• Public Affairs

  • ACOEM Comments on West Virginia Board of Education Regarding Medical Examiners for School Bus Drivers

    July 7, 2008

    Ben Shew
    Office of School Transportation
    West Virginia Department of Education
    Capitol Building 6, Room 318
    1900 Kanawha Boulevard, East
    Charleston, West Virginia 25305-0330 

    Re: Policy 4336

    To Whom It May Concern:

    I am writing on behalf of the American College of Occupational and Environmental Medicine (ACOEM) in response to the Board’s request for public comment on Policy 4336, West Virginia School Bus Transportation Policy and Procedures Manual. Proposed changes include allowing physician assistants, advanced practice nurses and chiropractors, to perform required driver physical examinations. 

    The National Transportation Safety Board has published reports of accidents where the probable cause was the driver’s underlying medical condition.  There is, therefore, no question that this is an important public safety issue. Also, the Association for the Advancement of Automotive Medicine has pointed out the high error rate on the performance of driver medical examinations. So it is important to assure the quality of the examination process. 

    ACOEM is the pre-eminent medical organization committed to enhancing the health, safety, and productivity of workers, retirees, and their families. In its established role as a leader in the area of fitness for duty, ACOEM has offered courses on medical fitness of commercial drivers and on serving as a medical review officer, and has published newsletters on both topics. ACOEM is the only medical specialty uniquely involved in the matching of the worker’s capabilities to the job requirements.

    ACOEM’s 6,000 members perform hundreds of thousands of physical examinations for commercial truck and bus driver medical certification annually. ACOEM was the first professional organization to sponsor and promote the ongoing education of physicians and other health professionals in the performance of these examinations, and works closely with the Federal Motor Carrier Safety Administration to improve highway safety by producing trained medical examiners who can effectively determine whether a driver’s health meets the requisite standard for public safety.  


    ACOEM recommends that the Policy 4336 be revised as follows (revised text is underlined and in bold): 

    “15.2.10 The candidate shall pass a physical examination from a Medical Examiner, defined by the Federal Motor Carrier Safety Administration regulation to be doctors of medicine, doctors of osteopathy, physician assistants, advanced practice nurses and doctors of chiropractic (hereinafter “Medical Examiner”). The Medical Examiner shall meet all requirement and regulations set forth by the Federal Motor Carrier Safety Administration.” 

    This recommendation will allow the Board to take advantage of significant changes that will be forthcoming from the FMCSA.  Section 4116 of the Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users (SAFETEA-LU) requires the Federal Motor Carrier Safety Administration (FMCSA) to establish a national registry of medical examiners who are qualified to perform examinations and issue medical certificates. The FMCSA National Registry of Certified Medical Examiners (NRCME) program will require medical examiners to receive training and pass a certification test before being listed on the Registry.  This registry will be available to commercial motor vehicle (CMV) drivers and motor and bus carriers to identify medical examiners authorized to conduct the CMV driver physical examination. 

    The NRCME program will establish core curriculum specifications for training that address the range of knowledge, skills and abilities required to perform physical examinations of CMV drivers.  The NRCME program is integral to FMCSA’s medical program and will be the only program to qualify and list certified medical examiners that perform the required physical examination of CMV drivers. 

    I urge the Board to ensure that medical examiners are in compliance with current and future requirements from the FMCSA.  Thank you for your consideration of our comments.  If you have any questions or need additional information, please contact Patrick O’Connor at 202-223-6222. 


    Robert Orford, MD