year of supervised medical assisting work experience within the last 3 years, or 2 years within the last 5. Certification must be renewed every two years.

Governing body: AAMA

Awards the CMA (AAMA) credential through its own certification exam, and administers recertification.

Governing body: AMT

Awards the Registered Medical Assistant (RMA) credential.

Governing body: NHA

Awards the Certified Clinical Medical Assistant (CCMA), one of its allied health certifications.

State variation

Medical assisting is not a licensed occupation in most states, so in most places nothing legally stops you working as one without a credential; the pressure to certify comes from employers. BLS does note that some states require medical assistants to graduate from an accredited program, be licensed or certified, or meet other prerequisites in order to practice, and directs candidates to their state licensing agency. Check that agency before assuming certification is optional where you live.

Keeping the credential

There is no national continuing-education requirement, because certification itself is generally voluntary. The certifications that do exist expire: the CMA (AAMA) must be recertified every 60 months, either with 60 continuing education units (30 of which must be AAMA CEUs, with at least 10 from each of the general, administrative and clinical categories) or by retaking the exam; NHA certifications must be renewed every two years.