This is a medical examination. Mandatory medical examinations of employees Medical institutions for periodic medical examinations

The passage of doctors is mandatory for all workers in the medical field. The features of passing a medical examination depend on whether you are an employee of a public or private clinic.

For government agencies

Treatment and prevention centers are required to organize a medical examination for all their employees every year. This procedure is mandatory, regardless of rank, doctoral degree, or skill level. All fall into this category municipal organizations and government medical centers. If for some reason a specialist has not passed the test, he is not allowed to work.

Some specialists may check the health status every 6 months, as well as if there are complaints about the general condition of the body. Besides, unscheduled checks can be prescribed when there is a threat of an epidemic, as well as more frequent cases of the incidence of dangerous ailments. For employees receiving salaries from the state budget, it is not necessary to have a medical book. Mandatory bypass of doctors and testing once a year:

. dermatologist;
With analysis on RW;
OAM and UAC;
A smear during the passage of a gynecologist or andrologist;
Analysis of feces; vaccination against diphtheria;
Therapist.

For clinic workers

A medical examination for doctors working in clinics is mandatory, however, when visiting specialists, there is no hygienic preparation. At the end of the check, health workers are issued a certificate of passing medical commission, where information about the state of health is indicated, and a stamp is placed. All data about the employee is duplicated in his personal medical card.

For the medical staff of private sanatoriums and medical centers, the examination is recorded in a special medical book. It is purchased along with the work book and filled out for employment. The boss is responsible for adding each new employee to the team, therefore he is obliged not to allow candidates whose medical books do not have the appropriate signatures and stamps to work. According to the requirements of Rospotrebnadzor, the head ensures the delivery of all medical records of employees for peer review.

For employees of maternity hospitals, children's medical institutions, pathological clinics, the examination takes place in the standard manner prescribed for medical workers. The verification program includes a trip to the following doctors: narcologist, psychiatrist, neurologist, endocrinologist, ENT, dermatologist, ophthalmologist, gynecologist, oncologist, allergist and therapist. In addition, it is necessary to pass a number of tests: OAM, KLA, blood bioscreening. An analysis is also required for syphilis, gonorrhea, hepatitis, typhoid fever and staphylococcus aureus.

For pharmacists and pharmacy workers, medical examinations are carried out strictly according to the schedule. Planned rounds of doctors are carried out annually. AT without fail, pharmacists must pass the following examinations:

. drug control;
Psychiatric evaluation;
Dental examination;
ENT check;
Dermato examination;
Control by a psychiatrist;
Therapist's review.

Standard analyzes for pharmacists and employees working with medicines are as follows: CBC, OAM, HIV and hepatitis testing, bioscreening, smear, stool, for women - mammography.

Carrying out an annual medical examination of employees is a requirement of the law, and if it is not met, this may lead to adverse situations for the employer. How to organize a medical examination and comply with the requirements of the law? This article will describe all the nuances of organizing and passing this event.

An examination of an employee by medical specialists is necessary:

Before employment. The fact is that the employer must be sure that, for health reasons, the employee corresponds to the position held and can perform the work entrusted to him. It turns out that the conclusion that a citizen has undergone a medical examination for the first time indicates that he is healthy.
During the period of work at the enterprise. An employee is busy performing a particular activity and at the same time comes into contact with hazardous production factors, that is, he may get a deterioration in his health. In this regard, a periodical examination is organized in order to monitor the dynamics of his health.

What is the need for an annual medical examination

Medical examinations are organized on the basis of the requirements of the order of the Ministry of Health issued in 2012. And the main provisions on the conduct of a medical examination are contained in labor law, 212 article of the Labor Code.

In general, it turns out that the employer is obliged to organize a medical examination at the enterprise.

In each organizational structure the event must be organized annually, but it is not a fact that the employee must undergo a medical examination every year.

Should focus on normative act- an order of the Ministry of Health, which states how often for a particular profession or when working with harmful factors it is necessary to undergo a medical examination. For example, when working at height, it is necessary to undergo inspections once a year, and when working with a PC, once every two years.

Fundamentals of organizing a professional examination

Examination of workers by medical specialists is an event that requires not only the efforts of the employer, but also costs Money. According to legislative framework payment for such services is carried out by the enterprise and there should be no talk of payment by employees. Even if a specialist sends for an additional examination, it should be free of charge for the employee.

Some workers turn to private clinics to have their tests positive, although this is extremely wrong. This moment is recommended to be clearly monitored by the responsible person. And also the employees themselves need to inform the management that they are being sent for paid additional examinations so that the latter can stop these illegal actions in a timely manner.

Watch the following video about periodic medical examinations:

How to organize the passage of workers? This question arises before many leaders. The recommended sequence for organizing the passage can be set in the following order:

develop an appropriate Regulation or standard of the enterprise on passing a medical examination;
conclude contracts with medical institutions that have the right to conduct this event;
annually issue orders for the passage of professional examinations;
supervise the conduct of the event by responsible persons;
on the basis of acts from medical institutions, issue administrative documents on the implementation of the recommendations of specialists.

Now let's take a closer look at each item.

In order to organize the passage of a medical examination in the organizational structure, it is necessary to be guided by a single document. To do this, it is proposed to develop and approve the Regulations by order.

Information contained in the document:

Main sections	Description
General provisions	In this paragraph, it is recommended to reflect the purpose of developing the provision and indicate the list of normative and legislative acts on the basis of which it is being developed. The goal is to ensure the requirements of the legislation, and the documents are the Labor Code of the Russian Federation and the order of the Ministry of Health.
Key points	They should fix the procedure for organizing and passing a medical examination, namely: who concludes contracts with medical institutions, how the examination is organized, for example, specialists come directly to the organization or employees are sent to the clinic. How additional examinations are carried out, including at whose expense these activities are carried out.
A responsibility	If the medical examination is not passed or not properly organized, what consequences follow from this and how the person responsible is punished.

The draft documents are prepared by the service, coordinated with the primary trade union organization and the legal department. All employees without exception are familiarized with the situation.

How to submit lists of employees for a medical examination

It is important to timely submit lists of all employees for a medical examination. It is recommended to do this in the following order:

Prepare a list of all employees in the department so as not to miss anyone. It can be requested from the Human Resources Department.
When compiling the lists, be guided by the cards of the special assessment of working conditions, namely, in these documents there is a clause on passing a medical examination. If there are none, then you can use the applications from. It details the list of harmful factors and hazardous work who are required to undergo a medical examination. At the same time, everyone should take into account what harmful factors are present in the workplace, and their excess indicates that the employee must be included in the list for passing the commission.
It is also recommended to include data from the employee’s passport, the number of the pension and medical certificate, and the employee’s place of residence by registration in the list for a medical examination.
The lists must be approved by the responsible engineer for labor protection and transferred to the organization conducting medical examinations.
Before the direct organization of the medical board, the lists are specified, since rotation of employees is possible.

Preparation of medical records

Many workers wonder why they are being examined by different specialists and assigned different analyzes if they work in the same shop. This is all understandable and described in the order of the Ministry of Health. The fact is that for each profession and harmful factor, its own list of specialists, analyzes and instrumental examinations has been approved.

In this case, there are some nuances:

the passage of fluorography is required for all employees without exception;
women need to be examined by a gynecologist.

Without these analyzes and studies, the occupational pathologist will not deliver. On the description of the regulatory documentation, specialists draw up a medical card for each employee separately, where they prescribe different doctors for a medical examination.

The first stage of organizing a medical examination

The organization of the medical examination of the employees of the enterprise should be taken care of in advance:

Develop a schedule for the medical examination and fluorographic examination.
Determine who will conclude contracts with medical institutions.
Prepare an administrative document on the organization of the event in individual divisions.

Medical examinations of employees must be scheduled

The document is signed stakeholders and approved by the head of the facility.

The event order must include the following information:

within 10 days before the start of the medical examination, it is necessary to familiarize the employees of the enterprise with the need to pass a medical examination under the signature;
appoint persons responsible for passing a medical examination and issuing referrals to employees.
determine the timing of the examination;
the administrative document may also reflect other points related to the medical examination of employees: for example, the delivery of specialists to the venue of the event, if there is a first-aid post on the territory and there are all conditions for passing.

Third stage

Now the medical examination has been completed, but not completed, the next step will be processing the results. This is done by specialists.

If there are doubts about the health of the employee, additional examinations are carried out.

The results of the examination of doctors, analyzes and instrumental studies are summarized and on the basis of this a conclusion is made, for example:

If, based on the results, the employee does not have, then, accordingly, the occupational pathologist provides admission to work.
If there are doubts about the state of health of the employee, then additional examinations are scheduled.
All information is transferred to the person responsible for the medical examination.
For additional examinations, the delivery of workers to the clinic is organized. Employees are assigned instrumental examinations, including ultrasound, blood and urine tests, ECHO-kg, holter and others.
If, according to the results of additional examinations, the results of the state of health are normal, then the occupational pathologist writes a conclusion on the admission to work of the employee. If, on the contrary, the employee's health readings do not correspond to normal values, then the employee is suspended from work or an occupational disease is recorded, which will adversely affect the enterprise as a whole.

How to control the conduct, responsibility

To ensure that the results of the medical examination are not negative and that as few people as possible have to be taken away from work and sent for additional examinations, the employer is recommended to provide for the following:

appoint a person responsible for passing the medical examination and at the same time select a responsible employee who would report on each step of the event;
during the period of inspection, the person in charge must contact all employees and specialists in order to promptly resolve the existing problem situations and, if possible, eliminate these problems.

It is worth noting that problems can also arise during a medical examination, namely, an occupational disease is recorded, which, as noted earlier, can bring trouble to the activities of the entire enterprise as a whole. In connection with this circumstance, it is recommended to constantly communicate with specialists during the medical examination, perhaps it will be possible to avoid unnecessary problems.

If the inspection is not completed on time, the employer may have problems. Initially, the person responsible for organizing the event should report to the management about the failure to pass the medical examination.

If no action is taken, the consequences may be different, for example:

punishment from state inspector by labor;
when investigating the consequences, the employer and immediate supervisor will be punished.

Punishment can be administrative as well as criminal. So it is recommended to organize the event correctly and follow all the recommendations of specialists, and if an occupational disease is detected, the investigation should be carried out in a timely and efficient manner, and it is possible that the employee himself is to blame for the disease.

Find out about guarantees for employees sent for medical examination in this video:

Question form, write your

The article contains the procedure for conducting a medical examination, taking into account recent changes, the algorithm for conducting a periodic medical examination, an explanation of when it is necessary to conduct an unscheduled one, and what penalties threaten for not conducting a medical examination.

Read our article:

Medical examinations of employees of enterprises in a new way in 2019

Medical examination (MO) is a comprehensive examination of an employee in order to identify negative changes in his health and determine his suitability for performance job duties. First of all, a medical examination is necessary for personnel who are exposed to harmful and hazardous production factors (HOPF) at their workplaces. The list of such factors and the procedure for passing medical examinations by employees are established by Order of the Ministry of Health and Social Development of Russia dated April 12, 2011 No. 302n.

In March 2018, the approved changes came into force. It was expanded (clause 20 of Appendix No. 2): instead of employees of social shelters and nursing homes, employees of organizations should now be sent to the Moscow Region social services providing social services:

in a stationary form of social service;
semi-stationary form of social service;
in the form of social services at home.

The procedure for conducting a medical examination in Appendix No. 3, as well as the requirements for documents confirming its passage, have not changed.

The service was created in order to simplify routine tasks, including those related to the organization of a medical examination. The service will automatically generate completed lists of the contingent, referrals for a medical examination and schedule medical examinations, in addition, in the service you can see the item of order 302n and the frequency of medical examinations simply by typing the name of a specific position.

Article 213 of the Labor Code of the Russian Federation - medical examinations

What is the purpose of mandatory periodic medical examinations?

The following employees should undergo periodic preventive medical examination.

Exposed to harmful or hazardous production factors, in the presence of which mandatory preliminary and periodic medical examinations are carried out.
Performing the work specified in the list, during the performance of which mandatory preliminary and periodic medical examinations of employees are carried out.
. If persons under the age of 21 are involved in these works, they undergo medical examinations annually (Article 213 of the Labor Code of the Russian Federation).
Involved in underground work. Such workers undergo periodic medical examinations annually (clause 12 of Appendix 2 to Order No. 302n).
Employed in organizations Food Industry, Catering and trade, waterworks, medical organizations and children's institutions (Article 213 of the Labor Code of the Russian Federation). The frequency of medical examinations for specific professions is given in Appendix No. 2 to Order No. 302n.
Athletes. They undergo medical examinations annually (Article 348.3 of the Labor Code of the Russian Federation).
Persons under 18 years of age. Pass medical examinations annually (Article 266 of the Labor Code of the Russian Federation).

The List indicates the jobs and professions, in the performance of which employees must undergo mandatory preliminary and periodic medical examinations, regardless of the established at these workplaces and the presence of HSPF.

Name of works and professions	Frequency of inspections
	1 time per year
10. Run directly on mechanical equipment having open moving (rotating) structural elements (turning, milling and other machines, stamping presses, etc.)	1 time in 2 years
11. Under water, performed by workers in a gaseous environment under normal pressure conditions	1 time in 2 years
12. Underground	1 time per year
13. Performed with the use of insulating and filtering gas masks with a full face	1 time in 2 years
14. In food industry organizations, dairy and distribution points, bases and warehouses food products where there is contact with food products in the process of their production, storage, sale, including work on sanitization and repair of inventory, equipment, as well as work where there is contact with food products during their transportation by all modes of transport	1 time per year
15. In public catering organizations, trade, buffets, catering units, including transport	1 time per year
16. Performed by students of educational organizations of general and vocational education before and during the internship in organizations whose employees are subject to medical examinations	1 time per year
17. medical personnel medical institutions, as well as maternity hospitals (departments), children's hospitals (departments), children's clinics, departments of pathology of newborns, premature	1 time per year
18. In educational organizations of all types and types, as well as children's organizations that do not carry out educational activities(sports sections, creative, leisure children's organizations, etc.)	1 time per year
19. In seasonal recreational organizations for children and teenagers	1 time per year
20. In preschool educational organizations, orphanages, organizations for orphans and children left without parental care (persons replacing them), boarding schools, health educational organizations, including sanatoriums, children's sanatoriums, year-round holiday camps as well as social shelters and nursing homes	1 time per year
21. In organizations consumer services(bath attendants, employees of showers, hairdressers)	1 time per year
22. In swimming pools, as well as balnearies	1 time per year
23. In hotels, hostels, passenger cars (conductors), as a stewardess	1 time per year
24. In organizations medical industry and pharmacy network associated with the manufacture, packaging and sale of medicines	1 time per year
25. At waterworks related to water treatment and maintenance of water supply networks	1 time per year
26. Associated with the processing of milk and the manufacture of dairy products	1 time per year
27. On the management of ground vehicles	1 time in 2 years

*If persons under the age of 21 are involved in the listed works, they undergo medical examinations annually (Article 213 of the Labor Code of the Russian Federation).

Medical examinations should be carried out already at the workplace of harmful or dangerous production factors specified in the list, while their level does not matter.

The following factors are excluded:

3.5. – ;
3.8., 3.9. - air temperature;
3.12. – light environment;
4.1. - physical overload;
4.4.1., 4.4.2., 4.4.3. - sensory loads.

For these factors, medical examinations are carried out only if, according to the results of the SOUT, working conditions are classified as harmful or dangerous.

How to arrange a preliminary medical examination

When hiring, for example, accountants, programmers, management personnel and other office employees who work at a computer for more than 50 percent of their working time, the employer is obliged to send them for a medical examination (clause 3.2.2.4 of the List of harmful and (or) hazardous production factors, approved by Order No. 302n). The frequency of MO is once every two years.

Passing a periodic medical examination

The procedure for conducting periodic MOs is regulated by Order No. 302n. The algorithm is the following:

The medical organization, within 30 days after the completion of periodic medical examinations, summarizes their results. Then, together with the territorial bodies of Rospotrebnadzor and representatives of the employer, it draws up four copies, which are sent within five working days from the date of approval:

employer
to the center of occupational pathology of the subject of the Russian Federation;
to the territorial body of Rospotrebnadzor.

One copy of the final act is kept in the medical organization for 50 years.

When are extraordinary medical examinations of employees carried out?

Extraordinary medical examinations are carried out on the basis of medical recommendations specified in the final act of the medical examination.

at work with harmful or hazardous conditions labor, including underground;
at work related to traffic;
athletes ();
working in organizations of the food industry, public catering and trade, water supply facilities, medical organizations and children's institutions, etc.

The employer has the right to send an employee to an extraordinary MO in the following cases:

at the request of the employees themselves (Article 219 of the Labor Code of the Russian Federation);
in accordance with the recommendations of specialists who participated in the preliminary or periodic examinations, as well as according to epidemiological indications;
in accordance with ;
according to the conclusion of the territorial bodies of Rospotrebnadzor with mandatory justification in the direction of the reasons;
when a case of a nosocomial infection is detected, by decision of specialists from the bodies and institutions of Rospotrebnadzor.

In the absence of the above grounds, the employer is not entitled to send the employee for an extraordinary medical examination without his consent.

The employee is obliged to immediately notify his immediate or superior manager about the deterioration of his health, including the manifestation of signs of an acute occupational disease (Article 214 of the Labor Code of the Russian Federation). The employer, if there are obvious signs indicating a decrease in the employee's ability to work, may send him for an extraordinary medical examination.

Who to send for a medical examination

Responsibility for failure to pass a medical examination in the organization

The employer is responsible not only for the timely organization at the expense of the Ministry of Defense of employees at their own expense, but also for the admission to work of persons who have not passed the preliminary or periodic inspection, or not admitted to work on medical indications. If the inspectors of regulatory authorities establish such a fact, the employer may incur administrative liability.

According to part 3 of Art. 5.27.1 of the Code of Administrative Offenses of the Russian Federation, the fine will be as follows:

for officials - from 15,000 to 25,000 rubles;
for persons carrying out entrepreneurial activity without forming a legal entity - from 15,000 to 25,000 rubles;
for legal entities- from 110,000 to 130,000 rubles.

The amount of the fine is calculated based on the number of employees who have not passed the mandatory MO. If, due to the lack of a medical examination, the employee’s health is inflicted grievous harm or his death will come, officials suffer (Article 143 of the Criminal Code of the Russian Federation).

How to conduct a medical examination medical workers, what tests should health workers pass, which doctors to go through? Is there a law on medical examinations in Russia? Read about how to organize a medical examination of different categories of medical workers in our material.

From this article you will learn:

The law on medical examinations: does such a normative act exist in Russia;
The order of procedures that involves a medical examination (medical examination) of medical workers;
What analyzes necessarily include a medical examination of different categories of medical workers;
Medical examination of medical workers: what are the features of the procedure.

Passage of a medical examination by medical workers

The Labor Code describes the categories of workers who must, upon employment and during labor activity undergo medical examinations. The document also regulates the actions of employers, as well as the financial side of medical examinations. Benefits and budget subsidies for medical examinations are expected for medical state institutions.

The law on medical examinations, if approved, will fully regulate the entire procedure for passing a medical examination.

Medical examination of medical workers: the procedure for the procedure

Passage of a medical examination by medical workers primarily depends on whether the medical institution or organization itself is public or private.

Medical examination of medical workers of state institutions

Municipal organizations, state medical institutions must organize for subordinates of any rank, qualification, academic degree a medical examination (medical examination) once a year. Some people may be tested twice a year or for health reasons, indications, or in case of epidemics and increased cases of infection with dangerous diseases. For categories of employees employed in work paid for by their state budget ( state organizations, institutions, centers) there is no need to start a medical book.

For specialists of all professions:

checking with a dermatologist;
check with a venereologist with a preliminary analysis for RW;
verification by a therapist;
vaccination (immunity to diphtheria);
blood test (detection of typhoid fever);
analysis (smear) for STDs (genital infections);
analysis for the presence of intestinal infections.

Medical examination of medical workers of clinics

For employees of clinics, a medical examination is mandatory, but a professional examination and hygienic training of employees is not carried out (regardless of their position).

The program of professional examination of doctors, orderlies, other health workers includes the following list of specialists who need to be seen:

expert in narcology;
ophthalmologist;
otorhinolaryngologist;
psychiatrist;
neurologist;
dermatovenereologist;
oncologist;
allergist;
endocrinologist;
therapist.

An examination by a neurologist, allergist, endocrinologist and ophthalmologist is necessary for those categories of doctors and medical staff who, in their work, are in direct contact with chemically and biologically hazardous environments.

The program requires testing:

blood (clinical) general analysis);
urine (clinical general analysis + sugar + protein);
blood (biochemical screening);
blood (test for syphilis);
analysis for gonorrhea;
analysis for hepatitis B, C*;
analysis for the detection of typhoid fever**;
analysis for staphylococcus ***.

*According to the list necessary analyzes, which involves a medical examination of medical workers, it includes an analysis for hepatitis. This analysis is given by all workers, without exception, whose employment involves contact with patients with these diseases or with material carrying this infection. According to the current on the territory of the Russian Federation regulations(which are collectively referred to as the “physical examination law”), the test must be performed after consent has been obtained for the employee to donate blood.

** Testing for typhoid and other intestinal infections should be mandatory when a healthcare worker gets a job. During work, the analysis can only be given if there are indications for this or an epidemic has occurred.

*** Analysis for staphylococcus is performed by a test from the nasopharynx. Such clinical analysis should be carried out upon admission to a medical position. In the future, the employee is invited to undergo this examination every six months.

A feature of the results of medical examinations is the strict entry of data into the medical book. For specialists working with newborns, in the maternity hospital, as well as pathology departments and children's departments, the presence of this document is prerequisite. Such requirements are assumed.

Under current regulations and laws, neither government nor commercial medical centers, institutions do not have the right to allow citizens to work who do not have a medical book, or it is not filled out properly.

Medical examination for pharmacists

Employees who work in pharmacies have close contact with a mass of people. Therefore, they can both be potential distributors of infections, and be exposed to various diseases transmitted by airborne droplets and through touch. It is necessary to conduct a medical examination of medical workers (pharmaceutical workers) by doctors before taking up duties, as well as a medical examination (medical examination) in accordance with the approved schedule. This schedule should not include planned visits to polyclinic specialists less than 1 time per calendar year. Such conditions are enshrined in.

In terms of the procedure for passing a medical examination, workers employed in the medical industry are also equated to pharmacy employees. The medical examination of medical workers is the same for pharmacists, drug packers, people involved in the sale of drugs.

The medical examination of medical workers provided for this category of working specialties includes the following procedures:

obligatory control of the state by a narcologist;
conducting a psychiatric assessment;
therapeutic examination in the clinic;
visit to the dentist;
check with an otorhinolaryngologist;
dermatovenerological examination.

In addition to a medical assessment, workers in this category of professions must pass the following tests:

blood (clinical studies for infectious agents, as well as testing for hemoglobin, platelets, erythrocytes, erythrocytes, erythrocyte sedimentation rate) and biochemical blood screening;
blood for RW and HIV testing;
analysis of HBs and HCV (hepatitis B and hepatitis C);
urine (protein, sugar, sediment analysis)
swab for infection with gonorrhea;
radiography (digital fluorography is allowed);
analysis for the detection of helminthiasis;
for women - an examination by an obstetrician-gynecologist, and after 40 years - an additional breast ultrasound or mammography.

Upon admission to a new position, a person is required to pass a smear from the throat, nose (definition of staphylococcus aureus). Later, this analysis can be requested only if it is preceded by a doctor's indication. The main list of mandatory doctors and tests is carried out according to plan and during employment. If necessary, the medical examination can be repeated more often than once a year. The reason for this is the epidemically difficult situation in the region or the indications of the health of the employee.

The medical examination data is recorded in a personal health passport, which must be issued to each employee in the clinic. The medical document after a medical examination has been passed, it must be kept in the registry of the medical institution where the annual scheduled examination is carried out. After the conclusion of the therapist, the "passport" must be given to the owner.

Work permit for healthcare workers

When the medical examination of medical workers is completed, the conclusions of the medical examination and the correctness of filling out certificates or medical books should be checked. If the conclusion has no contraindications for employment or continuation of medical practice, work in medical positions and professions, the specialist is allowed to work.

The list of those diseases that are an obstacle to the ability to take jobs in medical institutions are indicated in full in (paragraph 48 of Appendix 3).

The legislation does not contain data on HIV carriers, so the admission of such workers is also possible.

Admission to work in medical institutions after a medical examination of medical workers has been completed can also be carried out after checking with an occupational pathologist. Its task is to reveal the relationship between detected deviations in health or obvious diseases and professional working conditions. If the connection is revealed, the employee should be sent to an occupational pathology center, where a professional conclusion of the commission is given. The authorized body must be notified of the diagnosis. federal agency which oversees the sanitary and epidemiological well-being.

You will also find the following resources helpful: