FAQS

The basic purpose of the medical is safety. In most industries there are national safety standards, such as land transport standards, and in the rail industry there are a series of defined medical standards which legally must be met before a person can work in the rail corridor.

You would, however, have to have a serious medical issue to not meet the standards. There would need to be something significant to not pass the medical. So, the medical is to help keep you safe; for your sake, and in some cases for the public’s sake.
Also, there can be a secondary purpose of the medical, should you wish. Your company wants to give you the opportunity to be proactive about your health; and, if you want to, to discuss with the doctor factors which can help you to have a long and healthy life. (e.g., blood pressure, cholesterol, sugar, weight and diet).

Confidentiality is a key element to the entire medical process.
Although the doctor will need to get enough information to understand your health, no information will be divulged to your company without your knowledge or consent. There is usually no need for any of your personal information to go to management. Medical information stays with the doctors, and the usual communication that is going out of the doctors’ office is simply that you pass the medical.
Under rare circumstances, with your permission, it may be useful to explain some things to management. This would always be discussed with you first; what information, to whom, and why it might be necessary. Your consent would be necessary to proceed.

There are two main components to the paperwork for your assessment.

1. Patient Health Questionnaire:

Doctors get more meaningful information from what you tell them about your medical history and symptoms than from the actual physical examination itself. This is why it can sometimes be useful for the doctor to have access to some of your previous test results or clinic reports. Again, this would be only when necessary, and after discussion and consent.
The questionnaire contains sections on fatigue and mental health. Two of the biggest causes of accidents in the workplace are fatigue, and stress/mental health.
Also, if these issues occur, they can have medical causes which, in turn, can usually be helped. The doctor is especially interested to hear how things really are for you.

2. Consent for the assessment

3. We may also need photo ID for your assessment.

Please note this specifically applies to rail medicals, however, elements may apply to other medicals too.

When you arrive, you are likely to see the nurse or clinical assistant first.

It is their job to carry out:
• height, weight and measuring neck circumference
• near and distance vision tests
• blood pressure
• ECG
• spirometry
• audiogram
• urine dipsticks and urine drug test if required

A category one rail medical requires most of the above, and blood tests for cholesterol and sugar. You will be provided with a blood test form at the appointment. Please try and get this done at any Lab tests branch on the day of your appointment.

A category two rail medical does not require an ECG usually

A category three medical requires less. This level of medical is focused on safe hearing vision, and mobility.

The doctor will usually see you last.

The following description pertains to a category one or two medical.
Each doctor tends to have their own system for checking over the necessary things, but the following may help you to know what to expect.
The doctor may run the medical as an interactive process, both to gain more information and to discuss health issues and areas of health promotion. A common way of carrying this out is to continue to question and discuss things throughout the examination process.

One approach is to start at the top and work down, commencing with checking your vision, this starts with checking your:
• colour vision, then visual fields to confrontation, then pupils, eye movements, and other cranial nerves (excluding. taste/smell)
The doctor may then move down to the neck; to check the lymph glands, thyroid, trachea, and carotids, listening for bruits.
They may next check your heart and chest, whilst in a standing position, also looking at nevi/checking the skin while listening. This may be done with your shirt on or occasionally off. If you are a woman you will not be asked to remove your bra.
Next is the musculoskeletal examination; this includes:
• Testing of cervical movements, then shoulder and arms, hands, behind neck/elbows back, then a full shoulder arc until hands are up high behind back (for internal rotation), touch shoulders, straighten arms, then pronation and supination of the forearm with elbows fixed at 90 degrees.
• Then checking your wrist, hand and finger movements, strength, and sensation followed by pulses.
• Thoracic and lumbar movements, such as, touching your knees, then toes, then back extension and side bend are next. This is where a modified Rhombergs can be used which also tests lumbar nerve motor outflow i.e. walking on heels, then walking on tiptoes, then shutting eyes and continuing on for a few steps on the spot, walking on the toes
The last part of the examination is often with you lying up on the couch. Here the doctor will do reflexes, cardiac apex, abdominal checks, including asking you to cough while he or she feels for inguinal hernias. These tests are all done with you clothed.
While you are lying down the doctor may examine foot sensation, pulses, and ankle movements. Also, straight leg raises, then bending and examining your knees for movement/effusion/crepitus ligaments, and following this by rotating the hips.
It is virtually never necessary for very personal aspects of your check up to be done by the company doctor, such as breast or testicular examination; although there are very occasional circumstances when this could be appropriate.
If you have any questions, please ensure these are raised PRIOR to your medical.

Our highest priority is the safety of you and our team. All of our staff are fully vaccinated and have the most stringent infection control measures in place.

Please email us on medicals@yourhealthcentre.co.nz and our team will guide you through the process