There are two ways to obtain a nurse aide certification in Maryland: by completing a nursing assistant training program and passing the competency exam, or by endorsing an out-of-state certification. Out-of-state candidates who plan to apply for endorsement in Maryland must have an active CNA certificate, and be in good standing on their state’s Nurse Aide Registry. Those who are not on any other state's registry and seek initial certification in Maryland, need to attend a one-hundred hour, state approved nurse aide training course.