snifter

Medicals - Panel doctors instructions and what you need to know

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    I thought I'd post this in a new thread so it is more easily found by people in the future. The link was posted over on PIO by a member and its a good read for anyone due to have a medical for their visa application.

     

    There is a PDF link on this page you can download and read here -- Instructions for Panel Doctors

     

    A few things to note that seem to always get mentioned in threads around the forum. This is based on my own reading of this PDF so please read it yourselves and take from it what you will :)

     

    * Breast exam - This PDF states -

     

    Question 14: Breast examination

     

    Breast examination is not routinely required in women under the age of 40. Breast examination should be offered to all women over the age of 40.

    Breast examination should be conducted if there is a history of breast cancer or breast lumps, or axillary nodes are palpated. Applicants should be asked to remove brassieres only for the purposes of and during breast examination. Such examination must be conducted with sensitivity and, in the case of a male doctor, in the presence of a chaperone. If an applicant declines, is unduly anxious or upset about a breast examination, please do not insist. Note the clinical indication(s), if any, and the applicant’s unwillingness on form 26.

    Additionally, in countries where breast examinations are not routine, a panel doctor or clinic staff member should advise adult female applicants when they schedule their appointment, or at reception, that a breast examination may be required if clinically indicated.

    If there is a risk based on the family medical history, or if otherwise clinically indicated, the case should be graded B. **See note below on Grade B reference**

     

    *HIV and Hep B & C - Healthcare workers, people with tattoos - Although it doesn't state people with tattoos *have* to have a test for HIV I've read some people say they were tested for it and had tattoos. Nor does it state healthcare workers are required to undergo a test for HIV. It does state about Hep B & C being done if having tattoos.

     

    -----

     

    Grade A - Grade B.... what does it mean? The breast exam blurb mentioned a 'Grade B', in the PDF it explains what these grades are. I've copied and pasted below

     

    42.3 ‘A’ recommendations

    ‘A’ should be written when all the criteria below are met:

    • No significant conditions or findings are noted.

    • The physical findings are completely normal, including a blood pressure at or below the recommended levels, no significant cardiac murmur, no albumin, glucose or blood in the urine, and a visual acuity corrected if necessary, of no worse than 6/12 in the better eye.

    • No medical or surgical condition is present which would require further investigation or treatment currently or in the foreseeable future (say, the next 10 years).

    • The applicant can cope independently with the activities of daily living without family or other assistance. Nursing or institutional care is not required currently or in the foreseeable future (in the next 10 years, or 3 to 5 years in persons 70 or more years of age—see Attachment 3: Activities of Daily Living (ADL) Assessment.

    • The results of the chest x-ray examination are completely normal, except for conditions listed in part C, page 49.

    Where any condition or indication identified is stable and of no clinical significance, A is the appropriate recommendation.

     

    42.4 ‘B’ recommendations

    B should always be written when any of the above conditions are not met, when conditions or findings are present, or if the panel doctor has reservations about an applicant’s fitness, notwithstanding the absence of abnormal findings. Doctors should note that the grading does not determine whether a visa will be granted. Further, a B grading does not mean that an applicant will not meet the health criteria. The grading is simply a means

    of processing forms efficiently.

    For details on the recommendations to be given for commonly seen conditions, please refer to Attachments 4 and 5.

     

    And last but not least, please don't think you have to sit in your underwear in front of everyone else attending with you. Or that you will be examined in front of them also. There should be facilities in place where you will be examined privately and you can always ask for a gown or speak up if you are unhappy with anything. The PDF states about a 'chaperone' and states 'be courteous and respectful towards applicants, mindful of their time, dignity, privacy and cultural practices'. So if you want that curtain pulled or to wear a gown, say so. Don't sit there like a lemon and say nothing :cute:

     

    :)

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    I thought I'd post this in a new thread so it is more easily found by people in the future. The link was posted over on PIO by a member and its a good read for anyone due to have a medical for their visa application.

     

    There is a PDF link on this page you can download and read here -- Instructions for Panel Doctors

     

    A few things to note that seem to always get mentioned in threads around the forum. This is based on my own reading of this PDF so please read it yourselves and take from it what you will :)

     

    * Breast exam - This PDF states -

     

    Question 14: Breast examination

     

    Breast examination is not routinely required in women under the age of 40. Breast examination should be offered to all women over the age of 40.

    Breast examination should be conducted if there is a history of breast cancer or breast lumps, or axillary nodes are palpated. Applicants should be asked to remove brassieres only for the purposes of and during breast examination. Such examination must be conducted with sensitivity and, in the case of a male doctor, in the presence of a chaperone. If an applicant declines, is unduly anxious or upset about a breast examination, please do not insist. Note the clinical indication(s), if any, and the applicant’s unwillingness on form 26.

    Additionally, in countries where breast examinations are not routine, a panel doctor or clinic staff member should advise adult female applicants when they schedule their appointment, or at reception, that a breast examination may be required if clinically indicated.

    If there is a risk based on the family medical history, or if otherwise clinically indicated, the case should be graded B. **See note below on Grade B reference**

     

    *HIV and Hep B & C - Healthcare workers, people with tattoos - Although it doesn't state people with tattoos *have* to have a test for HIV I've read some people say they were tested for it and had tattoos. Nor does it state healthcare workers are required to undergo a test for HIV. It does state about Hep B & C being done if having tattoos.

     

    -----

     

    Grade A - Grade B.... what does it mean? The breast exam blurb mentioned a 'Grade B', in the PDF it explains what these grades are. I've copied and pasted below

     

    42.3 ‘A’ recommendations

    ‘A’ should be written when all the criteria below are met:

    • No significant conditions or findings are noted.

    • The physical findings are completely normal, including a blood pressure at or below the recommended levels, no significant cardiac murmur, no albumin, glucose or blood in the urine, and a visual acuity corrected if necessary, of no worse than 6/12 in the better eye.

    • No medical or surgical condition is present which would require further investigation or treatment currently or in the foreseeable future (say, the next 10 years).

    • The applicant can cope independently with the activities of daily living without family or other assistance. Nursing or institutional care is not required currently or in the foreseeable future (in the next 10 years, or 3 to 5 years in persons 70 or more years of age—see Attachment 3: Activities of Daily Living (ADL) Assessment.

    • The results of the chest x-ray examination are completely normal, except for conditions listed in part C, page 49.

    Where any condition or indication identified is stable and of no clinical significance, A is the appropriate recommendation.

     

    42.4 ‘B’ recommendations

    B should always be written when any of the above conditions are not met, when conditions or findings are present, or if the panel doctor has reservations about an applicant’s fitness, notwithstanding the absence of abnormal findings. Doctors should note that the grading does not determine whether a visa will be granted. Further, a B grading does not mean that an applicant will not meet the health criteria. The grading is simply a means

    of processing forms efficiently.

    For details on the recommendations to be given for commonly seen conditions, please refer to Attachments 4 and 5.

     

    And last but not least, please don't think you have to sit in your underwear in front of everyone else attending with you. Or that you will be examined in front of them also. There should be facilities in place where you will be examined privately and you can always ask for a gown or speak up if you are unhappy with anything. The PDF states about a 'chaperone' and states 'be courteous and respectful towards applicants, mindful of their time, dignity, privacy and cultural practices'. So if you want that curtain pulled or to wear a gown, say so. Don't sit there like a lemon and say nothing :cute:

     

    :)

     

    Hi there

     

    The problem in the UK is that hardly any of the Panel Doctors bother to read DIAC's Instructions to Panel Doctors. The doctors here reckon that they know how to assess someone's health without a bossy little Aussie trying to tell them how to do it.

     

    It is therefore easier just to shut up and put up with whatever the Panel Doctor feels inspored to do, unfortunately. When they are not impressed by the MOC trying to instruct them, they are even less impressed when the lay-applicant tries to do so, ergo the Panel Doctors Instructions should be treated with caution, I reckon!

     

    Cheers

     

    Gill

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    Hi there

     

    The problem in the UK is that hardly any of the Panel Doctors bother to read DIAC's Instructions to Panel Doctors. The doctors here reckon that they know how to assess someone's health without a bossy little Aussie trying to tell them how to do it.

     

    It is therefore easier just to shut up and put up with whatever the Panel Doctor feels inspored to do, unfortunately. When they are not impressed by the MOC trying to instruct them, they are even less impressed when the lay-applicant tries to do so, ergo the Panel Doctors Instructions should be treated with caution, I reckon!

     

    Cheers

     

    Gill

     

    This was more to inform and reassure people on a few points which seem to come up time and again around the forum. Not to get people to tell the panel doc what to do with regards to the medical exam. I posted this to help clarify a few pointers that come up time and again. I've read a number of threads on this forum and PIO that people are worried about these things.

     

    Women often worry when they read of others saying they had a breast exam. Many generally miss that this is usually only done as routine for 40 plus age group and start fretting about it when there is probably no need. Women younger don't seem to have them from what I've read posted but many worry about having one.

     

    Same with HIV and Hep B & C tests. Most miss this is usually only done if considered a high risk group (ie a number of tattoos or healthcare worker).

     

    Personally I'd not be happy with a breast exam if it is not mandatory and I was not considered high risk (I am over 40 and so am expecting one having read this as being the norm around forums). But I would always ask, not just assume, especially for an intimate exam. That is the kind of person I am with regards to anything medical.

     

    And the whole dignity/privacy thing. Most people seem more worried about sitting in their underwear, themselves and their children, than anything else. The daft thing is, so many people worry they will have to sit in their undies in front of their kids (and vice versa) when in fact most people report this is not the case and there are such things as curtains, private rooms and gowns :cute: So again, I was posting to try to let people know its not usually a case of sitting there in your undies with the whole family for an hour. That people can just ask for a curtain to be pulled or a gown to put on. That is a simple rule for anyone in healthcare to ensure they practice and maintain a persons dignity and privacy. I know I certainly would ask for those small things if I felt I needed them, same as having a second person in the room during an intimate exam. Its a persons right and anyone decent in the medical profession should respect that. Nothing to do with telling them their job.

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    Guest Guest6899

    We already know were going to get referred so im not going to "upset" the panel doctor. As a nurse i already work with many premadonna consultants and doctors and i know how to put them back in place but on this occasion i will just do as im told and be a good little patient.

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    This was more to inform and reassure people on a few points which seem to come up time and again around the forum. Not to get people to tell the panel doc what to do with regards to the medical exam. I posted this to help clarify a few pointers that come up time and again. I've read a number of threads on this forum and PIO that people are worried about these things.

     

    Women often worry when they read of others saying they had a breast exam. Many generally miss that this is usually only done as routine for 40 plus age group and start fretting about it when there is probably no need. Women younger don't seem to have them from what I've read posted but many worry about having one.

     

    Same with HIV and Hep B & C tests. Most miss this is usually only done if considered a high risk group (ie a number of tattoos or healthcare worker).

     

    Personally I'd not be happy with a breast exam if it is not mandatory and I was not considered high risk (I am over 40 and so am expecting one having read this as being the norm around forums). But I would always ask, not just assume, especially for an intimate exam. That is the kind of person I am with regards to anything medical.

     

    And the whole dignity/privacy thing. Most people seem more worried about sitting in their underwear, themselves and their children, than anything else. The daft thing is, so many people worry they will have to sit in their undies in front of their kids (and vice versa) when in fact most people report this is not the case and there are such things as curtains, private rooms and gowns :cute: So again, I was posting to try to let people know its not usually a case of sitting there in your undies with the whole family for an hour. That people can just ask for a curtain to be pulled or a gown to put on. That is a simple rule for anyone in healthcare to ensure they practice and maintain a persons dignity and privacy. I know I certainly would ask for those small things if I felt I needed them, same as having a second person in the room during an intimate exam. Its a persons right and anyone decent in the medical profession should respect that. Nothing to do with telling them their job.

     

    Hi Snifter

     

    I wasn't criticising you.

     

    I am just grumbling about the stupidity of culling the number of Panel Doctors in the UK down to practically zero and then imagining that the survivors of the culling process are going to waste their time reading endless sheafs of Instructions from DIAC.

     

    Only a bureaucrat could invent such a daft scheme.

     

    Cheers

     

    Gill

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    Guest Harbords

    Hi....we had our meds done in Cardiff. We went in one at a time. We had to undress top half (in private) to have chest x ray done. We then went to see the doctor one at a time. We did not have to undress again and were just asked if we regularly carried out breast examinations ourselves (not over 40 yet). We all had bloods taken (except little Grace). It was all pretty straight forward and painless....female doctor was very nice

     

    Sharonx

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