To become a BMT-CN®, a nurse must first be a licensed registered nurse (RN) with experience in oncology or transplantation. They must then pass a rigorous certification exam administered by the Oncology Nursing Certification Corporation (ONCC). The exam covers a wide range of topics, including patient assessment, transplant procedures, complications, and long-term follow-up care. Continuing education and recertification are required to maintain the certification.