Primary Care physicians are often requested to provide information on a patient’s fitness to return to work following injury or illness. U.S. primary care physicians report that they are requested to provide opinions regarding work ability or "fitness for duty," on average, in up to 10% of all office visits. However, very little training is routinely offered in medical or postgraduate education pertaining to the health effects of work and assessing work readiness. Both generalists and specialists report that dealing with sickness certification and work ability can be problematic, including potential conflict of interest between their best medical judgment and what their patients desire. Education in a structured approach to fitness to work assessment method can enhance physicians’ knowledge about work fitness assessments as well as their confidence in performing assessments.

Currently there are resources and guidelines available for physicians regarding work fitness such as the American Medical Association publication Guides to the Evaluation of Work Ability and Return to Work and the American College of Occupational and Environmental Medicine (ACOEM) guidelines on Preventing Needless Work Disability by Helping People Stay Employed . A simple but systematic approach to fitness to work assessments is offered in this module to help facilitate the evaluation process and increase the consistency of clinical decisions. Essential fitness to work definitions such as impairment or restrictions are explained and utilized in the module for familiarization with basic clinical concepts used in evaluation work fitness.

NUMBER OF CREDIT HOURS: The Harvard Medical School designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This course should take approximately 1 hours to complete.

COST: $20.00 for the average learner. Participants living in emerging nations receive a 50% discount or can register for free. See our International Pricing Page for details.

OVERALL LEARNING OBJECTIVES:

1. Train physicians to more accurately assess medical readiness for return to employment after illness or injury.
2. Understand the impact of work and unemployment on health.
3. Identify features of both functioning and impairment in an individual’s clinical presentation.
4. Communicate meaningful and useful information on limitations and restrictions to the requesting party.

CLINICAL LEARNING OBJECTIVES:

1. Clinically enhance focus on functioning by reviewing reported symptom severity, obtaining a functional history; and then, determining objective evidence of impairment and comparing them to the physical and mental requirements of the patient’s essential job duties.
2. Identify current barriers to work, and formulate treatment plans and realistic goals to address the primary barriers.
3. Be aware of resources for physicians in assessing fitness for duties.

METHOD OF PARTICIPATION:

Registrants participate in the learning process by answering interactive multiple choice questions that are dispersed throughout the case presentation. You must answer a question correctly in order to continue through the course. If you answer a question incorrectly, you will be prompted to try again.

In order to earn credit, physicians must complete the entire educational activity before the termination date (see above). Non-physicians may register for the course but are not eligible for AMA PRA Category 1 Credits™. Instead, non-physicians will earn a certificate of participation after successfully completing the course before its termination date.

COMBINATION OF MEDIA USED:

This internet enduring material is a case-based, interactive presentation comprised mainly of text, interactive questions, and images. A variety of media, including video clips, audio clips, and Flash animation, may be presented. Links to any necessary plugins are provided when necessary, but no plugins are required for general use of the CME website, and you may skip the multimedia presentation(s) within the course if you choose.

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STEFANOS N. KALES, MD, MPH Course Co-Director

Dr. Kales is an Associate Professor of Medicine at Harvard Medical School, and Associate Professor & Director of the Occupational Medicine Residency at the Harvard School of Public Health. Dr. Kales is also the Medical Director of Employee Health & Industrial Medicine at the Cambridge Health Alliance, a Harvard-affiliated system of three hospitals. He is Board Certified in Internal Medicine and Occupational Medicine, and he has been elected as a Fellow of the American College of Physicians and the American College of Occupational and Environmental Medicine. Dr. Kales is on the editorial boards of Environmental Health Perspectives and the Archives of Environmental and Occupational Health. He has participated in a wide range of research, advisory and teaching activities on four continents resulting in numerous scientific publications. Dr. Kales’ group has provided seminal contributions in the clinical epidemiology of cardiovascular events in firefighters; including the first definitive statistical association of strenuous job tasks and on-duty cardiovascular deaths, which was subsequently confirmed in a later New England Journal of Medicine publication. Their work is influencing medical standards for firefighter’s fitness for duty, the need for improved wellness programs, better control of risk factors, and whether firefighters can safely return to work in the presence of significant coronary heart disease. DISCLOSURE: Phillips_Respironics, Grant Recipient, Sleep Apnea; Novartis

CHRIS STEWART-PATTERSON, MD Course Co-Director

Dr. Stewart-Patterson has practiced Occupational Medicine since 1989. He provided occupational medical services to municipal Fire Rescue Services, RCMP, and Canadian Armed Forces among other organizations. His clinical practice includes frequently providing fitness to work assessments. He specializes in fitness to work evaluations for safety critical/sensitive occupations such as police, firefighters, correction officers, sheriffs and railway personnel. He frequently lectures both locally and internationally on medical and psychiatric disability evaluation including a series of lectures at Harvard Medical School Dubai Center. He is an instructor for the American College of Occupational and Environmental Medicine lecturing on assessment of disability and fitness to work. Dr Stewart-Patterson is a clinical instructor in the Faculty of Medicine, University of British Columbia. DISCLOSURE: Reported no relevant financial relationships with commercial entities

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DIETER AFFELN, MD, MPH Reviewer

Dieter Affeln, MD MPH, is the chief of Rehab Medicine and medical director of Occupational Health Services at BID Needham. He completed the Occupational Medicine Residency at the Harvard School of Public Health and has practiced occupational medicine since 2001. He is also a certified Medical Review Officer. He has a special interest in ergonomics. As the former employee health medical director at BIDMC, Boston, he supported the development of ongoing ergonomic programs and research studies at the institution. Dr. Affeln received his MD from Cologne University, Germany, and trained in Family Medicine in London, UK. In addition to his hospital commitments he is also the medical officer of the German International School and the German General Consulate in Boston, MA. DISCLOSURE: Reported no relevant financial relationships with commercial entities.

IAN CONNELL, MD Reviewer

Dr. Connell received his M.D. from the University of Toronto in 1974. Dr. Connell completed his studies in Occupational Medicine and received his CCBOM in 1994 and FCBOM in 2005. He has practiced Occupational Medicine since 1985. Dr. Connell has provided occupational health services to the Fraser Health Authority, Vancouver Coastal Health, Terasen Gas, Work Ability Centre, Norampac, Metro Materials Recycling, Medisys Health Group and other organizations. Dr. Connell was a former Chair of the Medical Review Panels, an independent review tribunal of Workers Compensation Board decisions, for over fifteen years. Dr. Connell has extensive experience in performing medical disability evaluations and independent medical examinations. DISCLOSURE: Medisys Health Group: Physician consultant, perform IMEs, Occupational & Executive Assessments

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SANJIV CHOPRA, MD Planner

Dr. Sanjiv Chopra is Professor of Medicine and Faculty Dean for Continuing Medical Education at Harvard Medical School and Senior Consultant in Hepatology at the Beth Israel Deaconess Medical Center, Boston. In his role as Faculty Dean for Continuing Education, Dr. Chopra provides oversight and leadership of the Department and oversees the academic development of our programs. Dr. Chopra is an experienced clinician, researcher, and educator. In his research roles, he has served both as a principal investigator as well as co-investigator. He has more than 120 publications and five books to his credit, addressing topics in disease states, patient care, and leadership. Dr. Chopra’s teaching experience is extensive, and he has won numerous teaching awards for his work with medical students, residents and physicians. Currently, he directs and speaks at 10 multiday CME courses, nine of which are through HMS. For his full bio, please click here. DISCLOSURE: Reported no relevant financial relationships with commercial entities.

ANDI LONG, EDM Planner

Andi Long directs the Department of Continuing Education’s Distance Learning group, which offers a variety of online continuing medical education programs to health care professionals around the world. Andi develops strategies for new pilot programs and systematically rolls out new distance learning initiatives and has a leadership role in IT planning and other online processes for HMS DCE. She oversees the day-to-day operations of each distance learning activity and ensures ACCME compliance across all enduring programs. She has had the privilege of working with hundreds of Harvard Medical School Faculty members to develop high-quality, engaging online programs that physicians in more than 170 countries have taken part in. Andi earned her Ed.M. in Technology, Innovation, and Education from Harvard Graduate School of Education and graduated from Bridgewater State College, summa cum laude, with a degree in English. Her professional interests focus on teaching and learning with new technologies and online course development. DISCLOSURE: Reported no relevant financial relationships with commercial entities.

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NUMBER OF CREDITS: 1 

The Harvard Medical School is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Harvard Medical School designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This course should take approximately 1 hours to complete.

Within 2 weeks of completing the course, you will receive your certificate via email.

Click the image to view a sample of the certificate

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