Is the model tuberculin skin test (TST) training program used by the National Health and Nutrition Examination Survey (NHANES) described on page 50 of the guidelines required for all settings?

No, CDC guidelines are recommendations, they are not requirements. “The suggested TST training recommendations are not mandatory” (from p. 45 of the guidelines). “The number of training hours, sessions, and TST readings should be determined by the setting’s TB risk assessment” (p. 48). Settings with a low prevalence of TB may not be able to meet NHANES TST training recommendations.