In order for a youth to earn the National Medal for Outdoor Achievement, the youth must complete the following requirements:
- Earn the Boy Scout First Class rank or Sea Scout Apprentice rank, or complete Venturing Ranger Award requirements 1 through 6 and hold the Venturing Discovery Award.
- Earn the National Outdoor Badge for Camping with a silver device.
- Earn any two additional National Outdoor Badges, each with two gold devices.
- Complete the requirements for all of the following:
- Backpacking merit badge or Ranger Backpacking elective;
- Emergency Preparedness merit badge or Ranger Emergency Preparedness core;
- Nature merit badge; and
- Wilderness Survival merit badge or Ranger Wilderness Survival core.
- Complete a 16-hour course in Wilderness First Aid from the American Red Cross, Wilderness Medical Institute, or other recognized provider.
- Become a Leave No Trace Trainer by completing the 16-hour training course from a recognized Leave No Trace Master Educator.
- Plan and lead, with the approval of your unit leader, an outing for your troop, team, ship, crew, patrol, or squad in two of the following activity areas: hiking and backpacking, aquatic activities, or riding. Include in each outing a service element addressing recreational impacts resulting from that type of activity. With the approval of your unit leader, you may plan and lead the outings for another Cub Scout pack, Boy Scout troop, Sea Scout ship, or Venturing crew.
- Complete at least one of the following:
- Plan and lead, with the approval of your unit leader, an adventure activity identified in the National Outdoor Badge for Adventure for your troop, team, ship, crew, patrol, or squad.
- Successfully complete a season on a council summer camp staff in an outdoor area, such as aquatics, Scoutcraft, nature/environment, climbing, or COPE.